Avinza - Is it a 24 hour or 12 hour pain relief?

mergatroy · 07-11-2006, 12:40 PM

My PM&R dr. had my blood tested for morphine and demerol. He was surprised to find it was negative for both. I told him it was probably over 24 hours since I had taken the Avinza. When I got home and looked it up, it was not even 24 hours since I took it. I was also surprised. I am real new to opioids and naively thought Ligand was being 100% truthful.

I emailed a contact at Ligand, asking about this and their spirit of cooperation evaperated instantly. When I contacted them about my not being able to swallow after 90mg of Avinza, they said they had never heard of this before and asked me lots of questions over a few weeks. I gladly cooperated, after all, we both have my health to worry about. This word naive keeps popping up.

Now I have heard from others using Avinza that they use it on a 12 hour cycle. That makes sense to me because my Avinza quits working way before the 24 hours. Please don't think I am "bashing" Avinza, it has helped a lot.
But it is not as effective now as it was on day one. We can all say "Of course it is not as effective, your body has adapted to the Avinza." But the 24 hour usefulness, or lack thereof, has always been there. Let me explain that...initially I noticed my pain was worse in the evenings (took avinza at 7am) but I attributed that to my body being...tired after being up 12 -15 hours. I never thought about the meds not lasting 24 hours. Did I mention being naive?

IF that is closer to the truth...the 12 hour concept. I wonder about taking 90mg of avinza at 8am and 8pm? 180mg total, but at any given time, I might only have 120mg in me. And the dr. thinks the 120mg is the max I should take due to respiratory problems (severe asthma).

I was told by Ligand to take all the avinza in the morning. I have also been told NOT to take an opioid within 2 hours of bedtime, due to the swallowing problem. And yes, I still have trouble swallowing when horizontal.

Do any of you take avinza based on a "12 hour" time table? I would like to try this, but will ask the dr. first. I don't think my body would ever have much over 120mg in it, but it would take a blood test to be sure. Opinions?

Kissa · 07-11-2006, 01:39 PM

While the Mfg. deems that Avinza is a 24 hour dosed medication many of us who have taken it, disagree. I found it to be ineffective after the 14-16 hour mark. Many doctors are now prescribing it and Kadian on a 12 hour schedule instead.

I ended up going back to MsContin on an 8 hour schedule because it was more effective as a whole for me.

I'm curious about the swallowing, it isn't a normal side effect. In fact, it's down right scary. Is the doctor simply not concerned about this enough to try you on something different like Methadone to see if the problem is eliminated? I personally would be demanding answers from everyone and anyone who comes in contact with the product (ie Mfg, Doctor and Pharmacy) because it does in fact sound like an allergic reaction.

All the best
Barbie

ozzybug · 07-11-2006, 06:55 PM

D-
I have to agree with Kissa about not letting this go. You are having problems with swallowing which, if this is an allergic reaction could lead to problems breathing. Allergic reactions can increase/get worse with continuous exposure to the allergin. I'm not saying that you are having an allergic reaction, but if it were me, I would probably be talking to the doctor about changes ASAP.

If I remember correctly though, there are several other meds that you can't take, or am I confusing you with someone else? If so, I'm really sorry.

It's scary to think that Avinza is advertised as a continuous 24 hour medication when a blood test showed that it wasn't in your system. PM doctors will dismiss patients from their practice if the medications they are prescribing are not in your system. How did the doctor react when the test came back negative?

Oh, I do hope you get some answers soon! Keep on researching.

Lezlee

mergatroy · 07-12-2006, 02:04 AM

I never thought about him dismissing me from his practice. I think he wants to check this out for himself. I do to.

Kadian? Never heard of it, he didn't mention it. Guess I can look that one up.

Swallowing? I did go to Ligand. They said NO ONE has ever, ever, ever had that problem before. My PM&R dr. knows about this problem, said it was no big deal. I need to tell my Pulmonary dr. about it.

Maybe I SHOULD ask for another med, except he said I would have to ..uh...
what is the word...get off morphine...sorry, new to this stuff. He said it might take a couple of months to get of "off Avinza". What do I know? I said ok.
DOES IT TAKE TWO MONTHS to get off Avinza? I do not feel addicted or dependent on it. Of course, if withdrawals started I might change my mind real fast.

Can I go from morphine to another drug easily? I can take all my "capsules"
to him, count the ones I have taken vs the ones prescribed vs what I have left. No one in my entire family has ever taken opioids before. So this is real new to me. Opinions appreciated.

Another oddity with him is that I called his office on a Monday morning, told them I was in a lot of pain, can I increase my dosage? No one called back.
I called the next day. No one called back. I called Wed. No one called back.
Finally I went in to see him and he told me they were busy. I asked him what we should do if we are in a LOT of pain. He said go to the ER, or come to his office. I would change dr. but I am getting close to leaving him anyway I think. I found another PM&R dr. I like better, but I am not sure about "changing horses" in the middle of the stream.

Has anyone ever been taken off Avinza after 7 months? 120mg a day?
1. What did they put you on?
2. Did it take you 2 months to get off the Avinza?
3. IF you got another Opioid prescribed, did you take it simultaneously with
drug they used to get you off Avinza.

Last question is....what would you think of my taking 90mg at 8am and 90mg at 8pm? I don't think I would exceed the 120mg he prescribed.

Thank you so much for all your help. This is a great site. It is the first one I bring up in the am and when I get home.

ozzybug · 07-12-2006, 02:17 AM

D-
I can't speak as to taking your medication any other way than exactly as your pm doctor prescribed. That is for him to decide.

However, this doctor is in pain management, and when a patient calls in with a serious issue, and increased pain is a serious issue, I find it inexcusable that for three days straight, there was no return phone call. And if you were to go to the ER, once they find out you are in pain management, they may not want to do anything for your pain without speaking with your pm doctor. If they were to call his office, would he even speak with them, or would you have to sit in the ER for 3 days for him to return a call to them?

I think finding a new pm doctor would be in order at this point. You are paying him to take care of you and manage your pain. Why pay someone who doesn't return a phone call? It's all up to you, but you deserve more courtesy than what you received these past few days.

Let us know what you decide with the pm doctor, and please take care. Don't allow yourself to be ignored.

Lezlee