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  • Oxycontin vs. MS Contin need quick help

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    Old 04-19-2006, 11:31 PM   #1
    cptpooface
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    Oxycontin vs. MS Contin need quick help

    I recently posted a thread titled "how do I know if I have built up a resistance to my pain meds". I recieved a lot of feedback and am grateful for the help. I needed to start a new post because I have rectified that problem only to run into another problem. I apologise if I am starting too many posts.

    I went to my doctor a week ago to tell him I was not getting effective pain relief from my current pain meds. If you read my other thread you will know what my problem was. I was taking 15mg of MS Contin twice daily, and at first this helped my pain a lot, but lately it has been much less effective. So I went to my dr. and told him about this. He told me I had probably built up a tolerance to the MS and that we had a few options. He said the last thing he wanted to try was upping the dose to 30mg of MS. That was the last resort. First he said he wanted to try switching to a different drug at the same strength. He said that while I had built up tolerance for MS Contin, I would not have a large tolerance for a different drug of the same strength. He suggested I switch to Oxycontin. He said that MS Contin had around double the strength that Oxycontin had. So for example, I was taking 15mg of MS Contin so to equal that I would have to take 30 mg of Oxycontin. This is the route we decided on. He looked at a conversion chart and said he would give me 40mg of Oxycontin. He wanted to give me 30 mg of Oxy but they only come in 20mg and 40mg. So he gave me the 40mg and said that 40mg of Oxycontin is pretty close to 15mg of MS Contin.

    Now for the problems I have run into. When I started taking the Oxycontin I felt a lot more side effects than with the MS Contin. The first two times I took Oxycontin I got a euphoric feeling attributed to narcotics, I had never felt this with MS Contin, this worries me because that could raise the risk of addiction. The euphoria has not returned since the second pill I took. However, each time I take the Oxycontin I feel extremely nauseous, and have vomited a few times because of it. I find myself itching more than usual, and often get really lethargic and drowsy, though that may be attributed to the gravol I took for anti-nauseous. The pain relief is fantastic, it works well for at least eight hours and I am pleased with that aspect. So I need to know a few things.

    1. I am wondering which if any of these side effects will go away once I get used to the drug. I remember getting fairly tired for the first week or two of taking MS Contin, but after a while it went away. Will any of these side effects go away with Oxycontin. Is there any way to fight the nauseous feeling. I can handle the itchiness and even the drowsiness, but I can't handle the feeling sick.

    2. I am wondering if the Oxycontin actually lasts for twelve hours? I was told that some doctors claim that MS Contin will last twelve hours but in fact it only lasts seven to eight hours. Is it the same with Oxycontin, they tell me it will last twelve hours, but will it really only last eight?

    3. While looking up information on the internet I found a few places that listed the strength of Oxycontin at 1.5 times the strength of MS Contin. That would mean 40mg of Oxycontin would equal 60mg of MS Contin can anyone verify this one way or the other?

    The Oxycontin is working extremely well with pain relief, and many of you know how hard it is to find a medication that will work. I have found one that works for me, but it has tremendous side effects. Is there any way that I can combat the nauseous feeling I get? I cannot get through my day feeling nauseous, but if I take gravol I feel drowsy and cannot function. All the other side effects I can handle, I just need to get rid of the nauseous feeling, any help would be greatly appreciated.

     
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    Old 04-20-2006, 05:45 AM   #2
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    Re: Oxycontin vs. MS Contin need quick help

    Well your doc has it backwards, xy is stronger than miorphine so your taking ore than twice the amount ofmorphine. As far as growing tolerant and not having choices, that's rediclops the doc can't adjust MSContin upwards and gave up on it as soon as you became toerant, what's hegoing to do when you become toerant to Oxy? When I was converted from 120 mgs of meth to 200 mgs of Kadian, "morphine" I was sick as a dog and getting no relief. If I had given up then I would have never known I could have gotten relief from morphine. But they slowly adjusted the dose to 300mgs a day then 4000 and at 600 I was getting better relief than the meth with less side efects. If I wrote of morphine at 200 mgs I would probably still be bed wridden.

    Yes nausea is a side effect that deminsishes. I have a full bottle of visterill that hasn't been refilled in 4 months with 6 refills on it. But your taking the equivelent of 60 mgs of morphine twice a day now. Had he just increased the morphine you wouldn't have jacked your tolerance quite so high, and you would still be getting relief.

    I've never seen a conversion where morphine was stronger than Oxy at best some charts say it's equal or 1:1 but most are 1:1.5 meaning oxycodone is 50% stronger. I use 30 mg Roxicodone for BT pain where 60 mgs of MSIR barely touches the pain, so I could argue oxy is twice as strong for me. But your doc has an odd way of doing things an an interesting take on the strength of opiates. Doubling a dose is usually considered safe, but trippling is so far out of the scope of normal practice, your family would have a clear cut case of malpractice should anything negative happen to you.

    Side effects will deminsih but if you thought tolerance to morphine was a problem, wait untill you have been on Oxy 6 months.You will get great relief during the honeymoon phase from having your dose trippled, but if OxyC is dosed twice a day, you will need an even stronger BT med to bridge the gap between 12 hour doses. Due to his conversion you will have gone from the weakest dose of MSC available to 3 times the dose of a stronger med. Unfortunately you will become tolerant to that at some point too.

    What's next Duragesic, and when the 25ugh patches don't help, there are no other choices besides methadone? The make MSC in strenghts of 15, 30, 60, 100 and 200, you had plenty of room to adjust the dose. OxyContin comes in 10, 20, 40 and 80, notice the lower strengths available, because it's a stronger med.

    You will run out choices and rule every med out without ever increasing a dose? That makes no sense at alll. Adding a 3rd dose of MSC just evened your serum level out over 24 hours, it didn't raise your serum level so it wasn't an increase in strength, it was a change in dosing. You just don't have the 4 hour gap between doses like you did with twice a day dosing of MSC.

    Good luck, Is this guy a PM doc or someone playing PM doc.
    Enjoy the added relief for a while, It may never happen like that again. Most docs start low and 20mgs of oxy would have been an increase over 15 mgs of morphine.Pretty scarry when any doc feels comfy prescribing any med simply because they are a doc. I wouldn'tt ask my GP to treat cancer or ask my shrink to treat jock itch. Why other docs feel so comfy stepping into another specialties shoes just amazes me, and your guy doesn't know his meds or dosing, please find a real PM doc. Just because a GP or Gyno is willing to treat pain with meds once reserved for cancer only doesn't mean your getting the best care simply because your getting the strongest meds available.
    Morphine is still a very viable option that he's ruled out because you didn't respond any longer to he lowest dose they make? A little knowledge is truly a dangerous thing.
    Dave

     
    Old 04-20-2006, 06:01 AM   #3
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    Re: Oxycontin vs. MS Contin need quick help

    the very first question I have for you is just what manufacurer is listed on your med bottle,and what is the actual name of this version of oxycontin/does it happen to say oxycodone ER?if this is the case,you may just be reacting to the actual generic you are taking and not the actual oxycodone itself.i had the same exact problem you are having,the nausea?I also had a headache that seemed to always be going on in the background,when I was switched from the name brand to the ER crap last year.I had been taking the name brand oc for well over a year and a half with absolutely no problems at all.but once i tried the endo(the manufactuer)version,god it was just horrible.when I saw my NP the next time,I told her about the reaction and she just wrote DAW on the Rx and i was back on the name brand with no problems at all once again.all of the nausea and the headaches went away.

    after reading here and on a few other forums about this ,med I found out I was definitely not alone with having this sort of a reaction to the Endo version of the OC.this 'could' be the problem.since I do not actually know what you are really taking right now,its kinda hard to say,but if you are on it,i am willing to bet that a change to the name brand will be much better for you.even trying another generic could do it too,since I havenot heard anything real bad about anyof the other generics out there,just that endo crap.

    as far as it actually working the full 12 hours,thats not actually true in most cases.luckily for me,when I told my PM about the fact that the OC seemed to stop working at around anywhere from 8 to 10 hourd after taking it,she was very aware of the 'not lasting" thing and she had no problems in going to every eight hours for me.she just told me that despite what they are aware of,they still start every patient out on the every 12,as some will actually respond okay.its only when a patient actually tells them that they feel ist is not working that they will change it for them.just talk to your doc about this.andthe possibility of either trying a different generic of the OC or better yet,trying the name brand just to see if that makes a world of difference as it did for me.all you doc has to do for you to get the name brand is write 'DAW"(dispense as written)on the actual Rx everytime it gets filled out,and the pharm will give you nothing but the name brand only.you may have to pay a bit higher co pay in most cases for the name brand,but for me,its money well spent just not having to deal with all of the side effects from the endo version.they were really bad for me too.Hopefully this is indeed the problem and a switch will help you alot since the OC appears to be actually working for you.good luck and please keep me posted.Marcia
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    Old 04-20-2006, 03:36 PM   #4
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    Re: Oxycontin vs. MS Contin need quick help

    Well it looks like I am on much too strong a dose. When I went from 15mg MS to 40mg Oxy it tripled my dose. I have been on this dose for nine days. I have an appointment to see my doc tomorrow. When I go and see him I need to have some information on a few things, and I would appreciate it if you could help me out. Now that I have been on this Oxy for nine days, will my tolerance to MS have gone up? I was on 15mg of MS when he changed to oxy. So if I were to go back to 30mg MS would I still have too much tolerance for the 30mg MS to do any good? I am going to need to know what dosage of MS will still be effective, because I would like to get off this oxy. I need to know what dosage will still be effective, because I think the doctor may try to cover his mistake up and say that since I was only on the 40mg oxy for nine days the 15 or 30 mg of MS will still be effective. Will the 30 mg MS still be effective or am I going to have a huge tolerance to the MS. I guess I need to know what drug and what dose I will need to be at in order for it to be effective. Maybe the MS will never be effective because to much tolerance has been built up, maybe I will have to change to completely different drug, I don't know, if you could all give me your opinions I would appreciate it.

     
    Old 04-20-2006, 04:45 PM   #5
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    Re: Oxycontin vs. MS Contin need quick help

    It is pretty unlikely that you'll have a tolerance build up to MSC just from switching to Oxy for a short duration. I can't believe your doctor gave you such a high level of oxy compared to what you were on with MSC and then tell you they were the same... so much for education.

    The MSC should still be somewhat effective but the dosage is very low in compared the amount that you could be taking. Add too that that MSC does not last 12 hours like doctors want you to believe, it really only buys you about 8 or 10 hours tops if you are lucky. There is no way for anyone to know what dosage of MSC will be the right dosage for you, everyone is different. By simply adding an additional dosage of MSC it could prove to be enough relief. It is also plausible the doctor could double the dosage from 15 mg to 30 instead. Going in small increments is pretty much the standard way to do things that way if you do develop tolerance you have some room to increase the dosage and so that you are not over medicated.

    I had serious problems with Oxy like you did and can not take it, I simply can't tolerate it at all. I don't have any of the problems with MSC like I do with Oxy.

     
    Old 04-20-2006, 08:17 PM   #6
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    Re: Oxycontin vs. MS Contin need quick help

    Hey Cpt,

    I agree with the others about MSC. Like Shoreline said, your Dr has it backwards on the strength. You are probably experiencing the nausea due to the strength increast of the medication. That dose is a pretty big increase.

    As far as tolerance to Oxy, probably not yet. Although you start to become dependant to meds after about 7 days of taking it pretty regular. But if you switched back now, you would be alright.

    MsContin works just like OxyContin as far as delivery. About half the dose at .6 hours, and the rest at about 6 hours later. If you want a smoother delivery of Morphine, I would go with Kadian or Avinza. Although Avinza has a small amount of instant release pellets. Most people that have been on Kadian have nothing but good things to say about the release system they use.

    As far as what dose of MSC will work for you. Who knows.... Like Kissa said, everyone is different, however, titrating in smaller doses is usually the best way to find out where to go dose wise without ending up with too many side effects. I agree that maybe by simply changing from a BID to TID dosing may provide good pain relief to you. If it were me, I would want to go that route before actually increasing each dose.

    Either way, I wouldn't give up on the Morphine just yet. You are at a low dose of Morphine, and you said you have pretty low side effects with it. As you said, you are already experiencing side effects from another drug (oxy).

    Good luck at your appt. Hope you can get everything worked out. Take Care.

     
    Old 04-20-2006, 09:13 PM   #7
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    Re: Oxycontin vs. MS Contin need quick help

    I've read the problems with generic OC. I can't really say why a fller would cause nausea but it seems to happen to some. also think trippling a dose of opiate would cause nausea and dizziness. Headaches can occur with most opiates because they increase inner cranial pressure. Dizziness is another symptom of too much med.

    I doubt the problem would be tolerance after 9 days, but once tasted, "relief" it may be hard to accept less, how much relief we need is a question we all have to live with. I would love to be able to just knock myself out safely on occaision.

    This is a honeymoon that would eventually level out too as far as pain relief. We all need a break from time to time so It's not like you did anything wrong. But 20 mgs of Oxy 3 times a day may be effective enough maybe you could step down to 30 mgs of oxy 3 times a day. If you have good insurance, The less you can get away with now the better, if you'r still going to need meds in 5 years.

    30 mgs of morphine 3 times a day would have been the ideal thing to try if you didn't have to stop due to side effects. Hopefully the decrease or switch will solve the side effect problem. I can't imagine a doc having a problem decreasing a med . The 40's willl always be there and it's nice to know they work.
    Good luck, Dave

     
    Old 04-20-2006, 10:11 PM   #8
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    Re: Oxycontin vs. MS Contin need quick help

    Geez. I can't even get my Doc to admit to me that OxyContin exsists and here, you're being thrown 40 mgs of Oxy!

    Alan

     
    Old 04-21-2006, 06:16 AM   #9
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    Re: Oxycontin vs. MS Contin need quick help

    It's all just a little sick,isn't wolf?it amazes me at how agressively some docs will treat pain patients and yet other docs wouldn't let you touch any sort of narcotic even if you had cancer.It would be wonderful if they would all get on and stay on the same page.a little continuity would be nice.

    Hey shore,i don't think the endo probelem is with the fillers,but some how related to the actual delivery system in some way.with the name brand oxy,you will see those "ghost matrix's"or the 'shell' of the delivery system in, pardon me,your,BMs? but with this endo version,they actually dissolve into your system in some way and there is not matrix left behind.I really do think there is something having to do with that.it really did cause me some horrible nausea that I just did not actually ever have with the name brand.once I was back on it,i was fine.But something is just not right about the endo version.i felt a very definite difference between the two also the coverage did not "feel' the same either.usually when I take the OC the first place I feel any sort of actual relief is in my c spine area?with the endo,it just didn't go there in the same way.the relief was not as quick or as effective.maybe its just me,but I did see alot of other folks on various forums with the very same problems that i described,and it only seemed to be with the endo version,or the problem was the actual oxycodone itself.who the heck knows.marcia
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