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Question about Legal Limits & just general advice

AnonymousUserAnonymousUser Posts: 51,513
edited 06/11/2012 - 1:39 PM in Pain Medications
About 18 months ago I finally went to the doctor regarding my back pain. MRI & Cat Scans revealed bone spurs on nearly every vertebrae and the lowest disc is compressed.

I was sent to a Pain Management facility and started on 7.5/500 Lortabs....90 per month.

Over the course of the last year or so, we have stepped it up to 10/500 Lortabs...180 per month (6 per day).

**My Pain doctor has said that this is the legal maximum that he can prescribe. I am in Las Vegas, NV.**

I am to the point now in my tolerance that I am taking 2 in the morning, and then 5 more throughout each day....but if you have been following with the math...I don't have enough.

Before I go back to my Pain doctor on Friday, I wanted to talk to my peers about the options.

The thing is that I *like* the Hydrocodone. It doesn't impair me in anyway, and simply takes the pain down tremendously. I just need about 30 more per month....but if this is the limit, then I'm not sure what to do.

My brother lives in Reno, NV and is prescribed FAR more of the same pills. The difference is that he sees a family physician and not a Pain Specialist. Is there a difference in what they can prescribe?

My other thought is...if qty 180 *is* the maximum for 10/500 Lortab....perhaps I should ask for something like Percocet qty 30 to take in the morning, and then follow up with Hydrocodone throughout the day?

I am hesitant to step-up beyond Hydrocodone to the more powerful Oxycodone...But, if it can cut down on the amount of Acetaminophen my liver processes daily, I'm sure that would be better for me in the long run.

Any advice or information is very appreciated.


  • This is between you and your prescribing physician. I would recommend being honest about how much or how little it takes for you to get relief and let the doc make the determination as to whether or not changing out the medication is prudent.

    There are several laws from what I understand that govern how much a doc can prescribe. There may also be guidelines within the clinic or hospital he works from that limits him as well. Only your doc can tell you for certain what he is being limited by.

    Honesty is always the best policy when dealing with your doc.

  • I understand that and am always honest with the doc.

    It's just that after speaking with my brother in the same state, I was very confused.

    I feel very guilty asking for more meds, and I know it's just me....but when I ask for Percocet AND Hydrocodone....I feel like a junkie.

  • Whenever there's a valid need, then you should not feel guilty asking for something to provide you pain relief. One thing I've seen over time, is that asking for a specific drug sends up red flags. Asking for help on the other hand allows the doc to remain in control of the situation and keeps you from feeling like a drug seeker looking for a particular drug. If the doc asks you which drugs work best for you, then there's nothing wrong with telling him and also expressing concern over the levels of Acetaminophen.

  • Although certain states have regulations limiting the number of pills or milligrams of a certain substance, I am not aware of this limitation by Nevada for prescriptions of hydrocodone. Since it was the state with more hydrocodone pills prescribed than any other state in the country, I am guessing that you don't get that rating by limiting the number of pills that a doctor can prescribe.

    In any event, it is more likely that the doctor was referring to the medical guidelines that recommend no more than 4000 mg of APAP per day for an individual. If you were to receive Norco 10/325 instead of your 10/500 tablets, the 175 mg of APAP less that you would recieve in each pill would make increasing the number of pills possible without exceeding the recommended dosage of APAP. You might check with your doctor and see if that is indeed the case.
  • here where i live the dr gives me 240-10-325 a month.
  • It sounds to me like your pain is not been treated correctly. If you need to take more medication than what is prescribed to you, then your pain management is off.
    You need to be honest with your PM Doctor and let him know that the dosages of medication that you are in are not working for you. Maybe he can give you an extended release medication, so you don't have to take as many during the day, or he can give you another medication for break through pain and keep you on the same amount of Lortabs that you are in right now.

    The one thing about taking too many Lortabs is... Lortab contains Tylenol (Acetaminophen), and Tylenol is absolutely awful for your liver. If I was you I would ask him to prescribe me a medication that does not contain the Acetaminophen, and also a medication that can be long acting, so you maybe have to take 2 or 3 a day instead of 8 or 10. This is just my opinion and God knows that I am not a Doctor! I am just a professional intractable pain patient that has been through a lot!

    Take care,
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