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  • New doctor = new Rules

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    Old 12-27-2016, 08:21 PM   #1
    newtopainmeds
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    New doctor = new Rules

    I have been taking OxyContin 60mg 2X per day and Hydromorphone 4mg usually just 1X per day for BT.
    New Dr won't write Hydrophorphone (or any BT med) so he gave me a list of meds I can swap the Oxy to. The only thing on it that I have taken before is Hydrocodone. I have no idea how any of the other meds on the list work. I need something long lasting (OxyContin doesn't last 12 hours)
    List of new meds include:
    Nucynta (tapentadole)
    Embeda (morphine)
    Belbuca (butrenorphine)
    I want to take the least amount that I can take as long as it relieves the pain. I am afraid of taking too much and then becoming Immune to it like I did the Hydrcodone.
    Can I get some advice???

     
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    Old 12-28-2016, 04:08 PM   #2
    backhurtz
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    Re: New Dr. =new Rules

    Is Opana on the list of possible new meds? Generic is Oxymorphone HCL ER. It is an extended release medication, that lasts the 12 hours, and works pretty well for me anyway.
    Nucynta ( be careful if you take anti depressants)has had mixed reviews, and the other two, the extended release morphine generally seems okay, as long as you haven't had previous issues with morphine. The buprenorphrine patches I would also say have mixed reviews.

    Last edited by backhurtz; 12-28-2016 at 04:10 PM.

     
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    Old 12-28-2016, 06:21 PM   #3
    tortoisegirl
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    Re: New Dr. =new Rules

    Welcome! Sorry you are going through this. Will your doctor not consider prescribing Oxycontin 40mg 3 times a day instead of 60mg 2 times a day? It is fairly common to not have it last 12 hours, and that is the same daily dose, so it is worth asking about if your pain is well controlled with Oxycontin except for it wearing off too quickly. It is unfortunate they won't do breakthrough meds any more...any chance an NSAID or muscle relaxer would be helpful? I get short & long acting opioids, but have finally found a NSAID (Diclofenac) and muscle relaxer (Lorzone) which is helpful, so I often take those before (or with) the short acting opioid.

    As for the other meds: Many patient's pain doesn't respond to Butrenorphine, and use of other opioids with it is limited, so I would push that to the bottom of the list. Both Embeda and Nucynta ER are helpful for many folks...it depends on the person. I believe Embeda is more likely to be longer lasting as well as being generic, so unless you have previous experience where you didn't do well on morphine, that would be my pick. They do have a long acting form of hydrocodone now (Zohydro, and maybe something else too?), so if you have done well on it in the past, that is definitely an option as well (although it is brand only), although it is typically a better option for folks on a lower daily dose.

    You may want to check your insurance as far as if they will cover the brand name options (sometimes they don't, or it is a step therapy so you have to fail other meds first, or if you have to pay a percentage it may be cost prohibitive). I hope you get things sorted out soon. Best wishes.
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    Old 01-21-2017, 08:25 AM   #4
    DMJ618
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    Re: New Dr. =new Rules

    Embeda isn't generic. Pfizer had a fantastic once a day morphine medication called Avinza. But there was some bizarre legal mumbo jumbo going on that allowed another company to make a generic before the patent ran out. Pfizer decided to discontinue Avinza and now they offer Embeda. It's a tamper resistant version that makes it useless if crushed (drug addicts do this to snort or inject). I wasn't switched over to this, so I can't say how well it works.

    All I know is that Avinza really did work for me for the full 24 hours. I took it in the morning and by the next morning my pain would be a bit higher, but nothing terrible. They even thought of that though, Avinza has a bit of immediate release medication. You don't have to wait for hours for it to start working, for me at least it was about 20 minutes and I'm ready to start my day.

    I somehow managed to stumble onto this messageboard by searching for the generic Avinza. I want to ask my doctor to switch me to that. I'm currently taking Kadian twice a day and it's better than MSContin at least.

     
    Old 02-22-2017, 05:11 PM   #5
    Johnny Dee
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    Re: New Dr. =new Rules

    Quote:
    Originally Posted by newtopainmeds View Post
    I have been taking OxyContin 60mg 2X per day and Hydromorphone 4mg usually just 1X per day for BT.
    New Dr won't write Hydrophorphone (or any BT med) so he gave me a list of meds I can swap the Oxy to. The only thing on it that I have taken before is Hydrocodone. I have no idea how any of the other meds on the list work. I need something long lasting (OxyContin doesn't last 12 hours)
    List of new meds include:
    Nucynta (tapentadole)
    Embeda (morphine)
    Belbuca (butrenorphine)
    I want to take the least amount that I can take as long as it relieves the pain. I am afraid of taking too much and then becoming Immune to it like I did the Hydrcodone.
    Can I get some advice???
    Geez you are in a jam. My PM just dumped me he is a crack pot and prescribed 2x Opana 40
    16 x 8 Mg Deloided and 1 80 mg Oxicotin plus 75 mg of fenytail a day.
    He reasoning was Medicare auidited him and he was over billing so they cut the cord on his payments. He is plea bargining to repay 400 k of over charges . He told me this how stupid.

    Anyway I ran out of pills yesterday and have a new doctor scheduled for 2 days from now. I have been on this regime for 5 years. It feels like I have a bad case if the flu plus I have all the old pain back with leg tremors and chest pain. My heart is good but feels like a brick on my chest. I went to the ER they were full in detox and couldn't help." So I understand askew no about replacement meds as I'm sure the new dr I'm seeing Saturday' will throw me a curve. Getting in to detox is not easy anywhere it's a clear any system. I'm going to try asap if I can. Maybe a option to a new script.

    Say a prayer everyone I hope to be taken care of by the new dr.

    Last edited by Johnny Dee; 02-22-2017 at 05:16 PM.

     
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