I was on Avinza 60mg q24H, however the med never lasted past the 16th hour and I had to use my bt meds for coverage. After doing that for a month my doc's switched me to Kadian 30mg q12H and cut my bt meds in half. The later regimen may provide full coverage but it seems less effective.
Do both these meds contain the same drug and deliver it in different ways?
If they are in fact the same drug and I am taking the same amount daily, why does my pain relief feel significantly less with the BID 30mg Kadian versus the 60mg QD Avinza?
You may need to adjust your dose to 60mgs bid.Your doctor has to start you at a dose he thinks will work.I'm sure he would expect you to ask for an increase if it isn't working.This is your pain so don't be afraid to say " hey,this isn't working I need to raise my dose".Good luck to you and hang in there....Dave
They are both Morphine products but are delivered a bit differently. Avinza releases 10% at first and then the remainder over 24 hours where as Kadian doesn't have any quick release and just releases continually over 24 hours. Doctors find that both medications are actually more effective dosed twice daily as opposed to once daily.
As to the dosage, yes Kadian 30mg twice a day is the same as Avinza 60mg once a day.
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.
So far the Kadian 30mg BID doesn't compare to the Avinza 60mg QD as far as pain relief. I figured it's the same drug and same dose and should work just as good. Oh well. This Morphine does a number on my GI Tract, that's my biggest complaint. I wonder what the next step is going to be. I go back to the clinic on the 21.