Discussions that mention morphine

Pain Management board

Hey Toonces, I think I remember your other posts:) It always depends on the doc, but in general I think most people will start with the hydro's, tylenol 3's and darvecet with the usual take 1-2 every 4-6 hours. Then they progress to higher strengths. If these don't work the next step is percocet or oxycodone(with various generic names). With these couple steps, the level of tylenol is what becomes a concern, plus the fact that the pain is being chased with short acting medications. The next step is to go to long acting medications and their are many different ones using morphine, fentenyl(the patch), dilaudid, oxycontin, hydroLA(which I think must be compounded).

Depending on pain and how much SA meds you are on, the docs usually start you out on a low dose and have you come in every 2 weeks to titrate up in dose if necessary. Toon, you might be ready for a long acting since tylenol could be an issue with what you are on, but you also have room in the fact that it looks like tramadol is your main med with vic as your breakthrough and you are on a very low dose. Many forms of hydro come with lower doses of tylenol in them so if the amount of tylenol is a concern, you could talk to your doc about those other options. For example, zydone is hydrocodone with 400mg of tylenol and I know there are others with lesstylenol.

Once you start on a LA and some docs will only prescribe long acting, then short acting meds are given for breakthrough and again can be any of the different meds, hydro, oxy with and without tylenol, dilaudid, morphine, fentenyl and tramodol. There might be a few others.

JFYI, hydro, darvacet, tylenol 3's(with codeine), tramodol are schedule III narcotics and can be called in to a pharmacy and can be written with refills. All the others are schedule II and you need a written script and there are no refills, you have to get a new script every month. Some docs want to see you every month and others will have you come in just to get a script and usually see you every 3 months and others give you post dated scripts with DO NOT FILL UNTIL on them which means you cannot fill them at the pharmacy until a certain date which they put on the script.

I hope I didn't go over too much stuff you already knew, I didn't mean to get on such a roll:D. I sure hope you can skip the chronic pain label and things will get better as I would not wish CP on my worst enemy, but if you have to be a CPer, you won't find a better place for information and caring and compassionate people. The support you find here is amazing and others will fill in any stuff I missed.

Take care