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KelsiedeeKKelsiedee Posts: 32
edited 05/29/2015 - 9:53 AM in Pain Medications
Okay, so let me preface this by saying this isn't the typical I need something stronger post.

I have three slipped discs, DDD, scoliosis, and recently, pretty bad sciatica. I'm on 10/325 mg Norco (1/2 to 1 tab every six hours). My daily max is 4. So, my issue is that my PM only gives me 100 pills, rather than 120.

Most days I take about 2.5 tablets total. That is the average, I'd say. But we all have bad days and I'll max out at 4 tablets on those days. My dilemma is that lately I've been having more bad days. So I'm scared I'm going to run out in the last five days. My pharmacy and insurance read it as a 25 day script. I haven't run out early this far, but I'm scared one day I'll have to choose between maxing out on a bad day or saving the max for a day that might be worse. I really want to approach my PM doctor about this but I'm incredibly nervous on how to do so. I know it's only 20 tablets, but I think we all know that can make the difference on a bad day. So if anyone can give me some advice on how to approach this, I'd really appreciate it.

Thanks!
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1

Comments

  • The best way is to tell the PM doctor the truth on how you feel. That is a valid concern. They will either increase your Meds or leave them the same. They won't punish you for saying what you feel. But just be honest and don't make any excuses. I have been there also, and sometimes he listens, sometimes he just says no. But don't give up.

    Hope you feel better soon
  • dilaurodilauro ConnecticutPosts: 12,223
    You should discuss this with your doctor before you run out. You do not want to be in the situation where you run out of your narcotics before the prescribed dosage as stated in your prescription. Once you do that, you could easily be put under the red flag and trouble may follow you wherever you go (in terms of getting pain medications)

    On the other hand, if you discuss this with your doctor, letting them know that your current dosage of medications does not always work. You have bad days where you feel that you need more that what is prescribed. That way the doctor can determine how it should be handled.

    As wstones stated, sometimes the doctor will hear what you are saying and provide you with relief, but they may be times when that will not happen.
    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
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  • Thanks you guys. I'm just always so nervous with my PM doctor. He's an intimidating guy and I don't want him to see me in a bad light by asking for more tablets, which I know he very well may.

    Dilauro, just to clarify, I didn't mean in my original post to sound like I wanted to take more than prescribed. On bad days, I take four tablets ( the max allowed per day), but say I have more bad days than good and have to take four tablets, I would need the 120 tablets to complete the script. As of now, I'm only getting 100 tablets (a 25 day script). Basically my main goal is to have the power to take four tablets on a bad day without fear of running out. Hence the need for a 120 tablet prescription. I hope that doesn't sound whiny haha. I think something just got lost in translation.
  • Into a problem is that the prescription would only be for 25 days, if you are taking 4 tablets every day.
    Even if you are having a frequent number of bad days, the directions say 1/2-1 tablet every 6 hours. Therefore at the minimum , you should be starting with a half tab during a 6 hour period, then only using the second half on those bad days during the same 6 hour period. With the maximum dose of 4 tabs per day, if you are starting with 1/2 tab dosing, you should be using two tabs per day , if a bad, then perhaps a third tab, leaving you with one tab left over for each day.
    All you can do is talk to your doctor and see what he says.


  • SavageSavage United StatesPosts: 7,385
    edited 05/31/2015 - 5:00 AM
    ....all above...just wanted to add.....at the time doctor ordered med, that was dosage most effective.
    You said .........now you are having more bad days.......
    So doc needs to know your symptoms have changed and med is not effective as before....by virtue of more bad days.....

    As above, doc may want to increase dose, not change dosage, or decide on another med to be more effective.
    It is trial.....and try again when it comes to treating chronic pain.....in my experience.
    Sue
    Honorary Spine-Health Moderator
    -------------------------------------------------------------------------------------------------------------------------
    Please read my medical history at: Medical History

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  • dilaurodilauro ConnecticutPosts: 12,223
    interesting is the pill count per month.

    I have been on oxycodone 5mg for almost 10 years now. All the scripts are written PRN, some with 4 max a day and other times 6 max per day.

    With 4 per day, the count should be 120, while the 6 per day is 180.

    I guess I am not sure where the pharmacist/insurance came up with 100. The PRN prescripts are filled taking into account the maximum dosage per day that would be used.
    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
  • sandi123ssandi123 Posts: 717
    edited 05/31/2015 - 8:08 AM
    Is that it is assumed that even though the maximum dose is 4 doses per day, that the OP is not going to be taking all four every day. The actual written instructions are 1/2 tab q6 hrs, so starting with that dose, she should be using a max of two tabs per her baseline dosing....for flares she still has 2 other tabs per day...during any given 30 day time frame if she is taking the baseline meds ,that's 60 tabs leaving her 40 for dealing with flares in pain during that 30 day period.


  • still, though, if her Rx is written as 1/2 to 1 tablet every 6 hours as she states, there is the possibility that 1may be taken every 6 hours to equal 4 per day...and written as such she is allowed that...and that will be 120/month

    If the doctor does not expect the possibility of 4 to be taken every day, then he should not write the Rx that way

    I, too, wonder where the 100 comes from as opposed to 120...geez, I don't know too many people that can survive on 5 mg of hydrocodone for 6. hours, but that is another discussion
  • Hey all, my apologies for my neglect of my own topic. On the whole, it definitely is best to just talk to my doctor and see what he thinks. But just to clarify, I know something's get lost in text. The 100 tablets is what is written on my script by my doctor. When I pick up my script from my pharmacy, it reads a 25 day supply with my max of four a day.

    And Sandi, it's ironic that you bring up the starting at a 1/2 tablet than moving to the other half if it's needed. I actually brought that up when he first prescribed because of all my spine health reading. :) I definitely wanted to make sure I understood the script. He asked how I was taking the med before when my PCP was prescribing. I told him a whole tablet in the morning, 1/2 in the mid afternoon, and one before bed. He said that was fine so I hope it won't be an issue that I'm still taking it that way most days.

    I guess my issue is on the whole is that on the bad days, four tablets do work along with heat and yoga and tens. So I don't feel that I need a stronger medication. I just feel that maybe I should discuss making the script have 120 tablets so that if I need to take four tablets, it won't run me out early. I know it's confusing and maybe a little silly on my part, but I just got used to having those four tablets on bad days from my PCP because she wrote my scripts for 120 tablets but when I switched to my PM, the script changed to 100 tablets. this whole world of PM is just so confusing.

    Quick edit: I too have no idea why my doctor decided on a 100 tablet script. So I'm just as confused as to why the doctor writes it like that. The pharmacy and my insurance read the script with the max taken into account, so they're correct reading it as a 25 day script.
  • Similar thing happened to me. 1) after 7 or so months of the same narcotic I build up tolerance pretty quick and have to slowly increase the dose. I started at 5/325 after about 6 months went to 7.5 mg. told the doctor so he jumped me to 10/325 every 6 hours, however I only took it once or twice a day, I would wait til pain hit a level 6 for me.
    After a year and a half on narcotics the 10/325 was only giving me relief for 1-2 hours and I didn't want to be taking it every 4 hours so my doctor out me on extended release 10 mg Oxycontin and I only take the immediate release for break through pain. That seemed to give me the most help. The nice thing is with the extended release you don't get loopy. At least I don't. So you can function pretty well through out the day. Maybe talk to him about an extended release option? And save the immediate release tabs for bad days?
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