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Old 06-01-2006, 07:44 AM   #1
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Question methadone vs. oxycontin

Just looking for some info on how much oxycontin it would take to equal the amount of methadone I am taking, 40mg at this time. The reason I'm asking is tht the reason I am seeing the PM doctor that I am is that my clinic only allows certain doc's to prescribe methadone so my gyno who handles EVERYthing else regarding my medical condition is not able to prescribe it for me and had to refer me to this other doctor. I am waiting on a phone call from my gyno tomorrow to see what my options are. As much as I hate the idea of going off methadone since it really has worked wonders for me, I am giving some thought to if she is able to prescribe oxycontin possibly I could switch and not have to deal with this PM that I am having so many problems with anymore at all... At this point I don't even know if she is allowed to prescribe oxycontin but I know that she can prescribe oxyCODONE because she had switched me to that right before we made the switch to methadone. So as much as I prefer the methadone I think that it might be worthwhile to switch if I can then have all my meds handled by my gyno rather than going thru this constant stress with the PM doctor. But I am worried htat the amount of oxycontin I would have to take to equal the methadone would be really high?

 
Old 06-01-2006, 08:34 AM   #2
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Re: methadone vs. oxycontin

Hey Tina,

Methadone and OxyCodone are a little difficult to find an equianalgesic dose for. But I'll give the straight accross conversions, but remember that a doc will not usually start you right at the equal dose. It will usually be titrated.

Side by side of Meth and Oxycodone is Meth is 20mg to Oxycodone 15-30mg (see why its difficult). So the average used is 20mg of Oxycodone.

So basically you could get away with a straight accross conversion. 40 for 40, etc. Again though, your doc may not be comfortable prescribing the same dose. Although 40 mg of OxyContin is not that high. Especially if they are going to use it twice daily 20 mg x 2.

Sorry to be so vague with the numbers, but the two drugs are hard to convert because of the range.

Take Care

 
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Old 06-01-2006, 08:35 AM   #3
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Re: methadone vs. oxycontin

So it sounds like they COULD be equal in mg....but it might differ from patient to patient if I am understanding correctly?

 
Old 06-01-2006, 08:57 AM   #4
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Re: methadone vs. oxycontin

Oh believe me.... I absolutely DREAD the idea of switching off of the methadone and going to an oxy version... But if that ends up being my only option I just wanted to at least be somewhat educated about it. I really really, really, do not want to go off of the methadone. Not at all. But if this is going to continue like this where I am afraid to talk to my own doctor, and or gets worse I won't be able to live like this. I'm miserable right now. All this stress has done is make my pain WORSE! And then emotionally I am just shot right now. I really thought I was done with all of this emotional ups and downs...will I get my meds, won't I get my meds...etc... that I went through for years before I (thought) found a good doctor!

 
Old 06-01-2006, 01:08 PM   #5
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Re: methadone vs. oxycontin

I too am going to ask my Doctor at my appointment tomorrow if I can switch to Oxycontin from methadone. I currently take 45mg a day (15mg 3x's a day). Methadone makes me feel confused and tired and not want to do anything but lay on my couch. It is destroying my relationship with both my husband and even my kids (7 & 5 1/2). They all notice that I just do not act like "me" anymore. I think this has all begun since I started taking the methadone, and then got worse when they increased it to the 15 mg about 4 months ago.
My question/worry is, will I go through any withdrawl from the methadone if I go right onto Oxy?
Thanks for helping me with this and "listening" to my rant....

 
Old 06-01-2006, 01:11 PM   #6
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Re: methadone vs. oxycontin

Quote:
Originally Posted by poor_Stacey
I too am going to ask my Doctor at my appointment tomorrow if I can switch to Oxycontin from methadone. I currently take 45mg a day (15mg 3x's a day). Methadone makes me feel confused and tired and not want to do anything but lay on my couch. It is destroying my relationship with both my husband and even my kids (7 & 5 1/2). They all notice that I just do not act like "me" anymore. I think this has all begun since I started taking the methadone, and then got worse when they increased it to the 15 mg about 4 months ago.
My question/worry is, will I go through any withdrawl from the methadone if I go right onto Oxy?
Thanks for helping me with this and "listening" to my rant....

 
Old 06-01-2006, 01:51 PM   #7
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Re: methadone vs. oxycontin

From the way it sounds oxycontin is not much weaker than methadone, so I would HOPE that you wouldn't have a lot of withdrawel. But I'm not sure. Hopefully someone else here will know better than I do. It's funny how different meds effect people differently. Oxy meds always got me all buzzy feeling. Methadone doesn't do anything like that to me. It's like I took nothing at all except my pain goes down, and I do have a little more trouble sleeping. But otherwise I feel better on the methadone than I did on any of the others. Which is why I'm hoping to not have to make any switches....but I guess we shall see. Let me know how it goes for you Stacey!

 
Old 06-01-2006, 04:50 PM   #8
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Wink Re: methadone vs. oxycontin

I was on Oxycontin before but it made me dizzy. I've actually tried a lot of different ones, let's see: Morphine, Oxycontin, Oxycodone, Methadone, and seems like there is something else but I cannot remember, go figure, considering.....
The reason I think I can handle it now is because I think I have built up a tolerance to heavier medication. When they first put me on Oxy, I was fairly new to painkillers, having nothing but Vicadon before. That I stomached really well, but for long term use, I guess it's a no, no. All I know is I can't stand the way I feel all the time, I feel like I've lost my zest for life.
I'll keep you posted though, and let you know what my Doctor says

 
Old 06-01-2006, 05:05 PM   #9
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Re: methadone vs. oxycontin

Tina... I think that is a VERY good thought. If your Gyno could prescribe something else like Oxycontin, it would probably be a lot easier and you seem like you have a really good relationship with her.

20mg 2x a day isn't bad at all! I'm speaking in terms of actually have to "take something". 2x a day is easy!

I'm glad you thought of that. I'm looking forward to hear what your gyno says Friday.

That would be awesome if something like that worked out. I would let the GYNO know EVERYTHING you feel and how you can't even call her for fear she'll do something... and it's so much harder to talk to her, etc. Regardless of what anyone says, patient-doctor relationship is VERY important. You HAVE to feel comfortable where you are getting treatment.

And not everyone reacts badly to OxyContin or gets that "euphoric feeling". In fact, I'd think that it would be a lot less than a regular non time released version of Oxycodone at a high dose.

I think this might be a really good thing for you, especially since I've been following your posts. It just makes sense.

 
Old 06-01-2006, 08:27 PM   #10
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Re: methadone vs. oxycontin

Hey Tina: A couple things you might want to consider before jumping over to Oxycontin. I may be totally wrong on this, but I thought the conversion was about 4 to 1, Meth to Oxy. I know when I was on Oxycontin I was taking 3X160 or 480 mg per day. Also, my tolerance went up quite fast on it. On the Methadone, I take 3X 60 or 180 mg per day. With Oxy, I think twice a day dosing doesn't cut it for most people. You just can't squeeze 12 hours out of the Oxy, so you need to have three doses per day to be comfortable.

The last thing, and please correct me if I don't remember correctly, but I seem to remember you saying you had some problems with other drugs. You liked the feeling you got and I think it was Hydrocodone. If I remember this correctly, you might want to throw this into the mix when making a decision.

Good luck on whatever you decide to do. Is it possible to have a heart to heart with your present doc who prescribes your Meth? Give it some thought.
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Old 06-01-2006, 11:59 PM   #11
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Re: methadone vs. oxycontin

Director is correct about the messed up coversion. Unfortunantely, Methadone is in a whole other class the oxycodone (other than opiate class) and that makes the conversion difficult. Also, methadone has a very long half life compared to others and takes several days to even get to the correct serum level. So the conversion is a difficult one as I previously stated. If you want the straight across conversion equianalgesic wise, I put that down earlier. However, again this is a hard drug to convert.

As far as the euphoria with oxy, that is true, however, it also one of the first things to go. Unless of course you are raising the dose to achieve that. But at the same dose for a period of time, the euphoria will go.

Addicts will continue to raise the dose in an attempt to chase the first "high". Although, it will never happen again, so they just continue to chase it to get whatever "high" they can get. Not real smart, but luckily only a very small percentage of pain patients get "addicted."

Take Care, good luck with the appts.

 
Old 06-02-2006, 01:19 AM   #12
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Re: methadone vs. oxycontin

Tina I have a little better conversion for you.

You said you were taking 40mg of methadone daily correct? If so, you will need to account for an incomplete cross tolerance. Which basically means tolerance to one opiate may not be the same with another.

So basically I did a 50% incomplete cross tolerance. Of course this means the dose of oxy may be kind of low, but you need to see how you respond. And then titrate up from there if needed.

I also used a Chronic dosing of Methadone compared to an acute dosing. I believe you have been on meth for a while?? Acute dosing changes things quite a bit.

So here you go:

40mg of Meth daily (chronic dosing)-
50% incomplete cross tolerance-
= 50mg of oxycodone daily

The original conversion I gave in an earlier post is based on an acute dosing of methadone NOT chronic. So in that case 40mg meth with 0% Incomplete Cross is 40mg oxy. A chronic dosing of meth with 0% incomplete cross tolerance is 100mg of Oxy. But that is not going to happen. A doc will not generally convert at 0% incomplete cross. I just wanted to give you all the numbers

Of course the incomplete cross tolerance could be 25% and in that case your oxy dose would be 75 mg. But I tend to think your doc will use the 50% and titrate up from there. Most studies suggest using 33-50 % incomplete cross tolerance to prevent an OD or bad side effects.

So I would expect you to be around 40-50mg of oxy daily. Guess it depends on the doc though.

Again, meth is a hard drug to convert from.

Hope this helps some.

Last edited by ARANGER; 06-02-2006 at 01:28 AM.

 
Old 06-02-2006, 06:57 AM   #13
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Re: methadone vs. oxycontin

Thank you EVERYONE! I appreciate everyone's advice so much. Aranger, your information is always so thourough and easy to understand. I appreciate that! Math has never been one of my strong points, I was an English and History major. Director, nice to see you here. Yes, you are right. The main reason I do NOT want to make the switch is I dno't want to feel that crapy euphoria that comes along with the oxy meds. At one time I thought I liked it, but now after being on the methadone and NOT having it, WOW...what a better way to live. My main reason for researching all of this is that I do fear that even after attempting to have a heart to heart with my doctor next week I am afraid she will not take it well no matter how nice and polite I am about it. Some people don't like to have their motives questioned, period. Adn if she drops me, I just want an idea of what my options are.

I'm actually waiting right now for a call back from my gyno from the other day. She is the doc that used to treat my pain, decided to put me on methadone, and referred me to this pain management doc. So I'm hoping to get some advice from her as to how to handle everything... The other reason that I want to talk to her is that this BT pain seems to have been increasing, gratned slowly, over the past month or so. So givnig it some thought I am starting to wonder if something is wrong or has changed in my condition. That is the problem with my disease. The pain levels are known for going up AND down quite drastically at random times. But going to the ER wont' get me anywhwer. Tehy will do an ultrasound and see nothing as usual. But you can't see my disease with that sort of test. You actually have to do laproscopic surgery to detect it most of the time. So it would be a wasted trip. Who knows....maybe my gyno will have some sort of solution on HER end that could make things better without raising my dosage of methadone. I don't know. I have been dong some research on some new endometriosis meds (preventative, not for pain treatment) so maybe one of those would be an option and could hlep. My worry is that I am growing more lesions and that is what is causing the pain to be growing.... but we shall see I guess.

Thanks everyone again...

 
Old 06-03-2006, 06:13 PM   #14
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Re: methadone vs. oxycontin

Okay, Now I SWITCHED from 45 mg METHADONE to 20mgx2 OXYCONTIN as of yesterday. Today I feel like total ****.My hands keep going numb. I've had diarrhea, I've thrown up. My legs ache SO BADLY.
History:
35-year-old ex-Hatha Yoga instructor and Men's Magazine Model
Also modeled Brazilian bikini's
Was training myself for possibly becoming a semi-pro fluff weightlifter (the kind that just look super fit!)
Old head on collision from when I was 19 years old finally came back to haunt me after having two baby girls back to back, just as I had been forewarned as a 19 year old girl. About 2 years ago my back started to go to hell. Lumbar. I was teaching over 8 hours a week of Yoga plus working out with free-wrights 4-5 days a week for 1 hour plus cardio 4-5 hours a week.
Bent down to pick up the then 3 year old for time out and the old #5 gave out on me and shattered. End up with a fusion L5S1 with nerve entrapment, Nerve damage, and tons of out of control scar tissue.
Anyway, besides the point, but that is the reason I am on drugs, before that, I was clean and sober health nut.
Now I take, well 40 grams of Oxycontin a day, 2 Norco for breakthrough (using those now) topamax, wellbutrin, Lexapro, and Limbrol and smoke pot when I feel like it to ignore the pain of my life!

Last edited by poor_Stacey; 06-03-2006 at 06:15 PM.

 
Old 06-05-2006, 02:09 PM   #15
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Re: methadone vs. oxycontin

Tina I thought you had told me once that Oxy caused you really bad headaches and that it didn't control your pain well nothing liek the methadone does for you, that every time the medication time released in your system you would get a headache, maybe you just forgot how bad they were but you had mentioned they were pretty severe.

I still think you should talk to your PM Doc and not be so scared of her and get this out in the open. what's she going to do, fire you as a patient because she doesn't like your honesty? I don't think so..... I know this women really scares you and like I said before you are HER patient, ( I once had a boss like her and I stood up to this women and told her how I felt about her) after that we got along really good.... it worked. she respected me. you are paying her to take care of you so your not the bad guy here, I think you should at least try and talk to her about all your issues before you are Without a pain Doc. your condition is pretty severe and your going to need to be on pain meds until you have the surgery so I think you should at least TRY and work with this Dr since there are no other pain Docs on your insurance plan.... what if your OB Dr retires or switches offices the new Doc is not going to want to treat you with heavy narcotics or what if she is afraid of the DEA than what? than you will be without a Dr again so you need to make this work pls at least try and talk to this Dr and don't be so frightened of her, she is human just like you and I go in get your medications and get out like you do at every apt, you don't have to like her or be her friend just get this out in the open and ask her to put you back on the 50 MGS as it works better for you...........

good luck.

 
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