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Old 04-11-2010, 09:18 PM   #1
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long-lastinr break-through medication

Hi there, in your experience, what breakthrough medication lasts the longest? I've been taking oxycodone for about 1.5 years. The only problem I have with it is that when my pain is worse than normal, I find that it doesn't last 4 hours until I can take it again. I am already taking a long-acting medication (Kadian). Some days it is enough, but I need the BT medication about 4 -5 days out of 7. My doctor has suggested trying immediate-release morphine sulfate, but I'm concerned that it will be even shorter-lasting than the oxycodone. What have you found?

 
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Old 04-11-2010, 11:57 PM   #2
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Re: long-lastinr break-through medication

Toonces,

Everyone metabolizes medications differently, personally hydrocodone does nothing for me.

My concern about you switching to MSIR, is that you already have a tolerance to morphine from the Kadian.

You might get some more pain relief if you stop driving off cliffs...

~Myo

 
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Old 04-12-2010, 09:00 AM   #3
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Re: long-lastinr break-through medication

Hey Myo, Unfortunately unless you have Hydro compounded the dose will alwaysds be limited by the amount of apap in each tablet. I would simply discuss the problem with your doc. Duration is the first sign of tolerance, It's still working, just not as long. I don't know when the right time to ask for an increase is, but Oxy comes in strengths up to 30 mgs per dose. Personally I think oxy is the longest lasting compared to oral morphine and dilaudid. The only thing else might be opana. That did seem to last a little longer and it's in he same family of synthetic opiates as oxy, but it did make me feel very diferent and dopey where oxy didn't. Due to cost and being name brand only may be enough reason not to try it, but your doc knows what's out there. He just needs to know what's going on to do anything.

Whether he does make a change at your next apt or simply notes your complaint is entirely up to him, he may want to see if your tolerance progresses past the very first sign. He may want to seee if the the change n weather helps and may suggest doing something for your general well being now that it's spring. There isn't a right or wrong they to do at the first sign of tolerance, how your doc treats you or what he prescribes is entirely based on what you communicate and his own comfort level with the meds he's prescring already

I have never seen a med that truly gave 4 hours of relief in my life as far as short acting meds and I've had a lot of surgeries and procedures long before long acting meds were invented. After any surgery making anything last 4 hours was a nightmare. 3-3.5hrs was more realistic and often docs would order 3-4 hour dosing knowing they simply don't last that long.Then their are docs that would order 4-6 hour dosing as if they never had surgery themself. Which I'm sure they hadn't.
Good luck, Dave

 
Old 04-12-2010, 03:30 PM   #4
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Thumbs up Re: long-lastinr break-through medication

Quote:
Originally Posted by Shoreline View Post
I have never seen a med that truly gave 4 hours of relief in my life as far as short acting meds and I've had a lot of surgeries and procedures long before long acting meds were invented. After any surgery making anything last 4 hours was a nightmare. 3-3.5hrs was more realistic and often docs would order 3-4 hour dosing knowing they simply don't last that long.Then their are docs that would order 4-6 hour dosing as if they never had surgery themself. Which I'm sure they hadn't.
Good luck, Dave
Toonces,

Unlike Shoreline, I actually have had great success with percocet and MSIR lasting 4 hours. I have been able to work an 8 hour shift (one hour lunch) with the help of BT meds to get me through the day. I just know it typically takes 30 mins for my body to metabolize so I have to set my alarm clock 30 mins earlier. So say I take my med at 4 am it kicks in at 4:30 am and I can rely upon it to last until 8:30 am but I know that I have to take another dose at 8 so it can metabolize by 8:30 am and last until 12:30 pm so again I make sure to take my dose at 12 pm. Then I take my final dose at 4 pm knowing my 12 pm dose will wear off at 4:30 but last me til 8:30, 30 mins after I've gone to sleep at 8 pm so I can wake up at 4 am the next day.

I did this consistently for 7 months at my last job which was from 8 to 5 with a 2 1/2 hour commute by mass transit each way, until I was promoted and could afford to move closer to work.

~Myo

Last edited by Myofascial Pain; 04-12-2010 at 03:31 PM.

 
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