Well, generally speaking, I don't get bent out of shape over many things in life ..... But for some reason, this just hit me wrong. As soon as I got home from the doc I immediately started researching Exalgo .......after reading post after post ( from different sites ) I believe I just panicked .....the first 15 or so comments Talked about how expensive it is , it made everyone sick , it's worthless, on and on ....... Looking back , I probably over-reacted ...I forgot to put on my " Internet filter glasses " .....( not believing everything we read on the wide wide web ) ok thanks for settling me down .... Shuuuu weeeeee Ha ha ! Rich
You know we all have those moments....they kinda go hand in hand with the "I'm really sick and tired of having to do this" moments.
You do have a choice here, if Exalgo is expensive or it does make you sick you can stay on Opana, there really isn't much difference in the two and your Dr. should be aware of that fact.
If you wanted to try something different out of that whole ballpark of meds, you could try just regular Morphine, it's not expensive, it's always in stock, don't see alot of people complaining of harsh side effects, and you can get it in LA or SA.
Don't be afraid to tell your Dr. what you want to do, or what you would like to try, it's your body, your wallet, and your the one dealing with the pain while driving back and forth to the pharmacy, not him.
And don't worry about the occasional over-reaction....I think we're allowed to do that every now and again, considering what we have to go through on a daily basis!
A few months ago I switched from taking Oxymorphone to Dilaudid. I think the conversion charts are overly optimistic with regard to the Hydromorphone. I was started at 12mg/day but I ended up needing 4mg/6x/day = 24mg to achieve the level of relief that I was getting from Oxymorphone 5mg/6x/day = 30mg. After a couple of months I switched back to Oxymorphone (much better) and just used my left over Dilaudid as a back up BT med.
If you thought Opana was hard to find, and/or expensive, Exalgo will be a similar circumstance, or worse.
I really didn't want to switch .... From day one I have not had one bit of trouble with Opana ...... The problem ??? No one has it !! The past 3 months have been a nightmare. It's funny... The drug reps tell my Doctor there is no problem ... All issues have been resolved .... But the pharmacists say ...... "we don't have it .... And we can't get it " .... So I had to have some sort of backup plan.... I just got a call from Rite Aid .... My Exalgo is ready .... So, tomorrow will be " day one " ..... Also , I'm wondering why my Doctor has prescribed 2 of the most expensive PM meds on the market .... Why not give something cheap ? He has repeatedly said , " they are all basically the same ...... " guess I'll find out ....
Thanks again for your help ... I appreciate you guys ( and Gals )
Rich. ( I'll let ya know how it goes this week .... Exalgo is a " once every 24 hrs med " .....that will be interesting !!! Ha ha ! Ha ha !
Hey man .....well, you called it brother !! ( Iso ). ... Here's where we stand ....if I want to stick with Opana , I'll have to wait until mid August ( according to the head person at Rite Aid )
My doc put me on Exalgo ( as mentioned in the earlier post ) AND , as you predicted ... I can't get it !!! ( it's on back order ?.. COME ON people !! ) .....AND, my Doctor is getting ready to go on vacation...... This is so sad, it's almost funny ( SAD, that I find myself in this situation ) ......So, I'm going to try this .....( tell me what you think )
Instead of 2 Opana per day ... Go with one in the AM ....then 1 Percocet every 5-6 hours ... I have 39 pills ( Opana ) ?? Then , heck , I really don't know what to do ....
What do a think Iso & Kat ?
Very simply. Get generic Oxymorphone. It will last nearly as long as Opana. I have taken both, I actually prefer the generic, it's cheap, it's easy, they can get it quickly, you can dose it any way you need to.... 10mg/6x/day, or 20mg/3x/day... It gives you options. You can easily drop your dose over time if you want or need to do so, you can split pills etc...
I've done some digging around and researching. It seems that a few months ago Opana became pain Dr.'s new favorite med, it's being prescribed alot, the demand is more than the production. Also, Endo Pharmaceuticals has just revamped the formula for Opana to make is safer and not so easy to abuse. Similar to what Purdue did with Oxycontin a couple years back. During this switch over period there will be limited quantities while they clean out old stock and get the new formulation on the shelves. So that's whats up with trying to get it.
If your going to change meds you need to decide tonight and get with your Dr. before he goes on vaca.
Trying to do it yourself and take some of this med, a little of that is never really a good idea. If your on a Pain Management Contract it's really not a good idea.
If you've been getting good pain coverage from 2 doses of Opana a day, switching to 1 Opana and a few Percocets each day most likely is not going to give you the same coverage and your getting the added extra daily acetaminaphen.
Switching to plain Oxymorphone would be one alternative, it's just not Long Acting, so you take it throughout the day, which you don't have a problem with. The med in itself seems to work ok for you so that shouldn't be a problem.
Another alternative would be to get out of that group of meds and switching to something like Morphine, it's LA and SA, not expensive and always in stock.
Unfortunately it's got to be your choice, what works for me or Iso, may not work for you, the 3 of us have very different kinds of pain. You have 17 days of Opana (39) left, it might be best to stay on that, since you know it works, until your doc gets back from vaca, provided he'll be back in that time frame.
Can't thank both of you enough ...... One added note ( complication ) Remember in my earlier post ??? I mentioned my Doctor put me on Exalgo 12 mg ?? Well, The guy at Rite Aid said , It's been ordered .... Now , if it comes in soon ..... I'll need to make another decision if I'm going to " start this med " , knowing I'm not going to stick with it .... I already know it's going to be expensive and hard to get .... Gosh !!! Nothing seems to be going my way on this deal .... I hate to put my body through " Opana, then Exalgo , Then something else , ?? The Pharmacist said I didn't have to take the Exalgo , if I didn't want it ....they would just put it their stock .... Hummmm So .... sounds like I need to get with my Doctor ...soon ( per our last appointment, he was rather emphatic that he wants me on Long acting meds .... But, we'll see
The pharmacist is correct, he can just restock with the Exalgo when it comes in, they won't force you to take it. Don't do anything that your not comfortable doing. Meet with your Doc and you and he figure it out.
The reason he wants you on LA meds, is because you've been on LA meds for quite a while, and if you go down to SA meds it's going to be difficult to keep your pain under control, unless your pain has gotten alot better since you started, and I don't recall you mentioning that it had.
There may be some docs out there that are in cahoots with the drug companies to push there meds or whatever, but all pain docs are not like that. Most of them are actually thinking about your welfare and what will work best for you. When chronic pain gets to a certain level for anyone, it's hard to keep it manageable with short acting medication. Your body is constantly trying to play catch up from the last dose to the next, and it just can't get ahead of the pain.
But for you, as for any of us, when it comes down to it, it's our bodies we have the final say. If you want off the LA meds for your own reasons, talk to your doc about it. If you do go down to just Percs or SA Morphine or something like that, ask your doc for just the narcotic med, you don't need all that tylenol everyday taxing your kidney's and liver. Percocet without tylenol is Oxycodone.
Well my friends.....what a terrible day .....I won't re-post my story ...but here's the deal..
I was on Opana 30 ER. .... Obviously , most folks know by now, we can't get the drug.....so my Doctor put me on Exalgo ER 12 mg .....I've used Perocet 10/325 or BT pain.....
OK OK ...... After some insurance issues, ( all resolved now ) I got the new drug yesterday.
SOOOOOOO today was D-Day for me ..... I woke up, took the Exalgo pill ....( it's a once every 24 hour med ) ......for 7 hours, I had stomach cramps .....not unbearable but none the less , THERE ....my bowels have alo been screwed up ..... Wow , I have felt like a truck ran through me ..... It's been awful .... I'd hate to see how my body would react to eliminating opiates ...... It's very troubling because Exalgo is a cousin of Opana ( Oxy vs Hydro ) .....finally at 3 pm I took a percocet ...... All those issues disappeared .....
It's been a real learning experience ...... Dealing with this crap .... And also dealing with legal matters concerning my Dad's passing ... Shuuuuuu weeeee it's a lot to handle .....
Thanks again everyone
Rich
Sorry bud, sounds like your definitely going through it. Might help to take some OTC pepcid and/or gasx with the Exalgo until your stomach gets used to the med, it won't hurt anything in terms of efficacy of the drug, but can save you the extra gastric stuff that you surely don't need right now, you've got enough to deal with. Besides the tummy stuff, is it being effective on your pain?
You were taking 60mgs total of Opana a day? And it was replaced with only 12mgs of Exalgo a day? Why such a big drop? Did you request it? Online conversions say you would need 45mg Exalgo a to replace 60mg Opana.
Well.....my Doctor used a conversion chart ..... He said the only ER choice s he had was 12 or 16 mg , he debated which route to go , finally deciding on this strength . Gosh, it's 4:00 am ......been up all night. This has been awful. The only relief I get is with the Percocet ... I was tempted to go back to Opana ( I actually have 10 days of pills left ) but we are supposed to go on vacation with our daughter and her family .... I wanted this switch-over to be completed before next week. Gosh !!! I also sent a email message to Endo ( makers of Opana) their press release says there IS a steady flow of the new Opana available NOW ...but guess they forgot to tell the pharmacies ....thanks again Rich
Mallinkroft's official conversion calculation for Opana to Exalgo is 1 to 0.6, then Dr.'s usually deduct 25 to 50% for cross tapering when switching to a new med, which would put you needing around 18mgs of Exalgo at the minimum dosage. Yes the pills do only come in 8mg, 12mg and 16mg...but you can take a combination of pills to equal your recommended dosage or close to it.
If your still not getting relief, I would call your Dr. and get this taken care of before you leave on vacation and get stuck very far away from your Dr. and in a possible "emergent" pain situation.
He lowered your pain meds substantially when he moved you to the Exalgo, he may have had a reason for doing so, but he's started you off well below your minimal dose and it's not covering your pain. You 2 need to have a conversation about that and what to do next. Just because a tablet only comes in certain milligrams is not a reason to set your dosage. And it's not a max daily safety issue, the FDA UCM248769 daily max for Exalgo is 64mgs a day.
Another horrible day with Exalgo ..... The drugs in this product simply do not "jive" with my body ..... I know it's only been 3 days BUT that's IT NO MORE ... So, I contacted Eudo Pharmaceutical .... ( makers of Opana ) .... The lady was very understanding ..... She took all of my info .....( and complaints) ....Fortunately I got a appointment to see my Doctor tomorrow morning .... Once I have a script for Opana ER 30 ( what I've been taking for almost 2 years) Eudo will assist me in finding the med..... She said all issues have been resolved AND the pharmacies should be receiving the Opana ..... But , we will see
***** Final point
It is simply amazing how these drugs affect people differently. As they say , " your mileage may differ " You can say that again
Thanks
Rich
Well I'm glad your getting it cleared up before you went on vacation, I'd be worried for you being away from your Dr. and not having your pain covered.
Now you can go and just enjoy your Daughter and her family and rest and relax. You've had a tough time of it lately. Hopefully the pharmacy will have their ducks in a row and the Opana won't be difficult for you to get.
Hey, was wondering if you'd made it back from Vaca yet and seeing how everything went? Hope the pain meds are working out these days and your getting good relief. Sure hope you had a great visit with your daughter and family and had some painfree days!
Re: Using Opana... and scared 
