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best breakthru meds?

dmoonchildddmoonchild Posts: 383
edited 06/11/2012 - 8:25 AM in Pain Medications
SO far Ive taken vicoden and oxycodone. Not the best relief. Does Dilaudid work well? What would be the conversion from Vicoden 10mg and Oxycodone 5mg to dilaudid?
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Comments

  • have you tried a higher dose of the oxycodone like the 7.5 or 10's? And also with the oxy is it with or without the tylenol. I am not sure what the conversion would be. Dilaudid did ok for me. It seems that the percocet 10/325 work the best for me. MJ
  • dilaudid is great, for me at least. If you take say, 90 norcos per month, then 90 4mg dilaudid is about the same. They take a bit longer to soak in and work, so they are not as immediate of a BT as the norco, but they have much better pain control for me, they last a couple hours longer than a norco, and have no dizziness/euphoria/anything, just, clean pain reduction. I'm an advocate, yes =) Maybe ask your doctor for 10 along with your norco, just to try for a couple days, then if you like them, don't fill the norco and ask for the month of dilaudid. Dilaudid is cheap cheap too, if $ is an issue. And, no tylenol =) That was why I changed, and all the other pluses were just bonuses. Hope you have the same luck with whatever you end up choosing.

    JWM
  • My ER med is oxycontin 40 mg and that isnt working now either. The last visit with my Dr he said he really doesnt want to go higher since im Only 40 yrs old. 40 is the new 30 ya know. ;) It is just not enough. I dont know what Dr's think pain relief is. Right now all I can do is go to work, lay in bed all weekend to recoup for Monday. I cant do any chores, shop, play with my kids even color with them. I wold like my pain meds to at least allow me to do some everyday things. Im so fed up with this whole thing.
  • have you tried methadone? I wouldn't suggest getting off of the 40's right now. If you are taking 2 a day, 3 a day is definitely a very good option. When I took 40mg oxycontin, 2 a day didnt cut it, and 3 a day was perfect. If that's not an option..

    You might ask your doctor what he/she thinks about adding a *low* dose methadone to the mix, like, 10-15mgs daily. It can help immensely, but if you have tried it already and it didnt work, the mix wont work either. If you do ask and they say 'sure lets try it' then just fyi taper onto slowly, like 2.5 twice a day for 2 days, then 3 times a day for 2 days, then the 5mg twice a day, or 3, whatever they recommend.

    I've found myself, (and heart) that doctors are Rx'ing methadone at the proper dosages, such as 30mg per day, but are not titrating patients onto it SLOWLY; its very, very touchy if you don't do that. Luckily I knew better.

    Too much info as always, but that's the norm for me. Good luck!

    JWM
  • I did ask my Dr about taking the oxycontin 3 x's a day but he said no way. I think that would help me a great deal
  • Thats a bummer; I was really hoping you'd get the 3rd dose; i don't know what else you can do now. For me, and MANY people here, the '12 hour' oxycontin just doesnt cut it for 12 hours, and when you switch to 8, you get a slight increase in your overall baseline/minimum level of the drug in your system, and you avoid the 30-40% dropoff that happens at the last 3 hours of a normal 12 hour dose. (result: much less reaching for the BT bottle) Oh well. =(

    Your doc isn't comfortable with it, so it's time to decide if you can bear with the pain, or maybe move to a different PM. Either way, it's tough. Good luck to you.

    JWM
  • JWM said:
    have you tried methadone? I wouldn't suggest getting off of the 40's right now. If you are taking 2 a day, 3 a day is definitely a very good option. When I took 40mg oxycontin, 2 a day didnt cut it, and 3 a day was perfect. If that's not an option..

    You might ask your doctor what he/she thinks about adding a *low* dose methadone to the mix, like, 10-15mgs daily. It can help immensely, but if you have tried it already and it didnt work, the mix wont work either. If you do ask and they say 'sure lets try it' then just fyi taper onto slowly, like 2.5 twice a day for 2 days, then 3 times a day for 2 days, then the 5mg twice a day, or 3, whatever they recommend.

    I've found myself, (and heart) that doctors are Rx'ing methadone at the proper dosages, such as 30mg per day, but are not titrating patients onto it SLOWLY; its very, very touchy if you don't do that. Luckily I knew better.

    Too much info as always, but that's the norm for me. Good luck!

    JWM
    Methadone is an excellent idea JWM! I was on Oxycontin 20 mg but once I switched to Methadone I found out that the Methadone worked much better with fewer side effects. Definitely see what your doc has to say about that. :)))
  • I went from taking the oxycontin to methadone a few years back (not taking either any more) and I thought I had pretty good pain control with the methadone. After I stopped taking it for a few months I realized that while I was on the methadone I was very slow- talking, getting around, thinking. I didn't realize it until I was off of it. If I remember correctly I took like 10 mgs three times a day. It gave me great pain relief, at the time and I wasn't afraid of it (it kinda got a bad rap after the celebrity scandals with it). It may not have that effect on all people, just what I experienced.
  • I had the same experience with methadone as you did trater. I was tired of being slow and stupid and told my doc that I was going to wean off them. I got down to none and my pain was horrifying! Now I'm on the Fentanyl patch and has started Opana as a BT med. Both are working pretty well. I only use the opana when it get really bad because it makes my body very slow. My mind is fine though LOL.

    Each of us is so different and what works for one won't necessarily work for another. To further that, what works for us one week may stop working the next! Pain management is a tricky business and we have to stay in tune to keep up with how our bodies are reacting from day to day.

    Hope each of you have a pain free day as is possible!

    Griff
  • JWM said:
    For me, and MANY people here, the '12 hour' oxycontin just doesnt cut it for 12 hours, and when you switch to 8, you get a slight increase in your overall baseline/minimum level of the drug in your system, and you avoid the 30-40% dropoff that happens at the last 3 hours of a normal 12 hour dose. (result: much less reaching for the BT bottle)
    Yes, it's all about keeping your blood plasma level up. When it drops off due to the ineffectiveness of the LA meds, then patients tend to use more of their BT meds.

    What kind of Doc do you see? Is he a pain mgt Doc, or a GP? It seems that many GPs are afraid to script OC 3 X.

    Good luck,

    Ex
  • When do you talk to your dr again???
    I know a HUGE PAIN to go in and ask for something different, its like a 'cloud' over your head while doing it.
    I do not like to tell people what to ask for.
    Methadone helped me LIKE WOW. I did not get that dragged out zoned feeling. I was on 5mg in the AM 5mg in the PM. I of course went off due to having surgery in hope of fixing the issue. Plus like its been said "the bad rap" its gotten. But we have to remember those are the people not using them as perscribed or getting the illegally.

    I'v always been curious why oxycontin does not work since its only oxycodone without the tylenol so you think WOW this will work!!! When I was on 10 mg 2x's a day. I really really thought ok without the tylenol IT WILL WORK. It did the first morning. Fentynl patches and Meth was my choice of meds while in PM.

    They offered it to me for my post op pain for Monday's surgery as that is what they give all patients, and I SAID NO [( [( Give me my percocet. HELLO YOUR CUTTING a 8 inch half moon incision on the side of my stomach and 2 5 inch incision on my thighs and you do oxycontin? HAHHAHAHAHHAHAHAHHAHAH NOT ;) Of course you have to remember someone like my husband who has 1 small procedure done his whole life well yeah oxy would kick his butt. Wow ultram kicks his butt, wish I was at that point ~X(
    I also just recently was put on lortab and taking ultram with it, besides a racing heart, it works not so bad, mix that with my valium or soma and I am good to go for ahwhile.
    In time I will have to go back to pain managment for my back, I cannot have all this tylenol in me everyday.

    Everyone is going to have a different opinion and every single med out there is going to work for one, not the other and so on.

    Ok enough rambling from mama bear ;) #:S AND NO 'C' if yo u see this my meds have not kicked in yet lmao!

    I wish you the best in luck in finding something!!! >:D< >:D< I will be thinking of you O:) O:) O:) O:) O:) O:) Please continue to keep us up to date!!!!!
  • TerriJV said:

    I'v always been curious why oxycontin does not work since its only oxycodone without the tylenol so you think WOW this will work!!! When I was on 10 mg 2x's a day. I really really thought ok without the tylenol IT WILL WORK. It did the first morning.
    I didn't think oxycontin was the same as oxycodone.
    I thought that there is oxycodone and oxycodone-APAP (which is oxycodone with Tylenol). I thought oxycontin was different.
  • I don't know if I will need break-through meds or not, but I just switched meds.

    I had been taking oxycodone-APAP (percocet) 5/325 4Xday. I tried Opana 5mg 2Xday (though the doc did say I may need a higher dose), for about 3.5 days but the pain got really bad. But just before I gave the Opana a try, my doctor told me I could take 10mg of the percocet. So I ended up taking two doses of 10mg, the night before I started the Opana.

    When I called the doc, I told her the 10mg percocet had brought my pain level down, and because of the cost of the Opana, I'd rather go back to percocet, but at 10mg. She told me to go ahead, using up my 5mg tablets (at double doses for 10mg per) and she would write the new script for 10/325.

    When I went to pick up the script, it was written for 5/325, so I asked to talk to the doc. I started telling her that we had talked about going to 10/325 4Xday, but that since then I actually felt like I needed a higher dose than that. Well, then she said that she really felt that I needed to be on a longer acting med, and wanted me to try the Opana again, but at a higher dose. I told her I wasn't happy about having to spend $50/month (versus $10/mo for percocet), so she gave me an Opana coupon card. It gives me $25/Rx for a year (so 12 months worth of Rx's, at 1/2 off).

    At the same time I told her that the Opana she presecribed the first time was not the ER version. She thought that maybe the med didn't say ER, but that it was supposed to be an extended release med. But I told her that I had looked up the med (for the price) in my Rx service website, and that there were indeed regular and ER versions of Opana.

    At this point, she had to go to her computer and start to look up info. And when she came back she had the Rx written for Opana-ER 10mg 2X day.

    Then I asked her how important it was to take on an empty stomach (like the drug insert sheet says). She wasn't aware that the drug is supposed to be taken on an empty stomach, and she said they have not been telling their patients to do so. She told me I should ask the pharmacist, to be sure.

    I aksed the pharmicist, and all she did was read to me from this book that she had. Now maybe this drug hasn't been around long enough for pharmacists to have gathered stories from customers using them. But I just figure I'd better stick with taking it on an empty stomach.

    And unlike other pain meds, Opana (reg or ER) does not say that taking it with food will diminish the effectiveness, it actually says it goes into your system more quickly if you take it with food.

    Anyway, to get back to the subject at hand, my doc said that if the Opana ER works, we might just need to add a break-through med. What that may be remains to be determined. But I hope that it will be percocet again. I have had lots of side effect with other pain meds, and to find any that work and don't make me sick, is a miracle in my book.

  • my 2 cents..

    Taking Opana at all diminishes it's effectiveness =P. Opana just doesn't work well at all, period.

    Many doctors think it's twice as strong as oxycontin but it's the other way around and by further..
  • Well, I'm not sure if it is going to work for me or not, I'm not ready to say it is or isn't. I would imagine that it is like other meds, in that it works for some, but not for others.

    I will be sure to let you all know how it works for me. I am giving it at least through the weekend.
  • oxy never worked 2x a day for me either, but it seemed like every 2 years, i would need more.

    i started at 20 mg. 4 x a day, then 40 mg. 3x a day. the past 3 years i was at 80 mg. 3x a day. that actually worked and i didn't seem to need more, but i moved and when i moved back, my pain clinic wouldn't take me back and no pain doctor would touch me on that high dose.

    so now i'm just suffering. i wish i could work. i'm literally homebound and in bed 24/7 and now on lyrica which helps with withdrawals mostly but is making me suicidal and unable to even read, which was my escape. i was forced to stop the breakthrough meds--3 4mg. dilaudid a day --first, then down to 2 oxys.

    today i start 50 mcg. fentnyl which i know is about half of 2oxycontins.

    i don't think i can bear it. i was in so much pain, i slept with my tens unit and now i have huge burns and blisters. i knew this would happen, but it felt so good to turn it way up and i feel nothing when it is down because i am numb where the pain is.

    i don't know what to do. i hope the epidural helps.

    i'm so sick of pain doctors. i just don't want this life anymore.

    i need help. i should go to the hospital but there is no one to take care of my cats and they are my only family.
  • Your cats will be Fine, leave them food & water & they will be fine. Please go get help your Life is very important. Sometimes we are in alot of Pain and it seems like nobody else understands us. You need to talk to someone before it get's worse. Say a Prayer and Get help,
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