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Old 02-14-2010, 02:24 PM   #1
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Possible change from Vicodin to Oxymorphone NEED HELP PLEASE!

Why would my PM doctor want to switch me from Vicodin 10/325 to Oxymorphone ( I dont know how many mgs.)?
I never told him the Vicodin wasnt working. I did tell him that I eventually would like to try and slowly get off of the Vicodin because I have been taking it for about 2-3 years and am afraid of becoming addicted. I take on average 4 Vicodins per day. Lately in the last 2 months however it has been 5 or 6 Vicodin per day. I never heard of Oxymorphone, and I do not know anything about it. Can anyone please tell me about it or their experiences with Oxymorphone? Is is stronger than Vicodin? My PM doctor said I would only have to take 1 Oxymorphone every 12 hours. I am very nervous about this possible change. He did not tell me anything at all about Oxymorphone. He is a very good doctor though.
Thanks, Joe.

Last edited by Cowpin8; 02-14-2010 at 02:26 PM.

 
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Old 02-14-2010, 05:58 PM   #2
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Re: Possible change from Vicodin to Oxymorphone NEED HELP PLEASE!

Oxymorphone, aka Opana comes in both IR & LA forms. Your doctor is thinking about putting you on the LA form if he says you will take it once every 12 hours.

Hydrocodone (Vicodin) & oxymorphone both break down into the same metabolites/chemicals in your body as well.

One of my former PM doctors tried me on Opana, and unfortunately it did nothing for my pain at all. I might as well have taken a sugar pill. It is also at the top tier of co-pay with my insurance, so I paid a hefty sum for medication that didn't work.

Having said that, I can not tell you it won't work for you just because it didn't for me. It may work for you since everyone responds to medications differently. You will need to be patient & allow it time to build up to the proper BPL in your system though. This is also one of those meds that sometimes has to be titrated up to the correct dose.

Keep checking back because I know of other people here with CP that have taken Opana too. I have heard that this med was highly touted to be the absolute 1 dose per day medication that would last the 12 hours, but so far, I've not seen anyone who has said it actually lasts the full 12 hours either.

I hope it works for you! Your doctor is probably wanting to get you away from the IR, short acting meds and get you on an LA med since you are a CP'er. Many PM doctors use LA meds with maybe a SA medication only for BT pain, so this is what it sounds like your PM is thinking about trying.

Last edited by ozzybug; 02-14-2010 at 06:01 PM.

 
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Old 02-15-2010, 08:54 AM   #3
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Re: Possible change from Vicodin to Oxymorphone NEED HELP PLEASE!

My PM was going to switch me from Perc (7.5 ) to either Vicodin 10 mg OR Opana or Nucynta for my BT pain( sticking with hte MS Contin for LA ).. I chose the Nucynta to try as she thought it had properties to help with radiating pain. My question was WHY go down a peg. At least your Doc was going UP the ladder. I think these Docs get worried about sticking with one med for too long or something

 
Old 02-16-2010, 08:46 AM   #4
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Re: Possible change from Vicodin to Oxymorphone NEED HELP PLEASE!

My doctor did something similar with me. Vicodin (hydrocodone) was the only thing really giving me any relief at the time. But my pain was increasing and I was taking 6-7 10/325mg per day.

I believe when you start taking that many per day (over 4 or 5) most PM doctors will switch you to a long acting medication. This is for a couple reasons: 1) it is not great on your body to be taking tylenol every day. 2) A long acting narcotic will keep your blood plasma level evened out and this will help not only your pain spikes, but also your emotions. Ex can explain this in more detail.

I was on OpanaER for about 4 months and unfortunately it did not help my pain. I was then switched to another long acting narcotic, Kadian....and this helped me pain much better. I was still taking short-acting medications (break-through meds), but my dr completely took away my Vicodin and gave my oxycodone (it has no tylenol). That combination seemed to be ok and I was happy to give up all that tylenol I was taking.

I hope this helps some.
Jdsun

 
Old 02-16-2010, 10:33 AM   #5
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Re: Possible change from Vicodin to Oxymorphone NEED HELP PLEASE!

I really hope it helps because the Vicodin 10/325 works fine and I NEVER have taken more than 5-6 per day. I also NEVER asked my PM Doctor to give me more, or to increase the dosage.
Is there any acetominophen or ibuprofen or aspirin in Oxymorphone?
If not, then How does it work against pain? What is in it exactly?
I am definitely nervous about taking this stuff. I remember when I had my Neck surgery in 2005 the nurse was giving me Morphine intraveneously, and I was BEGGING the nurse to stop because it completely knocked me out (literally) and when I woke up I had the worst headache imaginable. My head hurt so bad I would have preferred to be dead. I pray to god this Opana doesnt cause that to happen. Any more experiences would be appreciated!!!
Thanks guys +girls, Joe.

 
Old 02-18-2010, 12:04 AM   #6
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Re: Possible change from Vicodin to Oxymorphone NEED HELP PLEASE!

I am going to be taking 20 mgs. of Oxymorphone (Opana) every 12-hours regardless of my pain level at the time of the next pill. I am currently taking Hydrocodone APAP 10/325 as needed for pain. I take about 6 each day. Usually I take 1.5 Vicodin at a time. (One and a half)
Can anyone tell me what to expect? What is the diffence going to feel like?
Please any stories or experiences will be greatly apporeciated. I will be starting this new drug on Friday, February 19th and I have never taken Opana before. I am a little nervous of the effects of Oxymorpone. Is 20 mgs a lot?
Thanks, Joe.

 
Old 02-18-2010, 12:02 PM   #7
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Re: Possible change from Vicodin to Oxymorphone NEED HELP PLEASE!

Cowpin,
I've been on Opena ER 40mg every 12hours now for last 7 mos. I educated myself well before agreeing to taking this newer approved drug. Its Oxymorphone which is one of the stronger analgesics. The FDA banned most forms of it years ago but recently approved the Opana version because of its time release system which cannot be "broken." As I've learned over the years this is what the drug abusers apparently do. IE - crushing it up to inject or whatever the heck they do. They want to get high by getting around the time release of the med. (These are the Bast*rds that make us legit cronic pain patients have to go above & beyond to get the help we need - but thats another entire post) Anyway, the time release system in Opana is suppose to be unbreakable, no matter how they try to get around it, which probably why its growing in popularity in PM field.

BTW, I've mixed results but mostly positive with Opana ER. While its suppose to be 12hr med, I find it at times it comes up a few hours short for me, but everyone can be different. They also say to take it on an empty stomach, but I found taking it with a little food helped me get more relief. One huge nice difference is that you actually do get pain relief without the groggy or "buzzed" feeling which can drive ya nuts, especially after waking up without the "cob-web head" feeling. There is also no drifting off to "la-la land" type sensations you get with some pain meds. I suppose the "unbreakable" time release system and the non-"High" pain relieve is why the FDA approved the new drug and why more and more PM docs are prescribing it.

I would recomend giving it a try to see if it helps. I've read & heard much feedback from people getting tremedous relief to others getting limited. Like all pain meds, everyone is different. For me, if I had something for BT to go with it for the really bad days, it would be the perfect pain med for me. Unfort, for whatever reason, my PM doc does not believe in BT meds. If I had something for the BT pain on those bad days, I'd say that combined with the Opana would rank up with the better meds I've tried over the last 18yrs.

My doc started me out on low levels and work up the dosage. Keep in mind it can take several days until the levels in your system get up to where they need to be, so don't give up on it quickly, stay the course to know exactly how and if it helps you. Good luck & let me know how you make out.
KurtAS

 
Old 02-18-2010, 07:25 PM   #8
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Re: Possible change from Vicodin to Oxymorphone NEED HELP PLEASE!

I took my first dose (20 mgs.) about 4 hours ago. Im still alive. I did fall asleep for about 2 hours. I personally dont think the 20 mgs. is going to last 12 hours. My head hurts a tiny bit. 2 out of 10.
Thanks, Joe.

 
Old 02-19-2010, 06:13 PM   #9
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Re: Possible change from Vicodin to Oxymorphone NEED HELP PLEASE!

Joe, I have been on Opana 20mg 2x a day with percocet (I am allowed 4 a day) for breakthrough pain. I am so, so happy with the opana. Besides a little constipation which I now take prune juice with cetricel for and that works GREAT.

I DO think having something for breakthrough pain is important. I also do NOT drift off with the opana. I can function, even drive.

I hope that I will be able to continue with this drug. It IS a very, very strong narcotic, much stronger than oxycontin, I am told. If you need to, you can certainly add some over the counter tylenol to take with it, if you feel you need it. I DO think tylenol adds good pain relief, so that is what I would do.

Please let us know how you are doing as you go along..
I wish you the best
Madison

 
Old 02-22-2010, 11:01 AM   #10
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Re: Possible change from Vicodin to Oxymorphone NEED HELP PLEASE!

I switched from Percocet to Opana a few months ago. As the DR described to me, and I have read.. Opana is what your liver makes after digesting a percocet. It works great for me, but lately I've been getting very agitated on it.. just one pill makes me clench my teeth, horrible headache and makes me want to lash out at people. I see my PM DR tomorrow, I'll be asking for something else. But it did help the pain. And it is similiar in pain relief to percocet.. for me anyway.

 
Old 02-23-2010, 09:45 AM   #11
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Re: Possible change from Vicodin to Oxymorphone NEED HELP PLEASE!

The Opana 20 mg. every 12 hours seems to be helping the pain. I would only say that I think I need 25-30 mg. every 12 hours. I dont know if they make a 25 or 30 mg. pill. Opana makes me tired for the first 2-3 hours, then after that I am perfectly fine. I do not feel loopy or high or euphoric at all. It is completely different than Vicodin. Opana feels like more of an actual medication, not just a quick acting drug like Vicodin. Vicodin olny lasted 3-4 hours for me and made me feel weird. My only hope is that their is no negative effects from Opana. I currently do not feel any side effects. I know this is going to sound stupid, but I also have depression (I take Zoloft) and since starting the Opana about 1 week ago my depression feels a lot less. I know it sounds crazy but its true, its helping with my depression.
Any information or experiences about Opana (Oxymorphone) would be greatly appreciated. I love reading other peoples stories and experiences.
Thanks again, Joe.

 
Old 02-23-2010, 01:20 PM   #12
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Re: Possible change from Vicodin to Oxymorphone NEED HELP PLEASE!

Quote:
Originally Posted by Cowpin8 View Post
. I know this is going to sound stupid, but I also have depression (I take Zoloft) and since starting the Opana about 1 week ago my depression feels a lot less. I know it sounds crazy but its true, its helping with my depression.
.
I think EX could answer this better, but I will try. When I was on vicodin, I would get major mood swings. When I first took my pill, I would feel fine, but then about 3 hours later, I would feel very moody and irritated. I didn't even realize how bad I was feeling until my doctor put me on a long acting medication (Kadian 1, every 12 hours). He also put me on Zofran. What the long acting meds do, is even out your blood plasma level. Meaning....you have a steady stream of narcotics in your system. So, every time my vicodin wore off, not only did my pain increase, but my mood worsened. I was on a roller coaster of emotions.

So, I am thinking that the Opana is doing what my long-acting med did, and is keeping your pain and your emotions even.

I am happy to hear that you are getting some relief. Hopefully the tiredness will go away after a few weeks.

Jdsun

 
Old 02-24-2010, 12:25 AM   #13
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Re: Possible change from Vicodin to Oxymorphone NEED HELP PLEASE!

Quote:
Originally Posted by jdsun View Post
I think EX could answer this better, but I will try. When I was on vicodin, I would get major mood swings. When I first took my pill, I would feel fine, but then about 3 hours later, I would feel very moody and irritated. I didn't even realize how bad I was feeling until my doctor put me on a long acting medication (Kadian 1, every 12 hours). He also put me on Zofran. What the long acting meds do, is even out your blood plasma level. Meaning....you have a steady stream of narcotics in your system. So, every time my vicodin wore off, not only did my pain increase, but my mood worsened. I was on a roller coaster of emotions.

So, I am thinking that the Opana is doing what my long-acting med did, and is keeping your pain and your emotions even.
Yes, Jdsun is correct....Since the Opana is working on controlling your pain, you are realizing many positive benefits overall....Everything from less pain, to feeling better, to less stress on your body, to more consistent hormone production, & etc. Simply put, it's working and doing it's job, so you feel better overall.

CP puts a lot of stress on the body. When the body fights the stress, all sorts of things can happen and your body basically goes into a total tailspin.

Glad to hear you're feeling better.

Regards,

Ex

 
Old 02-24-2010, 12:42 AM   #14
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Thumbs up Re: Possible change from Vicodin to Oxymorphone NEED HELP PLEASE!

I've posted this in another thread I am sure... In my mind a good responsible PM specialist will cycle your LR & BT meds when they notice your tolerance getting too high... mine currently cycles my LR med between methadone and MS-CONTIN (lr morphine) and my BT med between percocet and instant release Morphine...

As others have said your body metabolizes different opiates different ways. Rotation lets your tolerance drop in relation to one med as it builds up tolerance to another. Then once your tolerance is down for the first set and up for the second set, they cycle you back. And your opiate specific tolerance reverses back to your original path after its been reset. Sometimes they use 3 different types of pain meds to cycle through, each set metabolizing differently.

I've had outages of meds due to my doc not assigning anyone to cover my case when he went on vacation one time and being snowed-in unable to get to a pharmacy a second time. Both times I experienced intense pain, irritability and a desire to stay in bed with my heating pad.... symptoms which can be directly attributed to my condition but I suppose if someone was stubborn enough they could argue they were withdrawal symptoms??? Only way to prove it would to go without the pills for a month or two until the meds were completely of my system and I still had the same symptoms.

Personally, I think medication rotation is the reason I didn't have any other symptoms one could only attribute to withdrawal, there by actually diagnosing drug withdrawal.

Just my 4/25ths of a bit (think about it )
MP

Last edited by Myofascial Pain; 02-24-2010 at 12:47 AM.

 
Old 02-24-2010, 10:43 PM   #15
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Re: Possible change from Vicodin to Oxymorphone NEED HELP PLEASE!

Oxymorphone has actually been in use for decades, just not in an oral version. The Iv stufff used in the hospitals is the brand name Numorphan. All they have done is created an oral version.

The idea of LA meds is to reduce the need and impulse to reach for the bottle which perputautes tolerance and the roller coaster that short acting meds cause. Oxymorphone is in the exact same family has hydrocodone, oxycodone and Hydromorphone. There all synthetic opiates with the same characteristics and side effect profile. There is no tylenol or motrin in any long acting meds and some oral long acting meds last 12-24 hours. So 2 hours into the first dose isn't really a rair shake at how long it truly lasts. The more remarkable thing about oxymorphone is that is much weaker when given in oral form. The IV conversion from morphine is 10:1where the oral conversion is 3:1. meaning your body metabolizes oral morphine much more effeciently than oxymorphone.

Your paying a specialist to treat you, there is nothing wrong with educating yourself but that is part of what your paying your doc for. The How it works? just like any other opiate. It binds to opiate receptors and provides pain relief along with all the symptoms most experience from any opiate.

He's switching you because it doesn't make sense to treat long term pain that you say is 24 hours a day with a short acting med, you end up always chasing the pain and it's much easier to keep pain in check than to bring a high level down.. You shouldn't have the constant ups and downs with LA meds which prevents People mistaking the high or euphoria from when SA med kicking in 20-40 minutes after a SA is taken with actual pain relief and not feel satisfied untill that warm feeling rushes over your body. LA meds are designed to slowly onset and slowly wear offf, making it easy to maintain a constant serum level. It also breaks the habbit of reaching for the pill bottle at the first sign of any change in pain. The more they can seperate addictive type behavior from simple pain management the better off everyone that truly neeeds and truly practices PM we will be.

Nobody stays on SA meds for life, It was just a matter of time untill he switched you to one of the LA meds and since there are only a handful to choose from, Opana is going to be some docs first pick.

Good luck and the intial side effets of any drug change often wear off when given a fair chance. Because there are so few LA meds, I would give it a fair shot and not simply give up because it feels different or takes a week for the drowsiness to deminish. Your body will get used to this and this is simply how pain managemnet works. It's trial and error with both med and dosage.

There is also a black box warning regarding drinking alcohol and using opana LA, The alcohol breaks down the time release mechanism which can result in an OD, so I wouldn't even mess with nyquill or any liquid cough med without thouroghly reading the label. It is a stronger med, but that's why your taking less mgs per day. Hope that answers most of your questions. Good luck, Dave

 
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