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    Old 10-11-2013, 10:29 AM   #1
    kimtulip
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    questions about morphine with methadone and oxycodone-

    I recently was put on 1 morphine ER 30 mg pill a day adding to my other meds which are;4oxycodone a day @30mg each,taken 1x every 6hrs plus 6- 10mg methadone a day taking 2 pills in the morning and 2 @ noon and 2 @ night,I also take 1 soma @3x a day.My doctor had replaced 2 of my oxycodone aday with 2 methadone and the 1 morphine exstended release.My question is since the morphine is exstended release does it actually do anything by taking only 1 pill anight that's 30mg?I was thinking about asking my pain doctor to take away one of the methadone and replace it with another 30mg morphine,since its exstended release, wouldn't I need 1 in the morning as well for it to work right? I can't tell I am taking anything when I take the estended release 30 mg morphine.Everyone I know has told me they never heard of taking 1 exstended release morphine a day.My doctor took the 2 oxycodone away because there was something about too many of his patients receiving too much oxycodone,so I went from 6 of those to 4,and was raised to 6 methadone which had been 4,i know it sounds confusing that is why I keep repeating myself,LOL.But anyhow does taking 1 ER morphine in the morning and 1 ER morphine @ night with the other meds sound better,because like I said I cant feel it working any-?????

     
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    Old 10-11-2013, 10:45 AM   #2
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    Re: questions about morphine with methadone and oxycodone-

    I would appreciate any info anyone can give me on hoe effective the 1 ER morphine is,so please answer someone and give me your output on the meds. TY

     
    Old 10-11-2013, 06:06 PM   #3
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    Re: questions about morphine with methadone and oxycodone-

    How do you feel? Are you still in pain taking these different meds? Methadone, oxycodone, morphine? I think that one persons experience cannot relate to someone else, especially when you are talking about three different meds in various dosages.

     
    Old 10-11-2013, 08:35 PM   #4
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    Re: questions about morphine with methadone and oxycodone-

    I would ask your doctor what the purpose of this single morphine pill nightly is. If you had complained of more pain at night (it waking you up, etc), is that why they added it? Why not just increase your methadone dose at night though? I can say that oxycodone is about 1.5x stronger than morphine, so 30mg morphine is about equal to 20mg oxycodone. But its a significant amount when added on top of a dose.

    When it was added, did your pain levels improve? How are you doing overall? It seems silly to fill 3 scripts a month when two would do the same thing though. I think it makes more since to switch the morphine to methadone than it does to switch out some of the methadone or oxycodone for morphine. It also seems like your breakthrough medication dose (oxycodone 30mg four times a day) is quite high in relation to your long acting dose (60mg methadone + 30mg morphine).

    Do you take the four doses of oxycodone on a schedule, or just as needed? Since they are usually taken every 6 hours, it seems like your doctor is giving you enough to take on a schedule though. Breakthrough pain meds are typically more effective only when taken as needed. If you take them around the clock, you don't have anything to take for true pain spikes.

    For example, I get enough to take one dose a day. If you need four breakthrough doses a day, then your long acting med dose probably isn't high enough...chronic pain is better treated by long acting than short acting opiates.

    However, I wouldn't walk into your doctor and start asking for specific med/dose changes. You might want to do this over time, such as first questioning the purpose of the one morphine pill a day, and ask if it can be simplified. I think its good your doctor has already converted some of the oxycodone to methadone.

    How did your pain do with this switch? Be sure to tell your doctor if the conversion didn't seem equivalent, or seemed too strong. Its different for each person. It can also take a couple weeks for a long acting med switch to fully take effect. Methadone in particular can have a very wide variance in conversion to/from. Best wishes.
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    Old 10-11-2013, 08:36 PM   #5
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    Re: questions about morphine with methadone and oxycodone-

    Quote:
    Originally Posted by kimtulip View Post
    I recently was put on 1 morphine ER 30 mg pill a day adding to my other meds which are;4oxycodone a day @30mg each,taken 1x every 6hrs plus 6- 10mg mebeing ne a day taking 2 pills in the morning and 2 @ noon and 2 @ night,I also take 1 soma @3x a day.My doctor had replaced 2 of my oxycodone aday with 2 methadone and the 1 morphine exstended release.My question is since the morphine is exstended release does it actually do anything by taking only 1 pill anight that's 30mg?I was thinking about asking my pain doctor to take away one of the methadone and replace it with another 30mg morphine,since its exstended release, wouldn't I need 1 in the morning as well for it to work right? I can't tell I am taking anything when I take the estended release 30 mg morphine.Everyone I know has told me they never heard of taking 1 exstended release morphine a day.My doctor took the 2 oxycodone away because there was something about too many of his patients receiving too much oxycodone,so I went from 6 of those to 4,and was raised to 6 methadone: which had been 4,i know it sounds confusing that is why I keep repeating myself,LOL.But anyhow does taking 1 ER morphine in the morning and 1 ER morphine @ night with the other meds sound better,because like I said I cant feel it working any-?????
    Hi there Kim. I am a chronic pain sufferer & also take MSER 60mg X 5/day along with OC 30mg ER.
    I have never once gotten any of the "Euphoria type effect" or a "happy buzz" etc..from the morphine sulphate. It does nothing to me what so ever as far as side effects & so on. It does aide a HUGE factor in my own personal pain relief which is the whole darn reason I take it lol.
    You say that "you don't feel like you took anything after you have done so, my question is are you looking for feeling like you got a good ole buzz kicking or what? I am not being rude dear I'm just trying to figure out what your hoping to "feel " with the MSER 30? Does it seem like its helping your pain at all? I did notice that all of your other narcs are IR which are completely different reacting meds once you have taken them. The ER takes much longer to kick in so as to give you the constant med in small amounts throughout the day/night whichever method each person takes. If the MSER 30 taken once daily seems like it is not controlling your pain effectively I do not see why it would be an issue to ask your doc to add a dose in the morning as well. Perhaps since your body is used to the IR formularies maybe it would be wiser & maybe for you more effective to "feel" pain relief if you ask him to switch to the MSIR 30mg & see if that works better for you.
    I have known several people whom have only taken 1 MSER 30mg @ bedtime. It is not that uncommon honey. Each person reacts, responds, metabolizes, etc..medications very differently. Hence which might work fantastically for me might not work on you what so ever.
    You know your body & what works best for you better than any one else. If you are having any success as far as pain control with the MSER 30mg X 1 @ bedtime then that's great!! If you think that it is not working at all to help your pain I would not want to continue with the medication. Instead of asking your doc to add an additional one in the morning of a med that is not effectively helping your pain ask him if the MSIR would possibly work better for you.
    I wish you the very best of wishes in finding a good med regiminne that helps you with your chronic aliments! Take care & good luck!

     
    Old 10-12-2013, 03:31 AM   #6
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    Re: questions about morphine with methadone and oxycodone-

    Hello,no I didn't mean I did not feel a buzz I ment I don't feel like ive taken any pain medicine,i start feeling worse as a matter of fact,like ive missed my pain dose after around 45 minutes.The reason he started me on that medicine was because when he took the 2 oxies away ,he added 2 methadone,but it didn't seem to cover all my pain to a certain exstent.So he asked me if I could take morphine and said he could add 1 of those and he was going to add the regular quck acting but I asked for that thinking 1 would last all night,but like I said I cant really tell much is helping with my pain,but I haven't told him yet,since I had asked for that I was kind of emberrased and also I just don't understand why it wont work on me,i thought maybe taking just one of the ER's was why,maybe my other medication was overpowering or something,i don't know,lol,but yes I think I will see if he can just put me on regular morphine.Just taking the 6 methadone with 4 oxies wasn't working as I felt week and my back hurt,which it didn't when I took the 6 oxies and 4 methadone.

     
    Old 10-12-2013, 03:35 AM   #7
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    Re: questions about morphine with methadone and oxycodone-

    yes im still in some pain,the 2 methadone and 1 ER morphine just doesn't make up for the 2 Oxies they took away,but im gonna ask for regular morphine instead of the 1 ER morhine,i think 1 reg morphine at night will work better-thanks for answering

     
    Old 10-12-2013, 04:04 AM   #8
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    Re: questions about morphine with methadone and oxycodone-

    [QUOTE=kimtulip;5231905]yes im still in some pain,the 2 methadone and 1 ER morphine just doesn't make up for the 2 Oxies they took away,but im gonna ask for regular morphine instead of the 1 ER morhine,i think 1 reg morphine at night will work better-thanks for answering[/QUOTe

    Hello there again Kim! Your very welcome for the answer to your post hun. I am sorry that your doc hasn't been able to find a great med regiminne to effectively control your pain. Unfortunately, the process of finding what helps with each individuals chronic pain can take what seems like forever, tons of trials of meds, often retrials of meds again, months even years of finding something that helps even a little, & even then at some point what works for many years will eventually need adjusted, sometimes even omitted. You sound like you have a high medication metabolism identical to myself & trust me honey it sucks! You will eventually find a great combo, trio, BT, etc..med plan that works fantastic for you! Until then, yes it absolutely sucks! I would give the immediate formulation of the MS a try as you said you'd like to. Hopefully it will be more efficient in leading you to a less painful life. I understand all to well what your going through! I have been there many times myself! I extend my wishes to you Kim & hope that you & your doc can come up with a better plan for you at your next appointment. Do tell him the MSER is not helping you at all, keeps you awake & in pain, & that you think it would be better for you to try the MSIR. Give it a try for 1 week. To me this is plenty of time to see how your body will react to it as you are very familiar with opiates & how each one effects you. This way if it doesnt work for you, you will not be stuck taking something that is useless in aiding your chronic pain. Good luck Kim!! I hope you can get pain relief very soon!!

     
    Old 10-12-2013, 01:06 PM   #9
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    Re: questions about morphine with methadone and oxycodone-

    I'd tell your doctor how you are doing, but not ask for specific med changes, just that you want to try something different. See what your doctor says from there. You say you are "still in some pain". The goal with pain management isn't to be pain free. In fact, not even close. 50% is a common pain relief goal. If they dose opiates to relieve all your pain, you will have more side effects and build tolerance quicker. Discussing pain relief goals with your doctor is important.

    Yes adding 20mg/day methadone and 30mg/day morphine may very well have not made up for the 60mg/day oxycodone removed, as conversions have a wide variation. This is something else to tell your doctor, as they can make adjustments. Had you taken morphine before and got relief? Interesting you say you feel your pain increases after taking it. The long acting morphine can take hours to kick in, and you probably won't actually feel a drop in pain like you would with a short acting med.

    The difference between the short and long acting single dose of morphine would be that the long acting would give you a longer period of relief while the short acting would kick in faster and not last as long. As far as being able to get you to sleep, yes the short acting would likely be better. You may wake up in more pain though than if taking the long acting morphine, as its been a longer time since its worn off.

    Also, a long acting med is more effective if taken around the clock than a single dose, as with the single dose your med levels start from zero. You may also just do better with a higher methadone dose at night. Everyone is different. For example, even though my pain is much greater during the workday than in the evening, I was surprised to find out I did best with evenly split doses of my long acting med, as my levels stay pretty stable that way (vs. taking a lower dose at night then having to play catch up in the morning). Best wishes.
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    Old 10-12-2013, 08:50 PM   #10
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    Re: questions about morphine with methadone and oxycodone-

    [QUOTE=bonzluvsopis77;5231909]
    Quote:
    Originally Posted by kimtulip View Post
    yes im still in some pain,the 2 methadone and 1 ER morphine just doesn't make up for the 2 Oxies they took away,but im gonna ask for regular morphine instead of the 1 ER morhine,i think 1 reg morphine at night will work better-thanks for answering[/QUOTe

    Hello there again Kim! Your very welcome for the answer to your post hun. I am sorry that your doc hasn't been able to find a great med regiminne to effectively control your pain. Unfortunately, the process of finding what helps with each individuals chronic pain can take what seems like forever, tons of trials of meds, often retrials of meds again, months even years of finding something that helps even a little, & even then at some point what works for many years will eventually need adjusted, sometimes even omitted. You sound like you have a high medication metabolism identical to myself & trust me honey it sucks! You will eventually find a great combo, trio, BT, etc..med plan that works fantastic for you! Until then, yes it absolutely sucks! I would give the immediate formulation of the MS a try as you said you'd like to. Hopefully it will be more efficient in leading you to a less painful life. I understand all to well what your going through! I have been there many times myself! I extend my wishes to you Kim & hope that you & your doc can come up with a better plan for you at your next appointment. Do tell him the MSER is not helping you at all, keeps you awake & in pain, & that you think it would be better for you to try the MSIR. Give it a try for 1 week. To me this is plenty of time to see how your body will react to it as you are very familiar with opiates & how each one effects you. This way if it doesnt work for you, you will not be stuck taking something that is useless in aiding your chronic pain. Good luck Kim!! I hope you can get pain relief very soon!!
    I absolutely Would tell your doctor how the MSER is NOT working to effectively control your pain & I would ask him to switch to the immediate release formulation! Your not asking for a "specific" med by switching to the immediate formulation of the exact same med! I would simply say "doc I am currently taking Oxycodone, Methadone, MSER, & Soma. Most of my meds are immediate release formulations that have worked previously to help control my pain. Since I began the Extended Release formulation of the Morphine Sulphate, I have found this med is NOT helping my pain at all, is keeping me awake at night, & never gives me any pain relief. I would like to know if I could possibly try the Immediate Release formulation of the Morphine Sulphate on a short trial basis to see if it gives me better relief than I am experiencing with the extended release formulation." Like I said, you KNOW your body & what works & does not better than anyone else! A good doctor will respect your honesty & be happy to aide you in finding a proper pain management solution. In most circumstances you would not want to go to a doc & ask for a certain drug, agreed. In your situation, however, you are simply asking to switch to an immediate formulation of the Exact med! There is absolutely nothing wrong with asking to do so hun. I just went through a very similar situation with Oxycodone IR. For me, the immediate reacting formulations simply do not stay in my system for long enough periods of time to give me any effective pain control! The long acting formulations work much, much better for myself, but everyone is different! My doc was very happy that I asked to be switched to the long acting formulation as he stated he would much rather have me taking extended release pain meds instead because he feels they work better for patients whom require around the clock chronic pain relief with the help of pain control meds! I wish you the very best sweetie at your next appointment! You will be just fine. Simply be honest, keep an open mind, & listen to his/her suggestions & keep your hopes high that the two of you will effectively work together to get your pain a bit more tolerable! No chronic pain patient is ever 100% pain free but with the help of meds, a good doc, a great nights sleep, diet & exercise, etc..you may reach the ultimate goal of 50% or more less painful days in your life! Best wishes Kim!!

     
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