Need opinions on b.t med. please - Pain Management Message Board

madhatter · 11-04-2005, 01:20 AM

If you read my other topic on problems with generic o.c, i was wondering instead of taking oxycodone i.r 15 mg. 2x a day for breakthrough,do any of you's think i would be better off in changing my b.t med. to diladid,lortab ,etc.
my base med.[oxycotin 60 mg tid] i've had no complaints except for the generic version.I'm just wondering if any of you are on oxycotin,and what has worked good for you as far as b.t med? Thanks for all your support!

Shoreline · 11-04-2005, 05:51 AM

HI MH, I'm sill a firm believer in mixing opiates. Using oxyIR for BT for OxyC just creates more tolerance to oxycodone, especially if you have to use the your BT meds as gap fillers for the gerneric OC. Morphine will bring suttle diferences to the table, It's available in 15 and 30 mg strengths and 30 mgs f MSIR would be equivelent to 20 mgs of OxyIR. Even if you can get DAW on the OxyC aproved I think you would still benefit from using a drug from a different class.

With the level of oxy your on, you would need too much Hydro w/ apap to be proportionally corect to create a 20-30 % increase neede to put a dent in BT pain. where 4 mgs of dilaudid or 30 mgs of morphine would be a slight increase over the present oxyIR and offer opiate receptor activity that oxyC alone doesn't produce.

Meth has a very slow onset and doesn't make for a great BT med, plus it hangs with you longer than you may like.But you would have the extra benefit of NMDA blocing from the meth which should decrease your tolerance or increase your threshold and tolerance to pain. There are also adjunct meds like Nemanda that is an even stronger NMDA blocker and provided better, longer lasting relief for my wifes present med combo, Instead of an increase they added Nemanda which did the trick and avoided her need for an increase.

Perhaps when a short acting version of Oxymorphonone hits the market in an oral formulation it can offer a subtle difference that you would actually feel and not raise your tolerance to oxycodone..
JMO, Good luck, Dave

madhatter · 11-04-2005, 09:07 AM

Thanks dave! Just when things were going good[pain level -wise] they come out with generic o.c! A while back,i was on ms. cotin,and it didn't agree with me at all! Do you think diludid would help,or what about demerol? I never tried neither of the two.

Wren9 · 11-04-2005, 10:58 AM

Quote:

Originally Posted by Shoreline

Perhaps when a short acting version of Oxymorphonone hits the market in an oral formulation it can offer a subtle difference that you would actually feel and not raise your tolerance to oxycodone..

Oxymorphone is the active metabolite of oxycodone. So wouldn't oxymorphone basically be the same as taking oxycodone, but in a "concentrated" form?

Just wondering.

Wren

RetiredDirector · 11-04-2005, 12:35 PM

H MH: I used Oxycodone 15 and then 30's for breakthrough when I was on Oxycontin. Dave is right, your tolerance (at least mine did) shoots up through the roof. Before I knew it I was taking 160 TID and on Oxycodone 30 mg Q4H, PRN. I think at that point or shortly after my doc swtched me to the Duragesic patch (Fentenyl). If I had to do it over, I think I'd ask if we could use one of the Morphines or Dilaudid for BT. I'd stay away from Hydrocodone for BT. You really don't need that Tylenol. Have you considered getting on the name brand Oxy? It might give more relief than the generic. I haven't heard too many good things about the generics.