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MidlineNotFine 05-18-2007 07:10 PM

OxyContin & Hydrocodone
 
I have had increasing abdominal pain over time. Luckily (put into perspective), they may have found a culprit though it might only be one of a few.

My pain specialist and I met recently. The doctor said 30-40 mg of hydrocodone per day was ok for now until my procedure and then we will re-examine. Because the hydrocodone (up to 10 mg per dose) treats my increasing chronic pain but not really bad flare-ups, he prescribed OxyContin 10 mg for those episodes that last hours. Good example was me rolled up into a ball on Easter in the bathroom during dinner b/c I couldn't do anything else.

My doctor is great. Very understanding and treating me for another condition as well but after researching it more tonight, in anticipation of another flare-up sometime soon (it's inevitable based on experience), it seems to me that OxyContin is meant for long-term relief and the short-acting hydrocodone for breakthrough usually. The Oxy is prescribed for 10 mg every 6 hours as needed whereas the hydrocodone is 10 mg every 4-6 hours as needed. Based on what I have read, the Oxy is meant to be a 12-hour reliever and I know (and the doctor and I discussed) that the hydrocodone was not addressing the severe flare-ups so I'm a little confused. Maybe it's an effective combination?

Should I be asking if oxycodone in a short-acting form was meant to be prescribed instead? I definitely don't want to take OxyContin for an acute attack if it's not likely to help either.

Any suggestions? Radiologists are looking over all sets of film and I'm hoping a soon-to-come procedure knocks out some of this. In the meantime, I want to make sure I limit and manage equally as best I can.

Thanks!

erfan 05-19-2007 12:11 AM

Re: OxyContin & Hydrocodone
 
Your Doc is wrong. OxyContin is a long term med that is supposed to last 12 hours although 8 is more like it from what I hear.

OxyContin should be rx'ed as a base med with hydro for b/t.

Personally, I take 120 mg of oxycodone a day for bt.

Oxycodone is short acting and is the med in oxycontin. OxyContin is the time released version of oxycodone.

Alan

whosit 05-19-2007 10:41 AM

Re: OxyContin & Hydrocodone
 
[QUOTE=MidlineNotFine;2992064]I have had increasing abdominal pain over time. Luckily (put into perspective), they may have found a culprit though it might only be one of a few.

My pain specialist and I met recently. The doctor said 30-40 mg of hydrocodone per day was ok for now until my procedure and then we will re-examine. Because the hydrocodone (up to 10 mg per dose) treats my increasing chronic pain but not really bad flare-ups, he prescribed OxyContin 10 mg for those episodes that last hours. Good example was me rolled up into a ball on Easter in the bathroom during dinner b/c I couldn't do anything else.

My doctor is great. Very understanding and treating me for another condition as well but after researching it more tonight, in anticipation of another flare-up sometime soon (it's inevitable based on experience), it seems to me that OxyContin is meant for long-term relief and the short-acting hydrocodone for breakthrough usually. The Oxy is prescribed for 10 mg every 6 hours as needed whereas the hydrocodone is 10 mg every 4-6 hours as needed. Based on what I have read, the Oxy is meant to be a 12-hour reliever and I know (and the doctor and I discussed) that the hydrocodone was not addressing the severe flare-ups so I'm a little confused. Maybe it's an effective combination?

Should I be asking if oxycodone in a short-acting form was meant to be prescribed instead? I definitely don't want to take OxyContin for an acute attack if it's not likely to help either.


Any suggestions? Radiologists are looking over all sets of film and I'm hoping a soon-to-come procedure knocks out some of this. In the meantime, I want to make sure I limit and manage equally as best I can.

Thanks![/QUOTE]

yes your doctor is wrong. I would ask him about this and bring up exactly what you said here. You should have a instant release form of oxycodone. Ask your doctor about percocet 10mg and this should provide better relief than the hydrocodone as it is much stronger than hydrocodone. The oxycontin will release 1mg or so an hour when you take it if 10mg tabs and when you have the attack as you say you really need a BT pain reliever that will relieve the pain fast and not over time. If your attacks last only 6 hours or so then a percocet should do the trick. I am in no way giving you medical advice in place of your doctor though and you should always consult your doctor before dong anything you see that I type because I am not a doctor or related to the field in any way. I am just having pain and know a few things because I have been through it before.


wvrecon

MidlineNotFine 05-19-2007 03:12 PM

Re: OxyContin & Hydrocodone
 
Thanks for the advice. I'll call my doctor Monday morning as I had a BT episode again today and the oxycontin did not help even when added to the hydrocodone I am prescribed to take regularly - which makes sense based on what I am reading here. All it did was make me a little more tired after the episode passed (5 hours this time).

Again, thanks for helping to clarify! Really appreciated.

MNF

whosit 05-19-2007 07:13 PM

Re: OxyContin & Hydrocodone
 
What exactly is your condition if I may ask?

MidlineNotFine 05-19-2007 09:09 PM

Re: OxyContin & Hydrocodone
 
No problem - happy to share. Unfortunatley, the doctors don't know. I have had upper midline abdominal pain for about 2 years. Have severe episodes of pain and also lingering pain. More recently my right side has become chronically painful and increasingly so.

My gallbladder was removed 2 years ago (gallstones) but the pain persisted. Since then there have been three MRI's, an upper GI scan, an ultrasound, two endoscopies (one w/o sedation which was a real joy!) and dozens of blood work along with loads of different medications tried (some with very unpleasant side effects with some still affecting me even after discontinuation for months). This was all a mystery until recently when they found probable issues with my biliary tree. They think that's what's causing the right-side pain, but they're not sure. Radiologists are going back and reviewing all tests again to compare and then there will be a consultation. Looks like a path to an ERCP to check for cancer (runs in family), fix scar tissue, open up the bile duct muscle ... they won't know until they are in there. Even then, I'm skeptical this will address the mid abdominal pain, but one can hope. If not, my GE specialist (third one by the way) says it's basically the only untried option left before this shifts to strictly pain management so I need to stay positive about the whole thing for me and my family.

Sorry to be long-winded. I appreciated your help so I thought I'd give some detail since you inquired. Thanks again for your help!!! I actually had a second attack later today - unlucky day.

whosit 05-20-2007 02:26 AM

Re: OxyContin & Hydrocodone
 
wow sounds complicating. I am sorry to hear they dont know what is wrong yet. Keep optimistic about it and hopefully they will fix it this time and you wont need anything for pain! PM is no fun because you still have to live with the pain no matter how strong your medicine is or how well it works, there will be pain at some point. it never fails. I wish you the best of luck and hope you get everything solved and they find everything. If you need anything we are right here to help if we can.

Wvrecon432

butrfligirl28 05-20-2007 07:44 AM

Re: OxyContin & Hydrocodone
 
Just remember, surgery itself caused your pain, and you are considering another surgery? Abdominal surgery is serious, and can cause ahesions and scarring that can make your pain worse. My pain is abdominal too, and caused by a surgery. I have been in pain management for nearly two years, as I continued to see many specialists to find the cause. The cause was FINALLY found, and has to be corrected surgically, as there is not other was to treat it. Do not rush into surgery, and I would try pain management and other specialists before I would agree to an exploratory operation that may leave you in more pain than you are suffering from now.

By the way, all the studies show that WOMEN are many times more undertreated for pain than men, and have a much harder time being taken seriously. For the same operations, or painful conditions, women are routinely prescribed lower doses for shorter periods of time.

MidlineNotFine 05-20-2007 09:54 AM

Re: OxyContin & Hydrocodone
 
Thanks again for the help, advice and thoughts. I am very glad to have found this board.

butrfligirl28 - regarding another surgery or procedure, I agree with you wholly. My first of three specialists wanted to do this over 16 months ago but I did not see enough data to support it. So I saw another doctor and had more tests ... and then another doctor with more tests. My common bile duct is more than 4x the ideal size so there are now risks in fixing and not fixing it. Trending the test numbers, it now looks to me like the procedure is necessary even though it may not "fix" me. The alternative of not doing it could lead to liver and pancreas complications.

What has really been good for me, and I don't know if this is the case generally, is having a specialist treat me for pain and the GE specialist(s) try and diagnose the abdominal problems. The GE specialist is really doing their due diligence to check and double-check all the film I think in part because they don't have to worry about being the one prescribing (and having me become dependent upon) narcotics. On the other hand my pain doctor knows me very well due to treating me for months for sleep disorders and is comfortable just addressing the pain issue while I keep him informed of every development. It has been a good group effort ... wish it hadn't taken 2 years to get to here!

Last thing - I am wordy! - I just wish I had taken more time to research and consider the ramifications before I had my gallbladder removed. I was in pain and I just trusted the doctors and now I may have semi-permanent or permanent plumbing damage. Hard lesson to learn.

Thanks again everyone. It cannot be said enough in my opinion!

MNF

Rrector 05-21-2007 01:47 PM

Re: OxyContin & Hydrocodone
 
Hey Midline...I just wanted to correct something in the post by WVRecon and the info he gave you in his 5/19 post. While it's true Oxycontin should be used as a base med and Hydrocodone or Oxycodone for BT, the manner in which Oxycontin releases the medication is not what he posted to you.

When you take Oxycontin, whether it be 10 mg or 80 mg, it is NOT released 1 mg an hour as he stated. Oxy's release function is the first hour you will get approximately half of the medication. If it's a 10 mg Oxy, you will get 5 mg. At approximately the sixth hour after taking it, you will get the second half of the med, about 5 mg. It doesn't matter what the dose is, this is the way it's released into the bloodstream and why it shouldn't be used for breakthrough pain, but it is used as the base med.

MidlineNotFine 05-22-2007 04:25 PM

Re: OxyContin & Hydrocodone
 
[QUOTE=Director;2996518]Hey Midline...I just wanted to correct something in the post by WVRecon and the info he gave you in his 5/19 post. While it's true Oxycontin should be used as a base med and Hydrocodone or Oxycodone for BT, the manner in which Oxycontin releases the medication is not what he posted to you.

When you take Oxycontin, whether it be 10 mg or 80 mg, it is NOT released 1 mg an hour as he stated. Oxy's release function is the first hour you will get approximately half of the medication. If it's a 10 mg Oxy, you will get 5 mg. At approximately the sixth hour after taking it, you will get the second half of the med, about 5 mg. It doesn't matter what the dose is, this is the way it's released into the bloodstream and why it shouldn't be used for breakthrough pain, but it is used as the base med.[/QUOTE]

Thank you. My doctor actually confirmed yesterday that this is what he intended and perhaps it's because the 5 mg is released in the first hour. I am not sure what the normal dose of oxycodone is in Percocet or related short-acting medicines but I typically take 5 mg of Norco (I break a 10/325 in half - the Tylenol aggravates my stomach - I have gastritis too) multiple times a day so during the onset of an attack I already have that in my system.

Anyways, it didn't seem to help much this past weekend, but my doctor did say if it's a smooth muscle problem, there may not be much that will help. I do appreciate the clarification! I'll probably just stick to the hydrocodone if the next couple of episodes are roughly the same - at least until they can go in and try and fix things.

Thanks!


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