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Old 08-18-2008, 07:02 PM   #1
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Help with difference between Dilauded and Percocet...PLEASE

Can anyone give me information on the difference between Dilauded (Hydromorphone) and Percocet (Oxycodone). Which is stronger and would work better for post surgical pain?

 
Old 08-18-2008, 08:03 PM   #2
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Re: Help with difference between Dilauded and Percocet...PLEASE

Kmit,

It's really hard to compare one class of opiate/opioid to another. A lot depends on the dosages you are dealing with. Also, they are 2 different classes of opiates. Kind of like comparing apples to oranges.

One converter says that 4mg. of dilaudid is equal to 10.67mg. of oxycodone. So, if a person was being given a choice between 8mg. dilaudid or 10mg. percocet, the dilaudid in this case would be stronger.

Hope this was what you were looking for. Take care, CMP/MM

 
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Old 08-18-2008, 08:43 PM   #3
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Re: Help with difference between Dilauded and Percocet...PLEASE

Yes, as Cmpgirl and Jon have pointed out, it can be difficult to compare when taking into account different strengths. For example, Dilaudid is about 3 x stronger than Oxycodone (Percs), so if you take 10mg of Dilaudid vs 30mg of Oxy, they are roughly equal. However, Oxy can become stronger if taking a higher dose.

As a very general rule, the spectrum goes like this:

OTC Tylenol, Motrin
Codeine (Tylenol # 3) Schedule III
Hydrocodone (Lortabs, Lorcet) Schedule III
Oxycodone (Percs, Tylox) Schedule II
Hydromorphone (Dilaudid) Schedule II
Morphine IV
Fentanyl (Actiq, Fentora, Patch) Schedule II
Fentanyl IV

There are also morphine pills that are somewhat equal to Oxy and Dilaudid. Because morphine has poor bioavailability (30%) when taken orally, you must take more to equal less of the others. But, when taken IV (such as post op), it's very potent.

This is a very rough scale, and isn't always true when factoring in doses.

Hope this gives you a general idea.

Regards,

Ex

 
Old 08-19-2008, 08:11 AM   #4
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Re: Help with difference between Dilauded and Percocet...PLEASE

Dear Ex,

I was not aware that Dilaudid came in 10 mg! Is that in pill form or what? The reason I ask is that I feel--at some point--I might need this! My physician, who is usually very aware of most items of this nature, doesn't seem to know of the 10 mg Dilaudid mentioned in your post. While I think the world of my doctor, your knowledge and opinions mean a great deal to me!!

So, I'm anxiously awaiting your response.

Sincerely,
Jon (Conductor)

 
Old 08-19-2008, 09:32 AM   #5
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Re: Help with difference between Dilauded and Percocet...PLEASE

I'm already on a fentanyl patch, 50mcg/48hrs., so I need to make sure that coming out of the surgery my pain will be able to be managed. One more question if I don't get any pain relief from Morphine IV, would that transfer into not getting pain relief from Hydromorphone (Dilauded)?

I read in one online med article that Dilauded doesn't last in your system as long as Percocet, so that may be an issue also. I took Dilauded last year after a kidney stone removal surgery, while I had a stint in, but can't really remember how well it did.

 
Old 08-19-2008, 09:46 AM   #6
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Re: Help with difference between Dilauded and Percocet...PLEASE

Hey Kmit,

I think when one is having surgery, it is crucial to speak directly with the anesthesiologist of recored, and make sure they understand that you are a chronic pain patient and are opiate tolerant. If you let them know exactly what meds you take and especially the strengths, they can make sure that your surgical pain control and your post-op pain control are appropriate to your specific needs.

It's also a good idea to make sure that the recovery room staff is aware as well. My sister-in-law had a bad experience one time, years ago, because nobody knew she was already opiate tolerant and tried to control her pain as if she were just any other patient. Her husband ended up tracking down her PM doc and having him talk to the recovery room staff and the surgeon so they would order up and dispense the proper amount of meds for her. She has made it a point to make sure everyone is informed and on board before any other surgeries she has had, and it has worked out fine for her, ever since.

When is your surgery? I wish you the best of luck with it. Take care, CMP/MM

 
Old 08-19-2008, 05:57 PM   #7
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Re: Help with difference between Dilauded and Percocet...PLEASE

Quote:
Originally Posted by conductor View Post
Dear Ex,

I was not aware that Dilaudid came in 10 mg! Is that in pill form or what? The reason I ask is that I feel--at some point--I might need this! My physician, who is usually very aware of most items of this nature, doesn't seem to know of the 10 mg Dilaudid mentioned in your post. While I think the world of my doctor, your knowledge and opinions mean a great deal to me!!

So, I'm anxiously awaiting your response.

Sincerely,
Jon (Conductor)
Sorry if I confused you. No, it doesn't come in 10mg....I didn't mean to imply that it did, but I guess it came across that way. I was simply using the dosage as means of comparison since it is a nice round number. Conversely, if I had used 8mg and then gave a 3-1 ratio example, it would come out to 24, which is in between two OC dosages....So, that's why I used 10mg.

Some do take 10mg, but they combine dosages of course.

Again, I'm sorry....I really didn't mean to suggest it came in an individual strength of 10mg.

Regards,

Ex

 
Old 08-19-2008, 07:00 PM   #8
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Re: Help with difference between Dilauded and Percocet...PLEASE

Not always i was on fen patch 100mg by 48 hr then Avinzer 120mg a day both did not much for my pain. Was put on 4mg dilaudid and Vicks es for breakthrough and finaly relief. Just had surgery was put on dilaudid IV of .2mg every 6 min did absoluty nothing. the wrong order was writen and nobody wanted to change it. came home next day went on 24mg Dilaudid for 1 week and the moved to my regular dose and all is good. Now down to 2 mg 3x a day. Cant stress importance of post op meds Speek to your PM and your surgon and have them speek to the shift nurse make sure they are all on same page. I had a terrible time and I spoke to them but surgon did not understand my tollerance to these drugs. Make sure they know your tollerance

Last edited by xlc12295; 08-19-2008 at 07:01 PM.

 
Old 08-19-2008, 08:10 PM   #9
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Re: Help with difference between Dilauded and Percocet...PLEASE

Cmpgirl,

Yes, my 3 Surgeons, and PM doc have met together and are on the same page and I will meet with the anethesiologist on Thursday after the pre-op stuff and make sure he is aware of the chronic pain stuff along with the 10 meds I take daily, my surgeons have also been in contact with him. My questions have mainly been directed for the pre-op discussions for my main surgeon as he is open to discussion regarding what works best for me as far as pain control and he will take all that in consideration with the meds I'm already on. My surgery is on Monday, a distal tibial tubercle osteotomy, basically they're going to reconstruct my knee and tibia, 1-2 nights in the hospital, then home.

 
Old 08-19-2008, 09:40 PM   #10
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Re: Help with difference between Dilauded and Percocet...PLEASE

Hey Jon, They don't make a 10 mg dilaudid pill, I believe exec was just using 3:1 as an equianelgesic comparison. The FDA electronic orange book is a great sight for what is new, who's making it and what dose.

KMIT, Things like poor bio availablity are acounted for in equianelgesic charts. The conversion from morphine to dilaudid is very different when using it IV Vs oral. The same holds true for Oxymorphone, It's much more potent when used IV, 10 times more potent than morphine, but when used orally it's only 3 times more potent than morphine.

From personal experience with post op pain, I would choose IV dilaudid over morphine any day, but once you get home and IV meds aren't available, I haven't found an oral dose of dilaudid that even came close to managing BT pain where I can with morphine, oxymorph or Oxycodone. Funny, Dilaudid works fine in my pump but I would never chose it as an oral. Morphine also works in my pump, It just takes more mgs per hour. What's stronger is more dose related than anything. Being on the strongest med on an equiangesic chart doesn't gaurentee anything if the dose isn't right.
Take care, Dave

 
Old 08-20-2008, 06:42 AM   #11
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Re: Help with difference between Dilauded and Percocet...PLEASE

Quote:
Originally Posted by Shoreline View Post

KMIT, Things like poor bio availablity are acounted for in equianelgesic charts. The conversion from morphine to dilaudid is very different when using it IV Vs oral. The same holds true for Oxymorphone, It's much more potent when used IV, 10 times more potent than morphine, but when used orally it's only 3 times more potent than morphine.
Good point...Dave said it better than I did. This is why the question is so hard to give a definitive answer.

Regards,

Ex

 
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