Is it just me, or does oxycontin not even last 8 hours? - Pain Management Message Board

mark76 · 05-19-2008, 04:54 AM

Most recently, I was on 15 mg twice a day, and I felt like the oxycontin worked for a few hours and then left me without pain coverage for the rest of the 12 hour period. My PM suggested that we try three doses (so 10 mg three times a day -- same total daily amount) and then titrate up. At this stage in my PM experience, I'm trying to minimize my medications even if I'm left with a good amount of pain (I realize that this is not always the smartest pain control approach, but I know it's easier to start low and go up high then the other way around -- just my personal view for myself at this point). Anyway, I was surprised to see that the 10 mg tablet did take just enough edge off the pain. Unfortunately, it only lasts for about 4 hours. I understand that LA medicines often work only 8 instead of 12 hours, but it puzzles me how sometimes the tablets seem to work only 4-6 hours.

At my next appt, my doctor is going to suggest we up my dose to 15 or even 20 times 3 times a day in order to get good coverage all day long, but I'm wondering if as a preliminary step, I could try 10 mg * 4 times a day. Has anyone had dosing this frequent on Oxycontin? 10 mg * 4 times a day is 40 mg total, still less than the 45 mg from taking 15 mg three times a day. So is my PM likely to find my 4 times a day dosing schedule to be totally outside the PM norm?

ms_west · 05-19-2008, 07:24 AM

I take mine 4 times a day. In the past it was helpful but right now it is hard for me to tell because I am in a big flare for the last 3 weeks.

Executor · 05-19-2008, 07:35 AM

I was on OC for several years and it didn't work very well. Started @ 2x, went to 3x...Never tried 4x because 3x didn't work well.

My PM Doc, an anesthesiologist, said he doesn't think it's anywhere near a 12hr drug. He thinks 8 @ the most. Since going on the patch, I have had remarkable improvement and don't even know it's on. The patch gives you very precise dosing each hour 24/7. Many who are on the patch don't need BT meds. Everyone is different though.

You might try 4x. I've also heard that Opana works much better than OC, but I haven't tried it.

Good luck.

Ex

cmpgirl · 05-19-2008, 08:09 AM

Mark, First, It depends on the person and how their body metabolizes opiates/opioids. In most cases with LA meds, a short acting or breakthrough med is used for breakthrough pain. You haven't mentioned whether you take a BT med.

Second, Almost everyone I know who takes Oxy, concurs that it does not last the full 12 hours that the pharmaceutical companies claim that they do. This being said, with the addition of the BT meds, they should stretch out to 7 - 8 hours of coverage.

I have heard of Oxycontin and other like meds being dosed 4x/day for some. It usually depends on 1) How the doctor feels about doing so and 2) if the insurance company (if applicable) will allow or approve it. My PM doc had to obtain authorization to increase my Oxycontin to 3x/day and has to renew this authorization every 6 months.

I would discuss this at length with you doctor and see what he wants to do. I hope this helps a little. Take care. CMP

gregar · 05-19-2008, 11:01 AM

I was started on 30mg twice a day. That didn't work at all so my doctor raised it to 30mg three times a day. After a week of that I realized it wasn't working as well as the doctor wanted it to work (he didn't want me to have to take BT meds unless I did something bad to cause it). So he had me try 40mg three times a day and said if that didn't work to try 30mg four times a day.

A little back ground (before taking the oxycontin I was on 50mcg fentanyl patch which worked well to kill the pain but caused lots of other issues so I had to stop using it). My doctor later told me that because I was on 50mcg of the patch that we had room to up the dose of oxycontin to around 110-120mg but wanted to start me out at the lower dose and then raise it as needed. The 40mg three times a day still didn't work. Just like you I don't seem to get the second release of the oxycontin so we settled for 30mg four times a day. But to be honest this still doesn't work as well as the patch. At best my pain is down to 2-3, I know I shouldn't expect to have 100% pain reduction but with the patch that is exactly what I had.

The worse part right now for me is my doctor has told me he is at the max level of pain med management he is comfortable doing, if I need more, then I'm going to have to start seeing a PM doctor that does nothing but manage pain meds. I really don't want to do that. With the issues I had with the last specialist, him giving up on me and handing my PM med management back to my GP because I wouldn't let them operate on my back (50/50 chance it would work, 20% it would make things worse and only a maximum of nine months relief from the operation was not good enough for me to let them operate).

Anyway, sorry for rambling. Maybe oxycontin isn't the right med for you, I'm thinking it isn't the right one for me but I'm too afraid to change now. I would suggest talking with your doctor if you can. Let them know that for some reason it seems like the time release mechanism that is used for the oxycontin doesn't seem to work for you.