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opana vs Kadian

dmoonchildddmoonchild Posts: 383
edited 06/11/2012 - 8:20 AM in Pain Medications
can anyone tell me the difference between Kadian & Opana? Is it different med? I had a bad reaction to Kadian and my new PM DOc would like to try a ER med for me. I see him thursday. I have taken Kadian, ( never again) and Oxycontin 20 mg. ( that did nothing for me). Im willing to up the dose on the oxycontin. I get no side effects from that. He would also prescibe the oxycodone I have been taking for break thru pain. Just wanting some info on opana, and maybe the cost


  • surgery section and look at the post about the horrible hospital experience. I believe that it was posted by diskreetkarma. He says that the opana is double the strength of oxycontin.
  • Opana is extremely expensive, but probably comparable to what you paid for the Kadian. Most insurance companies prefer plain old generic morphine ER - I asked the pharmacist I work with and she said it's really a negligible difference, but I am sure that the drug reps have been making their rounds. Strange that your doc hasn't suggested any ER meds that have generics? Oxycontin generic is no longer availabe, there are a few stragglers left, but I would imagine that when you last took it it was still available, so prepare yourself for a brand name copay. Doctors really don't seem to understand the whole insurance copay tier thing. I would suggest that you either call your insurance company or sign onto the website and view your formulary - they can tell you what tier a medication is in.

    I've never taken anything in the morphine family - oxycodone, both ER and IR give me no side effects, so I have been on that. Good luck!
  • I am currently taking Kadian... Can you tell me what your side effects have been? Mine were TERRIBLE. The severity of them has passed, but most are still lingering. I've been trying to get my doc to take me off of it, but he refuses to try something else.

    Just curious if your side effects are the same as mine

  • My previous PM doc put me on Kadian 20 mg and Skelaxin when I first went to see her. The first night I was sweating like crazy and had some wierd dreams. Te next day I just felt bad all over like the flu, and my back hurt worse than ever. Then it wasnt just bad dreams, they were horrendous nightmares that I couldnt wake myself out of. I would be screaming for my husband every time I fell asleep. I had to change my PJ's and sheets 8-10 times a night because they were drenched. It also felt like I was having a heart attack. I felt like I was in a daze, very irritable and the bad feeling would come over me like a wave, I would start to sweat and get very dizzy. I took Kadian for 4 days and it took 2 weeks to get out of my system. I wont even go into the bad effects of Skelaxin.
  • Kadian is time release Morphine Sulfate, and Opana ER is time release Oxymorphone. Kadian has an oral bioavailability of about 30%, where Opana is about 10%. About your reactions..

    dmoonchild, were you taking oxycontin regularly, and then switched over to Kadian? You mentioned that you were willing to up the dose on the oxy, which makes me think you were taking it. If so, the reaction you had sounds like one of two things: 1: it sounds like typical withdrawals from oxy. or 2: it sounds like too high of a dose of kadian (morphine ER). Kadian IS an ER med, it's time release mechanism actually works better than oxy (it is more even over the 12 hours). Maybe you have bad reactions to morphine?

    If you have good insurance and low med costs, i'd stick with Oxy. As for Opana, I pay cash, so the $750 a month is too much for me! Someone said in a previous comment that it's twice as strong as oxy.. I don't want to explain this all over again but when taken orally it's not, its more like less than half as strong. Due to bioavailability, if you've taken 20mg oxy then your doc would probably look at 40mg Opana. Personally, I think Opana is garbage. It's active ingredient IS twice as strong as oxy when injected, but when swallowed, only about 15%-20% as strong. A typical injection is ONLY ONE MILLIGRAM! That shows you how weak it is taken by mouth. Personally I think Opana should have 80mg and 160mg strengths..

    Ok, I've bashed Opana enough. I hope it helps someone, and maybe it will help you, but so far it's been a big disappointment. Good luck finding the right meds!
  • ">imageExcellent information you posted! Thanks for all the info!
  • I wonder if you are super sensitive to medications?? I too have suffered terrible side affects from Kadian.

    Severe irritability
    trouble passing urine
    insomnia... and over sleepyness (pick a day, pick a side affect!)

    I am starting to wean myself off of it now. I am done. It's not working for my pain anymore, and the side affects are just not worth it!
  • I'm the one that posted the horrible hospital experience thread and can tell you a little that I know about Opana. I have been on it for about 4 months if I remember correctly. I was on Kadian and started having really bad anxiety and panic attacks. My PM doctor immediately took me off the Kadain and put me on Opana. The other member mentioned that I said it's twice as strong as Oxycontin. This is true. Usually that just means that you'd be perscribed half what you'd get if you were on Oxy. I didn't like Oxy because I felt like they wore off too fast and I also think your tolerance builds too fast on Oxy and your dose becomes ineffective. That's my opinion and from my experience. After Oxy I was switched to Kadian. I obviously didn't like that because of the side effects. I haven't had any problems with Opana. I was on 100mg of Kadian twice a day and was switched to 40mg of Opana twice a day. That's equal to two 80mg of Oxycontin. I also take the instant release Oxycodone for breakthrough pain. I really don't get much of a high or an up and down that I felt on Oxycontin which I prefer to have. Opana is Oxymorphone. If you read my story that the other member mentioned,it'll make you want to bring the conversion chart if you ever have surgery. Here's the chart and below that I'll put a link to the thread the other member mentioned. I can't think of anything else to tell you but please let me know if you have any other questions. I'll try to check back but PM me if I don't. Here is a conversion chart. Opana is the first one which says Oxymorphone. The rest are compaired to the 10mg dose that the Opana is compaired to. Does that make sense? It says that if you're on 10mg of Opana that it equals 20mg of Hydromorphone, Oxycodone (Oxycodone is generic for Oxycontin) and it equals 30mg of Morphine or MS Contin. I hope this helps.


  • Sorry discretekarma, but that information is a little misleading to the other people here. First, I'm happy Opana is working for you. 2nd, it is NOT twice as strong as Oxycontin taken ORALLY. It IS twice as strong intravenously. I have taken both 40mg Opana and 40mg Oxycontin, and have no doubts about which is more potent by mouth.

    Conversion charts are not always correct. If you research the bioavailability of both Oxycodone (links below), and Oxymorphone, you will find that Oxycodone's is about 75-90%, and Oxymorphone's, about 10%. Injected intravenously, Opana/Oxymorphone is twice as strong as IV Oxycontin, as you mentioned, however, orally, Opana is about 1/2 to 1/3 as strong as Oxycontin. By using the bioavailability percentages, you can figure that one 40mg Opana, times a bioavailability of 10%(4mg in bloodstream), times 2 (twice oxy strength once in blood), is 8mg oxycontin equivalent. Oxycontin 160mg, as you mentioned, times 90%, (135mg in bloodstream), divided by 2 (half oxymorphone strength in blood), is 67.5mg, which is equal to about 320mg oral Opana. Got it? Your figures are waaayyy off. I'm not being stubborn or fightish about this, I want anyone to read this to know what is TRUE. I don't want someone who has been taking 20mg Opana to think they can jump straight to 80mg Oxycontin because you say they are the same, because it will probably kill them! Thats completely backwards. Read up on this please!

    I'm not sure where that chart is from, but ignore it. Read up on the drugs, and their oral bioavailability, if you'd like to know the truth. Yes, it's stronger, but since only a fraction of it actually gets metabolized, you only get a couple of mgs, hence it being WEAKER. And of course, never take anything you read on here as the ultimate truth, consult a physician, as I am not one myself!

    FDA info on Opana, quote: "..the absolute oral bioavailability of oxymorphone is approximately 10%.."
    Link: www.fda.gov/cder/foi/label/2006/021610s001,021611s001lbl.pdf

    RXlist info on Oxycontin, quote "..Oxycodone is well absorbed from OxyContin Tablets with an oral bioavailability of 60% to 87%.."
    Link: www.rxlist.com/cgi/generic/oxycontin_cp-page2.htm
  • I peronally don't think that what you said is right. You can either go to Opana's website or just google Opana Conversion Chart. I got the chart I posted here off RxList. It says Oral Conversion Ratio. I'm pretty sure that would mean that it doesn't have anything to do with IV. Nothing about that chart is about IV. I can tell you from my personal experience that I have taken pretty much all the medications on the conversion chart and it is approximately accurate...just like it says. It can never be exact because everyone metabolizes and reacts to drugs differently. What you're saying has to have some merit otherwise I'm sure you wouldn't be saying it but I find it hard to beleieve that every conversion chart is wrong. They all say the same thing.

    You mentioned that "I don't want someone who has been taking 20mg Opana to think they can jump straight to 80mg Oxycontin because you say they are the same"...They aren't they same...20 of Opana is the same as 40 of Oxy not 80. I'm sure they won't just switch from one to the other because I say so without a Dr involve.

    The conversion chart is right. Not only does it just make sense that it's right but the doctor that finally looked it up in the hospital, confirmed that it's right.

    I put two charts below. The first is a converter. It's not a special converter. You can use any and you'll get the same results. The second is the rest of the conversion chart that I got off RxList. I cut off the small print the first time I posted it. This is from RX list but like I said, you can google it and use any of a number of converion charts that say the same thing. I'd be very suprised if all the conversion charts on RxList, Opana.com, and many other websites were wrong and you were right. If it's true you should probably contact the surgeon general.

    I'm truely sorry if your post has been derailed. I hate it when that happens but I just wanted to make sure you and everyone else have the correct facts.

    If these sites are all wrong, you really should contact the surgeon general JWM.

    Good Luck,


  • someone had a valid question about 2 medicines, which I answered, and correctly. Please try not to hijack their threads in the future with an argument. If you have a question about your medicine, read about it, and not what the advertisements say (mfg website and conversion chart with links to buy narcotics online?) but rather what the pamphlets with pharmacokinetic info says. If you don't know what pharmacokinetics are, look it up. Find out what measurements are important. Learn what peak plasma is, peak concentration, cyp2d6, etc, and then message me. I'm not going to argue with you, you are wrong, and if you feel the need to complain, send me an instant message. I am including this information below because it is important that you stop flooding this thread with misinformation.

    Simple math:

    100mg Opana times 10% bioavailability is 10mgs in the blood.

    100mg oxycontin times a 80% bioavail is 80mgs in the blood.

    Oxymorphone is twice as potent as oxycontin(10mgs times 2, is 20), therefore 100mg oxycontin is approximately FOUR TIMES stronger by equivalency than 100mg Opana/Oxymorphone. (80/20 is equal to 4/1, or 4 to 1)

    If you can't figure that one out, well, sorry. I'd say ask a doctor, but the sad truth is that we usually know more than them on these matters. If you still disagree, like I said, message me, but keep it off these forums. Back it up with fact or research based figures, as I have, not incorrect calculators. Do some research on Morphine while you are at it. It's bioavailability is about 30%, which is why 30mg MScontin works about the same as 10mg Oxycontin, generally speaking. -goodnight-
  • While I have to admit that I know nothing at all about this topic, I do know that the info that discretekarma posted is the info that is in our pharmacy computers - I watched the pharmacist pull it up for a patient the other day. Therefore, I would say that it is what the manufacturers and the FDA use, also. Whether that is right or wrong, I don't know, but it probably is the generally accepted information.

    Most lay people, those that aren't chemists, etc. probably have a difficult time wrapping JWM's info around their heads, I know I am having a hard time understanding it myself, and that is exactly why I can't say he is correct or incorrect, either. I guess it does make sense, but, if it is, that means that the manufacturers have mislead pharmacists, doctors, and the FDA, which I find hard to grasp. It is certainly possible, and is sad commentary on the pharmaceutical industry...
  • Yes! You find it hard to believe that a huge, profit driven pharmaceutical company would mislead people? Or that doctors would push drugs that don't necessarily work just for perks? My PM tries to push a new drug on me EVERY MONTH that I don't need, and it's always name brand and less than a year old. I see drug reps at my PM's office EVERY time I am there, vs NEVER at my primary care doctor. Actually if you look at my link, the FDA article itself shows that oxymorphone has a low bioavailability of about 10 percent. So I would say, the FDA is well aware of how little of the Opana actually gets into your blood. I would believe them over Endo.

    I agree, it's definitely complex, and beyond what most people think about with narcotics, but it is so very important that it cannot be overlooked. You are correct; the manufacturers have mislead pharmacists, doctors, etc. This has not been something worth talking about too much in the past, because in the past most conversions were correct or very close, but with this drug people in pain are being SEVERLY undercut when being thrown onto Opana.

    Here is why it is so important: 100 mg's swallowed, is NOT 100mg's in your blood. Usually, your liver has to metabolize the chemical swallowed, and THEN it gets into your bloodstream . Some chemicals metabolize very, very well, like oxycodone, and some not very well at all, like oxymorphone. The unmetabolized chemicals pass through in our urine/etc. The number describing how much of it gets in your blood is called bioavailability, and it is the true measure of how much you actually GET, which you can compare against how much you swallow. This is why, when you swallow 40mg Oxycontin you get 30-36mg over 12 hours or so, and when you swallow 40mg Opana you get about 4mg over 12 hours.

    My main concern is that people switching to Opana are going to find that it does not control their pain very well. I hope that this information helps a few people to question or talk to their doctor about it, to ask them about it's low bioavailability, and in the future, I'm confident that you will see many, many people unhappy with the drug. In fact, try google, they are already out there and in numbers. I wouldn't be surprised to see them come out with stronger doses as well. My PM knows about it, we've had the talk. Time will tell for those who need to see something drastic happen to believe it, but it will.
  • I do see your point, and you make it very well.

    Also, remember that what doesn't work for you may well work for someone else, and not everybody that takes Opana is switching from Oxycontin... I for one like my oxycontin and have no plans to switch to something that expensive, so I do see your point.
  • I was on Hydrocodone 10 mg prior to going to se my first PM who switched me to the Kadian. I dont think it was withdrawel, because I still had some of the hydro, as I thought the same thing. I really think it was the morphine.Thank for all the info everyone. Amanda, I forgot another effect....hair loss, in clumps, and urine retention.
  • Rosetta, yes you are right what works for one, definitely can be different for another. Opana WILL help people. My main concern remains that people still might believe that Opana is stronger. Oxy works SO SO very well for pain, and Opana truly is a step down from Oxy, taken orally. For those not switching, it's definitely a viable option however as a starter, and can have a rediculously low amount of side effects. Unfortunately for me a side effect was no pain relief.

    Thanks for taking the time to read my long repetitive posts; I'm stubborn and I want people to know the truth!

    dmoonchild; oh my god, hair loss in clumps! Thats terrible! Sounds like morphine is not for you. I've had urine retention with ALL narcotics when adjusting to high doses, so that usually goes away.. Good luck and sorry for filling up your thread with so much typing and info!
  • I didn't start with Opana. I started with Oxycontin, then I took morphine, Kadian, and finally Opana. It just so happens that the Opana is 1/2 of the Oxycontin that I took and 1/3 of the Morphine and I have no problems. I didn't have withdrawal or anything else which I would have had if it the chart wasn't right. I see that the bioavailability is 10% but I'm sure they make it up somehow or it just wouldn't work. I can tell you from experience that the chart is accurate. I know other people that take Opana and they think it's even stronger than half of Oxycontin. I've never had any problems with Opana and I love it more than the other as do the other people I've met. I'm sure if you search for it you can find people that hate or complain about any drug.
  • I just started Opana ~1 week ago. At first it worked great (5mg IR), but that was an upgrade from 5-325 percocets. It seems to have leveled off quickly (not great pain releaf). Deffinately not worth the money, plus it makes me very drowsy. I'm going to ask to go back to oxycodone.
  • Anyone here want to kick a dead horse(opana) with me? Lol..

    Metalneck I'll 2nd the methadone suggestion; it's so underused, but works wonders.. I'm on a mix of morphine and methadone, both at 'lower' doses, and the combination is *perfect*. It's the only mix I've found that controls my pain as well as oxycontin does, but without making me feel high and having a terrible memory.

  • hey guys, enjoyed the above coversations, i have a couple of questions, i was on oxy a couple of years ago, , well long story, 2 yrs later, 4 surgeries later, in worse pain ever, 8 wks post op dx with faild back syndrom and arachnoiditis, i was on qty 8 norco 10/325 a day,, my new pm dr put me on ms contin er and morphine ir,, both 15 mg.. first off, i dont like the feeling i get, im nausious, cranky, the pain relief isnt worth it, so, ive been reading on nerve pain and methadone.. i just started taking topamax which i used to take long ago also.. whats your opinion on methadone and topamax.. for chronic, long term care..
  • I'm so glad to see that I'm not the only one who Opana doesn't work for. My PM had me so brainwashed that Opana was IT.
    He took me off Oxy 10mg and on Opana 5mg telling me it was equal. When I went back a month later and said I was miserable he doubled my Opana, but I'm feeling no better. Hmmm......
    JWM, do you have a degree in chemistry or something?? You are crazy smart! Scholar or not, I buy into your theory.... either that or it just plain doesn't work with my body chemistry. I wonder what perks my doc is getting from the Opana rep.....

    I'm a 29 year old mom in Phoenix hoisting kids all day long ... is pain relief too much to ask??
  • HotinPain thanks for chiming in to support me on this one. As you know others may not agree, but I would say you got ripped off. Your case is EXACTLY the situation I am afraid we are going to hear of again and again; PMs are pushing Opana HARD as a 'better' drug than oxycontin, and sadly, many of them just simply don't know or read up on how the drugs actually work in our bodies. I hope that many people who are getting great relief from Oxycontin will read this and NOT switch to Opana. Your doctor used the incorrect math thinking it's 'twice as strong' and you are in pain. Sorry =( I hope people spread this info, and take it to their PMs, so that it becomes common knowledge.

    One of the main reasons for the Opana push is this, as some of you know: generic Oxycontin was discontinued due to patent disputes/violations. For now, as pretty much all of the generic Oxy has run out, the ONLY manufacturer is the patent holder Purdue Pharma. The maker of Opana is Endo Pharmaceuticals. Endo and Purdue are obviously in 'competition' with one another for having the best pain killer out there, and since Endo can't make generic oxy anymore, the push on Opana is huge. When you think about that, it makes sense that they would be putting pressure on the doctors with whatever perks they are allowed. Purdue's patent runs until 2013 I believe, so expect the battle to go on for a few years. It's Opana vs Oxycontin, and we lose.
  • What kind of perks do Doctors get for a patient using a specific med? New golf clubs? Anyway.....I started with Oxycontin 30 mg every 12 hours yesterday. WHAT A DIFFERENCE! Really good med for me. Im getting relief for 8 hours. WOO HOO!
  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    Go for the methadone ... its cheap and does the job.

    Just my 2 cents worth ....

    Prayers for us all,

    Spine-health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!

  • dmoonchild, I'm happy Oxycontin is working so well for you; if anyone else has found that Opana just isn't all it's advertised to be, please reply.

    As for the perks of doctors.. The actual amount of documented information, such as from lawsuits, is somewhat minimal, but nevertheless pharmaceutical companies pay big time for 'marketing' expenses. Billions. The laws limiting perks to physicians are very minimal, and most are just 'guidelines'. Here is a very biased page, however, it has many, many direct quotes from reliable sources. The 2nd link is one such source.

    The Pharms and Doctors: Corrupting Medicine

    Quoted New York Times article on this issue..

    I've said it before, but I see reps EVERY time I visit my PM. They are always inviting him to seminars, buying lunch for all of the nurses and PAs, dumping boxes of samples, pens, tissue boxes, you name it. In fact, during my last PM visit, a rep actually BARGED INTO the room I was in with the doctor, without knocking, in a desperate yet forceful attempt to get him to attend a lunchtime seminar that Wednesday. Really? Yes. I'm not saying drugs don't work; they most certainly do. Most of them. Just know that pharmaceutical companies rarely have YOUR best interest at heart, but rather their bottom line. It's very expensive to get a drug approved for the market, and they only make their $ back if you swallow their pills, even if they don't work at all.

    wishing everyone a pain free day..


  • Sorry, but that's just my opinion. It didn't touch my pain, wasn't worth the money and IMHO just ain't worth it.

    I've never been on Kadian, but that's my definite opinion on Opana ER though I'm glad some have had some success with it. I took both 20mg and 40 mg and got about squat.

    Hope everyone feels okay today.
  • strike three, Opana loses. =) I think that just how a mild percentage of us just can't handle morphine, a similar percentage gets good results from Opana, which is why we have the couple people it actually helps, but, that's the exception.
  • I don't want to start a run on thread but when talking about bioavailability this is used to calculate doses of the same med given orally vs any parenteral form of administration. The Opana example cited would be 40mg oral with a 10% factor so you would administer 4mg IV or IM to get the same result. It is not used across meds.
  • Same AMOUNT, exept immediately into the veins in 5 seconds instead of over 12 or so hours, which is a huge, huge difference. You are right in that bioavailability is a pretty much exact way of looking at a SINGLE med, and that it differs when comparing meds, but it IS used across meds; the problem is that most of the so-so narcotic converters on the web don't account for it, and too many doctors forget about it, or aren't aware in some cases. Whether the defacto standard or not, it can be argued that bioavailability is directly relevant and must be considered. If not, then you end up with people going to lower doses of Opana and being in terrible pain. In the argument of common practice vs fact, the facts win. Good point, but Opana is still very, very weak.
  • ive been takin opana 5mg IR for 3 months,last month i noticed it wasnt working as well for me as it did on the first month and a half.I did tell my PM he just added Topomax which is a med for seizures it didnt help all i got from it was migranes ~X( ,im seeing my PM this friday im requesting another painmed Opana SUCKS!!!! :H
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