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Doctor says one med is same as others?

I just got home from an apt. and I asked the Doctor since
I have been taking Oxycotine and Endocet for 6 years
is there a possibility I could change back to the ones I took
before (Kadain and Persocet) and get better relief? Maybe
even be able to cut back the amount. He surprised me and said
no you have been taking Meds. for along time and they won't
react different. What??? I have did it and got better coverage with less.
Have you ever ran into this before?
Thanks Sherri


  • dilaurodilauro ConnecticutPosts: 11,348
    edited 03/20/2015 - 7:59 AM
    I was taking Oxycodone for over 7 years and the dosage just didn't seem to help as much. Talking this over with my doctor, we both decided that increasing the dosage wasn't really the right move. Instead she switched me over to Opana. I was then on that for a couple of years, same dosage and frequency as I was with oxycodone. I was getting better relief from the Opana.

    Now part of this could be somewhat physiological. Because if you look at the chemistry breakdown between Oxycodone and Opana, they are not that different.
    • Oxycodone formula =C18 H21 NO4 molecular mass = 315.364 g/molOpana formula = C17 H19 NO4, molecular mass = 301.337 g/mol
    I believe, and this is only my personal belief, no real facts, is that after a while the body gets accustomed to a medication and the effect doesn't seem to be as effective as when you first started with it. Then switching to another medication, that is basically the same, you get better results.

    Back to the Oxycodone to Opana switch... After a while, I found the same with Opana, not doing what it was doing before... We switched back to Oxycodone and I am back on track now.

    Sherri, I am not even sure if this even addresses your question
    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I never thought of the physiological end of it but I can see that.
    Really agree with getting better results when I switch, that has been my
    experience with several changes. For me it is like I am allergic to some medications just
    because of a couple of different ingredients, so why
    couldn't that not apply here. I might have to do some research on that
    subject, even thought I consider you knowledgeable.
    Where did you get your drug information on ingredients in medications, I
    could use that.
    Thanks so much for your help
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  • dilaurodilauro ConnecticutPosts: 11,348
    The chemical breakdown of all medications is in a couple of places.
    The easiest is Wikipedia

    It would be interesting to get more formal reasons for this.
    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • Rather than going up & up on dose I change meds & it works for me. My docs explanation is different narcotics work on slightly different receptors. Although my body might be used to OxyContin (for example) it's not as used to morphine or fentanyl. I've read many studies that say it should be common practice to change narcotic meds once you reach a certain strength due to tolerance. This is in the doctors guidelines for prescribing long term narcotics in many European countries.

    I was a literature student & my career was in logistics & contracts. If Shakespeare didn't ramble about it I don't really know but it makes sense to me when specialists say it & it seems to work for me. ;-)
    Osteoarthritis & DDD.
  • Thanks to you both I don't feel so nuts, I have been upset by his
    comments making me feel like I have no change of relief. I don't want
    an increase and we have tried changes in the current meds.'
    I take 3 (30 mg) oxycotine and 2 (10/325 mg) Endocet, to me that
    should kick some butt, but it is not. Things have changed though
    the tenderness in my left butt, waist, groin, leg down to knee and hip.
    This sounds crazy but it feels like my skin has been peeled off, that is
    how tender it is to the touch. Also there is a spot if you press on it or
    sneeze the pain sends you through the roof. I took all my research from
    here and other areas and think it is SI issues. He finally agreed now injection
    time but boy trying to tolerate with the meds I am on is really getting to me.
    I think I will open that conversation of changing with my GP. I have tried
    so many meds and have had so many reactions, so now I am looking for
    any and all (non-narcotic) I can ask him to try on Monday. I tried so many
    meds. in the last 13 or so years, running out of ideas.
    I sure appreciate your in-put it helps a lot. The thing too is I am worried
    if I mention it to my GP and he talks to this Doctor that said that he might
    get mad, that would be bad for me right now where I am so desperate.
    Thanks so much Sherri
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  • SavageSavage United StatesPosts: 7,385
    Your concern about prescribing doctor getting upset with med change..not done by him..can cause upset.

    That situation happened to me....it wasn't major pain med...but something I was taking, I mentioned to my psychiatrist it didn't seem to help much if at all. And he said like..well, try this...and he discontinued the original med, not prescribed by him, and put me on neurotin.
    My pain management doctor went Donald Duck on me and I didn't realize breach of etiquette or whatever doctors share with each other...until he settled down.
    Fortunately, he was not upset with me and he did leave neurotin as is...which was good since it still effective. :)

    But from then on, if inadvertently one doctor voices concern over med he did not prescribe...I tell doctor that I will bring that to prescribing doctor's attention. (Not in those words!exactly....)
    Lastly, when my pain management doctor dictates to his charting while I am there, he always makes reference to my urine test showing I am in compliance and....that he is "the only prescribing doctor "for my pain.

    In my pain management contract it said something to the effect of only receiving pain meds from him...one pharmacy..etc...
    I don't know if non narcotics matter.
    For what it's worth. :)
    Best of luck and may you get pain relief soon!
    Honorary Spine-Health Moderator
    Please read my medical history at: Medical History

  • Hi Savage
    Thanks and I agree with only getting meds for sure from one
    Doctor,, I always follow that rule.
    I did not make myself clear sorry, The Doctor I was asking about
    meds is one I had talked to my GP about going to and he agreed.
    This new Doc. deals in a lot of things besides meds to help with the pain.
    My GP prescribes all my meds and I just got through trying one (my request) like what
    you are taking for the third time but had reactions to it darn it.
    I was just asking this new Doctor to get his in-put on ideas, or if he knew
    of any new ones (not narcotic) or maybe changing my narcotic meds. since
    I had been on these forever and don't help much I think I have become
    tolerant of them. I have changed in the past and it helped, I will have to touch base
    with my GP.
    My GP's clinic is looking at dismissing all their Chronic Pain patients which
    will be a nightmare on to a new one. But really this Guy doesn't seem to up
    on different combinations etc. so maybe it is a good thing. I had a hard time
    finding him, in calling around so many GP's are no longer writing prescriptions
    for pain meds.
    For some months now I have had pain that really is just more than someone
    should tolerate for long as so many are on here. What is upsetting to me is
    how many other things, meds besides pain meds etc. do you have to do with
    serious side effects before they will consider upping them. They believe in my
    pain and I finally convinced him it is the SI joint. But I don't think they get how it
    feels like someone has skinned you and just touching it is un-bearable.
    Oh no there I go again whining I hate that,, there are so many on here with
    worse than what I am going through, including you. I feel like such a baby at times
    but it wears at you right.
    Don't you just hate it and it is so frustrating when your stupid pain level makes it
    such a struggle to do the things that actually help you lessen your pain. Hey
    I continue to fight on.
    I really appreciate all the support I get on here, wish I could give more.
    Thanks so much
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