Re: not much relief from hydromorphone(dilaudid).
I have to say, before my back pain started, i never would've questioned the differences between brand name and generic prescriptions. I thought it was like getting either the JIF peanut butter, or the America's Choice. Exactly the same ingredients, just a different label. With some medications, the generics are absolutely adequately, if not equal to the equivalent brand name medication. With pain medications, I've found a major difference.
I think I've spoken towards this before on here, but a little less than a year ago I came across an article that discussed the 20% differential the FDA allows for generics, and how this is detrimental specifically to opiates. Now, I haven't been able to find the article since, so I cannot vouch for the credibility of the article, but it did make sense to me. Whether the pharmaceutical companies are buying opium or synthesizing it themselves, the potency of the actual opium will always vary. When making a brand name drug, say, Vicodin, the pharmaceutical company will use its "premium opium" to help derive the codeine and thebaine, then use that to derive the hydrocodone, and the final product will reflect on the premium quality of the opium used to make the final product. However, the same pharmaceutical company may produce a generic version of Vicodin starting with opium of lesser quality. Although the amounts of the chemicals used and the process in which they synthesize the hydrocodone MAY be the same (although it may not be), the final product will be inferior to its brand name equivalent because the opium used in the generic is not as potent or strong.
I don't know how much of this is actually true, and when I have asked doctos and pharmacist most of them shrug their shoulders. Within the past month though I finally switched to brand name Vicodin and Norco, after having little success with the generic. I find a huge difference in the consistency and duraton of action with the brand name drug, and it really has made a major impact on my life. Rather than being frustrated after taking a generic Norco, and having it do absolutely nothing or last only for twenty minutes or so, the brand name provides me with at least an hour of relief every time I take it. My doctor has allowed for me to take a maximum of twelve Norco a day, so this really makes a significant impact on my pain relief for the day.
Whether or not any of my information on opium is valid, from my experience I would highly recommend trying brand name Dilaudid. I was on Dilaudid for about two months and found no relief from it at all, and I wonder now if I had tried the brand name version if it would've proved to be anymore effective.
Good luck, and let us know what you decide and how it goes.