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Old 05-04-2008, 12:53 AM   #1
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How much breakthrough medicine does your doctor give you?

I take 15 mg of Oxycontin twice a day (when I get up and before I go to bed). Also, I get 50 5 mg percocet pills a month to use as needed. Does the number of breakthrough pills seem a little low? It seems like 120 seems like a more typical amount. On the other hand, I read somewhere that if you're using more than 2 breakthrough doses per day, it means that your long-acting dose is too low. From that perspective,I think 50 doses makes sense, but I'm just wondering if my PM is more conservative than others.

Last edited by mark76; 05-04-2008 at 12:54 AM.

 
Old 05-04-2008, 05:00 AM   #2
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Re: How much breakthrough medicine does your doctor give you?

I get 120 5 mgs for B/T oxycodones a month. I agree, your B/T med amount is very low. talk to your Dr about this.

 
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Old 05-04-2008, 05:07 AM   #3
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Re: How much breakthrough medicine does your doctor give you?

Yes it is a very low amount. I get two scripts of 60 each of 10/325 percocet.

 
Old 05-04-2008, 05:28 AM   #4
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Re: How much breakthrough medicine does your doctor give you?

My BT med is Percocet 10/325 and I only get 60 per month with no refills.

Last month I had 12 left over. So I think it really depends like you said on what your LA med is doing for you.

I had been Rx'd 3X per day which is 90, but I was having so many left over we figured out that 60 would be plenty. In reality, 50 probably would be enough for ME.

I just had another LA med reduction though and used a whole percocet yesterday. I had been able to get by on a half of 10/325. So, I'm having to get used to the decrease in my LA med. If I can't I may have to go back up to the Avinza 30mg. Guess we'll play that one by ear.

Good luck to you. My advice would be to communicate with your doctor about your pain levels. If you are continuing to have pain, in spite of your medications, then your medications are NOT doing what they are supposed to do. EXCELLENT communication is the key in PM.

Take care, and feel better soon.
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Old 05-04-2008, 06:14 AM   #5
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Re: How much breakthrough medicine does your doctor give you?

I used to get 90 of the 7.5 Lortabs per month for breakthrough, now my new doctor is much more conservative,

I am taking the methadone for pain, Which is giving me the best pain management I have ever had, Bar none, but he doesnt believe in 'breakthough meds' and will not prescribe them.

He told me if you need breakthrough meds, in his opinion you need a higher dose of your base med.

I cant complain, at this point I am doing so well, but I must admit I worry about what the future holds and what will happen to me if my pain spikes or I develope a new problem.

~Fabby

 
Old 05-04-2008, 07:00 AM   #6
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Re: How much breakthrough medicine does your doctor give you?

i get the same two per day as you are on(this IS all my PM will allow anyone per day), but that is a 28 day supply with getting 56 per month. unfortunetly after being on the only two 5mg per day for the past four years,i am now becomming tolerant to this and need to discuss my whole PM plan with my NP after my rotator cuff repair gets to the point where its more stable and i know what i am dealing with. i am also on oxycontin. what you stated about needing your base med raised if the two per day is not working for you,is pretty much the way they do things,or do in my PM too,but of course only to a certain point. if you were just started on this dose,you may need some adjusting yet. i went thru about two months of adjustments when i first started.

the bigger thing here is this working for you the way it is? if what you are on now is working or has brought down your pain to a more tolerable level then thats about where you should be with this. but,on the other hand,if you feel that your pain is still way too out of control still, i would speak with your PM. its not so much in what you actually get,its how well is it doing the job for you,ya know? marcia
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Old 05-04-2008, 07:15 AM   #7
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Re: How much breakthrough medicine does your doctor give you?

I don't think there is any set answer for this question. It really does "depend" on many inter-related factors: Your type of pain (some is worse than others), your tolerance, the strength of your base med, and of course, the philosophy of your PM Doc.

The last factor is where it gets dicey....Many Docs believe different things. However, one has to also remember that those treating pain today are anywhere from GPs to anesthesiologists. It's very clear that some Docs are specifically trained in PM while others aren't......Or maybe went to a seminar or two.

It think it was Spinal who talked about "communication" being the key, which I think is 100% accurate. However, I also realize that some Docs are much easier to talk to and are more accommodating than others.

In summary, I think when comparing meds (which we all have a tendency to do), it's best that we try to relay these other factors involved as well, especially our condition. As we all know, everyone's condition is not created equal.

Hope I haven't confused everyone.

Ex

 
Old 05-04-2008, 08:17 AM   #8
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Re: How much breakthrough medicine does your doctor give you?

Ex you stated it very well, yes we are all different what works for some doesn't work for others.
In response to orginal question i have hydrocordone 750 usually 60 for 3 months supply . I break them in half and always have left overs, sometimes 2 a day, but usually less. While my doc does not count i do bring it in and show him. I am having longer and longer good moments so I do think the patch/break through med combo is working for me .
Because of my multi conditions and regular labs, my nurologist accepts the labs from my other docs.
Good question op even if we are all different and different causations as to what brings us to this place.....

 
Old 05-04-2008, 11:18 AM   #9
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Re: How much breakthrough medicine does your doctor give you?

I very much agree with the concept of each person's PM being an individual thing. Everyone's pain issues are different and should be tailored to individual needs. Hence, proper communication being a necessity. I am lucky enough to have a PM who has a very open mind about narcotic pain meds and he listens to what my needs are and acts accordingly.

He is of the theory that LA or base meds, should be strong enough to cover the majority of a patient's pain, with minimal BT required. But, he also believes that even with appropriate LA doses, BT pain will occur due to activity, tolerance and possible worsening of a condition. So, treatment and prescribing are an ongoing process.

That being said, not every doc, as Ex said, has this philosphy. In cases where a particular doc has some hesitation regarding narcotic meds in general, my scenario may not be a possibility for everyone. It really all depends on whether your pain is manageable with the meds you currently have.

Take care, cmpgirl

 
Old 05-04-2008, 01:46 PM   #10
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Re: How much breakthrough medicine does your doctor give you?

I am perscribed 3 percocets a day so I get 90 a month. I also take 10mg oxycontin 1 in am 2 afternoon and 2 at night. I am going to change it though to 2-2-2 and probably drop on my bt percocets. I also agree communication is key! Good luck,

niap

 
Old 05-04-2008, 02:28 PM   #11
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Re: How much breakthrough medicine does your doctor give you?

I'm on 20mg. oxy 3x per day and my PM gave me 112 vicodin 500-5mg for breakthrough. He knows I hate vicodin so these will last for months. I filled this script on 3/7/08 and have barely made a dent in them.
Fred

 
Old 05-04-2008, 11:06 PM   #12
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Re: How much breakthrough medicine does your doctor give you?

Well I am on the fentanly patch and also get 120 5/325 Percocets per month. I was only taking 2 or 3 per day but now its 3 or 4 per day.

I did try to up my patch in hopes of getting the BT med down but that was very unsuccesful. This is because the side effects were too great and stopped me from doing it.

brian

 
Old 05-05-2008, 01:44 AM   #13
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Re: How much breakthrough medicine does your doctor give you?

Up until last month I had only been given 1 script of 25-5mg Endone from a previous Dr and one from the Hospital.
It sounds like it is a lot easier to get the meds you need in the U.S. but here in Australia you have to be rolling around on the floor crying before they will give you 1 script (in my experience anyhow). I only hope that my new PM Doctor is able to give me something or I have to go to emergency every time I get bad enough that I'm tearing up and white with pain. Not long back one Pain specialist in North Queensland was de-registered for writing to many narcotic prescriptions(even with the support of his disabled patients, protesting). So most Doctors here are very careful what they give out.
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Old 05-05-2008, 10:41 AM   #14
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Re: How much breakthrough medicine does your doctor give you?

I get 120 10/325 Percosets and also 5 mg oxycodone. This is my first month on Avinza 90. Usually I have a few left, hence the switch to the Avinza. I can't say that I am all that enthused about Avinza, but I haven't been on it a month yet, so I will continue to give it the old college try. I am using more breakthrough with it. I am hoping that it is just an adjustment phase that I am going through with it, but have a niggling feeling that it doesn't give the depth of pain management that I was getting from the morphine.

 
Old 05-05-2008, 11:35 AM   #15
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Re: How much breakthrough medicine does your doctor give you?

I just started mine last week. 10mg of Oxycodone ER every 12 hours and 10mg Oxycodone (5mg pill) every 4-6 hours for severe pain. It is not working. He gave me 120 of the 5mg and 60 of the ER meds. At the rate I am going, I will run out of the 5mg pills. I go back next week. He did say something about increasing the 12hr meds if they did not work. All I know is the pain is still unbearable.

 
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