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  • Oxycodone to Methadone conversion and issues.....

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    Old 02-04-2008, 09:24 PM   #1
    Bilbo
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    Oxycodone to Methadone conversion and issues.....

    Hello Everyone,

    Im going to ask the question first as I ofter blabber to long and bury the question. So- If I'm taking 40mg of Oxycodone ER every six hours (sometimes every 8), what is the equivilent Methadone dose? An online calculator that I have used in the past, that figures both meds in 4-5 hrs timeframes, said it would be 160mg every 4-5 hrs. Thats insane. It must be an user error or problem with the calc. A new calculator I have found (that is amazing and from a very trusted source) says 120mg per day of Oxycodone equals 60mg per day of Methadone. Can someone validate this?

    Now on to the rest of the story. Havent posted here in a while. Been over in the Men's Health section after learning that my testosterone levels were/are very very low. For those interested, were talking 112ng/ml and normal range is 241-823ng/dl. I have questions about testosterone and it relation to pain so look for another post.

    Right now I have a bit of a problem. My wife quit her job as the stress was just to much to deal with. She was a loan officer for a major bank and we all know what's going on with foreclosures and the economy. Anyway, we are without insurance now. She took a new job in a field she loves but it has no insurance. I have Medicare and will be on Part D come March 1st. I would stay on my current dosage of Oxycodone if it didnt cost over $400 for a months supply!!!!! I found that absurd for a generic med that is fairly old as meds go these days. I also have to dump cymbalta and find something else as its just way to expensive.

    So Shoreline or anyone out there, please help me calc this. I did a search here and didnt find anything.....
    __________________
    2 Lumbar Lamies 93 (age 22); Cervical Fusion C4-C6 2004. Lumbar Fusion w/ hardware S1-L4 2007, DDD & stenosis entire spine. super low T. 30mg Methadone BID 10-20mg Norco 4 BT. 2mg Xanax PRN.

     
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    Old 02-04-2008, 10:37 PM   #2
    forginon
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    Re: Oxycodone to Methadone conversion and issues.....

    This will be rough as I don't have my conversion table with me. First, you convert your med to its morphine equivalent. So, your max daily dose of oxy is 40x4, or 160mg/day. That's equivalent to 240mg morphine daily. I don't recall what the conversion ratio is, but it's probably around 4:1, which makes the total methadone dose around 60mg daily. Nice work!

    It's reccommended to start at around one third to one half of the total, so you'd start around 20-30mg per day and titrate very slowly to effect. For pain methadone is usually given roughly every 6 hours.

    Like I wrote, I don't have all my info right now, so I'll double check tomorrow if Shoreline doesn't offer a definitive answer.

    steve

     
    Old 02-05-2008, 07:56 AM   #3
    forginon
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    Re: Oxycodone to Methadone conversion and issues.....

    BilboCameron,

    Re-checked my numbers this morning and come up with the same results.

    Bottom Line is 5-10mg every 6 hours, starting dose. It's expected that the dose may need to be titrated over time with this kind of conversion. Please don't let this seemingly low dose scare you. Methadone is a very potent opioid, your pain should be covered very well, and you shouldn't experience any withdrawal symptoms at all. If so, notify the doc immediately and he'll take care of you. My prediction is that this will offer the best pain coverage you've ever had. That's the way it was for me. I started even lower, at 2.5mg every 6 hours. But I had detoxed off of all opioids and this was appropriate. I ultimately landed at 80mg per day and never required any further dose escalations, neither did I need any breakthrough medications.

    Best of Luck,

    steve

     
    Old 02-05-2008, 01:48 PM   #4
    forginon
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    Re: Oxycodone to Methadone conversion and issues.....

    BilboCameron,

    My experience is somewhat different, except that my problem is blown knees and a few other issues.

    Interestingly enough, I also just found out I had a very low level of testosterone. I suspected it, and knew that chronic use of opioids can cause a drop in levels, so I had it checked. My level is at 66, where normal is between 200-1000. I just had it rechecked and if we get similar results then I will begin testosterone therapy. I'm really hoping it will help in getting more in shape and such.

    What kind of improvements have you made with the testosterone therapy?

    steve

     
    Old 02-05-2008, 03:56 PM   #5
    forginon
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    Re: Oxycodone to Methadone conversion and issues.....

    BilboCameron,

    This is just amazing. And yes, it was fasting.

    I have gotten so used to feeling poorly and depressed, I never would have guessed it was testosterone. And, I didn't realize that testosterone could assist with these complaints either. I was pretty surprised at the level from the test, but didn't know its true significance.

    I've already had my blood re-tested and am just awaiting results. My doc only indicated that it was a bit low. Hopefully he'll treat me aggressively enough.

    Thanks so much for all this info and encouragement. One funny thing. I was discussing this with my daughter the other day and I looked up what levels a woman would have. Believe it or not, I fall into their range. So, after a few minutes I quietly muffled under my breath, "I'm a woman." She said "what did you say." So I told her. And she said "no way, because you don't have enough estrogen." We both laughed. But I know this is serious.

    I gotta get this taken care of.

    steve

    Last edited by forginon; 02-05-2008 at 03:57 PM.

     
    Old 02-05-2008, 10:52 PM   #6
    trowftd3
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    Re: Oxycodone to Methadone conversion and issues.....

    Bilbo,
    Glad to see you back and glad that Steve helped you out and you got your conversion taken care of. Please let us know how the switch to methadone goes this time. I hope you're not as sleepy this time.

    Hope the hormone therapy works for both of you guys. I think I need my own.
    Take care.~Mush
    Hey!
    I never really put it together before but we have similar pain. Exactly where do you hurt? I have always dismissed the pain in my back near my shoulder blade because of the pain in my lung and the pneumonia. The doctors have said all along that it can't be my lung but I've just held on to that because I don't know what else to do.
    Refresh my memory...when, how and where did your pain start?
    I am so sorry that you are, like me, still searching for the answers. I am calling tomorrow to make my first acupuncture appointment. I had planned to do it before Christmas but had a $5000 intercostal block to pay off.(ok my portion was $650 but still....)
    Anyway, sorry to ramble on and on.
    __________________
    undiagnosed lung and back pain after pneumonia in '03, tmj, migraines,(two failed surgeries for) Kienbock's disease

    Last edited by trowftd3; 02-05-2008 at 10:57 PM. Reason: add more questions

     
    Old 02-06-2008, 03:01 PM   #7
    Bilbo
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    Re: Oxycodone to Methadone conversion and issues.....

    Thanks for the kind words and well wishes. Any positive energy thrown my way, I will take it.

    My pain is predominately in a muscle section called the Rhomboids. The pain basically rides along the inside edge of my scapula and pain radiates from the rhomboids, under the scapula and out to almost my arm pit. During really bad episodes my traps will hurt badly too and sometimes, if I press under my collar bone it REALLY hurts.

    Mainly, however, its the space between your spine and your scapula (shoulder blade). When it doesn't hurt it will just twitch and spasm. Sounds gross but its like there is this little worm in there.

    Its a lot easier to describe this pain in person. Its like someone knifed me in the back. Everytime I sneeze or cough it brings me to my knees.

    Hope that helps with describing it. My plight in getting it resolved has been that Dr's always want to look elsewhere for the cause. 1st it was the neck. They thought it started in some of the nerve roots in the cervical spine and that was because I had a very slight numb feeling in my pinky and elbow. One neck fusion latter and no fix. Then another Dr got hot and bothered thinking it was my shoulder. One shoulder scope later and no dice.

    I have had 12 different sets of injections into the cervical and thoracic spine. Facet joint injection, Medial branch block, Epidural steroid injections, myofacial injections, Radio Frequency leasioning.......no help.

    At this point I personally think its a ruptured ligament or nerve damage.

    I was involved in a car accident where I broke the seat belt, the steering wheel and the airbags didn't go off. I took a direct shot to the sternum with the left side of my chest and my right arm/shoulder was reaching for a cell phone on the floor. So, my right shoulder, in essence, kept going forward while the rest of me stopped and the steering wheel.

    Hope that makes sense.

    Quote:
    Originally Posted by trowftd3 View Post
    Bilbo,
    Glad to see you back and glad that Steve helped you out and you got your conversion taken care of. Please let us know how the switch to methadone goes this time. I hope you're not as sleepy this time.

    Hope the hormone therapy works for both of you guys. I think I need my own.
    Take care.~Mush
    Hey!
    I never really put it together before but we have similar pain. Exactly where do you hurt? I have always dismissed the pain in my back near my shoulder blade because of the pain in my lung and the pneumonia. The doctors have said all along that it can't be my lung but I've just held on to that because I don't know what else to do.
    Refresh my memory...when, how and where did your pain start?
    I am so sorry that you are, like me, still searching for the answers. I am calling tomorrow to make my first acupuncture appointment. I had planned to do it before Christmas but had a $5000 intercostal block to pay off.(ok my portion was $650 but still....)
    Anyway, sorry to ramble on and on.
    __________________
    2 Lumbar Lamies 93 (age 22); Cervical Fusion C4-C6 2004. Lumbar Fusion w/ hardware S1-L4 2007, DDD & stenosis entire spine. super low T. 30mg Methadone BID 10-20mg Norco 4 BT. 2mg Xanax PRN.

     
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