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    Old 04-26-2004, 04:48 PM   #1
    Jtruzman
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    Methadone Question For Shoreline

    My pm doc. has put me on Methadone 10mg's 2x a day. I was really scared to get on that medication because of the stigma that is attached to it. However, he told me it was a great medication because it actually helped with nerve pain as well. Anyways, I was reading a post about methadone and SHORELINE was saying something about METHADOSE and that it is not as strong as regular methadone. I am currently taking METHADOSE, I know so because it sais on the pill METHADOSE, but my pill bottle sais METHADONE. Am I getting a generic pill or something ? Can I just ask the pharmicist for METHADONE instead of METHADOSE to get better relief ? Shoreline if you read this plz help! I don't understand the difference between those two meds. Methadone and Methadose.. if methadone is stronger can I just ask for it instead of methadose ? My next refill comes up in a week and I would like to know!

    Thanks..
    L3-L4 Torn Disc
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    Old 04-26-2004, 06:14 PM   #2
    rlcowboy
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    Re: Methadone Question For Shoreline

    Hey I know you posted to Shore but I just wanted to say that I just started taking Methadone about seven weeks ago for very similar condition as yours. This past time when I got my new prescription I had to use a different pharmacy and I noticed the pills were actually bigger than my other ones and that they say methadose but methadone 10mg on the bottle. I have been taking these methadose for about a week now and I can't tell any difference. Maybe there is a difference but I sure cant tell.
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    Old 04-27-2004, 09:17 AM   #3
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    Re: Methadone Question For Shoreline

    Hey Joe, Methadone and Methadose are both generic alternatives for Dolophine. If the doc writes Methadone on your prescription either med "methadone or Methadose" is a valid substitute. It just depends on what manufacturer your retailer has an agreement with or what methadone product the local jobber carries. When He types in the generic drugs name on nthe sticker that goes on your bottle he may or may not use the name Methadose or methadone. It really doesn't matter because both are seen as the same by the FDA.

    Methadose is made By Mellencrodt, The smaller tabs made by Roxanne use the name methadone. Very similar to a doc writing a script for Percocet, If generic is allowed you may get Endocet or Roxicet any of a number of generic version of 5mgs Oxycodone and 325 mgs of apap.

    Regardless of what's on your bottle either product may be dispensed unless your prescription is specific. Like Methadone only or Methadose only. Or Percocet with no substitutes checked on the prescription. If a doc wrote a the script for Endocet, any generic equivalent can be used because the Name brand product "Percocet" wasn't written and dispense as written was not checked

    Mellencrodt is actually the only bulk manufacturer of methadone in the country.They also produce bulk morphine, bulk Hydrocodone, and bulk Oxycodone. How each manufacturer formulates each pill is up to the manufacturer and the guidelines from the FDA. Obviously Methadose uses a whole lot more filling agents than Roxane meth, mainly Glucose.

    How many actual mgs of active ingredient contained in each pill or generic substitute is spelled out by the FDA guidelines for generic equivalents. The FDA does allow what they consider a reasonable percentage of variation and can still call it equal. It's +15% or -20%. So a 10 mg pill can contain anywhere from 8.0 mgs to 11.5 mgs and still be considered an equivalent to the original 10mg Dolophine tablet.

    So Roxanne buys their methadone HCL from Mellencrodt to formulate into their final product.Generic methadone tablets and name brand Dolophine Diskettes and liquid versions of methadone. They may choose to use the high end of the allowable variation because meth is dirt cheap.

    It's the allowable variation that gets to some people. Another forum member and myself both had a Methadose tablet analyzed and found out why we were experiencing withdrawal when we were forced to use the Methadose brand. Both our chemical analysis came back at 8.2 mgs of methadone HCL in a 10 mg Methadose tablet. Skimming 1.8 mgs of meth from each tablet because the FDA allows them too, also allows the manufacturer to create almost 2 extra tablets for every 10 tablets made. Doesn't sound like a huge difference, But when you get 2000 extra tablets for every 10,000 tablets made, those little pennies add up.

    If you start with Methadose and stick with Methadose you will never know the difference. If your dose is reasonably low, loosing 3.6mgs out of your 20 mg dose may not be a noticeable difference. Not everyone has a problem with Methadose.

    But when your dose is say 150 mgs a day and your used to receiving that in the form of Roxane methadone, The way the FDA allows variations, each Roxane tablet may contain as much as 11.5 mgs of active ingredient. It would be dirt cheap to make a superior product compared to a manufacturer that uses the bottom end of the allowable difference

    So your 150 mg dose could actually be as much as 172.5 mgs of meth per day.

    If your next script is filled with Methadose, and they stay true to their penny pinching you would actually be receiving 15X8.2=123mgs of Methadose per day. Try dropping your daily intake of meth from 172 mgs a day to 123 mgs a day and see if you experience withdrawal. Even a drop from 150 to 123 would cause problems for many people.

    I've been through it twice and won't except Mellenkrodts version, Methadose. I take 15 10mg tablets per day. A decrease of 28-50mgs of actual methadone is more than enough to send anyone into withdrawal. Even if Roxane hits it right on the money and puts exactly 10mgs in a 10mg tablet I'm still looking at a 27 mg a day decrease in active ingredient.

    You certainly wouldn't expect less active ingredient in a pill twice the size, But apparently glucose and talc and other fillers are even cheaper than methadone HCL.

    I've never seen a low dose patient notice a dramatic difference, But the higher your dose, the less meth you actually receive by using Mellenkrodts methadone.

    Here's the rub. Mellenkrodt is the only producer of bulk methadone in the country, In the last year, Roxane meth has become harder and harder to find. How would a corrupt company like Tyco "The parent company of Mellenkrodt" capture 90% of the retail methadone market?

    By simply slowing distribution of bulk methadone to their competitors so they can't fill their retail orders and loose their distribution contracts.
    Then crank up production of Methadose and guarantee availability of their product.

    Would the two execs from Tyco that just had a hung jury for embezzling 600,000,000 dollars be capable of such dirty corporate play, A company that bought over 200 other companies last year alone in Hostile takeovers be capable of such nefarious activities when all it takes is one juror to create a mistrial. Nahhh....Not in America.LOL

    Take care, Dave
    PS. If you don't believe this is possible, Next time you are at the pharmacy, ask to see the bottle of generic Tylox they use and check how many mgs of Oxycodone are in each capsule. If it's more than 4.3 I'll recant everything I have bad to say about mellenkrodt. Name brand Tylox is 5/500. Not everyonewill notice the difference in strength, particularly if you have never had brand name. This is common practice. They are allowed variations and some companies take it to the limit.

     
    Old 04-27-2004, 10:40 AM   #4
    Jtruzman
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    Re: Methadone Question For Shoreline

    Thanks Dave! I was not too sure if I was getting the actual 10mg's of methadone in each methadose pill that I recieved. Since I am taking a low dose I guess it really does not matter. I completly understand the huge difference though when you are taking up to 150mg's per day and then switch to methadose and end up getting much less, therefore putting you through withdrawls. I'm going to ask the pharmicist if they can get Roxane methadone rather than that other company.. mellenkrodt. From what I understand Roxane Methadone actually has the 10mg's or a little more in the 10mg's pills and the Mellenkrodt 10mg Methadone pills have around 8.2mg's correct ? I know that methadone is pretty cheap but I feel like i'm getting swindled by Mellenkrodt. I mean, the DR. wants me to be on 10mg pills not 8.2mg's! The medication is working OKAY, but if I can actually recieve the 10mg's rather than 8.2mg's I would rather have that. Shore, do you think it's okay for me to ask the pharmacist ? I just don't want to raise any suspicion ya know.

    Thanks,
    Joe

     
    Old 04-27-2004, 12:45 PM   #5
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    Re: Methadone Question For Shoreline

    Hey Joe, You can certainly ask if they can get the Roxannee version of methadone. There are several things that may hinder the company, Like exclusive line agreements, where retailers make an arangement to carry an entire product line. If the pharmacy uses local jobbers, they usually purchase based on best price. You would think since they manufacture the bulk meth they could offer the lowest price and gaurentee on hand supplies, where many companies have dropped the Roxxane product because of availability. They just couldn't get Roxanne so they switched to Mellencrodt. Mellencrodt also recently came out with a version of LA morphine and were happy to anounce their product release and FDA rating of AB, which is not the highest rating so I don't know why they would brag about making something less than the highest quality.

    Often the large chains are hard to deal with and not to cooperative when it comes to getting specific brand generics. They make agreements to carry entire product lines Like Endo, Watson and Now Mellencrodt pretty much has a generic version of every SA pain med out right now.

    I'm sure in 6 months when the initial phase of new generics has expired and everyone can through their hat in the ring they will have a LA version of Oxy too. The Contin relase system was pattented in 1972 and it expired a long time ago.

    Did you end up having a discectomy or a fusion or are you still avoiding the knife. Hope your doing well in school. Take care, Dave

     
    Old 04-27-2004, 02:20 PM   #6
    Jtruzman
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    Re: Methadone Question For Shoreline

    Well the pharmacy I get my methadone is at a small mom and pop's store in the city. I might be able to get them to get the Roxxane version rather than the other one. I appreciate you letting me know. Anyways, I had my first surgery in April of 2000, I had a microdiscectomy at the L4-L5 level, then in December of 2003 I ended up having the L4-L5 level fused with ray cages. About 2 months ago I had an IDET done at my L3-L4 level where I have a tear around the disc. Other than that everything is going okay. It's really difficult to go to school with so much back problems, especially if you are taking opiates. If I did not have so much problems with my back I would probably be graduating this semester but noo.. This crap has put me back at least a year and half it really sucks. Thankfully, the pain is being treated well now. I had to threaten my PMD that if he was not going to treat my pain I would go to another doctor. At first he had my on Vicoprofen for 2 months, then I had my fusion and when I went back to him I was still having pain in my back and down both of my legs. The only thing he would prescribe me was Ultracet. It started to **** me off alot because I was suffering so much. So i told his nurse to tell him that he was not doing a sufficient job of controlling my pain. So then he decided to put me on TALWIN which I did not like at all.. gave me headaches and I got super nausea from it. Finally, I saw him again a month ago and I spoke to him and he said that I should wait 6 weeks to see if the IDET had worked or not. That's when he put me on the Methadone. So that's pretty much it dave. It's been a difficult 4 years let me tell ya. I'm 21 now, and I still remember when I first started posting on these message boards when I was 17 years old... it's really wierd let me tell ya !

    Talk ta ya later,
    joe

     
    Old 04-29-2004, 07:23 AM   #7
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    Re: Methadone Question For Shoreline

    Time flies when your having fun. "sarcasm". I know there is nothing fun about any of this mess. To have your back wrecked at 21 is a major bummer. I remeber you werre talkijng about possibly entering the medical profession. That may be a bit stenous specially during the residencies with 48+ hour shfts. Have you thought about social work or counseling in the pain field. It would certainly be an advantage to have first hand experience. It's also a job that would allow you time in between apts to lay down and catch your breath or stretch. Just a thought.It would give you the ability to be an advocate for proper PM treatment and although you can't exectly fix things people can certainly learn from those that have been there and done that already.

    The whole surgery thing is just a nightmare, After 30 + years of the medical comunity doing spine fusions they still can't tell you what the best method is, what hardware has the best succcess rate, Which aproach has the best success. Docs just hack and cut the way they learned and then discontinue meds to prove the have cured you. I guess there is some logic to needing tose if the surgery actually worked, I imagine that's what thetime spent of Ultram was about. They figure if you can get buy on Ultram after a fusion, even though you are already experiencing the domino thing with the disc above the fusion you must be cured.
    I can't believe they talked you into IDET after 2 unsuccesful attempts to relieve your pain surgically, but I know the feeling of having no other choice . Hang in there and don't sweat what you can't control. Take care, Dave

     
    Old 06-23-2004, 09:49 PM   #8
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    Re: Methadone Question For Shoreline

    May I jump into your conversation for just one moment? I have posted here recently to inquire about methadone use for pain at a low dosage and though I have had some response, I am still trying to learn as much as possible. I have not felt very well on it so far but it's only been less than two weeks. I wonder, do you get used to the side effects after a while? And are you guys scared of the addiction factor? I am very scared of both and nervous to continue taking it. It seemed like it was really helping the pain but making me feel quite sick and scared.

    thanks, asfirefly

     
    Old 06-25-2004, 01:32 PM   #9
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    Re: Methadone Question For Shoreline

    Hey Firefly, The urban myth that methadone is the hardest drug to discontinue is just a myth. Created by heroin addicts that simply switched from one potent opiate to another. If meth is so hard to disconetinue, why not discontinue Heroin.
    You don't seem to understand the difference betwen physical dependence and addiction adiction is harmful, destructive, all consuming to try to get that rush they got from the first dose but never possible. IMO Medth maint is simply switching from an illegal expensive opiate with no control of purity ot a FDA controlled opiate that is used for treatning chronic pain. A person with an adictive personality will become just as addicted to meth as they were to heroin, there reason for taking this potent opiate is not to manage pain, It is to prevent experiencing withdrawal from choices they made before they "got clean" with meth. An addict on meth maint for 10 years is not clean, they are still using meth as a cruch for whatever reasdon they used heroin I've seen people talk about using methbecause it can be converted to injectable material. They get a dose in the morning that can stave of withdrawal for 24 hours but what gains have they made. would they snub their nose at another shot of heroin if t was easily available. I doubt it, Meth has quaklkkkkkklities that would deminish the high of other opiates but whether you use meth, morphine OxyC0ontin, hydrocodone on a daily basis you do become physically dependent. The difference is that CP patents dependent on opiates have made this choice to improve their quality of life and ability to function. I've never seen a heroin addict say that Heroin improves their quality of life or ability to function.

    Addiction is destructive to almost every aspect of their life, Although use of opiates does cause physical dependence it improves a true CP patients quality of life.
    If you let urban legends and myths spread by addicts determine which med you will take you will likely never find a way to manage true chronic life changing pain.

    Diacetelmorphine "heroin " is still used as a pain med in the UK and other countries where the UK has Banned the use of SSRI antideprtessants in children. A child dying of cancer or in pain from cycle cell or any other unmanagable condition can take opiates safely. 100 mgs of meth causes no more dependence than 200 mgs of Oxycontin or 300 mgs of morphine, 300 mgs of Hydrocodone or a 100UGH Fentanyl patch. If you quit cold turkey foolishly you will experince the same physical withdrawal a heroin addict would, however unless your using meth for the same psychological disfunction that a heroin addicts injects that street sludge into their vein with no concern of aids, Hep or any other disease a cp patient can discontinue any opiate with a proper taper and not crave for the escape of euphoria caused by opiates.

    Persoanlly I don't take the medical advice of someone that has no concern for their own health, their partners health or an unborn childs health, and whose daily goal is to get as whacked as possible to manage their emotional pain. People have choices, whether they come from a bad home or experienced any form of abuse. If the drug is an escape, any drug will due.

    If the drug is for management of pain, the choice is based of the greatest efficicacy and least side effects to maximize quality of life and function. Have you ever heard a junkie say they shoot heroin to improve their ability to function or to maximize quality of life. Personally I think Heroin could be used just as safely as any opiate in the hands of a true CP patient. Not injectable to get a rush but in pill form or in IT pumps or in patch form. Long acting meds are designed not to create a rush or warm euphoria to sweep away their woes.
    If the use of any med is for pain and not for psychological comfort or physical pleasure it can be used as safely as any other potent opiate. If a patient can be compliant and not inject their oxy they can be just as compliant and not shoot their, oxy, meth, Dilaudid or Heroin. By the way, Heroin is a registered trade name of the Bayer company. It wasn't created by evil orientals, smoking opium was fine untill Bayer created a more potent opiate to relieve pain and to be abused by addictcs just like any med with street value for it's feeling.

    Use the serach feature firefly and type in methadone and learn about the med you are so afraid of because addicts continue to use it for the same reason they initially used heroin.

    I know if you type in methadone in a search engine you have to dig past page after page of addiction information to find actual clinal information about it's use for the treatment of pain.

    Here is a little help
    [url]http://www.ampainsoc.org/pub/bulletin/sep00/upda1.htm[/url]

    [url]http://www.mainehospicecouncil.org/MaineLink/vol2no2/methadone_rediscovered.htm[/url]

    A doc exlains the usefulness of meth and the difference between addiction and dependence. A litttle better source than an addict that feels he can't discontinue meth because it's so much more addicting than heroin, that's BS.......
    [url]http://www.hosppract.com/issues/2000/09/brook.htm[/url]

    If your pain can be managed without the use of opiates and dependence than you should exhaust other means to manage pain, not find the first doc that will give you the instant cure to all painful conditions, not every pain needs to be treated with opiates. If you need meth than use it, If you need morphine than use it. If you find a cure and that relieves your pain then taper off it. Like everyone else that uses opiates for post op pain. Anyone that has major surgery will need pain meds and there is a dependence factor involved but there is also a way to discontinue these meds if your pain is relieved. Without being labeled an addict and going through the withdrawal an addict goes through when he can't find his next fix.

    I really don't know how to be any clearer.
    Good luck, Dave

     
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