Shoreline

Hi Debbie, It's nice to se a doc that recognizeds all roducts are not equal, The generics simply have to meet a standard range that the proprietay drug reaches. The samne dose won'rtt create the same serum level in everyone, size, blood volume and metabolism all effect it so uou end up with give or take +20 or -20% when creating a generic. I hope he allws you t use the geenric norco, necause the same manufacturer makes both the generic and athe name brand product Your going to get aabot as close as you would from one batch to the next if your sticking with the same manufacturrs, just a different food coloering and imprint stamp in one Vs the other.

It seems allowing you to try a generic is less difficult than starting all over with a new med btut there are charts that can guide a doc into the right ballpark, but the ballpark may b large and take a few adjustmnents to get the same rlief, plus it may take more of one drug t o provide qual reief than another despite what all charts say.
Durageis is likely a tier 1, having the most expensive copay, MSContin has been aound the since 84 and if he's stuck on generic you would be in the 225-315 mgss per day range, or he could use Kadian or Avinza which likely are hifgher tier meds than the oldr MSC. Th last two are also true 12 hour meds that last u tp 24 hours
40-60 mgs of methadone even cash for brand name a day would cost you less than 115 a month, It's dirt cheap but has it's own unique properties.

Demerol isn't an option, due to metabolte build up.

Oxtcontin would be an option in the 120-160 range and is 9 years old. hopeflly not the most expensive tier.

Palladone, the new LA dilaudid is now available, the manufacturers guideline is rediculosly low so it would probably take alot of adjustmets to get to a working dose around 30-40 mgs a day. Likely top tier and all the name brand are expensive, but hopefully not to the extent of what your paying and you will spend making adjustments.

These numbers are just guides, there is no absolute conversin ratio you can use on everyone, so docs tend to start low but should expect and plan to see you more frequently untill the dose is adjusted correctly and side effects are managed or have time to deminish. There are 3 distinct families of opiates represented in the ones I mentioned and none are in the unique class that the fents are in.

So it's a big change and some differential withdrawal, milder than normal withdrawal, may take time to transition through as you find the right dose if you don't taper down on the fentanyl and do a cold switch like so many docs do.

Good luck, those are the US options, His rationale for name only may be that he doesn't have to prescribe as many lgs of an inferir product, but not all generics are inferior.
Take care, Dave