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Old 02-14-2013, 05:59 PM   #1
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Abruptly stopping percocet & starting Norco

Hello, a pain doc in the office switched me from oxycodone 10mg 4x day
To Norco 10mg. Is it possible I could experience withdrawl from not taking the percocet? I have grown tolerant to the percocet taking it for about 3 years and just wasn't getting the relief I once did.
I'm also on Dilaudid 8mg 4x day and long acting morphine 60mg 2x day.
I really don't want to experience withdrawl and forgot to ask the doctor when we were talking about what meds should take the place of the percocet.

Any information or personal experience would be welcome.
Thanks!

 
Old 02-14-2013, 08:14 PM   #2
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Re: Abruptly stopping percocet & starting Norco

Conversion wise, 10mg of Oxycodone would be equivalent to about 15mg of Hydrocodone (in Norco), but individual results vary. I would guess its not enough of a difference to put you into withdrawal, especially since it is a small percent of your daily dose with those other two meds, but you'll have to see.

Surprised they would switch you down in strength, unless it had worked better for you in the past. Why are you on two short acting meds both four times a day? That seems interesting. If you are needing that much for breakthrough, you'd think they would up/change your long acting med?

Which long acting morphine form? If its MS Contin and it isn't lasting 12 hours, be sure to bring that up to your doctor, as some find it needs to be dosed every 8 hours. It didn't even last 6 hours for me.

40mg oxycodone + 32mg dilaudid is actually considerably more than the 120mg morphine with standard conversion (60mg + 128mg = 188mg morphine). Usually the total breakthrough daily dose is considerably less than the total long acting daily dose. Curious about that too.

Also, 8mg dilaudid is way stronger than 10mg Norco and even 10mg oxycodone (its about equal to 21mg oxycodone and 32mg hydrocodone), so that can definitely explain why the oxycodone wasn't working. Hope you can find a good med combo. Best wishes.
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Old 02-15-2013, 09:25 PM   #3
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Re: Abruptly stopping percocet & starting Norco

Hello, I'm on morphine sulphate for long acting. I haven't had great luck with the long acting meds, thats why I'm on more short acting ones. I saw a doc that wasn't my regular doc and should have waited to talk to my regular doc before we changed anything. The percocet isn't working anymore. He asked about opana, my insurance won't pay for that and it costs over $1000 a month, he asked if I wanted to try norco and I said "what the heck" I wish he would have given me a stronger dose. I'm going to have to call anyway because I want to rip my skin off, the itching is so bad. I just wish we could get it right. Thanks for the response.

 
Old 02-16-2013, 02:05 AM   #4
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Re: Abruptly stopping percocet & starting Norco

Quote:
Originally Posted by Stupid feet View Post
Hello, I'm on morphine sulphate for long acting. I haven't had great luck with the long acting meds, thats why I'm on more short acting ones. I saw a doc that wasn't my regular doc and should have waited to talk to my regular doc before we changed anything. The percocet isn't working anymore. He asked about opana, my insurance won't pay for that and it costs over $1000 a month, he asked if I wanted to try norco and I said "what the heck" I wish he would have given me a stronger dose. I'm going to have to call anyway because I want to rip my skin off, the itching is so bad. I just wish we could get it right. Thanks for the response.
Hi stupid feet, I thought when i read your meds that you were given the morphine long acting & then a mild bt, the oxycodone & a stronger bt the dilaudid. I just wanted to encourage you because it took 5 years to find my perfect combo & we have even dropped the dosage in the last 5 months & it is still working even after 8 years. It surely makes it harder when cost is prohibitive & insurance dictates which med that you can have. My highest co pay is $69 & only one is that high. Since you are on ms contin or MSER, kadien is now offered in generic which is 12 or 24 hour dosing long acting morphine in a capsule & maybe your insurance would cover it now, its a capsule not a tablet. When my insurance suggested to my dr that i take MSER he refused b/c i have too much tummy acid & he was afraid that it would dissolve too fast & kept me on avinza,(24hour release morphine). And, last fall my dr who did physical medicine & rehab, a physiatrist decided to be a rehab hospitalist & not see pain patients anymore i was told for a year that he might do this, long story short i was left with fentanyl patch, avinza but no bt msir & i was fine, no withdrawal. It was not fun when i had bt but i really was fine no withdrawal, no # 10 pain. Then new pm/anes cuts out avinza & just gives me msir & fen patch & still i was fine. I dropped from 150mg of morphine to 90& i was fine so you will have to call anyway b/c of itching so maybe before you could find out about kadien generic & there is another long acting & kate knows it but i cant remember it hopefully she will provide the name for me! I hope this gets fixed for you, you poor thing you have been through so much, im sure the point of all this change is to lower the pain first & foremost, its time for relief @ least a controlled, reliable 5, right?

Last edited by gmak; 02-16-2013 at 08:26 PM. Reason: bad typos

 
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Old 02-16-2013, 06:43 PM   #5
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Re: Abruptly stopping percocet & starting Norco

I definitely agree it can be a long path to find a good med / treatment combo. Have they tried upping your long acting med considerably (and then dropping your breakthrough needs)? If you are using/prescribed more for "breakthrough" daily than your long acting dose, to me, that seems to point in that direction.

Agreed that a long acting morphine (or a different med all together) may be better. The two other long acting morphine formulas (both capsules) as Kadian and Avinza. Kadian now has a generic option. Typically, Kadian is taken every 12 or 24 hours and Avinza every 24 hours. There are few folks that MS Contin lasts 12 hours for...8 hours is more the norm. That could help too.

Are you taking most of your breakthrough meds at the end of your MS Contin dose? Also, I'm curious if you take the bt meds on a schedule or as needed. If you get four doses a day of each, that lends more to taking them on a schedule (so your doctor might as well up your long acting med to include that and get you more and more stable relief). Best wishes.
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