Shoreline

Hi james, 20 mgs of short acting hydro is weaker than the 7.5 mgs a 15 mg MSCotning sustain over 8 hours. The standard conversion from hydro to morphine is .8:1, meaning 8 mgs of hydro is equal to 10 mgs of morphine. a 15 mgs MSC suonly conatins 15 mgs of morphine, It doesn't sustain 15 mgs of morphine in your system, half is released aftr about 1 hour and the other half is released about 5 hours later. So the doc basically reduced your dose from 80-120 mgs of hydro to 45 mgs of morphine a day, about half the strength you were previously taking. This isn't unusual to start low when a new drug is introduced you haven't previously taken and often it takes a half dozen adjustements simply to reach a point hwhere you getting better relief. Docs should know the process and undertsand that adjustement will be neeeded so don't be afariad to discuss the increase in pain your experiencing. He should be expecting to hear from you when they make such a radical change, but the idea is to start low and work your way up, not start high and work your way down.

Morphine would be much more sedating at an equal dose of hydro and the sedation takes time to get used too. Docs are hoping you respond better to a different class of meds. Every time I have ever switched meds I was started somehwere around half to 1/3 of where I ended up after 3 months of adjustemnts. The medical term for adjusting a med to find the theraputic dose is called titration and your doc should be well aware that the process needs to continue untill they find something that provides equal or beter relief.

This was simply the starting dose, there is no weaker strength of MSC. The doc can't read your mind so unless you call in and ask to be seen because your miserable, he isn't going to call you and volenteer to increase your dose. Most docs won't make an increaese over the phone so you simply have to make an apt to follow up because your not recieving the relief you did from your prior med. There is no fast or safe way to jump from med to med without starting low and making needed adjustemnts. It's up to you to make the call and explain your situation to the doc.

Good luck, Dave