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Cadillac of Pain Meds? Opana ER

kcrozkkcroz Posts: 33
edited 06/11/2012 - 7:23 AM in Pain Medications
I am taking 40 mg of Opana ER three times a day. It is not working. I am waiting for a permanent cervical SCS. My PM says this is the Cadillac of pain medication and there is nothing else he can prescribe. I have been on this dosage for several months. When I started taking it, I was very nauseous but after several weeks my body adjusted. Before I was taking Oxycontin. My question - has anyone switched back to Oxycontin from Opana ER? This is why I need the SCS! I think everyone's tolerance builds and it gets to a point where nothing works anymore. I have read prior posts regarding the bio availability of Opana ER. I just need some relief.



  • I use to use opana and yes I did switch back to Oxicotin. You may get some reliefe from switching back ot and oxicodone. Opana is a ER version of diluadid and I built a tolerance to opana due to the amount of surgeries I have and dilaudid is what I use for IV meds in hospital.

    Would like to know how your SCS goes would love to get one after I heal from my next surgery.

  • i've said it a million times here before and I'll say it again.. Opana ER SUCKS. It's bioavailability is only 10%, which means you only get 4mgs of that 40mgs into your bloodstream. Oxycontin is about 90%, so you get about 36mgs of a 40mg pill, which is why it works SO much better. Your doctor is misinformed.
  • btw opana is NOT a version of dilaudid. Dilaudid is hydromorphone, while Opana ER is Oxymorphone. ~
  • My PM switched me to 80 mg Oxycontin three times a day. I can pick it up on the 6th. If I am understanding JVM correctly - even though he prescribed double the mg's of Oxycontin. My body should be getting 210 mg of pain relief instead of 12 mg daily. That is a BIG difference. As I said before, when I started taking the Opana ER I was nauseous for days. I thought it was because it was stronger. Now I am wondering if it was withdrawal from Oxycontin. Guess I will know in a few days. My PM also said out of all his patients, I am on the strongest dosage of pain meds. Does anyone else take this much pain medication?

  • the Opana IS 3 or 4 times stronger, by milligram, so that 12 would be 48 versus your 210, big difference still right? If you havent had 80's yet, ask your doctor, but I'd start at 2 a day, one morning, one night, for a week, before going to three, that's a hefty dose! It can cause nausea too; just plan on it, keep some sprite or other light soda around, prepare to lay down and watch a movie or something, and after a bit the nausea will pass. You are on a high dose, and yes other people here do take that much, but I am guessing you have had, or are probably GOING to have surgery sometime in the future? Just keep a log of your activities. 3 of those a day and I'd be smiling, happy, and drooling.(with MY pain) Let us know how the switch works for you! I am SUCH a 'Opana sucks' kind of guy that I'd love to hear a success story from someone. And since you were on oxy 40s before, please, try two a day, trust me, it'll make things a whole lot easier and you might be able to just hang onto the third one in case.. if you doctor says so at least! Good luck!

  • I have been cruising around this web site for months and never really had much to say or offer so I have never written before. But I just had to say that I always read the emails from JWM to be helpful and very interesting. My PM used to have me on Opana IR for breakthrough pain and I also thought it was awful and when I read about the bioavailability on this site I understood why and had them switch me back to oxycodone. Also for the writer wondering if anyone takes as much medication as she does well I wear 200 mg in patches of Fentanyl and take 4 15 mg oxycodone for BT as well as other meds and I function really well working as a nurse. It takes a lot to knock me out after 4 back surgeries with all the hardware. Anyway,Thanks JWM. You are pretty smart.
  • I have been behind the scenes reading for sometime now, but finally decided to join in order to post. kcroz, I am glad to see that your MD increased your dose, because despite the claim that Opana ER is the cadiallac, they still need tune ups. As with all narcotics it is possible to build a tolerance to the medication, therefore requiring an increase in dosage.

    As to the concern about others being on high doses, Allow me to reassure you that it is possible. I am on Fentanal 200mcg every 48hrs, Opana 80 Three times a day, and I utilize oxycodone 30mg 1-2tabs every 4hrs as needed for breakthrough pain, along with baclofen 10mg TID. and yes I am still fully functional, working full-time.

    I have been on long-acting pain meds for 4yrs. I have a chronic nerualgia in my right lower abdomen from a surgical wound as well as a T7-T8 disc herniation with spinal cord compression, distortion, stenosis and now swelling. Which is scheduled for repair 10/16.
  • i hope they find the right adjustment and the right med for you!! everyone should be able to live a normal life.

    for the others that have joined WELCOME. you came to the right spot that is for sure.

    just remember we are not medical professionals and can only give you our own personal experiences with these things.
    any reaction or such to a med please contact your dr or pharmacy.

    please can some of you send your PM docs to my area??? man oh man. i was lucky to even get 10mg of oxy 2x's a day. i told the dr it did not work. he did not up it.
    so we went to morphine that was a no go and he did not up it.
    then we went to the patches well we did start at 12.5 then he upped it to 25. HELLOOO NOT WORKING.
    so he did not up that one.
    then said the last thing was methadone. i was on 5 mg 2xs a day and well it worked for awhile but lost its effect as my back issues needed to be fixed. he was stuck on 4 meds and that was it. :O :O :/ :/ :B :B
    mind you he would not BUDGE on breakthrough meds. said if i wanted that i would have to cancel my contract with him and get them from my pcp. OK FINE...

    ya think that pain managment would be a governement type thing if ya know where i am coming from. all pain managment drs that treat long term pain should all be able to work with your correctly in treating your pain and give break through meds. i just don't get it.

    anyways sorry for my little rant. ;) ;) it just gets me i live with pain levels high most of the time and no one is around to help.
    and it really stinks when you have proof to back ya up.. ~X( X(

    GOOD LUCK HUN in your journey of getting the right med for you!!!

    terri >:D< >:D< >:D< O:) O:)
  • I'm wondering how kcroz is doing.. If I had to guess, probably better, but 3x80 oxycontin a day is a lot! I remember when I went from a few norco and 4 15mg oxy IR a day to 3x40mgs Oxy ER, wow, it threw me for a loop and really I was pale in the face for a week it was so strong. That's one of my other fears with these doctors who think Opana is so strong; its NOT, and going from 40mg Opana to 80mg Oxycontin is quite a leap in strength..

    I'm hoping kcroz is opiate tolerant, used to oxy, and doing well.(I didn't mention it before, in this post at least, but even 3x20mg oxycontin ER a day is stronger than the 3x40mg opana.. hence my slight concern..) Please post kcroz!

  • :) crazy5, hi and welcome to the forum! :H we are here to offer you support and answer what questions we can. JWM does have alot to say and is a smart guy. i like to read his posts too. good luck on your upcoming surgery. Jenny :)
  • Hey thanks both of you for the kind words =) Most of us here need them us much as we can get! Wishing everyone a pain-managed day, and hoping to hear back from the OP/kcroz,
  • I just read this and was surprised that you didn't mention it in your previous post.I stumble on a lot of your posts and of course it's not your responsibility to do so~but you usually are pretty accurate in your medication replies.

    You would think that her doc would have known that that was not a step up,but a huge leap.I JUST read this and was concerned :S
  • I am getting much better pain relief. If my doctor would prescribe B/T meds, I could easily take only two a day. In the past he always raises the extended release dosage instead of combining long acting and short acting medication. I had C5/C6 and C6/C7 fusion done last year and am waiting for a permanent cervical SCS. According to PM the SCS is my last resort. He will not increase the dosage. I am very grateful to have learned about the bio availability issue. He had no problem switching from three Opana ER 40 to three Oxycontin 80. As for being opiate tolerant....when I had my surgery the anesthesia used was equal to what would have been used for a normal 600 lb man. I weigh 145.

    Thanks again
  • kcroz I am so happy to hear that you are doing MUCH better; that's great news. I've been so adamant on these forums about the downsides of Opana and while some have agreed, your situation is the first/best 'live' confirmation, on a large scale with strong dosages. I hope that your doctor learns from this, and that he/she spreads the word. Opana DOES work for pain relief, but it's more of a weak med, and didn't touch a thing for you. I'm happy for you, enjoy life a bit now eh? Thanks for the smile this gave me; I'm off for a walk in the breeze

  • Bioavailability is taken into account in the formulation of the drug. When drug companies make a certain drug dosage they take the bioavailability into account. If doctors had to figure out how much of a medication to dose based on its bioavailability they would screw up drug dosing a lot worse than they do! The bioavailability argument regarding Opana and Oxycodone is fatuous. A similar problem is the patient who goes from 0.3 mg of Catapress for their blood pressure to 360 mg of Diltiazem. They think they are on a lot more medication, or if they go the other way, say from 10 mg of Valium to 1 mg of Xanax, that you are giving them less medication. The mg dosage takes the molecular weight of the drug and the bioavailability of the drug into effect.
  • Is that your son?
    Anyway - speaking of Dilaudid, how is it working out for you. Is it better paid relief over the norco?

  • I am new to this site. I came across this thread looking for some info on opana er. It seems like you all know a lot about this so heres my problem.....

    I recently moved from FL to CT. Before I moved my PM Dr was giving me oxy twice a day ( I was up to 160 mg a day) percocet (10mg) for breakthrough, and oxyfast in the morning. My new dr insists on giving me opana er and wont give me the oxyfast. I have been on pain meds on and off for about 6 years and have tried a number of dif meds. I know what works for me, but they insist on doing it there way. The opana is doing nothing for my pain. Any one have any suggestions on how to get the Dr to let me switch back.

    Keep the good info coming.

  • please don't post misleading statements in a thread like this. It has been proven multiple times that the terrible bioavailability of Opana makes it a poor choice for intense chronic pain. Did you read the whole thread? If drug companies were so smart and so were doctors, then we would have 160mg Opana (and stronger), which might actually help someone, and kcroz wouldn't have had to re-educate her own doctor on this topic.

    Do us a favor and don't be another 'fighty know-it-all' about opana and oxy; there were at least one or two in both of the other threads I was posting in about the same topic, and your posts just serve to misinform people.

    Please keep your opinions on topic and relevant. Narcotic medications are frequently compared against each other to gauge strength by milligrams based on the standard of 1mg of morphine as the baseline. These drugs all have something in common; they are Opiates or Opioids, derivatives of Opium or synthetics. Your blood pressure med example, as well as your valium/xanax example, both fail to have any such system of measurement relating them to each other, and as such present no relevant analogy whatsoever.

    FACT: The milligram dosage listed for your medication is the TOTAL amount, in milligrams, of the active ingredient in your tablet. It does not, has not, and unfortunately may never, ever include bioavailability info.

    Please post a new thread if you have a problem with with way people think drugs work, and cite some proof as well, with links. Just leave this topic alone; I don't want to have to prove it for the 20th time. Please.
  • JWM, Just wanted to say that your posts and the info in them are 100% on the mark. Opana sucks! The sad thing is that there is so much bad press about oxycontin these days, that more and more docs are taking their patients off the Oxy and putting them on one of the newer "Miracle" meds, like Opana (Oxymorphone) and Avinza (Morphine Sulfate). Unfortunately, the pharm reps are pushing these new meds like their lives depended on it, and since most doc's have not had any feedback from patients about them, they buy into the rep's hard sell. Avinza's been getting better reports than Opana, but since oral Morphine is two times less potent than IV Morphine, many docs are getting the doses wrong with that too.

    djb.... Sorry you've had this happen. Sadly, I doubt that you can get a doc who has any kind of prejudice against Oxycontin, to prescribe it for you. As I said in the above paragraph, the bad press and celebrity deaths connected to Oxy, have made so many docs skittish about it. I know you just moved, but is it possible to start looking for a different PM doc?? If not, maybe you can at least get your current doc to try one of the many other opiates/opioids that have been on the market for several years and have a more proven track record. Best of luck to you.

    Take care everyone, Mitzi
  • I agree that the bad press Oxycontin has gotten is completely undeserved. The 50 or 60 people that OD'd in one year, their lives were not insignificant in any way, but the number is. How many thousands, or hundreds of thousands (millions) die or have serious health problems every year from alcohol or tobacco? Some people are just numb to the bigger issues I suppose. One thing I will say is that Oxy DOES feel damn good at the right dose, and is easy for people with an abuse history to get hooked on, however, better screening and maintenance of medical records will hopefully one day minimize those situations.

    For anyone switched to Opana from Oxycontin; I'm so sorry! (djb..) I was lucky enough to have my 120x40mg opana script written alongside a boatload of morphine, so when the opana failed me, I had a life-vest, you know? For those being switched over by Oxy-afraid doctors, well, it's just wrong. One thing I DO know, is that you shouldn't be trying to get these meds from your primary doctor; primary physicians tend to be MUCH more Oxy paranoid. For djb, going from 2 80mg oxy a day to Opana must HURT. Talk to your doctor about bioavailability, print a post from here if you need to, and good luck. The chemical in Opana works wonders injected IV, but is almost useless in pill form. Some doctors will try to switch you just because they think you are hooked, not necessarily abusing, but the Opana is a bad substitute.

    I'm happy that my relentless struggle to prove that Opana is weak has finally resulted in multiple people coming out and confirming the fact. It really, really needs to spread through the medical community, as a major disservice is being done to many of our visitors and members here, and unknown numbers all around. Anyone want to head an organized action to get the info out, contact the MFG, etc? It certainly wouldn't hurt, and I'd love to be involved. Maybe I'll do it..
  • My doctor put me on Opana ER 10 mg. twice a day. I knew in the beginning that it made me feel sick all the time and thought it would pass but it didn't. I have been on it for two months now and I am so sick all the time that I can hardly eat anything and when I think of food or even smell it it makes me ill. Lately even the taste of Dr. Pepper makes me sick...?? Also I think it has caused me to feel depressed almost all the time and the reason I feel this way is because I wasn't feeling this until I started taking it, I thought that would pass as well but it hasn't either. Can anyone here give me the run down on side effects and similar ones like I have mentioned here? I am about to let my PM doctor know what's happening with me but would like to know any and everything you all have experienced with this drug so I can verify my claims. I am beginning to become scared by this med and I am not willing to kill myself for any drug...and I don't mean this literally I just mean..(Could this drug possibly be one of these drugs that we find out later was not safe??) Sometimes not only am I sick and can't eat but I am depressed and don't feel like going out anywhere doing anything it's like I have lost my zest for life sorta?. Basically too sick to leave the house. I just had a series of spinal injections and I go back for the last one in this series November 7th. I feel that the Opana is helping my pain but at the expense I feel I could be taking an unecessary risk possibly. I was on pain mgmt from 99' to 04' and I got myself in really good shape..the best shape I had been in for 10 years and I quit pain mgmt.Since then I have had cancer, shingles for five years and went thru para-menopause (I had cervial cancer as well and had a hysterectomy) and had to go back to PM. I was on 20 mg. Oxycontin t.i.d. and I can remember going thru severe withdrawals from it and I didn't have really good knowledge about the drug as far as dis-continuing it and because I had quit the PM doctor thinking I could do it on my own (my doc also left town and was doing Doctors on Borders treating soldiers or something to that effect) anyway I made it thru several months later and survived and then found out later on that what I had actually experienced was svere W/D's and that I could have died from it, due to being on OXY so many years. I went back to PM and was a little afraid of taking OXY again and now I have had no luck with these new (Other) DRUGS THAT THEY ARE PRESCRIBIG NOW. I have to say that OXY worked by far better than anything else I have ever tried because I know this now thru dire experience. The thing is my clinic which is THE SAME CLINIC I used before do not like prescribing Oxy anymore so I don't know how I will get switched back even if I decided to ask about it. Another thing, when I came back I actually came back to see my old doctor and they said he wasn't doing pain mgmt. amymore so I decided to stay with the clinic and give a new doctor a try. I am now very unsatisfied with this doctor just because he doesn't say a whole lot and doesn't follow up with me on procedures and if I want to talk with him about any concerns he seems like he is too busy most of the time and he uses his nurse alot to do his bidding for him. I used to be a Physical Therapist for years and I know this is incompetent care so now I dread the hassle of getting back to change docs, waiting to get in to see them etc.. Also I did a search on the internet and found that my old doctor is back and that he actually has his own PM clinic here in town and now I realize that they just lied to me in order to keep me from leaving and going back to see him again. Anyway, I know I went a little into detail and off of my regular topic here but it's been awhile since I posted and I just thought I might need to throw in a little detail. Anyway, about the Opana ER can anyone give me some details about your experience with this drug? Thanks all..have a happy pain free day.. Kim
  • Hi everyone. Please let me start by saying that any advice or information I may give has no legal tie to me. I with to provide you all with help and inspiration, but of course all individual cases may not be correctly evaluated online.

    My name is Dr. Ryan. I am a NYS registered pharmacist and I am also a D.O. (Doctor of Osteopathy) in both the USA and the UK. I am finishing up my MPH (Master's degree in Public Health) in May. I went to two Ivy League Schools.

    They reason that I am posting and joining this forum is because I too see a pain management doctor and I too suffer from chronic pain (Fibromyalgia, undiagnosed pain, migraines etc...) and I have had four knee surgeries. In addition to that, I am NOT ashamed to share that I have an anxiety disorder and take a medication for that.

    Last week alone I preformed 9 surgeries, all of which were successful. Because my medical expertise is in Neurology and Orthopedics, I am very familiar with pain medications.

    I am writing in early this morning to let you know how disappointed I am in some of you. Just because a particular medication didn't work for you, it is a shame that you would plant the seed in someone's mind that that medication is useless. If I have mistaken your intention, I beg your apology.

    I have been on Opana ER 20mg twice a day plus Opana (IR) 10 mgs up to three times a day PRN. I also take Skelaxin 800mg for muscle spasms. Without this cocktail I can guarantee you I would be less of a doctor and I would be incapable as a surgeon.

    Because of Opana's bioavailability, I understand that it might not work for all (among other factors). For other's it does work and it is MY personal Cadillac of painkillers that maintains my livelihood, my sanity, my family life and my standard of living. I am so lucky for my pain management MD.

    I wish you all the best and I am eager to talk and help you all in your desire to be healthier! Hear from you soon!
  • I have just come upon this thread and I find it an eye opener. I don't know much about Opana and I have learned a lot by reading this.
    From my understanding (correct me if I'm wrong) Fentanyl is a short acting opiod that is packaged in a delivery system which allows it to be an extended release medication. The immediate release form is fentanyl citrate and Actiq lollipops. What is Fentanyl's bioavailability? I'm on the 75 mcg patches.
    Hi Dr. Ryan, welcome to SH and we appreciate your input and I'm glad to hear the Opana ER and IR works for you. Have you ever been on any other pain medicines?
  • Wow.. and a dead topic arises with beaming praise for Opana, what a surprise. I think we already covered very well the fact that Opana works for some and usually not for others, and don't need to dig this topic up to try to convince anyone Opana is the Cadillac of painkillers; it's not. For one out of every two hundred people? Sure. Maybe. I've only met the other 199 though.

    Dr. Ryan, I doubt we'll ever see you again here, but if you do come back, please post a link to your public profile on http://www.osteopathic.org will you? I'd love to read about your background and education.

    I'm a skeptic and will cry foul often even at the risk of being wrong, but this post from a doc just sounds like manufacturer advertising to me.. It wouldn't be the first time. Opana does NOT absorb well taken orally, and does not work well for pain.

    Lastly, Opana sucks. This is just my opinion, which I base on personal experience, the experience of others, and the factual information I have learned while searching for the answer to 'why is Opana so weak?'. Please make your own judgement, but know that many have found mine to be correct.

    Now if we can just lay this topic down to rest once and for all.. =P


  • You are correct in that fentanyl is short acting, and usually packaged in a delivery system (patch) for extended release. Our bodies also store an amount of it as well when it's in our system constantly, which helps to even out the amount in our bloodstream.

    The bioavailability of fentanyl is about 90% transdermal (skin, via the patch) and about 50% with the actiq pops, which I think is labelled as buccal, aka through the cheek/gums etc I believe (not sub-lingual or oral). I'd guess IV it's at %100, as are most opiods/opiates.
  • Have you told your doctor? If the nausea hasn't cleared after 2 or 3 weeks I would wonder if you have a general intolerance to that medicine, just as some do with morphine/codeine etc. A blood test would be wise just to be safe. Good luck and talk to your doc!
  • Posts like that make me glad I'm pushy enough to ask my doctors what medications they take prior to allowing them performing surgery on my body.

  • I have been taking Opana-ER for about a month now, and it works for me. Previous to this I was taking oxycodone, but I really needed a long acting med and this is what my doctor put me on. It did take a little while to get the dose that works, but now I am on 20mg twice a day, and getting good pain relief from it.
  • my doctor switched me from 40 mg a day of methadone to 40 mg of opana. Its been a week now. Im not impressed. Methadone worked better on my back pain then this. I go in this friday with my progress. However I cant sleep thru the night on methadone but can on OPana. On methadone I wake every hour or two not from pain just boing awake. Im enjoying sleeping thru the night the first time in years however pain is too much. Does this happen to anyone else. He is gonna have to up the opana or put me on something else. I cant take sleep meds couse I will sleepwalk. Or Ive been standing and fallen back asleep falling to the floor. So sedidives and sleepmeds are a no no for me.
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