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I would welcome some knowledge from others. My pm doctor has me on Opana ER 30mg 2xdaily and Opana IR 5mg 3xdaily. It has worked fairly well for about three months I guess but I am considering a change for a couple reasons. First I have been hurting bad daily for about three weeks and it isn't helping like it was. I would normally just think well maybe it's time to go up in dose but the highest I could go on Opana would be to 40mg 2xdaily instead of 30mg. I would consider my dose overall to be on the high end , maybe I am wrong. And if it's not doing the trick at this dose I think a change would be good. I have a meeting in a week and wanted to go to that meeting prepared. He is probably going to give me some options. He first suggested methadone and I don't know if that is the route I want to go so I would love to hear from others. What works, what doesn't. I would appreciate you sharing your experiences.


  • That decision will be made between you and your doctor based on what he feels
    may be best for you based on his exam and treatment plans.
    Medications, like other treatments are based on your particular condition .
  • It could be a good idea to keep a pain diary. When you take your meds, when/what makes it worse or better. On many occasions I've had to take a 12 hour ER every 8 hours. What other meds are you on? Does your pain feel more nerve based? It could be you need to add something else or do some other therapies to manage your pain. I've been on some pretty high doses of meds (more than you) & I can honestly say that nothing takes my pain away. It's about finding acceptable relief that allows you to function & keep moving to help your pain. Ugh!! I know!
    I change narcotic meds rather than increasing doses now (mostly) but you haven't been on Opana long. Have you taken other ER meds? Is this a common problem? Do you have any stomach, digestive issues or diet changes that could effect the way the Opana is working? Do you take it away from food? I'm just giving some ideas to discuss with your doc.
    Remember the weather changes effect pain levels for a lot of us. Could it be your meds are working but your pain is just worse? Ugh! It's so complicated isn't it?
    Methadone is a very respected pain management tool. It considered the narcotic that works best for nerve pain. I'm a child of the "Just say No!" 80's so just the word 'Methadone' makes me think of heroin addicts! There are lots of discussions on it here. If your doc decides to go that way there's plenty of info. Just search at the top of the page ;-)
    Osteoarthritis & DDD.
  • CGCCG Posts: 3
    edited 11/23/2014 - 11:32 AM
    First - I want to share that I am a RN and a chronic pain patient for many years. I just had an eight level spinal fusion. I have a great deal of experience with narcotics (unfortunately), and am very well-read re the literature re their efficacy, side effect profile, mechanism of action, etc.

    I am concerned when I see comments about drugs that lack scientific support (ie, Methadone is the best drug for neuropathic pain). Methadone is not better or worse than any of the other narcotic when it comes to nerve pain - which is very hard to treat. There are a few drugs ,on the market used for nerve pain. For example, Neurontin (gabapentin) is frequently prescribed for radicular/neuropathic pain - though it does not help everyone.

    Re Opana - I have been on Opana ER for years and prefer it to Methadone, which makes me nauseated. 30 mg is a substantial dose and I personally not go above that. You could try OxyContin, which is taken every 12 hours and provides good extended pain relief.

    Everyone responds differently to individual medicines, so it is often trial and error. You could also add a medicine that increases your pain threshold. Many of the anti-depressant drugs will do this (eg, Elavil, Cymbalta).

    In between the ER meds, if you have break-through pain, there are lots of short-acting narcotics. Oxycodone and Dilaudid are two meds I have found helpful.

    Message sent to poster
  • I agree with what you say about trying different meds but the poster had good results with Opana & has only been on it for 3 months. I was wondering why. I'm not a medical expert, no one here is. We just share what we've experienced & chat about it.

    I stated there are other meds to help. My comment on methadone was repeating information provided to me by a couple of PM docs, reports I've read & lectures I've watched by pain management scientists at the leading universities. I didn't realize that was a controversial statement. It's just one of the 'positives' given me when I discussed switching with my doc.

    Anyway... Hi & welcome CG. You seem very knowledgable & experienced. I hope you will share & enjoy the support you receive in return.
    Osteoarthritis & DDD.
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