Discussions that mention morphine

Pain Management board


Hi weaver, I'm a little confused because there isn't a single 40 mg morphine tablet available in the US. MSC comes in 15,30,60,100 and 200. Are you outside the states.

As far as what a 40 mg tab releases over 12 hours compared to 10 mgs of hydro every 4, that dose of morphine isn't a hge increase. If your takin OxyContin, then he pretty much doubled your serum level which is more than most docs will do because of safety reasons.

Are you talking about OxyContin? Oxy is about 50% stronger than morphine and the way it's released, half the dose is released at about 1 hour and the rest at about the 6th hour. It is a relatively high starting dose and I do hope that your doc explained about physical depndence, 3-4 months of around the clock opiates at that strength and you will become physically dependent, meaning you can't stop abruptly or you will experience some nasty withdrawal.

If he's using oxy the next step down is the 20 mg tabs and then the 10 but each step cuts your dose in half and that's large enough to make you feel pretty wrotten.

Is this a PM doc or your GP playing PM doc. A doc that knows what he's doing is usually going to start at the lowest dose possible that gives you relief, the goal isn't to wipe all your pain out, just make it tolerable. If he had started you at 20mgs twice a day that would be about a 50% increase in strength and I don't understand why a doc would skip that step if it could relieve yur pain.

THe only place you have to go from 40mgs is up, that's why they usually start lower. When you add BT meds to the mix it just raises your tolerance even higher. You might want to describe your situation a little and double check your bottle, long acting morphine isn't available in a 40mg strength in the US in any form whether it's Kadian or Avinza, the 12-24 hour versions of morphine or plain generic MSC. OxyContin comes in 40 which is what I suspect your taking.

Because the increase is significant the pain relief may be very effective initially, but tough to maintain that honeymoon over time without leaving you very groggy and impaired by constantly increasing to maintain that level of relief. You might even want to have you spouse listen to you breath while you sleep to be sure your not struggling to obtain oxygen due to the respirtory supressant effects of all opiates and this being such a large increase and a med your not used to taking.
Good luck, Dave
Im such an idiot..... Can you tell I'm new to these drugs? lol

I have the bottle in front of me now... It is labeled IC OXYCODONE HCL 40 MG ER... which isnt hydrocodone like I said

Here is my history with pain meds the past 2 years so maybe you can understand whats going on for me. I am thinking the med above is highere than what I should maybe start with.

I have used Vicodin for the past 2 years - mostly taking 5/500's 2-3 times a day. Unless my pain levels were very low the 2 5/500's didnt do much at all.

What she did first was prescribe Vicodin 10/660 every 6-8 hours or up to 4 a day which I told her is basically the same dose I was using for my pain which didnt hack it.... only thing dif was I could take it 2 more times... but it wasn't doing the job the first time... so I could take it 4 times, but each time I wouldn't cut through the pain which usually runs from a 6-10 each day for me.

Then she gave me the above script. I know nothing about levels, but since it is working so good I wondered if I could get by with less? I know I will prob face some kind of withdrawal - hopefully, this surgery will help my pain levels.

I hope I cleared up some of the confusion. I also assume this drug is MScontin and not morphine. Is that correct?

I'd rather use something lower perhaps so after surgery I can bump it up. I mean its great feeling like I have nothing wrong lol but I know deep down there is a problem.

But, wouldn't it be something if the reason for my continued high levels of pain is just as simple as it hasn't been addressed properly and my body is just overly reacting to a learned pain response? Does that make sense and can that happen?
Quote from Shoreline:
Hi weaver, I'm a little confused because there isn't a single 40 mg morphine tablet available in the US. MSC comes in 15,30,60,100 and 200. Are you outside the states.

As far as what a 40 mg tab releases over 12 hours compared to 10 mgs of hydro every 4, that dose of morphine isn't a hge increase. If your takin OxyContin, then he pretty much doubled your serum level which is more than most docs will do because of safety reasons.

Are you talking about OxyContin? Oxy is about 50% stronger than morphine and the way it's released, half the dose is released at about 1 hour and the rest at about the 6th hour. It is a relatively high starting dose and I do hope that your doc explained about physical depndence, 3-4 months of around the clock opiates at that strength and you will become physically dependent, meaning you can't stop abruptly or you will experience some nasty withdrawal.

If he's using oxy the next step down is the 20 mg tabs and then the 10 but each step cuts your dose in half and that's large enough to make you feel pretty wrotten.

Is this a PM doc or your GP playing PM doc. A doc that knows what he's doing is usually going to start at the lowest dose possible that gives you relief, the goal isn't to wipe all your pain out, just make it tolerable. If he had started you at 20mgs twice a day that would be about a 50% increase in strength and I don't understand why a doc would skip that step if it could relieve yur pain.

THe only place you have to go from 40mgs is up, that's why they usually start lower. When you add BT meds to the mix it just raises your tolerance even higher. You might want to describe your situation a little and double check your bottle, long acting morphine isn't available in a 40mg strength in the US in any form whether it's Kadian or Avinza, the 12-24 hour versions of morphine or plain generic MSC. OxyContin comes in 40 which is what I suspect your taking.

Because the increase is significant the pain relief may be very effective initially, but tough to maintain that honeymoon over time without leaving you very groggy and impaired by constantly increasing to maintain that level of relief. You might even want to have you spouse listen to you breath while you sleep to be sure your not struggling to obtain oxygen due to the respirtory supressant effects of all opiates and this being such a large increase and a med your not used to taking.
Good luck, Dave

Dave, OK now I'm rather concerned. If there are doses of 10 and 20 before the 40 why would she jump that high? It's not like I want to feel like I have no pain at all, just get the levels below 5 for part of the day so I can function. I still feel like percs taken as needed would ahve been better for me now - then use the 12 hour relase aftger surgery... but didn't want to piss off the PM doc (its not my GP).

I see her for follow up on March 27 - by that time I will have figured out how this works for me. I do get irregular heart beats and I have since my 20's (Im 55). It happens usualy with stress and other things. I don't worry about it too much anymore, but wonder if this drug will be stessful for me if Im jumping 2 levels.

Right now, I guess I should enjoy the painless hours - even though I want to sleep half the day. Maybe a 2 week "rest" will be good for me after 2 years of high pain.

I'm just confused right now. I am usually proactive about my treatments. But kinda feel like this PM doctor is a bit of a control freak and I don't want to piss her off by telling her what I think I need...

Think I need a nap right now.... lol
Hey Weaver,

I along with the rest was a little confused about your post. You said you read the bottle and it said Oxycodone 40 MG ER? If thats the case, that is generic OxyContin 40mg. (Time realeased Oxycodone)

I totally agree with shoreline here that its a jump from your hydrocodone that you were taking. With that said, we say that Mg's don't matter when you have chronic pain, however, when you first start the med they should titrate you from the lowest dose possible. This way you can move up as needed. This benefits you in the long run and the Dr's usually like you to be at the lowest possible dose that works. But like shore pointed out, you can only go up from there (40mg).

Since you're pretty new to these meds (and there is nothing wrong with that), I want to give you a little info. First, Oxycodone is about 50% stronger than Morphine and Hydrocodone. So 40 Mg twice daily (80mg) from someone that was taking 4-5 10 mg Hydrocodone is going to be a jump.

Second, do not try and cut your dose of the Oxycontin. This is a time released med, meaning that it is released over an 8-12 hour period. If you think its too much and cut it, you will release all 40 mg at one time.

I'm surprised your Dr went from 10 mg a couple times a day of Hydrocodone to 40 Mg of Oxycontin BID . They make a 10 mg pill and can go up from there. Oxycodone seems to be one of these drugs that you build tolerance to rather quickly. So if you're taking 40 mg twice daily, you will build up a tolerance and need increases that will only have to go up.

You asked the question, if MSContin is the same and the answer is no. Ms Contin is time released Morphine. About 50 % weaker than Oxycodone. MSContin works like OxyContin it is just Morphine instead of Oxycodone.

I don't want to scare you and you are probably getting pain relief, but its best to start low and work up (titrate). You will probably find that it will be short lived. You will eventually need an increase to cover you pain.

With all that said, Dr's don't like to be second guessed, so I am not sure how to approach your Dr. Maybe Shore has some suggestions. I guess we just don't want to see you have to be taking 160 mg of Oxy to cover you pain and being tolerant. If you are getting good relief where you are at, its possible the 20's or even the 10's with a BT med would have covered your pain fine until surgery. They can actually dose OxyContin 3 times a day for better coverage. (Maybe 10mg 3 times daily)

Anyway to sum it up; it sounds like you have Oxycontin 40 mg with Hydrocodone 10 mg for BT pain. Like shore said, I would be careful as its a pretty decent jump in meds.

Anyway, I hope I didn't confuse you more. If you are taking the 40 mg Oxy now, and it covering you pain wise, I would steer clear of the BT meds to help control your tolerance if you don't need them.

Take Care
Hi Weaver, I hope your enjoying your nap. ;) I can't even remeber being pain free. You do become used "accomadated" to the sedative effects of all opiates long before you you become tolerant to the pain reliving effects. Oher side ffects like itching and nausea often deminish. The nes tha can be problems that don' go away are constipation and urinary retention. You definitely have to start a maint plan for constipation while taking LA opiates. They shut the muscles down in your bowels and stop the contractions that move things along. THere are lots of products and secret recipes if you find you need help.

What your experiencing is a honeymoon that i experenced when they finaly used pain meds after 7 years of non narcotic pain managment and limited meds after 3 surgeries. IT soundfs like you goals are reasonable, your geting great relief right now but things willl change over the next few weeks. If your still feeeling sedated you might want to try decreasing your dose if you get tird of the naping.

Oxy can cause tachacardia in some people but it's rare. It's a pro opiate which means it's actually more stimulating than morphine or methadone, but with the boost in pain meds enjoy the relief. The level of relief and side effects you have now are fine for post op but it's not a good way to live. I'm not sure if you just had surgery or have it scheduled. If you are still this sedated you may want to talk about using the 20's 2-3 times a day.

As fas as the increase, if your doc is very open minded, and you're a health man, You shouldn't have to worry about respirtory supression, you would feel very funky and have cold sweats if you were having problems. You can also smoothly taper of meds if the doc knows what he is doing. It just takes alittle longer he higher your dose and longer you have taken them.

OxyC is contreversial in the length it last, some say 8 some say 12. The manufacturer is very big on using it every 12 hours because that's it's novelty that earned them a patent. They do recognize the need for BT painmeds but remeber if you have BT meds, only use them for BT pain, It doesn't sound like you need them now ;)

If your allowed 2 or 4 doses of BT meds a day and you use the max every day, it just becomes incorporated into your daily pain med intake, so when you do have a bad day, they are no more effective than they were the previous 30 or 60 days you tok the max amount prescribed. So try to save it for when you need them. I look at BT meds as a tool the doc gave me so that I don't call him in the middle of the night and say I'm in horiable pain or have to go to the ER.

Can you tell us about your problem, are you a spiney? Something else? Anyway, I agree u deserve a break from the pain and that sleepiness should wear off. Many people on much higher doses are highly functinal and you would never know they take meds.

Take care, Dave