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Old 05-09-2007, 05:32 PM   #1
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shoulderpain HB User
Has anyone tried Opana?

Hi,

I've been on the same dose of oxycontin for a year, due to a failed shoulder surgery. It had worked well in controlling pain, I was even able to taper down a bit and still be comfortable. For the past 2 weeks the pain has returned significantly--I haven't strained the shoulder or anything so there's no good explanation. I'm going to discuss this with my pain management MD. I think perhaps I've just become too tolerant with the oxycontin. I don't want to increase the dose, and we tried switching me once to long-acting morphine. I didn't tolerate that well.

Has anyone tried Opana, the long-acting oxymorphone, and how did it work? Unless I hear some negative feedback on it, I'll ask my PM doc about switching me to the Opana, at least for a month or so.

Thanks and bless you all!

 
Old 05-09-2007, 06:51 PM   #2
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mudbone HB User
Re: Has anyone tried Opana?

I have tried it and yes it did work for pain. Mild sedation, long acting. It was not for me though. But if I can make a suggestion, If you are on OC now, do you take anything for breakthrough? This is where I am going; If so, then Opana also makes an instant release along with the "ER". Ask doc to try you on the "IR" as your breakthrough to see how it affects you, that way if its a no go, then you wont be stuck with a 12hr med.that you dont like for a whole month. You would still have your OC's. And if you did like them, perhaps then make the change over to ER.
Just an idea, because they did make my stomach feel weird and you also have to take them on an empty stomach. No food for 2hrs prior and none for 1hr after you take. Now that was with the ER. I'm not sure if that goes for the IR. Kinda wouldnt make sense would it? (Just hope your breakthrough pain follows your lunch and dinner schedule) LOL
Again this is just an idea that I'm not even sure if it can be done. I was just trying to save you from getting a month of med that you may not be able to use. good luck! Mud

 
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Old 05-09-2007, 08:37 PM   #3
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Re: Has anyone tried Opana?

I just started Opana last week. I had been on 120 mg of Methadone per day and my doc switched me to 40 mg Opana ER per day. So far, it is not working for me, but it might just be the dose is not high enough. Doc wanted to start me lower than he thought I needed just in case it would be enough. Right now I am not real happy with it, but when/if we get the dose right I might love it.

 
Old 05-10-2007, 11:59 AM   #4
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Wren9 HB User
Re: Has anyone tried Opana?

Jim, that is absurd! 120 mg methadone to 40 mg oxymorphone??? I would think it should be more like 160-240 mg Opana ER! (Disclaimer, I'm not a doctor.). You must be a hurting puppy. I can provide evidence of why it should be higher if you want.

100 methadone is about equal to 500 mg morphine which is about equal to 150 mg oxymorphone (Opana) (those are oral equivalents).

The prescribing info says that Opana is twice as strong as methadone -- that 20 mg methadone equals 10 mg Opana -- but that makes no sense. If you are going from methadone to Opana, you will need a higher dose of Opana. The opposite is also true: if you were going from Opana to methadone, the methadone dose should be lower than the Opana dose -- to do otherwise is dangerous.

I was taking 240 mg Oxycontin and my PA switched me to 240 mg Opana ER. The pamphlet recommended 120 mg Opana ER, but she said that was too "cautious" a recommendation...that I would experience withdrawal and extra pain at that level. 240 mg was a little bit too much, but only slightly. I probably would have done well on 160-200 mg a day.

Something did not sit right with me with Opana ER...and I chose to go back to Oxycontin. I'm not sure if I made the right decision though. I liked how the Opana had a smooth profile. I feel that Oxycontin is very much up and down. I have to take it 3 x per day. The Opana ER lasted a true 12 hours...twice a day dosing should be all that is needed. I would give it a try for a month and go back to Oxycontin if it doesn't work out. The patch (Duragesic) is another idea...that is one of the only pain meds I have not tried.

Oxymorphone (the ingredient in Opana and Opana ER) is extremely potent by IV. But orally, it is much less potent. It gets "hit" hard by first-pass metabolism and only about 10% is orally bioavailable. Oxycodone (the ingredient in Oxycontin) has 80% oral bioavailability. If both meds were taken by IV, there would be a huge difference in potency. But taken by mouth oxymorphone is only about twice as strong as oxycodone, and maybe not even twice as strong depending on the person's unique metabolism, health, age, etc. I also noticed that the dose felt more potent after taking it for a few days, which makes sense since the literature says it takes 3 days to acheive a steady state.

-Wren

Last edited by Wren9; 05-10-2007 at 12:20 PM.

 
Old 05-11-2007, 02:23 PM   #5
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shoulderpain HB User
Re: Has anyone tried Opana?

Everybody, thanks for your insight/advice. I'll certainly ask my PM doc about a 'trial' of using IR oxymorphone for breakthrough pain--it's a good idea. Especially since my pain varies a lot, depending on activity level. I'm curious though about those who said it just wasn't for them. What was the problem? Itchiness, nausea, or just feeling mentally kinda yucky? The oxy has been a lifesaver for me in controlling pain but I have been having bad nightmares since taking it. Then again, my situation is a nightmare and very stressful so who knows? Thanks and bless you.

 
Old 08-25-2007, 08:55 PM   #6
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victoria1951 HB User
Re: Has anyone tried Opana?

Quote:
Originally Posted by jimc View Post
I just started Opana last week. I had been on 120 mg of Methadone per day and my doc switched me to 40 mg Opana ER per day. So far, it is not working for me, but it might just be the dose is not high enough. Doc wanted to start me lower than he thought I needed just in case it would be enough. Right now I am not real happy with it, but when/if we get the dose right I might love it.
Oops. Didn't know how this worked. Now I do. Sorry.

Last edited by victoria1951; 08-25-2007 at 09:04 PM. Reason: no text was entered

 
Old 08-25-2007, 09:01 PM   #7
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victoria1951 HB User
Re: Has anyone tried Opana?

Quote:
Originally Posted by jimc View Post
I just started Opana last week. I had been on 120 mg of Methadone per day and my doc switched me to 40 mg Opana ER per day. So far, it is not working for me, but it might just be the dose is not high enough. Doc wanted to start me lower than he thought I needed just in case it would be enough. Right now I am not real happy with it, but when/if we get the dose right I might love it.
I was run over by a car June 3, 2000, and started on Oxycontin w/Percocet for breakthrough pain. Eventually, I got to 160 mg/day Oxycontin when 1 1/2 yrs ago was put on Methadone by a county dr. in Modesto, CA. That never helped but made me fall asleep at times I did not want. I'm back in upstate NY and found a wonderful pain specialist. He started me on 5mg ER 2x/day. Did not work. Now it is 10mg, still not working. I take Opana IR 5mg for breakthrough pain. Now, I have the 3 vertebrae, L3, L4, L5, collapsed and am in horrific pain. I am not getting relief and have had fleeting thoughts of taking the rest of my methadone (4 10mg tabs) to help. Of course, I haven't because I don't want to hurt myself (although the thought goes through my head from having such extreme pain). I'm going back Tuesday and am sure he'll up my Opana, but do you all think it is the best medication for such extreme pain?

 
Old 09-28-2007, 04:16 PM   #8
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3wilds HB User
Re: Has anyone tried Opana?

I saw your message and I need to say that just yesturday it was decided for me to go from 30mg of methadone to 20mg of opana er 2-3 per day. I'm afraid of withdrawls big time because I tried to cut down on methadone and only made it to 22.5 from 30 until I couldn't take it any more and I did it slow. I hurt my neck somehow at PT and I'm having withdrawls from oxycodone from a previous experience and I've only been taking it for a month. The methadone I"ve been on for around 1 1/2 years. What do you think? I hope you see this soon.

 
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