Discussions that mention tylenol

Pain Management board


Hi WLM, Although everyone will acommadtae and develop dependence at slightly different rates, the way you take them is a factor, If you have a routine you stick to like 12pm, 6pm and 12am and then have 10 pills to use throughout the month, that solid dosing schedule is part of what develops dependence. Even if you had only used one percocet at night to sleep it would take some time to be able to sleep without meds, but at approx. 30mgs a day of Oxycodone, your taper could be rather short and I doubt you would develop the same level of dependence of those who take LA meds around the clock for 6 months or several years.

You could step down rather easily using the 5mg percs and then the 5 mg hydro products. If you simply reducced your dose by 5mg per day every 3-5 days you wuld be looking at a month or so to wean off. You might still experience some sleep problems, some restless leg and have a few bad days at specific steps, But all in all you have done a great job at limiting the meds and the severity of withdrawal.

I don't know why docs prescrbe pain meds q4-6 hours when none of the SA meds last more than 4 hours. I would love to see a surgeon have surgery and be told he had to wait 2 more hours after watiing 4 hours for his next dose, Then they would realize, pain winds up beyond the doses ability to bring it back down.

By roughing it out you have limited the amount of dependence you would have . You might even get smoother coverage by breaking them in half and taking 5mgs every 3 hours, still the same number per day, just smoother coverage throughout, in which you don't have to pick what part of the day your miserable and when you absolutely need relief.

A dosing schedule every 3 hours over time would deveolop a little more dependnece but were still only talking 30-35 mgs per day which shouldn't create a tremendous amount of dependnece. I wouldn't go cold turkey, just slowly reduce you daily intake by 5mgs and when you are comfy as far as no withdrawal you can continue to decrease the same 5 mgs every 4 or 5 days. AS your doses drop to 5 a day and then 4 a day you would have to start spreading the doses apart, like evry 5 hours and then every 6 hours. Using both a dose based and time variable taper is usually what produces the least amount of withdrawal symptoms shold one day they corrct a problem or find another way to manage intractable pain.
God luck and again.
The only thing in common between short acting meds with oxycodone and OxyContin is the active ingredient,"oxycodone," But no time release with percocet or Roxicodone and no apap with oxyContin and certain SA oxycodone products.

My wife is loosing prescription benis and I called around yesterday to find out what the difference between 10mg percs and using 2 5mgs oxycodone tablets at a time and the price was 1/4 by using the plain oxy 5mg tablets. With 10mg percs we serrously pay for the conveinance of taking one large pill instead of 2 small pure oxy pills without apap. :rolleyes:
60 10mg generic percs cost between 120 and 140 dolars were 120 5mg generic 5mg oxy tabs would cost about 24 bucks, even the generic 15 mg Roxicodone was less than half the price of the 10 mg percs where ever I checked. I found the 15 mg generic roxi , 60 count for 44 bucks. 50% stronger then percocet 10 at 1/3 the price. I payed 89 dollars for my last script of 120 30mg generic roxicodone. 3 times the strength of Percocet 10, no apap and still considerably cheaper but they only last 4 hours like all SA meds.

In case it comes up, Pure short acting oxycodone products without tylenol are not Oxycontin either, just a short acting version of oxy , like percocet without any apap only stronger in some cases. The 5mg generic oxy tabs are the cheapest version for as little as 5-10 cents a tablet verses Percocet 10's at 2 bucks a piece depending where you shop.
Good luck and let us know what you decide Becky.
Take care, Dave
Hey NotSO, YOur doc has plenty of options as far as stronger versions of oxycodone withotut apap without going to oxycontin, Still short acting
"4 hours" but 10 mgs is not the ceiling on oxycodone. With meds that contain apap "Tylenol" the only ceiling is the one the tylenol creates. The max dose of apap anyone should take is 1000mgs per dose and 4000mgs per day. If you have chronic pain and take the max daily, your at higher risk of liver and kidney damage than the average bear. Cp patient should try to limit their apap to half of what is considered the max safe dose.

As far as what is available, If your in the US, They make Roxicodone in 5mg, 15 mg and 30 mg strength. They make a liquid version of oxycodone with 20mg per ml and 5mgs per ml, all these products are also available in generic.

There is no ceiling on the amount of pure opiate you can take, as long as you aproach a dose slowly enough to accomadate to the respirtory supression caused by opiates. But opiates alone, without apap, cause no internal
organ damage, no kidney or liver damage. That's how you see folks on very high "which is all relative" doses of pure opiates particularly the LA opiates. I've seen folks taking more than 2000mgs of LA morphine per day, 1200mgs of OxyContin, 600mgs fof meth and use up t 6-8 1600microgram Aqtiq pops, the active ingredient is fenatnyl which is hundreds of times more potent than morphine.

Theese meds contain no apap or aspirin or NSAIDS that do cause internal organ damage such as liver,kidney or stomach because these meds are not as water soluable and must first be broken down to enter the blood stream. The prolonged organ exposure to non water soluable agents is what causes problems. 17,00 people die every year from over doses of OTC meds like Tylenol, Aleive, Ibuphrofin and aspirin. I know one guy that lost 2/3rds of his stomach from ulceration caused by OTC NSAIDS before a doc had the sense to get him on pure opiates that cause no internal organ fdamage.

But there is no ceiling on how much short acting med or long acting med anyone can take, the only thngs that limts the dose is side effects. If the side effects are hindering more than the meds help, It's probably time for a change in meds. It's normal to feel like you better not rock the boat and complain about side effects for fear of the whole rug being yanked out from under you, but a decent doc will either help you manage them or change to a med that's less offensive to your system.

IF the 10mg percs don't work or say you have surgery after taking the 10's for several months, those same 10's won't be as effective on the increased pain from surgery. That's when the 15mg oxy tabs or the 30 mg oxy tabs or the use of liquid oxy that has a metered dropper allows you to create a dose not available in pill form and higher than the 10mg perrcs. If you need 25mgs you use 1.25 ml of oxyfast. If you need 60 mgs of oxy you take 2 30mg roxicodone. All these meds are also available in genric form.

The idea that someone will someday reach a dose of medication so high that apsolutely nothing works is a complete myth. As long as you can tolerate side effects, there is absolutely no ceiling on most pure opiates. As long as you tolerate the side effects and have acomadated and become tolerant to he CNS depression from opiates, A person taking 90 mgs of Roxicodone every 4 hours would be hard to dferentiate someone taking 5 mgs of Roxicodone every 4 hours. After a weeks, months or years on the same dose, You do become tolerant to almost every sdide effect, but tolerance to the anelgesic effect is the last type of tolerance to occur.

The only excepton is Demerol "meperdine/meperdine forte". Demi can build up a metabolite from poor mtabolization and cause seizure, that's why you rarely here about oral demi being used except short term. Demi is metablized so poorly that the equal dose of oral demi to 30 mgs of Morphine IR or 20mgs of Oxycodone is 300mgs. Demi is much moreeffective when given IM or IV just like many drugs, But demi is a particularly poor oral med to use as far as strength per mg.

Tolernce to the anelgesic effects is the last type of tolerance to occur, First you become tolerant tothe CNS depression r possible respirtory supresson, then you become tolerant to the cognativbe impairment of the feeling the med ma inducelike warm fuzzy and the fals sense of well beng "euphoria". I have seen folks relate euphoria to pain relief and if you feel your only getting pain relief if you feel sedated and warm and fuzzie, You will never be satisfied with any dose. It would take a dose increase weekly to continualy cause the euphoria of opiates. After CNS depression, the sedation and euphoria are the next to go. Cognative impairment deminishes and were simply left with pain relief.

One you find an effective dose and the condition is relatively stable and not progressing, I and many others have gone years on the exact same dose, with no or little noticable side effects other than constipatine.LOL. Nobody would even guess we take moderate or high doses of pain meds. An opiate naive person may be completely looped by 1 vicodin after a tooth extraction, where a CP patient with tolerance can take 60-90 mgs of Oxicodone and nobody would be the wiser. That happens to be my BT dose of meds. 1-2 or 3 30mg oxycodone tablets depending on the severity of pain. Even taking 3 at a time, I don't fall asleep , I don't slur, I can still drive to the grocery store. It's all a matter of accomadation and side effects deminishing as you aproach a dose safely and effectively.

It doesn't mean your not getting pain relief if your not feeling sedated. But those that make that connection between euphoria and pain relief are pretty much doomed to neever be satisfied with any dose of meds they are on because the euphoria will deminish and they think the anelgesia has deminished.

Otherwise no person on pain meds would ever be safe to drive even the shortest distance.We would all be stumbling , mumblng, goofs if accomadation didn't occur. Not that's it's legal to drive on opiates, we can be charged with DUI for jumping a curb or a rolling stop just as easily as the guy with a bottle between his legs. If the cop thinks your pupils are too small, your lips are dry, these are signs of opiate use and we can face the same driving under the influence penalties as a drunk driver. But I have been pulled over for an expeired inspection while taking 00mgs of Kadian "24 hour morphine" a day and usng 30-90 mgs of oxy for breakthrough pain. I was completely coherent, no signs of intoxication and the ticket was thrown out once I had the inspection done.

There will always be over zealous cops that want to do roadside sobriety tests on anyone suspicous, but my physical problems would cause more problems than the meds. I can't stand on one foot, when your fused to your sacrum, balance goes out the window, But I have no problem with my abc's and touching my nose. Although my posts may apear I can't spell any better than my daughter, It really is this very old and sticky keyboard and some slight dyslexia. I'm bad about proofing my posts and to see a string of E's in the word street doesn't mean I realy think there are 8 e's in that particular word.LOL

The only opiate side effects that won't deminish in time is constipation and sometimes urinary retention. Opiates slow or can completely stop the bowel contractions that move things along, thus the need for Kristaloose or lactaloose.They have a similar effect on the smooth muscle of the bladder wall. I have used Kritaloose while on oral meds and it's much better than the painful cramping caused by harsh stimulants like SenekotS. The stimulants simply cause contractons of bowels that are are already slowed and the material inside becomes dry and harder to mover. Kristaloose and other softeners dump large amounts of water into the bowels and that's how their softening action works. Something soft and well hydrated will move along much better than something dry that's been sitting there for days or weeks.

Something with a stimulatory action to create the contractions may be needed in addtion to the softeners, but my experience with high doses of morphine, one of the more constipating meds, was easily resolved with Kristaloose after trying all the OTC meds avalable. IF you do get into a pinch and the Kristaloose isn't working, a dose of magnesium citrate will likely get things moving and once moving it's easier to keep things moving. Mag citrate is the laxative component in most EX-prep kits used for stomach and intestinal diagnostic studies. Without clearing the path colonoscopies and other studies would run into a brick wall without using the prep kits first. Mag citrate can cause some uncomfortable cramping, and loss of fluids so it's important to continue to remain well hydrated. But it will work when you are just miserable and the normal routine isn't working. It's available OTC or you simply ask your pharamcist if it's not kept on the open shelves.

There were a couple other things I wanted to mention but won't fit hear, See the next page, Dave