Discussions that mention vicodin

Pain Management board


Hi all. I have chronic back pain and am currently using Fentanyl patches for my ongoing pain. I am trying to find a breakthrough pain medicine that works well for me. Vicodin and Norco worked well for me for a long time, but after a couple of years they started becoming ineffective. I am currently on 10/325 Percocet, and it doesn't seem to be helping much. I've also tried and failed with: Darvocet, Tylenol #3, and Lortab. Probably a few more, also, but can't think of at the moment. Any recommendations as to what I should try that may work better for my breakthrough pain?

Thanks in advance,
Cameron
Regarding the drugs you mention, as for potency, it starts with morphine, then up to hydromorphone, then to oxymorphone. Although oxymorphone is the most potent of the three, it is poorly metabolized when taken by mouth, so the dosing is a bit complex. The oxymorphone drug on the market is Opana (may be others), and it comes in both short acting and long acting formulations. I haven't yet heard from anyone taking Opana SA for BT pain. Maybe someone will chime in who has used it.

Hydromorphone (Dilaudid) is derived from morphine as a semi-synthetic opioid. Orally, it is about 7-10 times more potent than morphine. A number of folks here use it. I've used it for acute pain and didn't like it much, and it didn't seem to work that well for me. In fact, I switched to hydrocodone (Vicodin-much less potent) and got better results. This all points to the fact that each of us is different and react to the various meds individually. Other folks here swear by Dilaudid.

The lollipops, which use fentanyl (100 times more potent than morphine), are very good BT meds.

Morphine is good as both a short acting med and as a long acting med. MS Contin (MS for morphine sulfate) is a long acting med and not appropriate for BT pain. In your hospital stay it was being used as a short acting med given on a regular schedule which you had some control over. Maybe morphine is better for you as a short acting med than as a long acting medication.

You've got lots of good info in this thread to think about.

Best of Luck!

steve