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262iceman 09-04-2017 12:24 PM

Methadone to Opana to ? Need Help

I really need help, I was on Methadone for 10 years and it was working great, due to an ekg I was switched to Opana 40 mg and after 7 months I'm finally getting fully adjusted and they are making me switch again.
Going from the Methadone to the Opana was really really hard for me because my doctor did not get anything right about the amount to amount mg change and some new law had my paper work screwed up and ending up not having medication for 4 5 days during the switch, that s another story but this time she's giving me a months' notice and I procrastinated up until now which I go in a couple of days. She gave me these names Xtampza, Nucynta, Hysingla, patches do not work since I'm in physical labor field and get sweaty all day long. I tried researching them with no good understanding. If any one could recommend something that may work for chronic pain long term out of those name of medication in any way I would really appreciated it. I take Percocet's 20 which she suggested giving me a extra one during the changing process which is cool but really no big deal to me I'm worried about the change period getting used to the new drug and if it will work or not, all these new high tech drugs scars me and really need help if anyone has had any type of experience with Xtampza, Nucynta, Hysingla or any other suggestions. Methadone and Opana work good even great for the long term once figuring out the best times for me to take it and am hoping, praying that I am able to find something close in helping with the pain.
Thank you very very much


tortoisegirl 09-05-2017 06:07 PM

Re: Methadone to Opana to ? Need Help
Did your doctor give a reason for you needing to switch? That is annoying.

Everyone is different, so its tough to give any advice. I've only tried Nucynta. From my experience and what I have read, it is more hit or miss than average, and acts quite differently that other opioids (which could be good or bad). I think Nucynta is better to try as an as needed / breakthrough med rather than be stuck with it for a month.

Xtampza appears to be a new form of Oxycodone that is more abuse deterrent, and Hysingla ER is long acting Hydrocodone (the same medication that is in Vicodin, and Zohydro ER, another form of long acting Hydrocodone). My personal recommendation would be either Xtampza or Hysingla, depending on whether you previously responded better to Oxycodone or Hydrocodone at equivalent dosages.

I have also heard that due to the bio-availability of Hydrocodone (and morphine), it often isn't the best choice for patients beyond small dosages. The conversion tool I saw recommended converting from 40mg Opana to 120mg Hysingla (dosed once a day), which is the maximum dosage available (although you could combine two different dosages or take two of a smaller dose if required - you may run into insurance issues in that case though). Just something to keep in mind.

Also keep in mind your insurance coverage in general too - I recommend checking ahead of time whether you have coverage for these. Your insurance may charge you more, require a prior authorization, or even deny them outright and say they will only cover certain opioids. It is also very likely your pharmacy will need to order any one of these (as they aren't as common / more expensive), which can take up to a week.

Therefore I would make sure your doctor knows whatever you can find out in advance to try to make this as smooth as possible. It may be advisable to ask about a week's prescription for something else (like Opana) and a 3 week prescription for the new med, so you can drop it off at the pharmacy early to get going on the insurance and any ordering which may be required. Especially if your pain clinic is tough to deal with in between appointments (which is sounds like may be true based on your previous med switch).

Personally I haven't done well on any long acting opioid besides Methadone, as I find everything else inferior even at an equivalent dose (ie. I get a good bang for the buck with Methadone pain wise). I have mostly tried things out in the short acting form though so I don't have to be miserable for a month if it goes poorly. Best wishes.

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