Hey Twist, I can give you an idea of what meds cost in the US. If you guys up north stay true to the same price structure we have down here you can certainly find something cheaper but will have to shop around and see if there is a difference from store to store.
MSContin or the generic is actually the cheapest long acting med available next to methadone which isn't trluly a long acting. IT has a long half life and serum levels build upbut everyones response to meth is so widely different, titrating duringpost op recovery is a tough time to start a new med. You could probably get by with methadone alone because it's dosed every 4-6 hours, that is if if you can tolerate the side effcts.
As far a pricingf goes,, the newer it is, the more expensive it tends to be. Like avinza is the most expensive LA morphine, then Kadian then MSContin then it's generic version. OxyC is more expensive and LA didlaudid is the most expensive. Duragesic isn't cheap but the 50ugh patch is in the right ballpark for replacing 180 mgs of morphine. You might want to check pricing on 15 50ugh patches compared to the 60 mg LA morphine. The new LA oxymorphone will certainly be the most expensive but I'm not sure you have it in canada yet.
The way methadone is dosed, every 4-6 hours, you could probably get by on meth alone and come out paying about 1/4 the total price you do now. However trying to titrate meth for post surgery pain is tough because there isn't an exactly acurate conversion, that's the real reason it's not used as a front line drug. 10 people taking your dose and switched to meth would probably end up at 10 different doses and dsoing schedules. IT creates the widest response of all opiates and this is why it's considered a 3rd or 4th line drug because of the unpredictablity of strength in each individual.
As far as BT neds, Generic SA morphine is probably the cheapest, then generic dialudid if you don't use the 8 mg tabs and use twice as many 4 mg tabs and finally generic versions of oxyIR tend to cost more than morphine or dilaudid.
Adjustments for meth must come slow due to the buildup in your system and the way each dose builds upon the previous dose for up to 5 days. So you could be very uncomfortable the first day or two but by day 5 getting very satisfactory relief. Unfortunately because they know how meth works, there isn't much you can do the first few days of titrsation or untill you have stabalized on each new dose, which means 5 days before you can safely increase. If your taking methadone every 4-6 hours anyway, there really is no need to use BT meds when the idea of BT meds is to get you over the hump untill it's time for your next dose.
Have you looked into the cash price on generic 60 mg LA MSContin and perhaps considered switching your SA med to dilaudid or morphine IR. If you did this just once during the intial post op period it would save you some miserable days trying to titrate a new med while recovering from surgery. If that's just not possible and your doc is licened to prescribe methadone in Canada, 60 mgs a da would be a safe starting point coming from 180 mgs of morphine. The conversions that have meth 1:1 with morphine are comparing single dosing of the two drugs rather than the doubling of serum level that occurs with meth by the end of the 5th day. At 60 mgs a day, you could easily dose meth 10 mgs every 4 hours and eliminate the need for BT meds.
Obviously these are things you have to discuss with your doc and have to check prices and availabilty at your local pharmacy. Switching from generic MSC to meth I saved about 90%.
New higher strength sa meds that have recently come to market also tend to be more expensive. The new 10 mg percs are 4 times the price of 5 mg percocet, the same holds true for 8 mg dilaudid. If you use twice as many 4 mg tabs as 8 mg tabs you would save over half in the US. The conveinance of taking just one pill still comes at a high price the first few years of a new product strength. LA didlaudid is the one of the newer and most likely one of the more expensive and again, titrating during post op is rogh although adjustmaents can be safely made daily with opiates other than methadone or duragesic patches.
I'm sorry to hear about your husbands job and the strain and stress this must be causing. Try to lok at the flip side, at least he can take some time off to be with you while you recover and while he looks for a new job. :confused:
Take care, Dave