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4 pills per day limit, is this legit?

Recently my pain doctor changed me from 5 oxycodone 10 mg per day to morphine sulfate, 15 mg and 4 per day. It didn't work and now I take nucynta 75 mg 4 x a day. I asked if I could get the oxys back since they actually let me function. He said that 10 mg was the strongest (which I doubt) oxy and now there is a limit of 4 pills per day for everything. I am on my 2nd nucynta of the day. It may be working a little.

How does this sound? Thanks.

Diagnosis: Thoracic facet syndrome & cervical and thoracic radiculopathy from car accident trauma.
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1

Comments

  • When your doctor says a certain strength is the highest available he could mean it’s the highest he’ll write for (and not necessarily the highest manufactured).

  • my doctor "claims' he has to keep the mme to no more than 90mg (which is really not true federally)...I am prescribed 2 MS Contin 15mg per day and 4 10mg oxycodones that equal 90 mme ...I had been taking 3 MS Contin since they don't last a full 12 hours for me, but he cut one out to allow me to keep the 4 oxy and get it down to 90 mme

    I know my insurance will not allow more than 6 immediate release pills per day but had no problem with 3 extended release ones

    I agree with L4_L5 that he's shooting you a line of you know what with the 4 pill max total...he just has a yellow streak down his back

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  • Please understand that individual State Board of Medical Licensures can set limits for physicians to follow on medication above and beyond what the CDC recommends.  I'm not saying that is the case here, but doctors are being threatened with their medical licenses if they deviate.  It really stinks because they can be sued for under prescribing and they can be sued for over prescribing.  We are in a dangerous time regarding mixing politics with medicine.  I know it's normal to want to blame the doctor especially when we feel like crap.  The government is really putting them in a precarious situation. 

    I've always been one to follow the law, but if my meds get cut to the point I'm in worse pain, I will look into medical marijuana.   

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • Whatever the cause, it stinks. I take my prescriptions as directed, never run out of it. I had something a month ago that worked but could have been better. At the doctor's suggestion I went to something that did not work at all. Now I have something that maybe works 30% as well as what I originally had. This one runs out next week so I have to call him for a renewal, but will state my case again. I would absolutely hate to be doctor shopping to get something that works.

    Diagnosis: Thoracic facet syndrome & cervical and thoracic radiculopathy from car accident trauma.
  • From personal experience it depends on the state. For example in Michigan you can be prescribed up to 40 morphine equivalent IR doses in a day. Now if you get above 90 IR and ER combined paperwork has to be filed with the state. I may be incorrect with this but that is my understanding 

    ACDF C4-5 June 23rd, 2011

    Another surgery in the near future. I am 26 years old.

    Current Meds- Norco 7.5/325, Cymbalta 60mg, Gabapentin, Adderall 20mg
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  • peanut006peanut006 MichiganPosts: 147

    @Donnabe, I'm from michigan and am prescribed more than 40mme immediate release meds a day. But I do not take any extended release medication. So I know that the 40mme of instant isn't mandatory. This is just my personal experience though. I've been with the same doctor for 20 years and on this same medication and dosage fot the last 8 years. 

  • I am not a fan of Morphine Equivalents.  There is such a difference between how our bodies process oral medication that it's not a true representation.  I've seen a study that says you actually get about 30% of active medication after digestion.  So, when medication is delivered orally, the Morphine Equivalent should be adjusted.  If it's delivered via IV, now were talking apples to apples.

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • The user and all related content has been deleted.
  • Something is rotten for sure. Even at 5 pills per day I'm having trouble with pain. I started with three 5mg pills 7 years go, now up to five 10mg pills a day. The body gets used to it.

    Now we are focusing on my shoulder and I may get handed off to an orthopedic doctor (that I know). They also do pain management, so it may be 1-stop shopping with some luck. There is also a pain management practice that does allows the use of CBD oils, etc. I think if my pain persists some sort of combination may do the trick.   

    Diagnosis: Thoracic facet syndrome & cervical and thoracic radiculopathy from car accident trauma.
  • I currently take 4 10mg Ocys a day and my PMS stated she could not precribe higher. Didnt actually state why but think it may be Barrows/Az State regs.

    With all this political crap going on, my Pharmacist will over ride my Doc if I try to refill to soon. I travel in Motor Home alot and my Az Oxy prescriptions canot be filled in another state, so have tried to get refills a couple days early. 

    So anyway, becaause of the deeds of a few we all have to suck it up a bit. And it will get worse before better. Doctors are really in the middle...

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