Is MScontin 40 ER a high dose? - Pain Management Message Board

theweaver2 · 03-17-2006, 06:31 AM

I love this board... As I will be using narcotics for the next several months, this will be a good support forum for me.

What I was wondering... My doctor gave me my first script for MScontin and it was 40 ER. It has me a little groggy but has almost wiped out the pain unless I'm just having a good day on top of taking the meds. I have only taken it twice so far.

She presribed it every 12 hours and I have vicodin 10/660 for any breatthrough pain.

Is it possible to be give too much pain meds??? lol Because maybe I can use a lower dose now because I have surgery sched in 6 weeks and will definitely need the higher doses then.

Anyone have any suggestions on dosing during this period? I thought perhaps with your experience, someone may know whether to go lower before surgery and jump up afterwards. I don't even know how large a dose 40 ER is..

Thanks for any feedback.

theweaver2 · 03-17-2006, 06:33 AM

Oh, I guess I could add that I was using 2 5/500's about twice a day before going to the 40 ER - it just seems like a BIG jump to me....

feelbad · 03-17-2006, 07:13 AM

I am just a bit confused here(nothing strange there)about the post you made on your other thread and this one.on the other post,you said the name of the med was hydrocodone ER 40mg?I know that one can't be right as there is no such med.but Are you sure that the one you are currently taking is indeed MS contin and not oxy contin instead?Just want to know for sure what you are actually on,what does it state exactly on the Rx bottle itself?Glad you have something that is working on your pain,whatever it actually is.Marcia

Shoreline · 03-17-2006, 07:15 AM

Hi weaver, I'm a little confused because there isn't a single 40 mg morphine tablet available in the US. MSC comes in 15,30,60,100 and 200. Are you outside the states.

As far as what a 40 mg tab releases over 12 hours compared to 10 mgs of hydro every 4, that dose of morphine isn't a hge increase. If your takin OxyContin, then he pretty much doubled your serum level which is more than most docs will do because of safety reasons.

Are you talking about OxyContin? Oxy is about 50% stronger than morphine and the way it's released, half the dose is released at about 1 hour and the rest at about the 6th hour. It is a relatively high starting dose and I do hope that your doc explained about physical depndence, 3-4 months of around the clock opiates at that strength and you will become physically dependent, meaning you can't stop abruptly or you will experience some nasty withdrawal.

If he's using oxy the next step down is the 20 mg tabs and then the 10 but each step cuts your dose in half and that's large enough to make you feel pretty wrotten.

Is this a PM doc or your GP playing PM doc. A doc that knows what he's doing is usually going to start at the lowest dose possible that gives you relief, the goal isn't to wipe all your pain out, just make it tolerable. If he had started you at 20mgs twice a day that would be about a 50% increase in strength and I don't understand why a doc would skip that step if it could relieve yur pain.

THe only place you have to go from 40mgs is up, that's why they usually start lower. When you add BT meds to the mix it just raises your tolerance even higher. You might want to describe your situation a little and double check your bottle, long acting morphine isn't available in a 40mg strength in the US in any form whether it's Kadian or Avinza, the 12-24 hour versions of morphine or plain generic MSC. OxyContin comes in 40 which is what I suspect your taking.

Because the increase is significant the pain relief may be very effective initially, but tough to maintain that honeymoon over time without leaving you very groggy and impaired by constantly increasing to maintain that level of relief. You might even want to have you spouse listen to you breath while you sleep to be sure your not struggling to obtain oxygen due to the respirtory supressant effects of all opiates and this being such a large increase and a med your not used to taking.
Good luck, Dave

theweaver2 · 03-17-2006, 08:26 AM

Im such an idiot..... Can you tell I'm new to these drugs? lol

I have the bottle in front of me now... It is labeled IC OXYCODONE HCL 40 MG ER... which isnt hydrocodone like I said

Here is my history with pain meds the past 2 years so maybe you can understand whats going on for me. I am thinking the med above is highere than what I should maybe start with.

I have used Vicodin for the past 2 years - mostly taking 5/500's 2-3 times a day. Unless my pain levels were very low the 2 5/500's didnt do much at all.

What she did first was prescribe Vicodin 10/660 every 6-8 hours or up to 4 a day which I told her is basically the same dose I was using for my pain which didnt hack it.... only thing dif was I could take it 2 more times... but it wasn't doing the job the first time... so I could take it 4 times, but each time I wouldn't cut through the pain which usually runs from a 6-10 each day for me.

Then she gave me the above script. I know nothing about levels, but since it is working so good I wondered if I could get by with less? I know I will prob face some kind of withdrawal - hopefully, this surgery will help my pain levels.

I hope I cleared up some of the confusion. I also assume this drug is MScontin and not morphine. Is that correct?

I'd rather use something lower perhaps so after surgery I can bump it up. I mean its great feeling like I have nothing wrong lol but I know deep down there is a problem.

But, wouldn't it be something if the reason for my continued high levels of pain is just as simple as it hasn't been addressed properly and my body is just overly reacting to a learned pain response? Does that make sense and can that happen?