Best plan to withdrawl from Oxy and norco

[Bilbo]

I am having surgery on my shoulder and hopefully it will put an end to my year of pain and agony. I am praying, trust me.

I am currently taking 20mg of Oxycontin every 12hrs and 3-4 10mg Norcos a day for breakthru pain. I take the Norco 1 at a time and only when the Oxy starts fading. I never got 12 hour relief from the Oxy. The best I ever saw was 6-7 hours.

Anticipating that my surgery will fix what ailes me, what would be the appropriate plan to back off these meds.

I ask because my PM doc has left it in my GP and Sugeons hand. I havent spoken with either but I get the feeling that they are not well versed in pain management.

I would just like to have some good ideas BEFORE I discuss it with them so we can agree on a plan. Nothing like getting a plan from a MD only to find out latter that its not effective or proper.

Thanks everyone.

Bilbo

[Shoreline]

Hey Bilbo, Although it's not unusual to turn PM over to the surgeon, The PM doc should have some input, since he is supposed to tbe the specialist with these meds. He should be jus as good at taperng them as prescribing them. I would be pissed.

The easiest thing to do would be to convert everythng post op to 10mg percoccet, taking 2 will double your present serum level oxyC produces and give the initial post op relief you need. As you begin to recover you start decreasing the percs to 1 and 1/2 a couple doses for the day untill you have every dose at 1&1/2, from there you reduce the 1&1/2 doses down to single pill doses,

Lets call 2 10 mg percs 20mgs of oxycodone

First few days you may need 20mgs every 4 hours, as things heal
you could try decreassng to a dosing schedule that would look like this
20mgs-15mgs-20mgs-15mgs-20mgs-15mgs You can break these in half Then
20mgs 15mgs-15mg-15mg -20mgs
give that a few days using whatever level you need at the time but knowing you need to reduce a half a pill twice a day every few days
Now your at 15mgs-15mgs-15mgs-15mgs-15mgs
Then 15mgs-10mgs-15mgs-10-mgs-15mgs
then 10mgs-10mgs-10mgs-10mgs-15mgs
then 10-7.5-10-7.5-10

It's easier to taper short acting meds than long because of dosage size. Once your down to 10mg per dose you could go to 7.5 strength and then 5 strength and then switch to Norco 5/325 not the 10's because 10 mgs of hydro is stronger than 5mgs of oxy.

With the 5mg norco you can start at one and a half then one then one and half untill your down to one 5mg hydro every 4-6 hours.

At this point you need to spread the time from every 4 to every 5 then every 6 so your taking fewer doses and less hydro daily. You could easily be off meds in 4-6 weeks by reducing a half a pill a couple times a day every 3-4 days and then spending 3-4 days at each new dose. This way you are really only reducing 1-1&1/2 pills a day every 3-4 days. But even starting at 12 pills a day, It won't take long and the progress will be smooth and steady.


I put the higher doses in the am and PM because I hurt more then, but you can adjust to your own pain levels and schedule. Simply removing a half a pill a couple doses per day will get you there and will be slow enough to do it comfy .

If you drop from what your taking to a decrease right after surgery, you will not only have post op pain but increased pain from withdrawal. Your doses are low enough that post op pain can be managed and the taper rather easy. Good luck with surgery.
Dave