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