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Adjusting to Extended Release Meds

optimistooptimist Posts: 546
edited 06/11/2012 - 8:27 AM in Chronic Pain
My PM has been trying to switch me from shorter half-life drugs to ER meds for better pain control and because I just didn't tolerate the way meds like Perocet made me feel (very unpleasant feeling, anxious) and only an incomplete pain relief of about an hour or so. So far I have tried Opana, MSContin and Kadian - none have given me significant pain relief but did give me such an unpleasant feeling and mood (even at the lowest dose possible) that I don't even want to think about increasing the dose recommended by my doc for pain control for fear those side effects will just be more prominent. (I just can't fathom anyone wanting to take these meds who is not is serious pain!!). I feel like I'm in a "lose-lose" situation. The only thing that seems to give me great relief without significant short-term affects are steroid injections, but we know long term those aren't good and are limited in number allowed/year. My pain is outright unbearable at times - well, many of you are/have been there. Is there anyone out there that had similar experience with these "feelings" but became tolerant to the negative side effects over time so they could increase the dose enough to get decent pain relief, and if so how long did it take? I have also been on Lyrica, Topomax, and now Elavil along with muscle relaxers too.


  • I can't tolerate the pain meds either and feel the same as you as to why anyone would want to take these meds if they were not needed. I ended up on methadone. It did have some bad effects for the first few weeks but I after that (been taking for 1 year) I have had no problems. I have a very low tolerance to these meds. Methadone is also very inexpensive. Good luck and keep us posted.
  • dilaurodilauro ConnecticutPosts: 9,859
    can take a little time, especially when you have switched to this after a long period of Immediate relief type of pain medication.
    Over time, I have used the ER version of Opana and Oxycontin.
    My personal experiences was that after a week of using the extended relief medications along with breakthough pain medications, I was able to manage my pain levels. Really never eliminating the pain, but making it tolerable. And for me, the best part of the ER type is that it is spaced out over a period of time and I do not get that immediate 'space' feelings.
    Discuss this with your doctor in details to see if there are other options to control and manage your pain. Many people have good luck with various pain patches
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Unfortunately I have no choice but to take pain meds. The pain is unbearable and I tried to go without ms contin but it was a mistake. I was ready to well you understand. It was good I had percocet left over although I don't like percocet for the mood changes. MS Contin gives me no feelings other than mormal. It's the nerve pain meds that got me at first Lyrica and flexeril makes me tired. That's good your Dr. gives you a choice. I wanted to try fentanyl but she wouldn't let me try it. So I'm on 30 mg MS Contin 4x day and still have pain. But I rarely take percocet for BTP. I had to go through Lyrica's side effects for at least a month but then I got used to the side effects. Good luck and hope you find something that doesn't affect you so much. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • who got anxious, kind of panicky from narcotics. I took Vicodin for a year maybe before it started bothering me. What could be more cruel than a person in chronic pain that can't tolerate pain meds yet its a well documented adverse reaction. Dilaudid does not make me nervous. I feel nothing but pain relief. I don't get sleepy or blissed out. Nothing except pain relief. Yet, like you, Optimist, my PM docs all want to get me on a long acting pain med. And it makes sense. I;ve tried Avinza (major panic); oxycontin (minor panic) Kadian --at an extremely low dose but I don't think it made me feel bad. Fentynal didn't make me nervous but it did make me nauseous. If your doc will permit a short acting drug, maybe Dilaudid will work for you too---but it all varies from individual to individual. Sometimes, its dose related. Weird. Optimist, my husband has it worse. He has had a heart attack and he is ALLERGIC to statins--his face swells up,his airwsay swells shut, he could die from the statins. When I was a philosopher we used to "postulate" an "evil genius"--a God-like figure who would sit in rhe heavens and play mean tricks on us all. It makes one wonder....
  • who cannot tolerate the ER pain meds. But, my doctor took me off Dilaudid, even though it helped better than this Opana ER he is trying to make me take. But, I understand, I had been on it for quite sometime and while I thought it wasn't doing too much for my pain, and while it wasn't long lasting, since being off it, I can sure tell now how much better it helped me.

    This Opana ER does nothing for me, I can't sleep at all, it has given me a tremendous headache, and when I told him, he then gave me a script for the headaches, (caffeine) but the meds for them didn't help either, so I suppose I need something for breakthrough pain, or I need to try something totally different. Does anyone have any suggestions? I take Neurontin for nerve pain and have for years, it works better than Lyrica for me, Zanaflex for muscle spasm, and Wellbutrin. I've tried Methadone also and it didn't help me at all. It made me "sweat" right thru my jeans! And,turned my face beet "red". I told my husband if it would have helped my pain, however, I would have stayed home, naked with a bag over my head (lol)!

    Dilauro, can I ask what you take for breakthrough pain? I have an appointment this morning, and don't know what to ask him. I don't know if the headaches would get better or if they might stop if the Opana was increased, but my head feels like it is going to explode.

    I am not getting any pain relief on 30 mg. every 12 hours of the Opana ER.....I know he won't put me back on Dilaudid. This is my Neurologist, but I think he is giving me the name of a pain clinic today. My other pain clinic doctor moved, so I've been looking for a new place, perhaps they won't be afraid to prescribe medications for me - he is a new Neurologist for me also and doesn't seem to understand the d*mn pain I am having.

    Maybe I should ask if he won't change the Opana, will he at least give me something for breakthrough pain. My pain begins WAAAYYY before it is time to take that 2nd Opana ER.

    Take care everyone and good luck Optimist. Let me know how things go for you.

  • dilaurodilauro ConnecticutPosts: 9,859
    Sandy, for the past 2 1/2 years I have been using Oxycodone IR 5mg capsules. They have been very effective. When I was using Oxycontin (various dosages), I would use the Oxycodone IR any where between 4 and 10 pills a day.
    When I started to reduce the Oxycontin intake (as I was feeling better) the breakthrough was reduced to an average of 5 a day.
    I have had a recent flareup (since Thanksgiving) that is just not going away. My doctor now put me on Opana ER 5mg, not a high dosage just to get things under control, perhaps for one month. And the breakthrough medication is Opana 5mg.

    So far, I feel that the Opana 5mg is more effective than the Oxycodone.
    But that could also be since I just switched and perhaps my body was getting so adjusted to the Oxycodone IR

    Hope this helps
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Switching to ER meds is a good move to get longer pain relief. I too have been switching from perocect to and ER for better control and so I do not feel like a prisioner to my pills. I can not take oxicotin, opana, fyentnal, they all just have to much of side efects for me. But have you tried the ER form of morphine. This is my 3rd week on. has lot less side effects and I like it cause you can not feel the meds like you do when taking perocect. I am not talking about avinsa but straight morphine ER. I'm glad I switched you may ask for morphine ER.......Hope you get the right medication for the pain relief you are in need of.....
  • Because I went to see my Neurologist this morning and after me telling him how bad my head was hurting, he wrote a prescription for Opana ER 40 mg. twice a day, raised my Wellbutrin to one pill a day, 300 XL mg, Ritalin LA 10 Mg one capsule a day - he said he would not put me back on the Dilaudid, and that I am taking too many pills a day.

    My problem is I had a hemorrhagic stroke 8 years ago that left me with a rare condition called "thalamic pain syndrome". You can google that and see it is terrible to live with. He said he knows what it is, but I'm beginning to wonder. I have this gnawing, irritating, burning, constant pain down the left side of my face, shoulder, arm, hand and fingers and I have been on pain medication for this horrific pain since my stroke.

    I don' know, but something doesn't seem right to me in as much as this neurologist says he understands my pain condition, that he continues not to listen to me when I try to tell him the Opana was causing me to have breathing problems and my head is hurting so bad, it is about to explode that he would give me the same medication in a higher dosage. Does this make sense to anyone?

    I don't know, I am asking is it possible my head will stop hurting because he took me off the Opana 30 mg ER and raised the dosage to 40 mg?

    Also, I have a herniated disk at L4-5, a small bulge at
    L3-4/w annular tears in both, DDD, and Scolosis and I am walking with a limp. Something I didn't do after my stroke. The back pain has worsened and one surgeon who saw me wanted to do surgery on me until he found out I had a stroke, he said I was high risk. I understand.

    I had back pain years before my stroke so my back problems are not something new, however, between the two, my pain is so bad, it is really getting to me.

    Last week when I called and told the office girls about the side effects of the Opana, (he had taken me off the Dilaudid and I was having a bad time of it), he asked if I was interested in being referred to a pain management group. I told the girl we would discuss it today. He didn't mention it today, and I just took the scripts and had them filled and now it is 10:00 p.m., I have my ice pack on my back, I'm having panic attacks, my head is hurting so bad, I can't breathe, things have worsened as the day has gone along. I wonder if I should be seeing a pain management doctor instead of this neurologist. He tries to tell me the pain will get better......neurologists always seem to do this (lol).

    I've had every injection, Epidural, PT and my last PM doctor told me I would need good pain medication for the rest of my life because of the stroke and back pain. Like a diabetic needs their medication, we need ours, certainly not to get high. I wish I never had to take another pill, but I can't live like this.

    Thanks for listening, just had to vent.

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