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Old 10-18-2007, 12:28 AM   #1
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whosit HB User
Thinking of changing BT meds....suggestions?

Hi guys, I am thinking of changing my BT medication because I dont feel it works as well anymore. I currently take Percocet 10/325. I would like something that works as well as it did. I cannot take hydrocodone because it upsets my stomach. Please guys give me some suggestions to give to my doc when I see him again in a cpl of weeks. I took long acting morphine before and it didnt work well either for me so a instant release prob wont do any better. I am also concerned about long term tylenol use as well so mabey a Oxy IR at about 15mg would be better?

Thanks

whosit

 
Old 10-18-2007, 06:55 AM   #2
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AnaDE17 HB User
Re: Thinking of changing BT meds....suggestions?

I take oxycodone hydrochloride 15mg and I think it's the same thing as you take without paracetemol. I don't know how conservative US doctors are but here they are pretty conservative. The only reason I receive so much narcotic medications is because of my spinal cord injury and paralysis. If the oxy+paracetomol isn't working it's unlikely the straight oxy will help either.
-Ana

 
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Old 10-18-2007, 08:00 AM   #3
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forginon HB User
Re: Thinking of changing BT meds....suggestions?

Maybe it's just a matter of increasing the dosage and going to a single entity oxycodone instead one with tylenol?

In that case, 15 or 20mg of straight oxycodone might do the trick. I use the concentrated oxycodone solution which is 20mg per millimeter. I am allowed 1-2ml every 6-8 hours. Works pretty well.

steve

 
Old 10-18-2007, 06:45 PM   #4
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conductor HB User
Re: Thinking of changing BT meds....suggestions?

Dear Whosit,

Do you mind refreshing me on your situation? What medications do you take? I'm sorry to have to ask. If you recall, I've been out of the loop for a little bit. I probably still am out of it! So, I would be thankful if you could tell me what long-term opiates you're taking.

Percocet has never really worked well for me. Early in my Pain Management pursuits, I was given Percocet. However, it didn't work that well after a short period of time. I wear the Duragesic Patch (Sandoz generic version) and use Actiq and Dilaudid for BT pain relief. Oh...I also use Fioricet for tension-type headaches.

Thank you for indulging me!

Sincerely,
Jon (Conductor)

 
Old 10-18-2007, 08:28 PM   #5
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whosit HB User
Re: Thinking of changing BT meds....suggestions?

Quote:
Originally Posted by conductor View Post
Dear Whosit,

Do you mind refreshing me on your situation? What medications do you take? I'm sorry to have to ask. If you recall, I've been out of the loop for a little bit. I probably still am out of it! So, I would be thankful if you could tell me what long-term opiates you're taking.

Percocet has never really worked well for me. Early in my Pain Management pursuits, I was given Percocet. However, it didn't work that well after a short period of time. I wear the Duragesic Patch (Sandoz generic version) and use Actiq and Dilaudid for BT pain relief. Oh...I also use Fioricet for tension-type headaches.

Thank you for indulging me!

Sincerely,
Jon (Conductor)




No problem, I currently take a 20mg and a 10mg Oxycontin(brand) 2 times a day, and percocet 10/325 for BT pain. The percocet just doesnt seem to work as well anymore. I have been on it for about 9 months now so not really that long but it just doesnt seem to work as well as it used to. It doesnt relieve the pain like it did before and i dont get good relief until the LA meds kick in. i have wrote my doctor a email about changing the BT med to either roxicodone 15mg or hydromorphone and asked if he had any suggestions to offer as well. The last time i asked him about it about 2 months ago he said:

Constant tolerance to a compound is definitely not a good thing. Suggests > average risk of an addictive change in brain biology. (this was copy and pasted from the email he wrote back.)


So I am afraid he might think I am just trying to get more meds from him. I just want to take less BT meds and have better relief, thats all. i explained all that to him in the email I just sent so I will keep you guys updated on what happens.


thanks


whosit

 
Old 10-19-2007, 07:01 PM   #6
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whosit HB User
Re: Thinking of changing BT meds....suggestions?

I emailed my doctor last night about switching the BT med and suggested roxicodone 15mg or hydromorphone. i explained everything to him and said the percocet 10mg wasnt working as well anymore and wanted to switch or go to 15mg per dose of just oxycodone. he usually responds very quickly and has always responded by the next day since i have been going to him. I have not got a reply from him about the issue as of now(10pm). Do you guys think he is mad at me for asking for a increase? I am hoping he dont label me as addicted to my meds as well.....I take everything just as prescribed all the time. If he suggest's that then i will just ask him to do blood level on me and that will prove I take everything as RX'ed. Anyway....any thoughts on the issue? Think it was too much that I mentioned hydromorphone, because it is so strong? thanks guys...


whosit

 
Old 10-20-2007, 02:02 AM   #7
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conductor HB User
Re: Thinking of changing BT meds....suggestions?

Dear Whosit,

There are others who can talk to you better about opiate conversion equivalents, but I will be glad to offer the tiny bit I know!

First, I wouldn't read too much into the fact that your doctor didn't answer you as quickly as he usually does. There could be a million reasons why this occurred, so don't let that bother you, OK?

It is my understanding--from both a Pain Management doctor AND someone who regularly posts on this forum--that these medications don't always "settle" on the same portion of the nerves that accept pain relief. For instance, my previous Pain Management Physician explained to me that oxycodone relieves pain on a slightly different portion of the nerve than hydromorphone.

As well, this same physician of mine explained that sometimes it makes sense to use a stronger (and faster-acting) dose of the same base medication to work on the BT pain--like utilizing OxyContin (long-term) and Roxicodone (shorter-acting for BT), which are both forms of oxycodone. Dilaudid (hydromorphone) is one of the strongest pain medications (shorter-acting) available for most people. Frankly, it might be something your doctor is researching before he gets back to you. My best suggestion is to give your doctor some more time and keep your faith in him. If too much time goes by for your comfort--contact him by phone. That's just my own completely unprofessional opinion!

Again, there are others on this forum who can respond to this much better than I can!! So, let's see what they have to offer.

I wish you well, my friend.

Sincerely,
Jon (Conductor)

 
Old 10-20-2007, 12:27 PM   #8
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whosit HB User
Re: Thinking of changing BT meds....suggestions?

Thanks,


He did reply this morning, he explained that he didnt have alot of experience with hydromorphone but just converted someone else to it. He explained the benefits of rotating medcations and has pretty much agreed to a change in my BT med. I am not sure but I think it will be hydromorphone 4mg starting with half the tablet first and then going to the full 4mg if that is not enough. I will def let you guys know how this plays out and how the new drug works for me. Thanks for all your support guys!

 
Old 10-20-2007, 05:13 PM   #9
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conductor HB User
Re: Thinking of changing BT meds....suggestions?

Dear Whosit,

I'm glad to hear that you heard! I have mentioned previously that I use Dilaudid, but I use Dilaudid 8 mg. Again, aside from fentanyl-based medications (like Duragesic or particularly short-acting Actiq), Dilaudid (hydromorphone) is one of the most potent--if not THE most potent--opiate available to us. It is important to really watch yourself on Dilaudid...I had it make me feel seriously naseous when I initially began taking Dilaudid at a lower dosage.

Please be careful as you get used to taking the Dilaudid (hydromorphone). This following information may or may not help. From what I understand, there are several generic companies who make this available. The Watson generic seems to work better for me. But, certain things work better for other people. So, there are several options from which to choose.

I hope that your Dilaudid trial is a success. From what I understand, Dilaudid (hydromorphone) settles on a specific place on the pain receptors--compared to other opiates. However, this whole concept concerning where some of these more potent opiates "settle" to provide pain relief doesn't make all that much sense to me. Even the idea of an electric light bulb perplexes me, so please know that I don't have much understanding!!!! However...My thanks goes out to those that actually possess a significant understanding of these truly astounding contraptions--and medications!!

Whosit, we expect you to keep us posted on the success of the Dilaudid. Many of us want to know of your success.

Thank you,
Jon (Conductor)

 
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