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    Old 11-12-2014, 03:25 PM   #1
    Nola3
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    Medication supply question

    Hello,
    I'm new here. Just a quick question - I have a 60day supply 5mg Oxycodone take 1 tab every 8 hours for pain. How do they figure out how long a 60 day supply should last? I am running low, and was sent to a pain management Dr, today actually. They just did a consult - my GI sent me to the PM Dr, and I have a follow up on 1/13/15 - so between now and the next appt, my GI won't refill my Rx - he sent me to the PM Dr for this.

    I had my last Rx filled 10/22/14 - and I'm running low as it is b/c I've had some serious pains - I did discuss this today with the PM Dr, but I am at a loss on what to do when I run out soon, since my GI won't refill.

    Thank you for reading and replying.

     
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    Old 11-12-2014, 03:46 PM   #2
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    Re: Medication supply question

    The quick answer is that every 8 hours would be 3 a day. That means for a script to last 60 days, you'd need 180 pills. Keep in mind, some scripts say "as needed" implying you shouldn't be taking 3 every single day. Although you don't actually say how many pills you received, you kind of made it sound like 60; correct me if I'm wrong. If that's the case, 60 pills for 60 days is a pretty small amount of pain med all in all. Just my opinion though.

     
    Old 11-12-2014, 03:50 PM   #3
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    Re: Medication supply question

    sorry about that. It says quantity 60 - so I was given 60 pills 1 every 8 hours. No mention of "as needed".

    I think I got confused and I didn't mean to say 60 days - so I was given in the bottle 60 pills.

    Last edited by Nola3; 11-12-2014 at 03:53 PM.

     
    Old 11-12-2014, 04:03 PM   #4
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    Re: Medication supply question

    Hi Nola3-

    So let me understand you-Your GI gave you an rx for Percocet 5/325 or oxyir 5mg, anyhow-the GI doc has prescribed it to be taken 1 every 8hours as necessary, right?

    Well, since oxycodone is a short acting drug, I think it is ridiculous to think 5mg of oxycodone will last 8 hours,but then again we are talking about your chronic pain not mine. You are being treated for a chronic pain condition, no? So, your GI has referred you to a PM, and the GI expects the PM to manage your meds?

    I get your confusion, even if you took as directed, and did take one every 8 hours, that is a 20 day supply-But, doctors do this all the time, even though it was prescribe 1 every 8 hours as necessary, and you would not be doing anything wrong if you took one every 8 hours if you NEEDED it, your GI expects you to make those 60 pills last 60 days-did I assume that correctly? were you prescribed #60 pills?

    That is what you need to make clear before you leave the office-since I don't know how long you have been getting prescribed the oxycodone,you didn't mention-has the 1 every 8 hours been adequately controlling your pain? If not you need to tell the doc that.

    So what is the plan with the new PM you saw today, how did it go-you should have brought up the fact you are getting low on the oxycodone-did you? Did he/she ask if they are helping you?

    Can you give more information, so you can get some more feed back?

    Hope to here more from you.

    EDIT-just read where you said you were rx'd #60-so that is a 20 day supply at 1 every 8 hours.
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    Last edited by BB07; 11-12-2014 at 04:08 PM.

     
    Old 11-12-2014, 04:18 PM   #5
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    Re: Medication supply question

    My GI Dr has been given me the oxycodone 5mg for over a year now due to Crohn's pains I've been experiencing. He no longer wants to cont to give me a prescription for the pain meds, and has referred me to a Pain Mgmt Dr. I went today.

    The bottle says, take 1 tablet every 8 hours for pain. 60 pills were in the bottle. I was given that Rx on 10/21/14 and now that I am running low - the GI won't refill it.

    When I saw the PM Dr today - all it was was a consult. She wouldn't give me any medications today. She did do a urine test though. My next visit with her is on 1/13/15. I will definitely be out of pain medication by then - so I am frustrated. She wanted to make sure with my GI Dr (Whom she does know personally) that he was giving her full control to take over my pain meds.

    Since he is giving her full control over giving me pain medications, I am fine with that, and she said she had to do the urine sample prior to prescribing more oxycodone. This is all new to me - going to a PM dr, so I don't understand why they need a urine sample, but I have no problem at all giving them one - nothing to hide here.

    SO all I know, when leaving the PM office today is: my next follow up visit, and that's it.

    I have a good relationship with my GI Dr's Rn, and I've emailed her to tell her that I will be running low on meds - -and my next appt is on 1/13/15 with PM. I go to UNC so they have it where patients can email the Dr/RN's and so I've done that. I even did that with the PM dr to let her know I am running low on medication and by the time Jan hits - I'll be out and will need something to help me function.

    Overall the appt was good - she knows and understand my pain, and is willing to work with me, so that is good. I just wanted to know how they (whether it's the pharmascists or Dr) how long 60 pills, taken every 8 hours should last?

    I hope I didn't confuse anyone more....I'm sorry....

     
    Old 11-12-2014, 04:23 PM   #6
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    Re: Medication supply question

    My notes I was given upon leaving the PM Dr says:

    We obtained a urine sample, as we do for all new patients, in anticipation of potentially writing your Oxycodone.
    We will have you see our Pain Management psychologist, as this wil be helpful to you.
    We will see you back in 6 weeks.

    Of course, they had NO 6 weeks avail appts so it had to be for 8 weeks out which is 1/13/15

     
    Old 11-12-2014, 06:38 PM   #7
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    Re: Medication supply question

    The urine test is pretty standard, in PM, expect them at every visit, even though they may not require one at every visit, expect it. The U/A is to ensure compliance-that you are taking any meds as prescribed, and only prescribed meds.

    Make sure you have told them everything you are taking-as it may affect the results of your U/A.

    Perhaps given the situation, your GI will prescribe one more time, since you have told them your next apt is 1/2015 and it looks like they indicated "taking the reigns" from there?

    Given that the GI referred you, and the PM are/have made them aware of the U/A, before thy prescribe, I am thinking they will cover you. But make sure you f/u your email, with maybe a 2nd email or a phone call before you are completely out.

    good luck
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    Old 11-12-2014, 06:46 PM   #8
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    Re: Medication supply question

    Quote:
    Originally Posted by BB07 View Post
    The urine test is pretty standard, in PM, expect them at every visit, even though they may not require one at every visit, expect it. The U/A is to ensure compliance-that you are taking any meds as prescribed, and only prescribed meds.

    Make sure you have told them everything you are taking-as it may affect the results of your U/A.

    Perhaps given the situation, your GI will prescribe one more time, since you have told them your next apt is 1/2015 and it looks like they indicated "taking the reigns" from there?

    Given that the GI referred you, and the PM are/have made them aware of the U/A, before thy prescribe, I am thinking they will cover you. But make sure you f/u your email, with maybe a 2nd email or a phone call before you are completely out.

    good luck

    Thank you so much for your reply. I've already mentioned to my GI that I will be running out, and they haven't said anything to me. From what I've gathered, the last Rx they gave me was the last one til the PM Dr takes over. I'll follow up with the PM Dr to make sure they received my email, and will call as well, to let them know when I'll be running out.

    I can understand the reasons my GI Dr has referred me to the PM clinic, and I am willing to work with them and just get this managed. I mean it is now under control, I take it that the GI just doesn't want to cont to prescribe me pain meds, and so referred me to PM.

    I didn't want the GI Dr nor the PM Dr to tell me or fuss at me if I ran out of medication before the alotted time - So that was why originally I asked how long should 60 pills last if I am taking them every 8hr for pain. I don't want to get on their bad side, etc or look bad to them.

     
    Old 11-13-2014, 01:18 AM   #9
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    Re: Medication supply question

    Hi Nola, IT sounds like you do understand and need o except the reality of the situation one withdrawal kicks in. Your GI doc wrote you that one last script to get you to your PM apt. Its the PM docs discretion to write a script today or not. It would actually be highly unusual to start treatment or change your treatment plan to a more aggressive med regimen without first doing a UA and doing a psych eval. I cant tell you how many dozens of times I have been told by PM docs that nobody ever died from pain.

    Nobody is obliged to keep you supplied with oxycodone without any break in usage. I get that it sucks, but you will not die if you have to taper down the last week or so and then manage without until the results of a UA come back so that the PM doc doesn't have to worry about providing pain meds to an addict that may have street drugs in their system or to a patient that doesn't really need them and sells the ones he does get on the street for a buck a mg.

    Yes you will probably experience some withdrawal but you should have some meds left and should be able to quickly taper off completely and limited the severity of withdrawal. Expect to go without for a while and expect to experience some withdrawal, but people really don't die from opiate withdrawal either. I do have empathy and get that it sucks. I have tapered off medication after every major surgery and it sucks. I have been in the exact same position, they give me one last script and refer me to a PM doc that cant see me before that last script ran out. This is really the test period to see how you respond and behave when he meds are removed.

    At this point, going to a another doc , your family doc, the ER and excepting more pain meds to prevent withdrawal or to treat pain could literally land you in jail and prevent you from ever receiving pain management again. Say you go to the ER in 2 weeks and they prescribe Percocet, you do this again the around Christmas time but this time its the Minor emergency center you go to. Then you go back to the PM doc and he writes you your first script. All it takes is a zealous prosecutor and they can and will convict you of doc shopping. Having 3 or 4 docs all prescribing the same medication for the same problem even consecutively is by definition doctor shopping.

    We can endure more physical pain than you are considering possible, given no choice you will survive the next month or so until you can get back to your PM doc. I would certainly talk to the psychologist about the amount of pain you were left in given the circumstances but the worst possible thing you could do is go from doc to doc getting limited quantities to get you through the transition.

    Its not doc shopping to be transitioned from One specialist to a PM spcisilist as was your GI docs intention, But if you through a couple more docs in the mix before the PM gets around to prescribing your not only put yourself in jeopardy legally, but it would be highly unlikely the PM doc would prescribe anything sronger than IBU if you were to see a couple other docs and receive oxy from them between now and your next apt with the PM doc. It may be a flat out test to see what you do , bu you could end up with legal problems that will haunt you for life .

    Nobody is gaurenteed continuous treatment with opiates. Although your GI doc has prescribed them for a year, he has no duty to keep you supplied until the PM doc feels comfortable prescribing. Its very likely your state has a data base of every controlled med written and filled as my state dose. I would think you need to consider this scenario where the first thing the PM does at next next apt is to check the data base and see what you have been up to since he last saw you. Don't hang yourself out to dry over a couple of Oxy IR per day. Withdrawal will be fairly minimal and you are expected not to doc shop to maintain your own supply and prevent withdrawal by resorting to illegal activity like doc shopping. That activity leaves a clear and documented trail which makes conviction a slam dunk for a prosecutor.

    You might have a little luck by seeing your own GP and requesting something much milder like Ultram or possibly a very limited amount of low dose hydro product to help you if things seem unbearable, but even then there is the appearance of impropriety. IMO you would be better served to simply go without than to risk any and all future treatment with opiates if your are seen , red flagged and potentially prosecuted for doc shopping.

    Regardless of the diagnosis we have and the length of time we spent prior on opiates, nobody is entitled to an endless supply. Its that entitlement that gets people in trouble and makes our country consumer of 90% of all opiates manufactured in the world. This is an absolute fact and rather sickening when you think about it, How is it possible that we consume this much of all opiates produced in the world, and yet is it absolutely true. Again if I were you, I would avoid any other docs and receiving scripts from any other docs at all costs, you will be OK and you will still have a chance at future PM with this new doc. Having to go 4-8 weeks with untreated pain will not harm you physically.The other side of the coin isn't so pretty.

    I endured intractable pain for almost 8 years without any opiate pain medication as I went through failed spinal surgery after spinal surgery. Yes I was given post op meds for a couple weeks but even with multi level failed fusions, when the surgeons cut me off that was it. PM docs didnt use opiates in the 90's and you simply learned to cope and endure. Im sure hearing this is unsettling but It is what it is and you don't want to get labeled a criminal or drug seeker while waiting for your next apt with the PM doc. If you need help or support while waiting, Im sure many including myself can help with your questions while going through withdrawal and waiting for your next apt. Take Care, Dave

    Last edited by Shoreline; 11-13-2014 at 01:30 AM. Reason: grammer

     
    Old 11-13-2014, 07:56 AM   #10
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    Re: Medication supply question

    Quote:
    Originally Posted by Shoreline View Post
    Hi Nola, IT sounds like you do understand and need o except the reality of the situation one withdrawal kicks in. Your GI doc wrote you that one last script to get you to your PM apt. Its the PM docs discretion to write a script today or not. It would actually be highly unusual to start treatment or change your treatment plan to a more aggressive med regimen without first doing a UA and doing a psych eval. I cant tell you how many dozens of times I have been told by PM docs that nobody ever died from pain.

    Nobody is obliged to keep you supplied with oxycodone without any break in usage. I get that it sucks, but you will not die if you have to taper down the last week or so and then manage without until the results of a UA come back so that the PM doc doesn't have to worry about providing pain meds to an addict that may have street drugs in their system or to a patient that doesn't really need them and sells the ones he does get on the street for a buck a mg.

    Yes you will probably experience some withdrawal but you should have some meds left and should be able to quickly taper off completely and limited the severity of withdrawal. Expect to go without for a while and expect to experience some withdrawal, but people really don't die from opiate withdrawal either. I do have empathy and get that it sucks. I have tapered off medication after every major surgery and it sucks. I have been in the exact same position, they give me one last script and refer me to a PM doc that cant see me before that last script ran out. This is really the test period to see how you respond and behave when he meds are removed.

    At this point, going to a another doc , your family doc, the ER and excepting more pain meds to prevent withdrawal or to treat pain could literally land you in jail and prevent you from ever receiving pain management again. Say you go to the ER in 2 weeks and they prescribe Percocet, you do this again the around Christmas time but this time its the Minor emergency center you go to. Then you go back to the PM doc and he writes you your first script. All it takes is a zealous prosecutor and they can and will convict you of doc shopping. Having 3 or 4 docs all prescribing the same medication for the same problem even consecutively is by definition doctor shopping.

    We can endure more physical pain than you are considering possible, given no choice you will survive the next month or so until you can get back to your PM doc. I would certainly talk to the psychologist about the amount of pain you were left in given the circumstances but the worst possible thing you could do is go from doc to doc getting limited quantities to get you through the transition.

    Its not doc shopping to be transitioned from One specialist to a PM spcisilist as was your GI docs intention, But if you through a couple more docs in the mix before the PM gets around to prescribing your not only put yourself in jeopardy legally, but it would be highly unlikely the PM doc would prescribe anything sronger than IBU if you were to see a couple other docs and receive oxy from them between now and your next apt with the PM doc. It may be a flat out test to see what you do , bu you could end up with legal problems that will haunt you for life .

    Nobody is gaurenteed continuous treatment with opiates. Although your GI doc has prescribed them for a year, he has no duty to keep you supplied until the PM doc feels comfortable prescribing. Its very likely your state has a data base of every controlled med written and filled as my state dose. I would think you need to consider this scenario where the first thing the PM does at next next apt is to check the data base and see what you have been up to since he last saw you. Don't hang yourself out to dry over a couple of Oxy IR per day. Withdrawal will be fairly minimal and you are expected not to doc shop to maintain your own supply and prevent withdrawal by resorting to illegal activity like doc shopping. That activity leaves a clear and documented trail which makes conviction a slam dunk for a prosecutor.

    You might have a little luck by seeing your own GP and requesting something much milder like Ultram or possibly a very limited amount of low dose hydro product to help you if things seem unbearable, but even then there is the appearance of impropriety. IMO you would be better served to simply go without than to risk any and all future treatment with opiates if your are seen , red flagged and potentially prosecuted for doc shopping.

    Regardless of the diagnosis we have and the length of time we spent prior on opiates, nobody is entitled to an endless supply. Its that entitlement that gets people in trouble and makes our country consumer of 90% of all opiates manufactured in the world. This is an absolute fact and rather sickening when you think about it, How is it possible that we consume this much of all opiates produced in the world, and yet is it absolutely true. Again if I were you, I would avoid any other docs and receiving scripts from any other docs at all costs, you will be OK and you will still have a chance at future PM with this new doc. Having to go 4-8 weeks with untreated pain will not harm you physically.The other side of the coin isn't so pretty.

    I endured intractable pain for almost 8 years without any opiate pain medication as I went through failed spinal surgery after spinal surgery. Yes I was given post op meds for a couple weeks but even with multi level failed fusions, when the surgeons cut me off that was it. PM docs didnt use opiates in the 90's and you simply learned to cope and endure. Im sure hearing this is unsettling but It is what it is and you don't want to get labeled a criminal or drug seeker while waiting for your next apt with the PM doc. If you need help or support while waiting, Im sure many including myself can help with your questions while going through withdrawal and waiting for your next apt. Take Care, Dave
    I'm not going to dr shop and I'm fully aware no one can die from pain. I'm not one of those types of people who will go from dr to dr not go to the ER for pain.

    My GI DR office and I have a good enough relationship to where I can tell them my situation, which I have, and they will work with me. I'm not a drug seeker and won't go do stupid things to get myself in trouble - My Gi office told me this morning they will cont to give me my pain medication until the PM takes over in Jan full time for this condition.

    All I orginally wanted to know was: if I was given 60pills 1tab every 8 hours how many days should that last me. :-) I've never been one good with math and was asking for help to figure that out.

     
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    Old 11-13-2014, 12:12 PM   #11
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    Re: Medication supply question

    Nola-

    You did the right thing-and I am glad your GI will continue to help you with your meds that help you until your apt with your new PM in Jan/2015.

    Nobody thinks you would doctor shop or go to ER to manage your pain.

    An op was just giving you a very zealous warning about what a lot of people do resort to, when their pain meds are interrupted suddenly, like during a transition to a new doc like a PM.

    But don't take that personally, I get that you simply wanted to know how long your meds should last-when you get your prescription, make sure you find out how long it has to last you.

    Typically in PM, your prescription is expected to last until your next appt. It is up to you to let your PM know whether it is helping or not, and you say your current regime of 5mg is helping-so if the PM gives you #60 pills, no matter what the directions say on how to take it-It is meant to last until your next apt-so if you are needing to take 3 tablets a day, make sure you tell the PM.

    good luck
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    Old 11-13-2014, 03:47 PM   #12
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    Re: Medication supply question

    60 pills at 3 a day will last 20 days. If all you needed was the math done, that's the answer. 60 pills divided by 3 per day equals 20 days.

     
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    Old 11-13-2014, 05:03 PM   #13
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    Re: Medication supply question

    Quote:
    Originally Posted by Titchou View Post
    60 pills at 3 a day will last 20 days. If all you needed was the math done, that's the answer. 60 pills divided by 3 per day equals 20 days.
    Thank you THANK you!!! Math is not my strong suit at all - so I always have the hardest time figuring things out like that. Thank you so much for explaining it to me.

     
    Old 11-13-2014, 05:11 PM   #14
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    Smile Re: Medication supply question

    Quote:
    Originally Posted by BB07 View Post
    Nola-

    You did the right thing-and I am glad your GI will continue to help you with your meds that help you until your apt with your new PM in Jan/2015.

    Nobody thinks you would doctor shop or go to ER to manage your pain.

    An op was just giving you a very zealous warning about what a lot of people do resort to, when their pain meds are interrupted suddenly, like during a transition to a new doc like a PM.

    But don't take that personally, I get that you simply wanted to know how long your meds should last-when you get your prescription, make sure you find out how long it has to last you.

    Typically in PM, your prescription is expected to last until your next appt. It is up to you to let your PM know whether it is helping or not, and you say your current regime of 5mg is helping-so if the PM gives you #60 pills, no matter what the directions say on how to take it-It is meant to last until your next apt-so if you are needing to take 3 tablets a day, make sure you tell the PM.

    good luck
    Thank you for all your help in understanding things. I do appreciate you taking the time to tell me all that you did, and all you shared From a reply someone answered 60 pills (1 every 8hrs)taken up to 3 times a day will last 20 days.

    When I go for my follow up in Jan, at the PM Dr, I will ask the all this and mention that at times I've taken up to 3daily. I did mentioned to my GI's office today, that the pain has been so bad at times, I've taken it every 6 hours or 7 sometimes - they said ok. When the PM dr and I were speaking yesterday, and I told her what I'm on is working, she said that's good, and that 5mg of Oxycodone is such a low dose - I am not familiar with different doses, etc of this medication. But the 5 does help, but at times I just couldn't bear the 8 hour, and gave in at 6, but close to the 7th hour. SO I am open and honest with them....

    Yes, I am so glad the GI will cont to fill until PM takes over. The GI office told me their policy is not to give out narcotics, and so that's why I was referred to PM, and I totally understand that.

    Anyhow, I am glad all this is clear to me, and i fully now understand since someone was kind to do the math for me, LOL! I stink at math.

    Thank you again for your help and willingness to talk and explain things to me.

     
    Old 11-13-2014, 05:41 PM   #15
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    Re: Medication supply question

    Nola-

    In my very 1st post to you, I did say that #60 pills, 1 every 8hrs is a 20 day supply.

    You mentioned that the 8 hours frequently is too long in between doses, tell this to the PM, ask if you may have enough to take every 4-6 hours if needed. Also ask if it would be a good idea to try a longer acting medicine. But I am not sure with "Crohns Disease" if a long acting drug is appropriate, because a longer acting drug will release medication slowly around the clock-don't know if it is necessary for you to be on a narcotic around the clock, so you should ask your PM doc about this.

    Do you have constant moderate pain, or does it stop-are you needing to dose again when the 5mg dose wares off or are there days when you don't need the rx'd med at all?

    For my CP, I suffer around the clock-s/p traumatic injuries to body; so it is necessary in my case to be on a opioid med around the clock-so I am prescribed a long acting medicine that helps me very much and allows me to function better in every day activities. My pain is reduced by almost 50% most of the time-I still deal with the pain, but with the help of the la medication, the pain is at a more tolerable level.

    If you suffer constantly without your oxycodone, then a longer acting med would be much better than the short acting oxycodone-you would not have to dose so frequently, and not have the highs n lows caused by the short acting med due to it wearing off n watching the clock for when you can take another dose-The long acting drugs keep you on an even keel because you have a steady dose in you system, being released slowly but constantly.
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