Shoreline

Hi Leslie, Although you may tolerate dilauadid better because Hydrocodone breaks down into hydromorphone before being eliminated. Dialuadid has a short half life, the long acting version isn't available in the states although it's purdues puppy, you may be disapointed with the duratiuon of action with opral dilaudid.It has a very short half life and duration when taken orally.

Have you considered a trial of intrathecal medication, You can limit some side effects because meds delivered to the intrathecal space are 300 times more potent. However IT meds also have their own unique set of side effects. Urinary retention is one but you have a choice of medication that can be used as long as it is preservative free. Morphine can be used, Dilaudid can be used, any of the Fenatnyl's can be used along with adding numbing meds and Baclofin for spasm.

Oral baclofin requires whopping doses to work where it's much more effective when deliverd IT. Once you run the gammit of all opaites IT pump may be the next step.Other meds can also cause urinary retention, specifically valium and muscle relaxers.

Hydrocodone can be formulated into a long acting version by a compounding pharamcy. Your doc just has to write the compounding instructions. Obviously it's more expendsive than a med he can take right off the shelf but it is an option.

When you compound a pure hydro product it becomes a class 11 med so all the restrictions would apply as far as no refills and a new script being needed each time. It's actually compounded with Dextromathorphan to increase it's duration and effectiveness. One of the folks that I know had this done used a combinitaion that created a 100mg LA hydro capsule and was taken 3 times a day with pretty good results aside from the cost of having a med specially compounded for you. It's a thought if you can't find another med that works.

As far as side effects, they all have them. Even a med like Hydro that you had luck with at lower doses could cause the same urinary retention when you reach higher doses and add dex to the mix.

Methadone is another option but it also has it's own unique set of side effects. You may have to accept some of the side effects and try dealing with them with adjunctive medication. Phenergan is a rather safe way to deal with Nausea, it's actually an antihistimine so it will also help with itching that all opiates can cause.Visterill is another antihistamine option for nausea and itching.

Hope you find the right med for you. Take care, Shore