Re: Avinza vs Kadian
Avinza and Kadian are pretty close to the same as far as release, however, there are some differences.
Avinza has a little bit of an immediate release built in where Kadian does not. So you may have been feeling a little more relief up front with the Avinza. Both drugs use pretty close to the same release mechanism for the remaining LA form of the med.
Avinza calls there release Spheroidal Oral Drug Absorption System or SODAS. These pellets release at different times due to acids and PH level in the Gastro track. Kadian has what is called a Polymer Coated pellet release. Each pellet again reacts with the acids and is released based on the pellets. This gives the 24 hour release.
Generally most people get better relief with BID dosing vs once a day. I agree with mpvt that it may just be that you are not at a high enough dose. I'm not sure of your history or how long you have been on opiates, but as you know tolerance to them happen rather quickly.
Everyone responds differently, but 30mg BID of Morphine is still on the lower side of things especially for LA morphine. If you are finding that you have to use more of the BT meds, then it is usually a pretty good indication that your LA dose is low.
I would keep a chart/diary of your pain level, how many BT meds you need on a daily basis, so that you have something to show your doc about the coverage of your pain.
Since you are just starting out on Kadian, you will most likely have to go through the titration process with your doc until you get to the right dose. When I was taking Kadian, I was on 100mg BID. I have trouble tolerating Morphine, but as far as the release, it was probably one the smoothest of all of the LA meds in my opinion.
Hopefully the doc will get you to the right dose soon. I know titrating can be a pain.