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Old 05-16-2006, 08:08 AM   #1
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need help with my maximum d. dose [what is it?]

I have some paper work to fill out,and i don't know what to put down for my m.d.d. I take 80mg of ocycotin tid. And 15 mg. of oxycodone 2xaday.The reason i don't know what to put for my m.d.d i don't know what to put down as far as,-80 mg of oxycotin actually has 40mg of oxycodone in it,and the 15 mg of oxycodone have 15 mg,right? So do i count the 80 mg of oxycotin as 80 mg? if so,then my m.d.d. would be all together270 mg[counting the 15mg oxycodone] how would you do it? Thanks very much-mad.

Last edited by madhatter; 05-16-2006 at 08:09 AM. Reason: f

 
Old 05-16-2006, 08:15 AM   #2
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Re: need help with my maximum d. dose[what is it?]

Hey MH,

Not sure if I understand your question. I get the part about the MDD, but you said your 80mg OxyContin has 40mg of Oxycodone? Thats where I'm confused.

But generally your MDD will be what you take daily at a maximum. So if its OxyContin 80mg TID = 240 mg and then 15 mg Oxycodone BID = 30 mg. Total is 270 mg of oxy daily.

I may be misunderstanding your post but that is how I would calculate it....

Take Care

 
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Old 05-16-2006, 08:28 AM   #3
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Re: need help with my maximum d. dose[what is it?]

I was told that oxycotin is just time released oxycodone,and the amount of oxycodone thats in oxycotin is half,like with the 80mg of o.c the total amount of oxycodone is actually 40mg. and it releases 20 mg of oxycodone the first hr. and 20mg the 6th hr..If this is not true,can you explain the mg. and time release etc. Thanks Aranger

 
Old 05-16-2006, 08:35 AM   #4
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Re: need help with my maximum d. dose[what is it?]

If you have an 80mg Oxycontin tablet, there's 80mg of Oxycontin in it.

All 80mgs of it will get released throughout the 8-12 hours that it lasts.

 
Old 05-16-2006, 08:40 AM   #5
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Re: need help with my maximum d. dose[what is it?]

Hey MH,

OxyContin of course now has generics which some have gotten a bad rap. Of course generics by some companies put less drug into their product and get away with a certain percentage by the FDA. However I believe it can't exceed 20% +/- (I may be wrong with the percentage but its somewhere close to that)

But at any rate 80 mg of OxyContin is 80 mg of time-released Oxycodone (Give or take a few mg's). It releases about half of its contents (40mg) at about .6 hour. It releases the remainder at around the 6th hour.

The release system is a basic wax matrix release. That is one of the reasons that many docs won't prescribe it due to how easily that release system can be destroyed. If you look at the other release systems out there like Kadian used, a polymer coated pellet, you don't hear of too many people abusing that drug. But with OxyContin abusers just have break or crush it and it will release all of the contents.

Thats probably a long way around your question, LOL. But basically if you are taking the 80 mg OxyContin then I would be putting down what the Mg's are for the tablet. In your case TID which is 240 mg of OxyContin.

Hope that answers you question. Take Care

 
Old 05-16-2006, 08:47 AM   #6
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Re: need help with my maximum d. dose[what is it?]

Thanks again,i now i while back perdue was working on a new oxycotin[nick named the smart pill] were if someone tried to crush chew etc. the smart pill would somehow destroy the oxycodone within itself.

 
Old 05-16-2006, 09:01 AM   #7
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Re: need help with my maximum d. dose[what is it?]

I remember that also. Not sure what the status is on the "smat pill." They were going to put NALOXONE in the pill I believe. This drug reverses the effects of opiates. Medics will give it to people that have OD'd on opiates many times herion. Its funny because it really ticks a herion addict off after paying all that money for the drug and injecting it and then getting shot up with Narcan and it immediatley reverses the effects of the drug.

By putting it in OxyContin, if you were to crush the pill, it would not allow the effects of the Oxycodone to work.

But I haven't heard much word about it lately. Not sure whats going on with it.

 
Old 05-16-2006, 10:02 AM   #8
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Re: need help with my maximum d. dose[what is it?]

My insurance allows me to take the name brand[perdue] I did try the generic,and at the time,i was taking 60 mg. tid[40 and 20] and when my pharmacist automaticly filled my script generic,i could tell imediately the difference.It was like taking 15 mg less[at least] And come to find out,the generic version isn't all that much cheaper[from what my pharmacist told me.]

 
Old 05-16-2006, 10:03 AM   #9
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Re: need help with my maximum d. dose[what is it?]

Oh that's really interesting and a very effective way to help prevent drug abuse. They should perhaps use it in MS Contin as well.

 
Old 05-16-2006, 12:55 PM   #10
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Re: need help with my maximum d. dose[what is it?]

Kissa, are you able to do to MS Contin what you are able to do to Oxycontin? I've never heard about people OD'ing on MS Contin like they do Oxy, but I am certainly no expert!!

Chaz

 
Old 05-16-2006, 12:56 PM   #11
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Re: need help with my maximum d. dose[what is it?]

Purdue basically tried the same thing they did with TalwynNX by putting naltrexone in it. Peopele were injecting Talwyn alone or with another drug to create a speedball. Now you can't obtain Talwyn in he US without the NX. It's interesting how they would get so upset about talwyn they would reformulate it when dilaudid was the preferred pharmacuetical of choice for IV abuse even when Talwyn was being abused.

As far as Purdues effort to do the same, they did a couple trials that killed the efectiveness of OxyContin which meant a lot more equations to try along with creating a LA version of Naltrexone or basically creating a brand new drug. With the lobbying power of the pharmacuetical bizz and the hundreds of millions they were already making on oxyC despite the crackdown by the DEA, Purdue wasn't going to give up their golden product or invest millions when they already had a winner in their hands. Instead, they wrote every major PM doc/clinic and pharmacist they could and insisted tOxyC was a 12 hour med, not to be prescribed any differently and these letters also encouraged pharmacist not to fill a script for oxyC if written differently than BID dosing. All their PAP patients that recieve free oxy also had to conform to the BID dosing schedule. Purdue also created an OxyC tracking system first implementd in Virginia that tracked every doc that prescribed it, every patient that filled it and every pharmacy that stocked it. This apeased the DEA as far as Purdue doing their part to prevent diversion and the pressure shifted to the docs prescribing it rather than the manfacturer making the drug.

OxyContin NX is on the back burner and will likely stay there IMO. Their CEO and CFO make over 50,000,000.00 a year to make these decisions to save the stockholders billions redevoloping a product that's proven to be a huge money maker.

Purdue created a web sight called partners against pain, brought on a few high profile docs to endorse the new thinking of pain as a destructive disease and whamo, opiates for the masses with one company monopolizing the entire LA pain med buisness for several years. They did an amazing job in turning the perception of modern thinking of present day management of CP with a multi pronged apraoach. They reached docs that saw the temendous need for pain management, patients via the web and politicians to keep their product on the market.

I say perception of thinking because all docs don't think the way that benefits Purdue or agree with docs that endorse Parners against Pain. Most docs we meet went to school long before the invention of OC. Those docs that did their internships and residencies prior to the invention of OC managed to practice medecine and perform surgery for decades without ever prescribing anything stronger than percocet for post op pain. Those are the majority of docs still practicing and they were tougt a very different phylosophy regarding the use of opiates.

Sorry to get offf track. Aranger explained the OC perfectly, your daily dose is the total number of mgs you take. Each 40mg oxyC contains 40mgs of oxyCodone, each 80mg OC contains 80, The contin delivery system just breaks that dose into two seperate releases.

I take it your changing docs, and that's the need for the information? Can I ask why your changing docs? There is a concern the next doc you see may not be comfortable prescribing that level of pain meds. You don't want to burn bridges but there are legitimate ways to get second opinions from other PM docs and a correct way to change docs if he seems to have a better plan.
Take care, Dave

Last edited by Shoreline; 05-16-2006 at 01:07 PM.

 
Old 05-16-2006, 12:59 PM   #12
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Re: need help with my maximum d. dose[what is it?]

Hey Chaz,

The Contin's have the same release matrix. But MSContin never really seemed to have the same abuse problems as OxyContin. Oxy is more stimulating and causes more euphoria than morphine. That may be why....

Actually MSContin has been around a lot longer than OxyContin.

 
Old 05-16-2006, 03:29 PM   #13
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Re: need help with my maximum d. dose[what is it?]

Thanks everyone. Hi dave,no i'm not changing doc. I'm going through the vesid program[i believe i mentioned this to you a while back] well,on these forms i had to fill out,for some rson or other,they wanted to know what meds. i was taking and how much,and i just wanted to be as acurate as possable.A few hrs. ago i called my pharmacist to make sure,and he said the same as you's. Thanks again-mad.

 
Old 05-17-2006, 12:01 AM   #14
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Re: need help with my maximum d. dose [what is it?]

Interesting stuff!

So Dave, do you think that Purdue and the Oxycontin saga advanced the proper use of opioids for non=mal chronic pain?


Hey Arranger.

I know and that is funny that in all that time I've never read of anyone crushing MS Contins and snorting them, or finding a way to inject them like I have with Oxy...??


Chaz

 
Old 05-18-2006, 09:30 AM   #15
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Re: need help with my maximum d. dose [what is it?]

Hey Chas, I do Think Purdue's release of oxycontin is what started a complete 180 turn in the way opiates are used to treat chronic pain. Many other things came along and things like The pain patients bill of rights, recognizing pain as a vital sign that must be monitored are a direct result of creating an effective way to manage chronic pain.

It did take some serious lobbying and marketing to change at first just a handful of docs POV on treating chronic pain. There were some strong proponents of treating pain properly, but I can't think of any doctor more famous than Dr Hurowitz of Arlington VA who gained national recognition when he was prosecuted. A few more docs were prosecuted in the early and mid 90's that sparked the debate as to when opiates should be used to treat non-malignant pain. Enough debate was going on that one pharmaceutical company saw the potential and capitalized on it. That was Purdue.


MSContin has been around since 84, but they weren't using it for non-malignant pain except by a few docs that ultimately paid the price like Dr Hurowitz and a few other across the country. Florida burned a few at the stake and so did California, Arkansas and Mississippi. What a handful of docs were doing in the 90's with the meds they had available cost them their livelihood and in a some cases their freedom. This same level of care is now expected barely a decade later.

Other pharmaceutical companies saw the potential billions up for grabs and created their own PM divisions and products stronger than anyone had ever seen just 10 years earlier. The Pharmaceutical biz has more government lobbyist than the steel, auto and insurance industries combined.

Although there have been some grass roots efforts to initiate change, nobody has been more effective than the pharmaceutical industry in getting their products on the market and their use turned into a right rather than an option when other efforts fail. The drugs sitting on the shelf as a last line of defense doesn't make the pharma biz billions, their actual use is what pays 8 and 9 figure salaries to their top execs.

I know the history of pain management could spark some serious debate, but I'm really not up to it right now. I did want to respond to your question Chas. I know things are a little different in Canada, but IMO without OxyC, there wouldn't be any of the other LA meds or high dose SA meds available and being used for chronic pain.

Cheers, Dave

 
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