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  • Tylenol 4 or Roxicet?

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    Old 05-12-2007, 01:46 AM   #1
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    Tylenol 4 or Roxicet?

    I have RSD in my foot, now spreading up my leg. I've had it for two years now. In those two years, I have mainly been on Tylenol 4's (60mg Codeine Phosphate, 300 acetaminophen). I get 90 a month.

    It's not working well anymore. I feel like they help with the aching pains in my foot and leg for about two hours, and then I'm back to 100% pain again. I've been doing some research on different painkillers, trying to see if there's one out there that may work a bit better for me.

    I don't like taking so much of the acetaminophen... I'm afraid it will do serious damage to my liver as time goes on. I would love to try Oxycontin (That's the one without the Acet. in it I think), but I've heard about how addictive it is, so I don't know if both my doctor will prescribe it, and if I want to take it since it is so addictive.

    I've read a lot of about Roxicet (Which I think is the same as Percocet?). It's 5mg Oxycodone and 325 of Acetaminophen. This would mean I would get more Acetaminophen, which is not good... but at this point, I am more worried about this pain that is controlling my life and making it hard to just get out of bed in the morning.

    I'm not sure if these are really stronger painkillers or not? I know that the Tylenol 4's have A LOT of Codeine in it, and I seem to do well with Codeine, it helps with most of my pain... I'm not sure how many mg's of Oxycodone are like equal to 60mg of Codeine. Does anyone know?

    I'm not sure what I should take... I will talk about it with my doctor when I go in a few weeks and see what he says, but I like doing research on my own first anyway

    I'm just confused by all the pills I read, they all have Codeine, Oxycodone or Hydrocodone.. and I don't understand the difference in strength. How much hydrocodone is as strong as how much Codeine or Oxy, etc. Does anyone know? Any help would be greatly appreciated

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    Old 05-12-2007, 07:30 AM   #2
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    Re: Tylenol 4 or Roxicet?

    Hey, Please don't make the mistake of feeling the need to remind your doc about the dangers of tylenol, Trust me, He knows and you are not taking anywhere near the max dose. For short term use the max single dose is 1000mgs per dose or 4000 mgs per day, if you use it daily for chronic pain they usually cut that in half and your doc is using half of what's considered safe for long term use, so he knows.

    If you need something stronger, explain that asking for something stronger that has more tylenol because your concerned about the tylenol doesn't come across as having much faith in the doc and makes no sense when it comes down to it. The next logical step would be hydrocodone, codeine is a reltively week drug. They do make hydrocodone products in 5/325, 7.5/325 and 10/325 just like they make oxycodone in those same proportions of opiate to apap. Why skip over the entire class when hydrocodone is the obvious next step, if it doesn't work, then you canreport it's not working and your doc can move along, but itt's all trial and error but jumping over an entire class because someothing sounds likeit willensure better relief is no different than placing your order for meds you want.

    . If you haven't tried the hydrocodone products it's the next logical step, if you apap dose ever reaches a level above that which is considered safe, he can use pure oxycodone or other pure opiate formulations that have no tylenol. If he feels you need long acting meds, andis comortable prescriing them, you will get ier some day to, but few docs make the jump from 3 T4's a day to Oxycontin.

    Telling your doc your concerned about your apap intake woukld be like demanding to see the pilot after take off and asking if he remebered to raise the landing gear. He really doesn't need your help when it comes to the basics, like tylonol dosages. I imagine you have knowledge in your field of expertise that you don't feel you need to be reminded of by every one you have contact with. Asking for a specific med change when it doesn't reduce your apap intake, doesn't really make sense and comes across as being dishonest or shopping or specific meds.

    If you need something stronger, just stick with the truth and let him be the doc, he's the one with a decade of education regarding drug safety. If or when your daily apap dose gets high, your doc will keep an eye on it and do liver function tests and make the apropriate med changes when they are needed based on your reporting of effectiveness, not on undue concern about apap when he's perfectly aware of the dangers of it. If he doesn't know too much apap is bad for you, you should be looking for a new doc, not trying to educate him on the most basic concepts of pain management.

    As far as strength of meds it goes, codeine -Hydrocodone- morphine-oxycodone-oxymorphone- Hydromorphone- methadone and fentanyl the last 6 listed are available without any apap. Give your doc the information he needs to manange your pain and let the doc be the doc. If you could spend 2 more years on hydro 10/325, why not. Why skip steps on the ladder. If he wants to do it, fine, but requesting specific drugs usualy isn't a good idea especially when you talking about going from the mildest pain killer to the ones that have the tightest state and federal controls and much greater potential for abuse. Why use oycodone if hydrocodone would work.

    Good luck, Dave

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    Old 05-12-2007, 01:15 PM   #3
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    Re: Tylenol 4 or Roxicet?

    Well, like I wrote in my post... I'm in extreme chronic pain, it's very bad. But I've said before to my doctor's that I don't want anything too strong, because I don't want to have myself get addicted to them, I've seen it happen so much... and while I do have faith in myself, you just never know.

    Hydrocodone is what Vicodin is, right? This same doctor originally put me on Vicodin ES (7.5/750) but they didn't help with the pain in my foot and leg at all. It's strange because two months ago I had my wisdom teeth pulled out, and my dentist gave me a prescription for Vicodin, and it helped my mouth pain... but not my foot. I don't know how it makes sense, I guess they are just different pains.

    I'm not sure, maybe the 10/660 would work.. maybe it won't. I will tell my doctor that the T4's are just not lasting long enough. The other problem is the cost of all of these medications. Since I'm at trial right now with Workers Comp, I'm trying to get Medicaid because I have no health insurance. As it is, the T4's cost about $60 a month (It may not sound like much... but when I'm totally dependent on my father, and he doesn't make too much money anyway, it's a lot of money a month.. plus the cost of my other meds). I think when I got the Vicodin's, they were about $1-$2 a pieces (The generic).

    It's very confusing... I know that I should probably get something stronger... I'm sorry that it sounded like I was going to demand Oxycodone from my doctor, that's not what I was saying. I meant that I've tried hydrocodone before, in Vicodin ES form, and it didn't help with this type of pain at all. I didn't realize how much stronger Oxycodone was, that's why I was asking in the post I've just heard horror stories about how addictive it is, and also I've seen that the price of it is a lot, so I know I won't be getting that.

    I wish there was something else in between the Codeine and Hydrocodone.. But I wonder why the Hydrocodone won't work for my foot, but Codeine will (And it's weaker?). The other weird thing, is when I took a Vicodin (For the first time in almost two years), I didn't get any of the 'weird' side effects. I didn't feel all fuzzy and everything, when I know my body couldn't be tolerant to it since I only took it for a month once in my life, two years ago. But every time I take one of the T4's, I feel strange for a while.

    Maybe I should go to school and be a pharmacist, then I will understand everything about all of these medications heh.

    Old 05-12-2007, 10:53 PM   #4
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    Re: Tylenol 4 or Roxicet?

    I dont know close to as much as Shoreline knows I'm sure, but hydrocodone 7.5 is equal to oxycodone 5mg. Its weird that codeine would work for you, and the hydrocodone didn't.

    Old 05-13-2007, 12:44 AM   #5
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    Re: Tylenol 4 or Roxicet?


    The best advice that Dave gave you and I'd give you too is to just report to your Dr. your condition and how the medication you are on is working now as compared to last month or last year.

    Different pain meds. can work on different receptors in the brain and we are all 'wired' differently. So you may respond really well to codeine but not as well to oxycodone. Or vice versa. That is why when a Dr. changes aa patients medication (pain) he/she will do their conversion and start the patient off at a percentage of what the med. 'converts' in the medical books to.

    So your 60mgs. of codeine converts to 9mgs. of hydrocodone. It also converts to 6mgs. of oxycodone. If the Dr. was changing you to hydrocodone he would probably like to start you on 5 or 6 mgs. to replace the 60mgs. of codeine and see how you respond. You may find it works much better for you and the 5mgs. of hydrocodone might work BETTER for you than 60mgs. of codeine. If not, he can, with meds. other than methadone, titrate the dose up quite easily and quickly.

    Good luck!!


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    Old 05-13-2007, 06:07 AM   #6
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    Re: Tylenol 4 or Roxicet?

    I think the next change would be to percocet (oxycodone and tylenol). You can get 5/325, 10/325, and others with more tylenol. After Lortab or Vicodin doesn't work, many docs change to percocet.

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