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Old 03-25-2011, 08:16 AM   #1
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Opana ER 30mg & no relief? Odd?

I've been switched to the Opana ER. However, I'm not finding ANY relief w/it and I know at 30mg, I should - well, I think. Is there any possibility that the med. is old or something? Anyone else found Opana ER to be ineffective? I'm confused. I've read great things about it and I'm not prone to complaining, but this is odd. Went from Embeda to Opana, fyi. Thanks to all that respond!

 
Old 03-25-2011, 09:31 AM   #2
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Re: Opana ER 30mg & no relief? Odd?

Same with me. Almost a week into the change but I am noticing relief. I think it just takes time

 
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Old 03-25-2011, 07:06 PM   #3
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Re: Opana ER 30mg & no relief? Odd?

Oxymorphone (Opana) has a low oral bioavailability at around 10%, very low. Which means when taken orally oxymorphone is poorly absorbed. Some people I am sure find it works for them and may also have a slightly higher absortpion rate, but the average person is around 10%. Don't get me wrong Oxymorphone is a very, very, very, potent drug when used intravenously in a hospital setting, but not so much orally which might be why your not responding to it.
Oxycodone is absorbed very well orally at about 80% which is very high. This is one of the reasons Oxycontin works so well for alot of people. Along with the other Oxycodone base meds including Percocet, Oxy-ir, Roxycodone, etc. Also this is probably one of the reasons why drug addicts started using Oxycodone because of it's high oral bioavailability, which allowed them to take it orally and still get high without having to inject it.
Drugs like Fentanyl are not absorb well at all orally. This is why it is used in a patch form (Duragesic). As well as in a lollypop (Atiq) that is rubbed around the inside of the mouth in order to be absorbed through the mucous membranes of the cheek. Also a fentanyl effervescant buccal tablet (Fentora) used mainly for breakthrough pain, which works similiar to Atiq, except you put it in the top part of your mouth between your cheek and let it absorb. Also injectable forms, but nothing that you actually swallow, again because of the very low bioavailability.
Another is Buprenorphine (Suboxone, Subutex) which is also very poorly absorbed orally. This is why it is used sublingually (under the tongue). Which makes absorption rate alot higher. It is also used in a patch form for pain (Butrans). Injectable forms are aslo available.
Methadone also has a very high absorption rate as well. These are just some examples of some of the drugs that have high and low absorption rates.
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Old 03-25-2011, 07:20 PM   #4
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Re: Opana ER 30mg & no relief? Odd?

The bioavaliability is taken into account when formulating the tablets though - the tablet contains a dose 10 times higher than would be given by injection, to make up for the difference in bioabaliability - I doubt thats the asnwer.

If might e tjat the individual has an especialy poor adsorbsion of tis particular drug, and would be better to try somthing else, however, you cant condem oxymorphone across the board based on low bioavaliability.

Penicillin oraly has low bioavaliability, but it has been curing infections by mouth for 60 years, because the dose is adjusted to compensate for this.

For this individual patient, it would probably be wise to change to a diferent LA med and see how that goes - Oxycontin, MS Contin etc.

Why did you stop Embeda btw?
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Old 03-25-2011, 09:12 PM   #5
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Re: Opana ER 30mg & no relief? Odd?

hi shawn-(frazzled) dont mean to hijack the thread but i use opana ER 40mg too; with poor results-but i also am using opana IR 10mg for bt and get good,long lasting relief-why would the opana IR 10mg give better relief than the 40mg ER? do you know the absorption or success in relief for brand name Kadian? the opana er also give me headaches and i had percocet10mg for bt-now just take the opana ir 10mg and no headaches so i am convinced it was the 40mg ER-and not taking percocet 10mg either-thats how well the IR 10 mg is working for me
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Old 03-26-2011, 04:47 PM   #6
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Re: Opana ER 30mg & no relief? Odd?

I'm on Opana 15mg ER 3x daily. I found that they did next to nothing for me which got me into a jam with my PM doc cause I was taking the BT meds (percs) just to get through work. They are switching me to MS Contin 15mg 3x daily next wednesday so my fingers are crossed. But for me Opana was very expensive and not work it. So I literally FEEL your pain. I don't know much about bioavailabilty but this stuff sucks.
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Old 03-26-2011, 04:54 PM   #7
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Re: Opana ER 30mg & no relief? Odd?

Same here 15mg 3x daily. No relief. PM switching me to MS Contin this week. Hoping for the best. Cause the Opana sucks.

 
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Old 03-26-2011, 09:58 PM   #8
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Re: Opana ER 30mg & no relief? Odd?

Opana-

It can be hit or miss. When I first started 10mg b.i.d. after I got tired of the anxiety and revved up buzz of OxyContin, the Opana didn't seem to be there at all..... It took a couple of weeks to adjust.

Once I retrained my mind not to expect the Oxy side effects I realized that the Opana was working -it was just cleaner. Currently I'm taking 10mg t.i.d. which has worked well for me.

The 'Contin' (Oxy)and the 'TimeRX' (Opana) release mechanisms are partly to blame. Many that take the 'new' Oxy OP claim it is awful..... Less so with Opana's system which is superior, but most still tend to prefer the IR versions.

Anyway, to help get the most of Opana ER; take with fatty meal + Hydroxyzine and you will increase the bioavailability and augment the effectiveness.
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Old 03-26-2011, 10:13 PM   #9
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Re: Opana ER 30mg & no relief? Odd?

Just an FYI for Maryland,

If Opana is somehow malfunctioning greatly, I suppose you could claim that you are getting the same, or more relief from MS-Contin. However, the facts of potency tell us that Oxymorphone is at least 3 times as potent as Morphine.

So, if your Doctor is keeping your dose the same with your new MS-Contin, you will be absorbing a substantial dose reduction.

Morphine has so many side effects that it may seem to be doing something with your pain that Opana wasn't but the reality of potency can't be ignored.



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Old 03-28-2011, 01:06 PM   #10
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Re: Opana ER 30mg & no relief? Odd?

Any ideas other than MS Contin then? I'm brand new to this PM thing so I try to do my homework but it gets so overwhelming. All I know is the payment for Opana was like a car payment and my ins. will cover MS Contin for $7. So no brainer for the $ side these days but if MS Contin isn't gonna kill the pain, I am very open to suggestions of other LA opiates if thats allowed on this board.
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Old 03-28-2011, 04:03 PM   #11
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Re: Opana ER 30mg & no relief? Odd?

Hello Friends,

First Thing is-
The Opana Website has a voucher worth 25$ off each script for a year. I've been using mine for 4 months now and my out of pocket is down to 33$ with the voucher. Not too bad.

Secondly, when my voucher runs out I will ask my Doc to write me for the generic IR Oxymorphone which will cost me only 12$.

Oxymorphone is one of a few Narcotics that is naturally long lasting even in IR form, perhaps 5-7 hours. Hydromorphone (Dilaudid) is very short acting, as little as 2 hours. Make your script TID (Three times day) and you will be well covered. I found TID much more flexible -allowing me to put off my 3rd dose of the day and use it late night as a 'sleep dose' when needed.

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Old 04-28-2011, 03:00 AM   #12
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Re: Opana ER 30mg & no relief? Odd?

I tried it for a month and it seemed to numb my memory a bit, but did nothing for my pain. I actually thought the drug may have been a placebo, it was that bad (fyi, it wasn't). My Dr. said it may be a metabolism issue, but I'm beginning to think that what works for some, but finding the right combo isn't easy!

 
Old 04-28-2011, 03:05 AM   #13
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Thumbs up Re: Opana ER 30mg & no relief? Odd?

Quote:
Originally Posted by Isotope View Post
Just an FYI for Maryland,

If Opana is somehow malfunctioning greatly, I suppose you could claim that you are getting the same, or more relief from MS-Contin. However, the facts of potency tell us that Oxymorphone is at least 3 times as potent as Morphine.

So, if your Doctor is keeping your dose the same with your new MS-Contin, you will be absorbing a substantial dose reduction.

Morphine has so many side effects that it may seem to be doing something with your pain that Opana wasn't but the reality of potency can't be ignored.



Iso
Yes, you're right and after Embeda 30, Opana 30, he quickly wrote MS 30, after a mess about the Exalgo (ins. etc). I don't think he was thinking as he was in a hurry. I need to go back, I suppose... but don't know if I can or how a PM will act about it. Only been with him since Dec. and we've changed meds monthly (except for the first). I don't know how to calculate the conversion. Numbers not my strong point! All the best and thanks for the info!

 
Old 04-28-2011, 03:13 AM   #14
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Re: Opana ER 30mg & no relief? Odd?

I've never heard of Kadian, but I'm going to look it up. Thanks for sharing!

 
Old 04-28-2011, 03:20 AM   #15
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Re: Opana ER 30mg & no relief? Odd?

I stopped it because it wasn't working at all. It was strange. All others have at least done something. I tried it for a month, but no luck. I had no ill side effects though, other than the norm w/PM. My Dr. said the same - metabolism issue w/me possibly. But how in the world would one get that tested?

 
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