Hello- I am new to this forum but have been pain mgmt. patient for 4 years now. Have been on MS Contin 30 mg 3 times per day with Norco 10/325 for breakthrough pain (max 5 per day). After same meds for 4 yrs, they have stopped working as well as they once did, so Dr. suggested I switch to something new for breakthrough pain, because he did not want to increase MS Contin. Just prescribed 4 mg hydromorphone (dilaudid), 1 every 6 hrs, 4 per day. I thought this would be so much better and I wouldn't really have side effects, since the dilaudid is also morphine derivative, but I can't stand them. They don't seem much stronger to me at all, and they must affect different receptors in the brain as well, because there is absolutely NO 'feel-good' (not that I really received that with Norco after a while, but I certainly felt when they were working, and the pain subsided as soon as they entered my system). If anything, I am moody, and other than the first day with dilaudid, they make me tired as well. I work over 40+ hrs a week and cannot afford to be either moody OR tired. First day I took (4 days ago) the new meds, I was VERY hyper and had insomnia as well. After that, they had the complete opposite effect. Has anybody else had bad luck with dilaudid, even after being on MS Contin? I think I am going to ask to switch back to the Norco again, even if they are 'weaker'. Just hate the way I feel on them. I must add that I was taking 2 Norco spaced further apart rather than 1 every 4-6 hrs, because after 4 years, it was no better than taking an aspirin. Feel stuck! Please reply back with any opinions on the dilaudid and/or Norco. Thank you!
The Following User Says Thank You to Sara6556 For This Useful Post: jl5541 (07-23-2011)
Hi There. I didn't switch from Norco to dilaudid, but I did try to switch from 10mg oxycodone to 4mg dilaudid and it didn't work for me either. The dilaudid did not have the same level of pain relief, and I ended up going back to the oxycodone for break-through pain. When I had dilaudid in the hospital IV after my last surgery, it worked awesome for my pain. However, when I took it in pill form, it didn't seem to relieve my pain well. I also would be afraid that it wouldn't last 6 hours. I tried it for about two weeks before switching back. Good luck!
While you might think that dilaudid would be "way" stronger" than norco, the truth is in pill for they just don't have the same effect as they do IV.
Many people switching from Hydrocodone or Oxycodone to dilaudid experience the same thing as you did which is "wait a minute I though these things were supposed to be so much stronger and they really suck for pain releif".
I also experienced the same thing myslef after being on Oxy and Morphine for many years. We did tried to put diluadid into my meds for better relief and it was just the opposite. I think the best time to prescribe diluadid is when you are opiate naÔve.
But just as suspect there is another side to the coin and that is after being on norco for so many years, you are experiencing the transition phase. The diluadud affects different receptors as you suspect and you are no longer filling the receptors which the norco affected, so likely you are experiencing a slight withdrawal as the newly affected receptors adjust.
So with time you will probably find that the diluadid may work a little better than you initially thought, once you get over the transition process which can take up to a month for your receptors to adjust.
I think you like myself and most people probably will and got better pain releif from the norco, even once your receptors adjust to the transition. So here's my important advice, if you are going to switch back, you need to do so soon, because the longer you take the diluadid the greater the chance you will have a slight withdrawal effect from those and feel the same effect when you try to transition back to the norco.
So call your doctor bring in your pills and tell him, thanks but no thanks. If you really want to try something stronger, your doc should have tried oxycodone Immediate release for your breakthrough versus the diluadid.