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Old 05-05-2008, 12:26 PM   #1
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Does Anyone Know of a Non-Morphine Equivalent to Avinza??

Hi Folks, I have an appointment with my PM next month (I see him every 3 months now) and at my last appointment we were talking about my meds and doses and pain coverage, etc. I currently take Oxycontin as an LA med and Hydro as BT. He was talking about switching things up a bit and getting me on a higher dose of LA meds and less BT. Which I am totally on board with. The problem is, that I can't take Morphine Sulfate products. They make me feel like my head is going to explode, among other nasty side effects.

So, I was wondering if anyone here has ever heard of a non-morphine based equivalent to the Avinza. Also, if anyone is taking this new 24 hr med, are they having any luck with it?

Any and all responses would be greatly appreciated. If I can take fewer pills every day, that would be great. But I don't want to risk the pain coverage being compromised. Thanks and I hope everyone is having a good day. cmpgirl

 
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Old 05-05-2008, 12:52 PM   #2
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Re: Does Anyone Know of a Non-Morphine Equivalent to Avinza??

cmpgirl,

Sounds like things are gonna change, eh?

Lucky you.

The opioid closest to morphine is oxycodone, which you already take. May I ask why you are changing? Is it just to get down to fewer pills?

Anyway, the other opioid in the general vicinity is oxymorphone (Opana ER). Opana also comes in a SA version simply called Opana. Opana ER is dosed every 12 hours, and I don't know if the 12 hour window works or not (as compared to OxyContin which really requires 3x/day dosing). This drug is roughly 3 times stronger than morphine, but only about 10% of it makes it to your central nervous system, so it's tricky to prescribe, and folks tend to get severely under-dosed at first. Hopefully, if moved to Opana ER your doc will work with you to achieve the proper level of relief.

Of course, there's the fentanyl patch, which is dosed every 48-72 hours. I'm sure you've read plenty about it. It works great for lots of people, and really cuts down on the number of times one must "take a dose."

Other than Opana ER and the patch I can't really think of anything else that meets your requirements.

I'll keep my thinkin' cap on and if I think of anything else I'll let you know.

steve

Last edited by forginon; 05-05-2008 at 12:53 PM.

 
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Old 05-05-2008, 01:20 PM   #3
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Re: Does Anyone Know of a Non-Morphine Equivalent to Avinza??

Thank you Steve,

I do take the Oxy 3x/day now, and I know my doc wants to increase me from 20mg to 30mg, next month. I had just been reading an article about Avinza, and I saw that it is supposed to be this revolution in narcotic pain meds. If it truly works for 24 hours, that would be a really good thing for many with CP.

In answer as to why?.......I am not getting the best pain coverage right now....living at about an 8 most days. So, I need to do something. And my PM is fantastic. He is so open to treating my pain in the best way possible for me. If anything, I have been the one who has shot myself in the foot, so to speak. I have put off or turned down med increases in the past, due to the many reasons we all talk about here every day. I've decided to stop being foolish and take some of my own advice. Scary, huh?

So........that's what led up to this question. I would like to take fewer pills every day too. With the new BP meds, and the anxiety med, my pill-minder is too small to hold them all! I just thought I'd put a feeler out and see if anyone had any info.

Thanks again for the reply. I know I can always count on you and the others here. Hugs to you and God Bless, cmpgirl

 
Old 05-05-2008, 03:34 PM   #4
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Re: Does Anyone Know of a Non-Morphine Equivalent to Avinza??

The only non-morphine long acting med out there that has not been mentioned is Methadone. You might get really good pain coverage and possibly not have to take near the amount of BT meds, if any that you are currently taking. have you ever tried this before?

brian

 
Old 05-05-2008, 03:38 PM   #5
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Re: Does Anyone Know of a Non-Morphine Equivalent to Avinza??

cmpgirl,

I did take Avinza for s short time and found it to come short of the 24 hour mark. I also found it to be weaker than I had expected with the hype and all. I wound not recommend it.

Kadian is the other 24 hour morphine med. Haven't heard much about it. But that's not going to help you anyway because of your problem with morphine.

If I were in your shoes I'd just go up on the OxyÇ. It's almost a rarity these days to find a med that one has no problems with, except for possibly dosing. Since you do respond to OxyC, I'd stick with it.

For me, I wish I could go back to methadone. They switched me from it to MS Contin when they suspected the methadone caused my heart failure last year. Even though the cardiologist said I exhibited no cardiac-methadone related issues, my PM doc and my GP were too gun shy to stay with methadone. What a shame. It worked so well for me, and I was perfectly stable at 80mg per day. Now I take loads of morphine with nowhere close to the pain relief I got with methadone. Se la vie (sp?).

steve

 
Old 05-05-2008, 04:54 PM   #6
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Re: Does Anyone Know of a Non-Morphine Equivalent to Avinza??

Thanks for the replies.

Brian, No, I haven't ever tried methadone. I guess because I have had good luck with the Oxy, in terms of pain coverage. I was just hoping there might be an option out there, where I could actually take one LA med every 12 to 24 hours and actually have it last that long. (Unlike the Oxy) The only drug I had heard of recently, that is "supposed" to last 24 hours is the Avinza, and being Morphine, that would not be an option for me. Sadly, you can't always trust the pharm company's claims of longevity, as shown by the fact that Oxycontin does not last 12 hours.

The Opana ER sounds good in theory, but I am leary of trying it, only to find it is less effective than stated in the pharm. literature.

So, as Steve suggests, I think for now, at least until I hear some verification by an actual pain patient, that Opana lives up to it's hype, I'll stick with the Oxycontin and just let my doc increase my doses. It has worked for me thus far, so I guess I owe it that. Maybe someday, there will be that wonder of medical science but for now, I'll just have to buy a bigger pill minder! Maybe this time I'll go with shocking pink! (To match my effervescent personality!! )

I wish you all peace and relief from the pain, cmpgirl

PS.....If anyone has tried Opana, I'd still like to hear your experience. Thanks!

 
Old 05-05-2008, 05:03 PM   #7
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Re: Does Anyone Know of a Non-Morphine Equivalent to Avinza??

cmpgirl,

Even if you intend to stick with OxyC, you might just ask your doc about his thoughts concerning Opana ER. This might be helpful down the line in case you do consider something besides the OxyC. If he admits to some knowledge of Opana, you might take it a step further and ask him what his patients have reported about its coverage. If possible, and the opportunity presents itself, you might then mention that you heard (or read, if you have) that it has only a 10% bioavailability (how much reaches the central nervous system), and ask how he gets around that with dosing. Just a chance to learn as much as possible up front, if you and he are comfortable together with this kinda dialog.

steve

 
Old 05-05-2008, 10:20 PM   #8
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Re: Does Anyone Know of a Non-Morphine Equivalent to Avinza??

Quote:
Originally Posted by cmpgirl View Post
PS.....If anyone has tried Opana, I'd still like to hear your experience. Thanks!
hi all~
I just began opana er 10mg on a try out for LA relief. I have chronic jaw pain along with some pretty bad arthritis and had been treating with a doc who recently closed his practice due to a medical problem. I was extremely fortunate to get an appointment with a new PM doc.
I've been on oxycodone 30 mg 4x a day but have been waking up in pain every morning around 4 a.m. I've been on the opana now 2x a day (for about 3 wks so far) but I'm still waking up, and I don't feel any difference at all cumulatively.
I think he wanted to start me out slow, to see that I didn't have a bad reaction to it.
I had high hopes for relief but so far -no go-I shall report back though.

 
Old 05-05-2008, 11:03 PM   #9
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Re: Does Anyone Know of a Non-Morphine Equivalent to Avinza??

Quote:
Originally Posted by eyesworld View Post
I think he wanted to start me out slow, to see that I didn't have a bad reaction to it.
I had high hopes for relief but so far -no go-I shall report back though.
Thanks, it would be great to know how this goes for you. Are you currently taking any breakthrough meds? If so, what are they? I was able in the beginning to go down from 6 BT meds a day to 5, and we were hoping to decrease the BT even more by increasing the Ocy again. But for the last 2 weeks, I'm back to 6 BT.

Is the Opana supposed to be that much stronger than the Oxy? It just sounds so strange to go from 30mg. Oxy 4x/day to 10mg. Opana 2x/day. Maybe I shouldn't be comparing apples to oranges.

Thanks again, and please keep me posted. cmpgirl

 
Old 05-06-2008, 08:44 AM   #10
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Re: Does Anyone Know of a Non-Morphine Equivalent to Avinza??

Thanks John, At least it's good to know that one of the meds that is getting all the hype, is living up to it. I've been down that road of not nearly enough coverage for the pain in the past, and I guess I am spoiled by my current PM's diligence and understanding. I'm sure, if he's had patients who have had good luck with some of the non-morphine alternatives, he'll let me know.

Once you've been down that never ending pain road, you get a little gun shy about ever ending up there again. And after coming to this board and seeing all of the people who have been struggling for years, and still do not have appropriate care, or worse yet, have it yanked right out from under them, you get to really appreciate what you do have.

Thanks again. I'm not giving up hope! Take care, cmpgirl

 
Old 05-06-2008, 11:04 AM   #11
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Re: Does Anyone Know of a Non-Morphine Equivalent to Avinza??

Hey Cmpgirl,

I was on Opana ER 10mg, and I didn't get any pain relief at all...I was taking Oxycodone IR 30mg every 6 hours and I wanted to try the Opana to cut down on the amount of pills that I was taking everyday, but I had to continue taking the Oxy every 6 hours anyway, because the Opana provided no relief at all.

I did, however, notice extreme fatigue while on the Opana and as a result, I didn't want to increase the strength until the fatigue got better...I took it for almost 1 month and the fatigue never went away, so I decided it wasn't worth it to me to continue taking it, so I'm still taking the Oxy IR every 6 hours...My pm won't rx Oxycontin or I would have preferred that to the Opana in my quest to reduce the number of pills I take everyday.

I began the Opana in 2006, right after it became available, so I didn't know if my experience was unique, but I've done some research on it since and I haven't heard of many people having good results with it. Of course, you may have better results, but I'd make sure you have plenty of break through meds available, just in case

 
Old 05-06-2008, 11:43 AM   #12
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Re: Does Anyone Know of a Non-Morphine Equivalent to Avinza??

Thanks Sammiejoe, I appreciate the honest critique. I am sorry your doc won't Rx the Oxycontin. Luckily, I at least have that. Are you seeing a PM doc? Or is it your primary or surgeon who is Rx'ing?

One of the many things I am grateful for, is that my PM is very open to all modalities of pain management. He actually teaches other PM's, which is a blessing in itself. At least the ones he is teaching will not come away from their education, with a closed mind.

He has promised me that whatever we decide for a long acting med, he will not leave me without sufficient BT meds. When he upped my Oxy to 3x/day, he didn't actually take any BT away from me. I did that on my own. It's just that now, after 9 months, it's back to all of them most days, so it is time for something to change. I can live at a 5 or even a 6, but 8 and 9 are not cutting it.

Hopefully, you can find a doc who will treat your pain with compassion. I don't know exactly how long you've had chronic pain, but I would think, from your post, it is not new for you. Take care and thanks for the info, cmpgirl

 
Old 05-06-2008, 10:03 PM   #13
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Re: Does Anyone Know of a Non-Morphine Equivalent to Avinza??

Quote:
Originally Posted by cmpgirl View Post
Thanks, it would be great to know how this goes for you. Are you currently taking any breakthrough meds? If so, what are they? I was able in the beginning to go down from 6 BT meds a day to 5, and we were hoping to decrease the BT even more by increasing the Ocy again. But for the last 2 weeks, I'm back to 6 BT.

Is the Opana supposed to be that much stronger than the Oxy? It just sounds so strange to go from 30mg. Oxy 4x/day to 10mg. Opana 2x/day. Maybe I shouldn't be comparing apples to oranges.

Thanks again, and please keep me posted. cmpgirl
I'm still taking the Oxycodone 3omg 4x a day + the opana er 10mg 2 x a day. What I'm hoping for is somthing that will keep me smooth as the oxy really only dulls my pain for @2 hours at a time-I feel like a bouncing ball-I was hoping the opana was going to carry me through without the drops-I have a lot of confidence in my new PM doc-I'll see what happens at my next appt.

 
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