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Old 04-19-2008, 08:40 PM   #1
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Question about Oxycontin..Please Help!

Hello everyone,

I have a long history of back and neck problems (including a triple fusion surgery that went bad). I am currently in pain management and am prescribed three 40mg oxycontins a day. The problem is that I am constantly experiencing withdrawal symptoms. I take the meds as prescribed (ie..one tablet every 8 hours)..but I keep having symptoms that include chills with simultaneous sweating, anxiety and nausea that creep up just a few hours after taking a dose. I wake up every morning in moderate withdrawal. Taking an oxy will produce relief within minutes. I am very familiar with withdrawal, so I do know what the symptoms are. I cannot understand why I feel this when I am supposedly keeping a steady level of oxycontin in my blood stream. Has anyone experienced this before? I have only been on oxycontin for about 4 months, so I do not think tolerance is an issue (I have been feeling these symptoms right from the beginning of being prescribed this medication).

The only other time I have been prescribed oxycodone was shortly after my spinal surgery in 2005. I was given percocet and had the exact same withdrawal feelings while on the percs. I even called my surgeon who was baffled as to why I would feel these symptoms.

It is very distressing, for I had finally found a drug that provided some level of pain relief, but this constant felling of being in withdrawal is wearing me down. I am getting to the point where I feel the need to "take something" to ease withdrawals. (please do not confuse this with any sort of drug craving...that is not an issue)
I go to my PM doc on April 28. I think this is an issue that I should bring to his attention.....maybe I should be prescribed some other long acting med.

Please give me any input or suggestions as to what may be going on here.

Thanks,
Lou

 
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Old 04-20-2008, 01:20 AM   #2
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Re: Question about Oxycontin..Please Help!

Lou,
I have a couple questions and then suggestions.

1. What brand of oxycodone are you taking?
2. Are you sure that it is the sustained release and not the IR(immediate release) oxycodone? (if it was the IR then the effects would only last 4-6 hours)
3. Do you have a high metabolism?
4. Are you eating heavy meals when taking it?(I believe that eating a heavy meal decreases the effectiveness- but somebody let me know if i'm wrong)
5. Are you taking any other meds that might counteract the oxy or decrease it's effectiveness?(I'm not sure what other meds will do this but you could ask your pharmacist or I'm sure another poster will know)

It sounds like you have a very high metabolism. You might need your oxy presribed 4x/day which some doctors will do. Have you every tried the fentanyl patch? I think you might do much better on it since the dose of narcotic pain reliever is delivered much more steady than the oxy and you only need to remember to change it every 2 or 3 days depending on what you are prescribed.

You could always try taking some Tylenol(acetaminophen) along with it to increase the pain relieving effects and to get the oxy to last longer. I have also heard that the drug Tagamet(OTC) also increases the effects but be careful when doing this and do small doses.

brian

 
Old 04-20-2008, 03:36 AM   #3
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Re: Question about Oxycontin..Please Help!

If you research this board you will find alot of individuals, myself included, who find with oxycontin that it does not come close lasting 12 hours. My doctor recognizes this and changed my medication around to:

4:00 a.m. 20 mg
10:00 a.m. 10 mg.
4:00 pm. 20 mg
10:00 pm. 10 mg

Prior to this change, I was taking 1 to 3 10/325 percocets as breakthru. Since this change, I am taking 1/2 percocet unless I am in alot of pain then I take 2. As a rule that 1/2 percoect does the trick.

It is a pain taking meds at 4:00 am but so worth it because I am not experiencing that up and down with the oxy.

FYI - When my doc writes the script, he says take 30 mg. 2x daily. Some insurances are funny and don't want you taking the oxy more than 2x daily because it is supposed to last the 12 hours.

Hope this helps.

 
Old 04-20-2008, 06:59 AM   #4
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Re: Question about Oxycontin..Please Help!

Quote:
Originally Posted by 123dietdrpepper View Post
IFYI - When my doc writes the script, he says take 30 mg. 2x daily. Some insurances are funny and don't want you taking the oxy more than 2x daily because it is supposed to last the 12 hours.
Hi Diet...OC is now available in 30mg....So be careful that the pharmacy doesn't dispence 30mg pills going forward. Also, because the 30s are now available, the insurance may not pay for the 20s and 10s.

Ex

 
Old 04-20-2008, 07:23 AM   #5
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Re: Question about Oxycontin..Please Help!

hey lou, i remember when you got bumped up not to long ago, i know it was pretty recent because 1 month ago i was on the same dose as you 3x a day. i remember our conversation and said u might want to ask your doc to go 3x per day as well. i dont think its withdrawal, could it be 3x per day too much? were you having the same issues at 2x per day?

 
Old 04-20-2008, 07:59 AM   #6
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Re: Question about Oxycontin..Please Help!

Lou- It may be that Oxycodone just doesn't work for you. You may need to try something else, such as the Duragesic patch...It releases meds every hour for 48-72 hours...Many PM patients change every 48...Although your Doc may start you at 72.

I don't get all the symptoms you describe from Oxy, but I do get the sweating and the anxiety. Once it wears of (2 hrs or so), it goes away. I've never had anything remotely from fentanyl.

Docs today (in general) would rather not script OC, so yours may be happy to move to the patch.

Just a suggestion........

Good luck.

Ex

 
Old 04-20-2008, 08:06 AM   #7
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Re: Question about Oxycontin..Please Help!

i too am wondering just what type of oxy you are actually on since you stated it "gives me relief within minutes"? oxycontin just does not release THAT quickly,ever. i usually feel relief with my oxycontin within 45- to an hour after taking it,never within just 'minutes' it just doesn't 'sound' like oxycontin that you are taking given the results you have that fast. my oxy IR doesn't even work that quickly. just a bit confused here thats all. are you taking a generic brand of the OC? are you actually swallowing this whole or changing the actual delivery system in some way? that would just make much more sense with what you stated. like i said,just confused.marcia
__________________
3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
Old 04-20-2008, 11:42 AM   #8
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Re: Question about Oxycontin..Please Help!

Hi Everyone,
Thanks for your replies. The oxycontin I get is "brand".. My doctor writes "medically necessary" on the scripts to insure I get brand. I have already had a month of the generic "Teva" oxy in the past and that stuff was awful (that's a totally DIFFERENT thread tho!) The prescription bottle states "oxycontin 40 mg CR". If I am not mistaken, the "CR" means "controlled release"?? The doc also has me on the shorter acting immediate release oxycodone for breakthru (5mg tablets up to 3 a day).

When I mentioned that I got relief "in minutes", I meant that the withdrawal symptoms lessened dramatically usually within a half hour. Funny thing though ...today, I took my second dose around 2 pm (first dose had been at 6am). I was not feeling any withdrawal sensations prior to takingthe pill. Here it is 2:30 and I have terrible sweats and chills, along with an increased level of anxiety. I just do not understand this. Maybe I just need a different med altogether. It's almost as if my body is "rebelling" against the oxycontin.

Over the past 5 years since my spinal woes began, I have been prescribed darvocet, hydrocodone & percocet....all short acting narcotics. The percocet is the ONLY one that caused me to feel these sensations of withdrawal (sweats and simultaneous chills along with anxiety). Of course percocet contains the exact same narcotic medication that oxycontin contains...ie...oxycodone. I actually got really good relief from the darvocet (the weakest of narcotics..go figure!), but I had developed such tolerance that I had to take 8-10 a day to sustain the effects...and the amount of tylenol being ingested was just not acceptable.

I will definitely have to discuss this with the PM doctor. The withdrawal symptom that always bothered me the most (ie..I simply could not physically tolerate)...was the sweats and chills. Even though the oxy is giving me great pain relief (interpret that as lowering my pain level to a manageable "5" vs the normal "8" to "9" I lived with previously), the distress of what I perceive as withdrawal (though it obviously is NOT, since I have the med in my system at all times) is making my life miserable.

Thanks again for all the replies.

Lou

 
Old 04-20-2008, 05:12 PM   #9
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Re: Question about Oxycontin..Please Help!

Quote:
Originally Posted by Lou1 View Post
I took my second dose around 2 pm (first dose had been at 6am). I was not feeling any withdrawal sensations prior to takingthe pill. Here it is 2:30 and I have terrible sweats and chills, along with an increased level of anxiety. I just do not understand this. Maybe I just need a different med altogether. It's almost as if my body is "rebelling" against the oxycontin.
This isn't withdrawal. Your body is starting to react as the med hits your system. Some level of Oxycodone is released immediately upon taking the pill (the rest is released later under the time release mechanism). It sounds to me that you are experiencing a paradoxical effect....The Oxy is acting like some form of stimulant.

I think you need a different LA med.

Ex

 
Old 04-21-2008, 07:33 AM   #10
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Re: Question about Oxycontin..Please Help!

Lou,
I have the same problem as you do, I also had my spinal fusion in 2005 and am also on Perc's and the same symptoms, the sweating is so bad it actually fogs up my glass's. I wake up every morning feeling like I went through withdrawal in my sleep (what little I got). and as soon as I take my morning dose, within minutes it goes away. But throughout the day it hits before my next dose it due again, I agree it's withdrawal. I went from every 12 hours to every 8 hours, I also wear the fentanyl patch and it STILL does it!
I am now withdrawing off the patch and within a couple of days from being completely off of the fentanyl, but even the 2 together didn't work, it was actually worse and magnified the symptoms.
Being I also have severe Panic disorder and take high doses of Xanax, I ask my shrink about it. He told me it's the ups and downs of the level in my blood stream between doses. after we take it, it goes back up and before the next dose it goes down and begins the withdrawal effect, then we take the next dose and so on.
I absolutely hate it, I don't know about you, but I can't sleep without a fan on me, otherwise I am tossing and turning and off and on all night the house will feel like it's freezing for 5 minutes then like it's 100 in here and I'm sweating to death! I ALWAYS wake up nausea's. (that's getting old!).
I talked to the pharmacist as well. But he told me no matter what happens DO NOT LET THEM PUT ME ON OXYCONTIN!
He said unless I want to suffer the unimaginable withdrawal, to stay away from it and try to deal with this on the Perc's.
He said Percocet is actually a form of Oxycontin, but not the actually drug to the point of the horrifying withdrawal from it. However actual withdrawal from Percocet is BAD if I stray and don't take them right, so I'm really careful too and follow Dr's orders,
The long acting is probably the only thing that can level this drug in our system enough to calm it down (somewhat), but at least it would be more comfortable.
But I can't take the LA, it didn't agree with me. I am very sensitive to many meds.
It's good to know I am not the only one out here going through this, Hubby thought I was going nuts, the neighbors have labeled my house *The Icebox*. Here in the south I am having alot of trouble dealing with heat outside and I LOVE to be outside, but not on this stuff.
Thanks for letting me vent, it's good to know I'm not alone in this either.
Sandollar

 
Old 04-21-2008, 11:51 AM   #11
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Re: Question about Oxycontin..Please Help!

Quote:
Originally Posted by 123dietdrpepper View Post
If you research this board you will find alot of individuals, myself included, who find with oxycontin that it does not come close lasting 12 hours. My doctor recognizes this and changed my medication around to:

4:00 a.m. 20 mg
10:00 a.m. 10 mg.
4:00 pm. 20 mg
10:00 pm. 10 mg

Prior to this change, I was taking 1 to 3 10/325 percocets as breakthru. Since this change, I am taking 1/2 percocet unless I am in alot of pain then I take 2. As a rule that 1/2 percoect does the trick.

It is a pain taking meds at 4:00 am but so worth it because I am not experiencing that up and down with the oxy.

FYI - When my doc writes the script, he says take 30 mg. 2x daily. Some insurances are funny and don't want you taking the oxy more than 2x daily because it is supposed to last the 12 hours.

Hope this helps.


I'm the same way. My doctor first put me on 30mg x2 a day when taking me off the patch. That dose didn't help at all. Then he upped it to 30mg x3 a day and this still wasn't enough. So he had me try 40mg x3 a day and 30mg x4 a day and the 30mg x4 a day worked best. I'm not exactly sure what is going on, or how the time release mechanism works in the oxycontin but for some reason it never releases any more medication after the first bit is released when I first take it.

I take them like this:

6:30am 30mg
12:00pm 30mg
5:30pm 30mg
11:00pm 30mg

Even taking them that close together that last hour or so my pain level starts going up quick. I've tried every 5 hours and that works better but when I wake up in the morning I get the withdrawal symptoms the OP talks about. I also start getting them during the day when I notice my pain levels going up close to the time I need to take my next dose.

Does anyone know or have a link to exactly how the medication is released over time in oxycontin? I'm not a doctor or anything like that but I know pretty much how other meds I take work and maybe if I knew the mechanism for time release in the oxycontin I could figure out why the oxycontin does not work the way it is supposed to and talk to my doctor about it. I feel I shouldn't have to take as much as I do to get good relief and would love to figure out how to make it work right! It would save me a bunch of money every month!

 
Old 04-21-2008, 03:46 PM   #12
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Re: Question about Oxycontin..Please Help!

Hi Lou: I guess I have to agree that the oxycontin is probably the wrong LA (long-acting) med for you. Since, as you said, it is essentially the same med that you had issues with in the past, I would say a different opiate/opioid would be more beneficial.

I hope you can get your doc to prescribe something different. I can't speak to exactly which med, as I take oxycontin and have never been Rx'd any of the others. I know several people here have had good luck with the Fentanyl patch. I'm sure they could anwser any questions you have about it.

Sorry you are having such a hard time. I know it's frustrating when you are in the process of finding what works best for you. I wish you the very best and please keep us posted. cmpgirl

 
Old 04-21-2008, 07:05 PM   #13
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Re: Question about Oxycontin..Please Help!

OMG! I have been on oxycontin ER for about 2 years. About 2 months ago they gave me those pink football shaped ones with 93 31. My pain has been awful since. Are you guys saying it is because of the brand? I just got a refill from the pharm. These new ones are pink and round and say ABG on one side and 20 on the other. I haven't taken those yet. Are they better? I thought I was getting worse. My pain has been awful lately.

 
Old 04-21-2008, 09:05 PM   #14
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Re: Question about Oxycontin..Please Help!

If you have been using the same pharmacy it should be easy for the pharmicist to let you know if you have changed brands at the start of increased pain.

If you look on the front bottom left of your current perscription bottle - It should have the manufacturer name.

ABG = Watson Pharmaceuticals
20 = mg. of your tablet/pill

93 31 = Teva Pharmaceuticals 20 mg. tablet

I do not know about the Watson brand but the Teva brand actually works well for 1/2 of the people and not for the other half of the people.

 
Old 04-21-2008, 11:42 PM   #15
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Re: Question about Oxycontin..Please Help!

Lou:
I think it is definitely time for a different LA(long acting) medication for you siince the Oxycontin is not agreeing with you. Here are the list of LA meds that you could possibly take:

morphine based - MS Contin, Kadian, Avinza

oxymorphone - Opana

Methadone

fentanyl based - fentanyl patch (Sandoz(generic), Mylan(generic), Watson(generic), or Duragesic(brand) - I take the Sandoz brand and have success with it. Many people do not have good luck with the Mylan brand and steer clear of it. However, everyone reacts differently so make up your own mind concerning it

I would suggest not taking Percocet either, although you may have find a differnt BT med as well but there are BT meds containing the same active ingredients as the LA verisons (ie. morphine, oxymorphone, fentanyl). You may want to seriously try either Methadone or fentanyl patch, just my suggesting. Good luck and let us know what you do ok?

brian

Last edited by brianpain33; 04-21-2008 at 11:43 PM.

 
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