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    Old 01-14-2007, 09:26 AM   #1
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    Lightbulb 1700 mgs of codeine contin DOC IS CHANGING MEDS HELP

    OK was taking 1700 mgs of codeine a day yes a day!
    tolerence built up over 20 yrs of meds,and im fine health wise
    doc wants to change me to something stronger so i dont need all these pills a day,
    a few months ago we tried some morphine wich didnt work to low a dose 2mlgs every 4 hrs,well it didnt work,then we tried 20 mgs of oxycodone 2xday plus 5mgs of oxy ir every 4 hrs .almost but didnt work,felt horrible on these tries....
    figure it was so low a dose then doc said lets go back to the codeine 1700 mgs again,i was sad.

    so last week we are tring again on the oxycodne and oxy ir

    ''40mgs 2x a day oxycodone, plus 10 mgs oxy ir every 4 hrs''
    prob here is it doesnt last very long weres off in hours

    Need help in finding out the equal dose to convert from 1700 mgs of ''codeine contin'' to oxycodone mgs, I would love to be able to have a good day,and get this sorted out once and for all....

    thank you so much
    2 herniated thoracic discs work injury 1990
    going to see doc early this week and would appreciate any help on this topic,so i can i help myself and doc to get this chronic pain under control!

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    Old 01-14-2007, 09:34 AM   #2
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    Re: 1700 mgs of codeine contin DOC IS CHANGING MEDS HELP

    all the help i can get!
    anybody that knows there stuff pls respond

    the 40x2 a day oxycodone
    plus 10mgs every 4hrs
    wears off to fast
    need someone to convert these meds pls
    thank you

    Old 01-14-2007, 09:35 AM   #3
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    Re: 1700 mgs of codeine contin DOC IS CHANGING MEDS HELP

    Hey Len-
    Has your doctor ever mentioned or considered Norco? It's stronger than codiene, but not as harsh on the system as the oxycodone. Basically it's the same thing as vicodin, but with less of the tylenol. I'm using 7.5 mgs and although it doesn't make the pain totally go away, it brings it down to about 4-5 range which is do-able for me.

    I wish you luck. Keep checking back because there are folks here who can give you the information you need as far as converting the medication totals. Sorry I can't help you with that part.

    Good Luck!

    Old 01-15-2007, 09:00 AM   #4
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    Re: 1700 mgs of codeine contin DOC IS CHANGING MEDS HELP

    Hey Len, You can go to the Purdue of Canada sight and see the full prescribing info and the conversions from one drug to another under Codeine contins' Imprint info.

    I tried to figure it out but as many times as I have changed meds and then onto the pump, they always start low. The manufacturers tell them to do the calculation and start at half of that. The idea is to see if cross tolerance is incomplete and they can get by with less of a different med. If you start high, you may not get a chance to make an adjustment .

    It took 20 years to get to where you at. There is no chart that will gaurentee equal pain relief particluarly when your high dose. Not that the codeine would convert to reallyhigh doses of oxy or morphine. It looks like he started around hal of what the chart says and the chart probably is half of what patients really need. Unless you are his only patient and doesn't expect to have to make adjustments it really doesn't make sense to give up and go back especially when your taking that much codeine.

    A much smaller dose of oxy of morphine would have to be easier on the stomach. Another problem is duration of oxycontin. I don't know if the codeine really lasted 12 hours, but in the stetes, neither MS or Oxy are well known for lasting 12. 3 times a day with morphine is standard and 3 times a day with oxy is what most folks need. BT meds can bridge that gap between hours 8-12, but that's not the intention of BT meds.

    Your doc can't even tell you where you should end up. It's a process of getting you in or near the ballpark and then workng on it from their. It took 16 adjustments and 6 months to switch from oral morphine to a pump delivering morphine. It's also taken 6-8 weeks to get every med I ever switched too at an effective level. It really sucks, you hurt, you may have withdrawal, but hopefully there is light at the end of tunnel if you trust your doc will work towards finding relief. It's not like he was afraid to increase the codeine contin. If you or your doc give up on a med too fast, their won't be anything left to try.

    Try and figure out what your doc expects, surely he doesn't think he can just pull a number out of the sky and gaurentee better relief? Is he expecting to make monthly adjustments or weekly adjustments untill it's right? A few weeks or months really isn't a long time when you have been in pain for 20 years and your probably going to be in pain another 20. It's just the price of safety and not starting higher than they have too.

    Codiene is much weaker than morphine mg: mg, and oxy is even stronger than morphine. It's going to take some adjustments and you may end up taking 4 times the dose you are now, your doc should know this. It's just a matter of how fast does he think he needs to get you there. Waiting a month betwen adjustement would be a nightmare, waiting a week isn't unreasonable.

    Even Purdue's guide is going to be conservative or they take a risk if a doc uses it and someone OD's. All I can say is give each dose a little time, allow your body to adjust and try to figure out what your doc is thinking as far as time line. When is it right to call and say you're still not there.

    Good luck, Dave

    Last edited by Shoreline; 01-15-2007 at 09:13 AM.

    Old 01-15-2007, 09:50 AM   #5
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    Re: 1700 mgs of codeine contin DOC IS CHANGING MEDS HELP

    Thank you for your time i just want this to work out,i dont care for the codeine ,it really hasnt worked they way it suppose to for years,just kept going and hoping for the best possible day!
    i would go to work because i need to
    hired another guy to help with all the heavy work and bending,and this does take off some pressure
    soon as i get in rest is always there ,and dont do much rest of the day
    i still have some door casing to nail to the door jamb,think its done lol.
    its just to much after work

    I beleive this route of meds can work its just got to be upped a bit i guess
    like most ppl here just want what best possible treatment i can get
    If the doc would dbl the dose it would be enough for sure as i am very close to a better day of pain control
    the codeine keeps my head cloudy and so far with these meds my head is not cloudy the days are clear never felt like this for so long with meds in my system,i want this to work i will not go back to the codeine,as it kept the pain ''just'' managed
    if anything this should provide a little more then that,more smiles and a happier me.most important less pain and less pills
    thank ppl i will stay in touch everyday

    Old 01-16-2007, 08:01 AM   #6
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    Re: 1700 mgs of codeine contin DOC IS CHANGING MEDS HELP

    Ditto on what shore just told you.i DO really think if you can just get the three times per day dosing schedule,that alone will solve most of your problems right there,and you can then use your break thru meds actually as breakthru and not part of your daily meds.i really didn't get gret relief either til i told my PM about feeling like the oxycontin just was not making it the full twelve hours at was right then that she upped me to the 3 times a day and it really helped sooo much more.actually most real PMs do know that OC just dosent realistically make it for that last few hours,but like mine does,the always START the patient on the every 12 but if the patient really feels it isn't doing the job,then they will go ahead and go to the every three.

    If i remeber correctly,that last release of the oxy comes at 6 hours in and then it is expected to actually last another 6 hours?not really effective,at least not for me.i don't know of too many people who could actually take any pain med and expect it to actually last a full 6 hours.for me,its like maybe four at best.just have a chat with your doc.the oxycontin at three times a day really helps me to stay more even with the pain that actually responds to it.good luck,marcia
    3-22-01,herniated C-6-7
    11-20-01,placement of hardware for failed fusion
    9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

    Old 01-16-2007, 03:16 PM   #7
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    Re: 1700 mgs of codeine contin DOC IS CHANGING MEDS HELP

    Hi there,

    I hope that you can find a happy medium with your Dr. to get adequate pain relief without too many side effects.....Like Shoreline's normal to have some effects...the key is managing them and finding a medicine where we can get our pain to an "acceptable" level...ha ha....and not be so debilitated by the medicine...

    After just having my 3rd cervical re-fusion for C6-C7 level and they went in from the front AND the back during the 5 hour surgery...They added a cage with BMP (bone morphonegenic protien) more metal plates, screws and rods....

    I am loaded up! Even have this cool "x-ray card" that I carry with me when I travel for the airport screening's taken about 5 years and lots of different Dr.s to finally be so happy with my new surgeon who just performed this surgery in November. And, my new pain mgmt. Dr from the last 6 months is in the same practice....And...all these years on testing/trying different medicines....

    I can't take any codiene makes me SO nauseaous...(sp?) and I feel awful! same with Neurontin....I was extremely dizzy and almost fainting and throwing up...

    I also tried the Duragesic patch and could have died on it since they didn't tell me that even taking a long hot shower which I LOVE to's an "event" for me...LOL...with my music playing, singing, etc....HA HA...but they had me (other Dr.s) on 75mg patch and I passed out on the floor with barely a heartbeat after my shower......So....never again.....but....I realize that there are tons of people who have perfect success with those....

    I am finally on a combo of Oxycontin 20mg. 3 times a day...Like feelbad and others's really better at 3 times a day since it doesn't seem to ever work for 12 hours....8 at a maximum for me.....Then I have Percocet 7.5/325 and I take 2 every 4-6 hours but no more than 8 in a 24hr period to watch the acetaminophen....I also have Robaxin 750mg as my muscle relaxer...I just LOVE this one since it doesn't make me tired but does an awesome job to keep my muscles from getting too take as needed....about 3 a day....Then I take Cymbalta for the nerve pain which does great....even though I've never been diagnosed with depression...i've had chronic pain for so long that I KNOW it helps me stay in a joyful mood and "deal" better with the pain....And lastly...I take Ambien 10mg (usually split in half)...NOT the CR should never split those.....and I take this if I didn't do very much during the day since that makes me less sleepy at night...It REALLY helps me get a wonderful night's sleep.....I've had this since mid 2006 and can go off/on this one with no problem....But it has helped me tremendously with dealing with my pain the next day as well because of a good night's's something that all my other Dr.s' before seemed to overlook.....along with a good anti-depressant.....physical therapy, accupuncture, massage, and even exercising...

    I just joined Curves (am I allowed to say that?) and because it's a quick, 30 minute's the PERFECT solution for me....I don't "over do" it there and it is both cardio and muscle toning in the same workout...even though I am still at a 4/5 on the pain scale and it's only been 2 months since the surgery...I feel better than I have in years....Even if that is the only thing I can get my body to do in the whole day....I want to be as "healthy" as I can be with this pain. I also have a pituitary tumor that just got diagnosed....

    I will be praying that you can find the perfect combination of medicine and other modalities to help deal with your pain. You will find so many knowledgeable people here who are going through similar things....Even though there is never a "one size fits all" regimine and you should always talk to your Dr. before switching or modifying your's nice to get "examples" of what others are doing to maybe as about....I certainly found great ideas as well as wonderful comfort from everyone here....


    Old 01-16-2007, 05:31 PM   #8
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    Re: 1700 mgs of codeine contin DOC IS CHANGING MEDS HELP

    I agree with a bunch of the folks here you would be better off if you doctor would prescribe you a LA (long acting) med that you could take 3 times a day then if needed something for breakthrough pain. 1700 mg sounds like a ton of medicine but I am sure codeine isn't nearly as effective as oxy, roxicodone, oxycodone etc. I noticed you are still working, I understand we all have to make money to survive, I was working at one time just to have enough money to buy the pain pills for the working I was doing, it was terrible but I would work under the influence and couldn't tell the damage I was doing until the meds either wore off or I ran out. Is your medical condition as such you can file for disability, social security or any type of assistance. I know what you mean about that bending twisting and lifting it will really get to you. I am totally disabled, it took my disability 31/2 years to go by, it was terrible that they make you suffer that long only to give you the back pay afterwards, but anyone in the Government work at a snails pace, it is called job security, they will have something to do tomorrow I guess. Tolerance to medicine was and is a terrible thing to deal with, I was taking LA opiate for 3 years and the DEA put one doctor in our area out of business years ago for helping people with their pain. Then several doctors if not all of them really clamped down out of
    fear after that. I was taking oxy 2 times a day 40 mg, and 3 roxicodone 15mg per day for BT pain and couldn't deal with the pain and the doctor refused to up my dose. In Dec 2004 I also had a Codman morphine pump implanted and I finally am getting some relief now. As Dave (shoreline) taught me through looking through these post once they get your pain under control you have to learn how to live with a certain amount of pain but not too a point of where you are suffering. I would say I am at 75% reduction in pain and I will take that all day long from where I came from. God Bless and I hope your meds get straightened out shortly. I really believe that if your PM Doctor can get you on the right LA meds you will do better.

    Old 01-17-2007, 01:21 AM   #9
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    Re: 1700 mgs of codeine contin DOC IS CHANGING MEDS HELP

    Hi Len,

    I don't know if anyone has brought up the 'ceiling effect' with pain meds..
    Basically it means that when you get to a certain dose, taking any more of a medication has zero effect.

    So if you were taking aspirin and the ceiling was 1200mg. and you took 2400 mgs. the extra 1200 would offer you no greater pain relief than the 1200mgs. would. Of course it would be much worse for you when it came to side effects.

    Based on what I've read over the years, morphine, oxycodone, fentanyl etc. do NOT have a ceiling effect and if a patient is getting dependant on a med. but tolerating it well the Dr. can increase the medication and expect better pain control.

    For whatever reason, the information I've read on codeine says that it DOES have a 'ceiling effect' so I'd think Dave's information would be right on when it comes to other meds..

    Good luck


    Old 01-17-2007, 10:36 AM   #10
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    Re: 1700 mgs of codeine contin DOC IS CHANGING MEDS HELP

    Thank you everyone,
    I went yesterday to docs again, In a way I hate to go ,not so much the doc and telling him the oxycodone needs to be upped( well sort of just wish i can have a magic wand and any pain med works )
    well he upped the break through meds only,10 to 20mgs not long lasting ones..
    I figure down the road he will eventually change the short acting to long acting form.
    The other problem is i dont like that a doctor is under pressure already helping with the pain"" upping the meds "" so i want to keep away from him as much as possible ,only needing to talk to him when needed telling him that it works and those such things!
    So we sat down yesterday he agreed to up them and talked about what some patients get for pain relief when they are terminally ill ,and he said that I get more,so sometimes I count my lucky stars,that im getting treated!
    BUT then you go to the drug store IT GETS WORSE,they say you still have pills and all sorts of Q ,related to my should have enough... and regardless of what your doc does you still got to get threw them geez
    told them doc and i counted the remaining and he upped them and gave me more so i can start the new dose as soon as possible, then get new refills next time,
    After all that he says(pharmacy) ill take a few minutes to get it ready I tell him Ill be right back, i get a call on my cell 4 min later from the drug store telling me were out of stock it will be ready next day!!

    I understand some times things need to be done and confirmed and what not, but this type of action from pharmacy when the script is done, only ADDS XXTRA STRESS to a person already suffering from CP
    and we dont need the xtra anything really.
    Then out of all of this there gonna call the doctor again geez!!!!

    When I see doctor next time it starts to look like im a headache and all because of a stubborn pharmacy( believe me they never smile and working for the public you should be in every way the best person possible)
    You can just tell when looking at these individuals they dont want you to have a good day, always got to poke there nose in there and looking for you to say something out of the norm...and call doc and say something,

    I hope to god this is the only place and last time that i will get this feeling
    coming from a pharmacy
    I am not a type of person to walk into a place and show my pain,umming and oooing,about how bad it is, its just not me.
    I hope the are not judging a book by its cover !

    thank you everyone for letting me vent
    probably better off doing it here and not at the pharmacy!!

    have a great day

    Old 01-17-2007, 03:17 PM   #11
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    Re: 1700 mgs of codeine contin DOC IS CHANGING MEDS HELP

    Thats horribe, I thanks my stars for the pharmacists I have. There is one at another big chain pharmacy in town, and hes the nosiest a** ever.
    The one I go to, the pharmacists smile, laugh, chat, ask how Im doing, ect. I love them all. There is one guy sometimes who can maybe cause a tad of trouble, but hes really anal, and has to call the doc on everything.
    I hope you get your meds straightened out!~

    Old 01-18-2007, 09:56 AM   #12
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    Re: 1700 mgs of codeine contin DOC IS CHANGING MEDS HELP

    Hey LenB...........OMG......I SO, SO know what you are feeling about your pharmacy. Before I switched to the pharmacy I go to now (at the request of the nurse at my PM doc's office because they work closely with this pharmacy and it is right next door) I went to two different pharmacies. I changed from the first because I felt that everytime I came to pick up my refill, I was being judged!! Same as you...........they would say...."well, gosh, you just filled your prescription ____ days ago" blah, blah, blah. Granted that was a while ago so I was going through my meds quicker than I was allowed because I was not getting adequate relief. SO......I couldn't stand the feeling of humiliation at the pharmacy anymore so I switched to one around the corner (I never double-dipped, only changed legitimately) only to get treated the same way. And.......they're not discrete about the way they treat you. They will yell across the whole pharmacy, "WHAT? SHE'S HERE NOW? SHE'S THREE DAYS EARLY. SHE CAN'T REFILL UNTIL MON." Right there in front of EVERYONE who is standing in line behind you!! I really felt that I was doomed to a life of embarrassment and humiliation every time I had to pick up a refill! Any I said I changed again at the request of the nurse........OMG what a difference a pharmacy makes!!!!! I have NEVER, not ONCE been treated that way at my new pharmacy! They have the same demeanor whether they are feeling an antibiotic for a 5 year old boy, or Oxycodone for me, a 41 year old woman. I felt SO grateful that at Christmas time I bought the pharmacy 2 pounds of See's candy and wrote them a "thank you" note in which I thanked them for treating me with dignity. I told them that I have never felt judged when picking up my prescriptions and that meant the world to me. I told them it's awful enough to be in chronic pain as we all are, let alone feel like nothing short of a criminal while picking up our legitimately prescribed medications! When I picked up my new prescription yesterday, the pharmacist actually came out to personally thank me for the card. I was SO, SO, SO glad that I let them know how they make me feel (or not feel! lol). Maybe they will take an extra minute to think about the misery that chronic pain sufferers go through and how horrible it is to add the extra burden of humiliation onto these patients. Although............the other pharmacies are the one's who need this information, not this SO............I really ramble but I wanted to say that there ARE pharmacies out there who treat there patients with dignity. I have one and obviously Izzy'sMom has found one. Maybe you could ask the nurse at your PM doc's office if she knows of a good pharmacy that you can switch to. Maybe there is one in particular that the office works with more exclusively and you could switch to it. Keep trying because, like we are all saying, that is just the most horrible feeling, to feel like you are nothing short of a drug-seeking, drug-addicted criminal when we all have legitimate, documented pain and injuries!!! Hang in there and maybe try that.

    Old 01-26-2007, 01:02 PM   #13
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    Lightbulb Re: 1700 mgs of codeine contin DOC IS CHANGING MEDS HELP

    i changed pharmacies and am very happy as i did get my meds filled here before,
    they were happy to see me !
    but the downside was i take the script and said i will pick it up later
    i got them the oxycodone slow release and IR release
    well i was taking them for a few days and tried to figure why they didnt work the way the others did the week before ,
    they were generic brand and geez they were awful as i didnt really have much of pain control if i did it was really low! didnt last long ,felt like half the dose the prior week!
    then again i start to think what am i going to do doc just gave me refills for 3 months o man
    and i figure i cant keep going on like this im just not getting anywhere
    so i figure here i go again bugging the doctor and the pharmicist on what to do told them i need the name brand .
    well i went to see my doc and told him whats going on and
    he looked and said there the same 20 mgs of oxy,i was like no there no good dont last long enough,
    right there he gave me a new script for 3 months and i gave him the rest of the pills back
    no problems and pharmacy was also happy for me!

    anybody else have a problem versus generic with brand name, oxycodone ,and the oxy ir,

    just happy all understood me and had no problem,doc wrote

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