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Old 02-01-2010, 06:04 PM   #1
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oxycodone/dilaudid equivalents

Hi there. Can anyone direct me to where I can figure out what the equivalent dose of dilaudid would be when compared to 7.5 oxycodone? I'm making the switch today for BT pain and it doesn't seem to be working very well. My doc said 7.5/325mg percocet is equivalent to 2mg dilaudid, but she didn't seem really sure of it when she told me. She had to really think about it and talked it over with herself for about 2 minutes. thx

 
Old 02-01-2010, 11:42 PM   #2
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Re: oxycodone/dilaudid equivalents

Quote:
Originally Posted by Toonces1 View Post
Hi there. Can anyone direct me to where I can figure out what the equivalent dose of dilaudid would be when compared to 7.5 oxycodone? I'm making the switch today for BT pain and it doesn't seem to be working very well. My doc said 7.5/325mg percocet is equivalent to 2mg dilaudid, but she didn't seem really sure of it when she told me. She had to really think about it and talked it over with herself for about 2 minutes. thx
She got pretty close. It's actually equal to 2.8, or rounding to 3mg. This may not seem like much, but Dilaudid is very potent, so a little bit goes a long way. However, when transitioning to a new med, it's always best to be a bit conservative because you never know how you'll react to a new med. So, 2mg is probably a good start.

During a transition once, I had nicely complained about how the transition dose wasn't quite right and my PM told me that he'd rather me be uncomfortable than dead. He said that in 25 years of PM and various surgeries and etc., that he's never killed anyone. That conversation put things in a different perspective for me re: transitions.

Best of luck to you and I hope your pain responds to the new med.

Regards,

Ex

 
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Old 02-02-2010, 12:51 AM   #3
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Re: oxycodone/dilaudid equivalents

Quote:
Originally Posted by Toonces1 View Post
Hi there. Can anyone direct me to where I can figure out what the equivalent dose of dilaudid would be when compared to 7.5 oxycodone? I'm making the switch today for BT pain and it doesn't seem to be working very well. My doc said 7.5/325mg percocet is equivalent to 2mg dilaudid, but she didn't seem really sure of it when she told me. She had to really think about it and talked it over with herself for about 2 minutes. thx
i wouldnt switch to dilaudid; it was my experience oxycodone worked better ask your dr to consider mscontin for long term relieif w 10/325 percocet for breakthru pain; it has helped me.

good luck

 
Old 02-02-2010, 05:01 PM   #4
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Re: oxycodone/dilaudid equivalents

thanks. I am already taking kadian 50 2x/day for long-acting relief, the dilaudid is intended for breakthrough pain. She didn't to seem to want to go to 10/325 on the oxycodone, not sure why. Prior to about a month ago it had been working pretty well for me (taking 2 - 7.5/325s).

Okay, so how long would you give it before you called your doc? I'm only on day 2, but I can tell you right now that this is not going to reduce my pain enough. I would say it takes me from an 8 to a 7.5.

 
Old 02-02-2010, 10:25 PM   #5
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Re: oxycodone/dilaudid equivalents

Quote:
Originally Posted by Toonces1 View Post
She didn't to seem to want to go to 10/325 on the oxycodone, not sure why. Prior to about a month ago it had been working pretty well for me (taking 2 - 7.5/325s).
Who knows what quirk she has over the med. Some Docs can be funny about certain things. Maybe she felt that a change was needed to a different chemical to give your receptors a break. There can be some merit in such rationale. However, if something is working and it's simply a tolerance issue, then usually a small bump in dose is a no brainer.


Quote:
Originally Posted by Toonces1 View Post
Okay, so how long would you give it before you called your doc? I'm only on day 2, but I can tell you right now that this is not going to reduce my pain enough. I would say it takes me from an 8 to a 7.5.
I'd give it one more day...That way you can say you gave it a several days and it doesn't look like you jumped the gun at the first sign of trouble. I would certainly call before the weekend and in fact, that would be part of my pitch.....I'd say something like "I've tried this for several days now and it's just not working....It seems to be getting worse and my pain is building....And with the weekend approaching, I really just want to feel better.".....Something like that.

Best of luck to you and please let me know how it goes.

Regards,

Ex

 
Old 02-02-2010, 11:14 PM   #6
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Re: oxycodone/dilaudid equivalents

Using a search engine you can calculate any narcotic just type in: dosage equivalents for narcotics. good luck

 
Old 02-05-2010, 12:47 PM   #7
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Re: oxycodone/dilaudid equivalents

Those tables are called, Equianelgesic tables. You have to remeber that these are just guides and I would bet if you pulled 3,entirely different guides you would see quite a bit of variation. The idea is to switch you safely, comfort isn't the primary concern. Some also have you factor in cross tolerance percentages. Not sure you know what someones level of cross tolerance is? But don't get stuck on a number. Personally, I would choose dilaudid for IV post op pain med. I have dilaudid in my pump, But I use Oxy for BT pain. When taken orally, dilaudid/hydromorphone simply isn't as strong and doesn't last as long. The conversion for IV use is very different than oral use. For instantce, when comparing to IV morphine, Dilaudid is about 7.5 times stronger than morphine, But when compared orally the ratio is about half that. For whatever reason, even taking higher doses than any table suggested, I simply don't get relief from oral dilaudid. I actually took a 60 pills back and watched them flush them in order to switch back to oxycodone.

The bottom line is you really won't know untill you try and go through the titration process. If it's just your BT med, You shouldn't be relying on BT to provide the bulk of your relief. If your pain is consistantly that high with your long acting med, It would make more sense to look at the LA med dose instead of what you use in case of an emergency or BT pain. That's what BT meds are actually for, Not to supplement the long acting every 4 hours.

In stead of talking about what med or what dose you want, it might be better to talk about your overall level of pain. If your at an 8 all the time, the problem isn't your BT med. If it's generally a 5 Maybe you shouldn't wait untill it hits an 8 to take BT meds. The higher the level of pain the harder it is to get in back down. LA meds are used for that exact purpose. There are more factors involved than what's the math conversion from A to B. No doc knows how you are going to repond when they start you on a new med, so starting low is the only safe thing to due. I do hope it works out for you, but give your doc a little credit as far as knowing what he is doing.
Take care, Dave

 
Old 02-05-2010, 07:30 PM   #8
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Re: oxycodone/dilaudid equivalents

Last December, I went thru a rough patch (and still am) and my PM added oral Dilaudid to my LA Oxy and Percocets I already take. Well, I should have just taken them back like Shoreline did because they had no effect on my pain what so ever. I thought that it was just me until I read this post and saw bama and Shoreline with the same experience. I hope it works better for you, Toonces....Janiee08.

 
Old 02-10-2010, 03:51 PM   #9
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Re: oxycodone/dilaudid equivalents

"Personally, I would choose dilaudid for IV post op pain med. I have dilaudid in my pump, But I use Oxy for BT pain. When taken orally, dilaudid/hydromorphone simply isn't as strong and doesn't last as long. The conversion for IV use is very different than oral use. For instantce, when comparing to IV morphine, Dilaudid is about 7.5 times stronger than morphine, But when compared orally the ratio is about half that. For whatever reason, even taking higher doses than any table suggested, I simply don't get relief from oral dilaudid. I actually took a 60 pills back and watched them flush them in order to switch back to oxycodone."

I told my doc I would take Dilaudid because it worked REALLY well for me post op in July. It was like .1mg drip every 10 minutes and I had virtually NO pain. I was in heaven as I was expecting this surgery to be really bad. It is not working for me now though in pill form.

I'm pretty good now about knowing when I need to take the BT medication. I used to wait too long. Now I know all the signs that I'm going down-hill and when the pain will just hover around a 6-7 (which I can tolerate if it's almost time for bed).

My doc is going to call in darvocet for me tonight. What should I expect? I don't think I had heard of this before, and I work with drug addicts often, so I have heard of a lot.

I was taking 2 tabs of 7.5 oxy before. Ultimately, I will go back to the oxycodone if this doesn't work.

 
Old 02-10-2010, 10:26 PM   #10
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Re: oxycodone/dilaudid equivalents

Darvocet is what I started with when I began this chronic pain journey. Ex will know more, but I believe it is @ the weakest end of the spectrum in terms of narcotics. It does contain tylenol and a very mild narcotic. An old medical book I have considered it a non-narcotic; but they have classified it as a narcotic in the past 20 or so years. I don't think that you could even compare Darvocet to two 7.5 of Oxy; the Oxy is wayyy stronger....janiee

 
Old 02-11-2010, 10:00 AM   #11
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Re: oxycodone/dilaudid equivalents

He's going from Oxycodone to Dilaudid to DARVOCET?! Something is very wrong with this picture.

 
Old 02-11-2010, 10:16 AM   #12
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Re: oxycodone/dilaudid equivalents

Wow- I agree with the comments about the Darvocet. I've had Darvocet before, after a dental procedure, and ended up throwing it away because it didn't touch the pain. I got way more relief from Advil, so took that to help the pain when the Darvocet didn't work. My dentist said he would write a scrip for some vicodin, but since the Advil was keeping the pain manageable, I declined. This was years ago, before I was a PM patient, so my body wasn't even accustomed to having opioid pain meds and the Darvocet did nothing, so that should tell you something.

IMHO, going from Dilaudid to Darvocet is a huge step down. Give it a try and see how it goes, maybe it will help.

Take care!

 
Old 02-11-2010, 06:17 PM   #13
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Re: oxycodone/dilaudid equivalents

HMMM...

Well, lucky for me I didn't need any BT medication today, but I don't know what I'm going to do when I do need it. I have a few oxys left in case I need them, but...

I kind of think my doctor was focused on what she could call in. I told her I could make it a few days with what I had left. She was talking about darvocet being metabolized differently and blah blah blah. I had never heard of it so I didn't know what to ask.

BTW - it's 100 propoxyphene (or whatever it's called) and 650 APAP, which means if I take 2, I'm taking 1300mg of tylenol? Isn't that too much at once? My dad died of liver disease so I'm a little sensitive to the tylenol thing.

I have a feeling I'm going back on the oxycodone.

 
Old 02-11-2010, 09:19 PM   #14
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Re: oxycodone/dilaudid equivalents

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Originally Posted by janiee08 View Post
Darvocet is what I started with when I began this chronic pain journey. Ex will know more, but I believe it is @ the weakest end of the spectrum in terms of narcotics. It does contain tylenol and a very mild narcotic. An old medical book I have considered it a non-narcotic; but they have classified it as a narcotic in the past 20 or so years. I don't think that you could even compare Darvocet to two 7.5 of Oxy; the Oxy is wayyy stronger....janiee
Janiee is right....Darvocet is the lowest rung on the ladder. It's not even listed on most narcotic conversion charts. It's lower than codeine. It's used a lot for arthritis in older people....It has a little more punch than Tylenol....And when combined with Tylenol, it can be good for chronic minor pain.

Regards,

Ex

 
Old 02-11-2010, 09:29 PM   #15
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Re: oxycodone/dilaudid equivalents

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Originally Posted by Toonces1 View Post
I kind of think my doctor was focused on what she could call in. I told her I could make it a few days with what I had left. She was talking about darvocet being metabolized differently and blah blah blah. I had never heard of it so I didn't know what to ask.
That may have been because she wanted to supplement with something until the next time she saw you...i.e could call something in. You're right about the "blah blah blah"....That's about all it is. Quite frankly, Darvocet shouldn't even be an Rx.

In fact, a big stir was created about 6 months ago when an FDA committee recommended that it be taken off the market. Their reasoning was that the drug proposed much more risk than what it provided, which is little pain relief. The FDA board declined to adopt the committee's recommendation, but the whole subject got some press for about a week or so. I'm sure you could find the articles via a search.


Quote:
Originally Posted by Toonces1 View Post
BTW - it's 100 propoxyphene (or whatever it's called) and 650 APAP, which means if I take 2, I'm taking 1300mg of tylenol? Isn't that too much at once? My dad died of liver disease so I'm a little sensitive to the tylenol thing.

I have a feeling I'm going back on the oxycodone.
Yes, it's 1300mg of Tylenol. If you've got liver disease in your family then it would be very prudent to watch your intake, just in case. In fact, there are 100% oxycodone products out there....Called Oxy IR. Comes in 5mg, 10mg, 15mg, 20mg, and 30mg. They contain no Tylenol. You are probably a candidate for the 10mg Oxy IR.

I'd think about telling her that you talked to your pharmacist about the Tylenol and your family history and he said to make sure that you told your Doc. I would also tell her that's when the pharmacist mentioned that there is a 100% Oxycodone product without any Tylenol. Things like this go over much better when you tell Docs they came from the pharmacist vs you found it on the internet.

If the Oxy worked best, make sure your formulate your words to where she knows without a doubt that it was the best by far.

Best of luck to you.

Regards,

Ex

 
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