Appt in 2 hours - Switching from oxycodone IR to Oxycontin ER

qty60 20mg

qty 60 30 mg maybe

does this dr have  any education enough to know what to give ya alone man?

scary...

absolutely no offence to you man

every medication is different in terms of whats effective, etc....

I think that you are going to be in trouble in 20 years if your goal is to do away with all break through meds.  Yes b/t pain can happen on any ER med.  If you are young and will have chronic pain for a lifetime, I would get a second opinion before taking the OC.  Studies have shown the younger you are the quicker you will need more meds to achieve the same level of pain control(tolerance).  In 20 years no Dr. is gonna be willing to write you what you need.  I'm not a dr.  I would not take any OC until you can see a pm because that conversion does not (to me) seem right.  It is easier to go up than go down.  I think all the posts in this thread are right on.  Take care, htmom

Matthew. your post on the "results" states that you have a one month scrip for #120 OxycodoneIR 10 mg., even if you don't take them your total Rx adds up to 120 mg. a day. Even at your stated intent of taking no more than 2 of the 10 mg.'s it's still too much in my book . . . 100 mg. p/d. Your nice Dr. might be opioid naive, since OxycodoneIR in 10 mg size is no longer being manufactured as of last year. You might be able to find some if you get lucky and locate a pharmacy with a backstock. I found this out a while back when my wife was Rxed  the same thing. All of a sudden, it was no longer available . . . that is what 3 different Pharmacies told us.

Htmom's advice to me has always been 100% correct and has proven itself to be of tremendous value. After a little over 2 years of taking an average of 150 mgs. of Oxycodone a day for severe cancer pain I was having more side effects than pain relief. This is called "being outside of the therapeutic range" of the analgesic. To give you an example; my calves and feet were cramping for 3-4 hrs. straight every morning . . . that's a continuous "charley-horse" for 3-4 hrs. My mental processes were shot, I had lost 90% of my short term memory. That's just 2 of the common side effects of continued Oxycodone use  for 2 yrs. . . . ask yourself if you really want to go there. Htmom helped me to choose a less harmful analgesic. It is very potent and is usually only Rxed for people like her and myself who have intractable pain. I would advise you to see your PMC immediately for their advice . . . the Rx that your nice Dr. gave you will definitely make you feel wonderful, but not for long. Good luck, my friend 'cause you're gonna need it...

                                                                               Q      

You have been overprescribed, IMHO. I am NOT a Doctor and my advice is worth what you paid for it. My 53 year old wife's spinal diagnosis is very similar to yours. We just did a comparison, using your post and her various Drs. reports. In some ways you are worse and in some ways she wins the pain prize. She is Rxed a total of 60 mgs. of Oxycodone p/d and, though she is still in some pain, that's what she takes. As I've posted earlier, this amount will steal your mind and turn you into a Zombie......Q

Reading a radiology report does not indicate pain.  I know of many people that have very serious scoliosis problems and have no pain.  I'm in no way saying that you do not have pain.  Get a second opinion.  I think the concern is over the ER and not the IR.  I have been a member for almost a year and that's the LONGEST reply I have ever seen Goat post (with a broken hand)!!!  Make sure you are on the lowest possible dose.  I will not tell my dr the truth about my pain because I DO NOT want an increase in meds.  I will be on meds the rest of my life and do not want to burn through everything in a few years.  I have to look out for me.  Most of the time my pain is well controlled and I deal with times its not.  It has worked for me.   There are some non-opiate meds that work very well for pain.  None of us can tell you what the right amount of OC is.  But as you can see there is a concern.  The decisions you make today will impact your lifetime.   I mean no disrespect and I'm not trying to cause you to panic.  Take care, htmom

Matt,

I think their concern comes from a few factors.

1) The tempation you may have to continue taking what the script says for the 10mgs

        * if you did this would be 120mg, essentially doubling your daily intake

2) Given the apparent long term nature of your condition, STARTING your oxycontin dose at 40mg doesnt give you alot of room to move up. It would suck to see you max out on the highest dose of the drug before you ever hit 40.

3) The part of your post that says you usually take about 1.5 your currently prescribed dose (i.e. taking 6 when the script says 4 per day). They might take this to be worried you would take the 40mg 3 times a day and be increasing your tollerance all the faster.

My opinion of this is that its not a HUGE overprescription. Starting at 20 or 30mg twice a day would probably have been a more conservative approach. It would give you room to move up over the coming 6months if needed. As one person said, its hard to dose down but dosing up would be easy. You want to take the lowest amount that will provide relief otherwise you will burn out your time before you hit the ceiling dose.

SO, the big question is do you make another appointment or do you just try to go with it?

Its up to you. Another option might be to start off taking the ER tablet one time a day, whenever it is that your pain starts to take off. Maybe take one IR before that and one IR after that in the day, just to keep at the exact same dosage. Your tolerance won't climb as high and you'll end up with a few extra pills at the end of the month so you can take 2 on days when you really need it. You could see how that works out, if it controls your pain, stick with it.

Everyone here is concerned about your future pain relief as I'm sure you are. The best option today might prevent you from options in the future. I think we've all done that and would hate to see you do it too.

This, I promise will be my last post.  I could be and have been wrong before and I'm sure someone will correct me if wrong.  I do not think there is a ceiling for opiates.  The problem you will have before you reach that point is no dr will write you that amount of opiates. You can read about several that have posted on that topic.  Regarding the post oneir #17 just made.  Do not self medicate.  If you get popped for a drug screen and you have too little or too much, you could be discharged from the practice.  You do not want your dr to think you are diverting OC.  40 mgs of OC doesn't seem like it is that much but if you consider that the largest mgs they make is 80 mgs.  I have read several people on here that were on or about the same mg of oxycodone IR you were taking and they were put on 20 mgs of OC bid.  It is and should be a personal decision about how much and what to take. You have to live with it.  Do some research.  Like I said we are not drs and can only give you our experiences and the experiences that we have read about from this site.  But do not panic. Take care, htmom

the original poster 1st stated that he had a problem with the oxycodone not seeming to be effective, my beleif he will find that the oxycontin will not be effective either as his tolerance has been stepped up, the use of break-thru medication is to be used if you have pain that cannot be tolerated,

mY Dr. prescribes me morphine sulfate 60 mgs one every 12 hours with one 7.5 /500 for breakthru, there are days that my activity level is low that 1 60mg an one 7.5 will suffice.

it seemed that the original poster was overwhelmed that the Dr. finally graduated him to oxycontin even though he did nt take the time to realize the fact that he was becoming oxycodone intolerant

I think that the temptation of the number of IR tablets will overwhelm him,

if I was him an if I could not tolerate the pain I would take as prescribed, but if you can tolerate the pain, i would suggest that you simply try to just take the oxycontin 1st an actually see if you need a break thru, but , if its like anyone I ever seen the wait of 20 minutes before the medication to kick in is gonna make the poster feel as if the medication is not effective at 1st.

also would like to add that the DR was way too lenient in prescibing that much even though it suppose to be for 2 months, I think that she should have simply wrote another script for 60 IR to be placed on file with the 2nd refill of oxycontin

I hope you respect this opinion, an I hope that you can keep the temptation off the IR

I, m no Dr. just a hillbilly

I deleted my reply, now that I know you have read it . . . I am satisfied with the result.

when your levels of oxycodone in your body go down using your method i am sure you will be taking that second pill at some point and then maybe the 10 mg pills...this is nothing personal just my thoughts...forums do have the ability to upset you a bit..you must have thick skin this is only the net..many here just don't want to see you posting about suboxone next year...take care friend.

"I thought that this was a forum where we could all talk openly about our treatments, but that response was in poor taste, quincy.  You are jumping to conclusions.  I just reread all posts I've made in this thread and I do not know what I said to cause you to conclude what you have concluded about me, but the fact that you're guaranteeing me that I will take my IR along with an ER before bed makes me question the validity of your input thus far.  I intend to do no such thing.  The worst of it all is that my denial of any of your accusations serve as nothing but fuel to your belief that I am being delusional; your baseless accusations have left me defenseless by their very nature.  This is a shame."  says MattJH.

I completely agree with you MattJH.  Just reading some of the posts on this thread makes you wonder if people are coming here to vent their frustrations on others with no basis for their accusations.

I know I promised,but here goes.  You were taking 50-60 mgs of IR a day.  The OC will keep a steady rate of 40 mgs of oxycodone at all times per 12 hrs.  Were you taking 40 mgs at one (IR) time?  For example if you were taking 2x10 mg percs every 6-8 hours, then you would need a constant rate of 20 mgs of OC.  Does that make sense?  I have not looked at the conversion tables and could be wrong.  Just my thoughts.  Some of the concern also comes from your previous post about cutting up OC.  Not that people chose to vent on here.  The stories we hear about people abusing OC sometimes has little to do with trying to control pain.  I have always thought that ER meds were for people that needed around the clock pain control.  I wish I had the nights off from pain.  I would let your dr know that you do not need the second OC.  As I said before you can do the research and hear the many horror stories of people that thought they would be given whatever amounts were necessary to control their pain.  Those people have found out the hard way.  I'm just letting you know what I have read.  There are very real consequences for overprescribing.  You will be on the losing end of it.  I hope your intentions are genuine.  This is my last post on the thread.  I wish you the best of luck and be an advocate for yourself.  Nothing I have said is meant to offend you. Take care, htmom

Fish, Q said that the 10 mg preparations of oxycodone IR were not being manufactured anymore.

Matt read your insert that you got with the Oxycontin.  Look for the Plasma Oxycodone by time monograph.  If you take a 40 mg pill you should receive a steady rate of 40 mgs over 12 hrs.  It does drop some over that time, but you will see for yourself.   Me and others have tried to help and you doubt EVERYTHING we say.  You came here for help.  I think your posts speak for themselves.

You don't seem to understand serum levels and how Oxycontin pills work.   By what you said, that little 40mg Oxycontin would have to deliver 40mg every hour.  That is not how it works.  The Oxycontin pills are designed to release there dose as evenly as possible over a 12 hour period.   Since everyone is unique, some people do not get a full 12 hours of relief and some are the opposite.

The point is everyones' body is different.

I was only trying to spare you some embarrassment Matt. OK then, for all of you that "need to know", here is the gist of my personally deleted reply #27. In Matt's OP, his Topic Post, he clearly states that he unilaterally upped his dosage of 10 mg. Endocets "instant-release oxycodone" from 4 a day to 6 a day. I have read that post over and over and not once is there a word about this Dr. being "involved" or "aware" (Those quotes are from Matt's reply #28,which is, to me, suspiciously hours after the OP and just 1/2 hr after my first reply #27). You further state in the same OP that you ran out EARLY TWICE. If your nice and compliant Dr. was so "aware and involved" (again from reply #28) why did you have to run out EARLY TWICE before you got around to having your scrip changed? Do you like adding all that extra hassle to your life? What kept her or you from writing/getting a scrip for #180 Endocets after you ran out the first time? To me, it all sounds like self-medication, which almost always leads to abuse.  By the way, Endocets are OxycodoneIR with acetaminophen. That is most of the problem for me. As I p.m.'ed you yesterday I was also concerned about your wanting advice on cutting up Oxycontin. It clearly states all over the insert and everywhere else they could fit it in on the package "Don't cut this pill up", what part of Don't don't you understand?

Matt, throughout all this useless blather you have consistently proven your outstanding capability to hear only what you want to hear, here's  an example: in my reply #13 I said that continuously taking high doses of Oxycodone will steal your MIND. Right after that, on your reply #14 you say that I referred to your SOUL. Man, it's obvious that your mind is already affected if you can't see the reply directly above the one you are writing. I do apologise for getting your age backwards, 23 instead of 32, I guess I have a little dyslexia to go with my ADHD. I seriously wanted to help you see through your own B.S. but I can tell that that is not a priority to you. Sorry I crashed your party Matt. Take all the Oxycodone you want. Who am I to tell you that it was the most horrible part of my cancer treatment. Go for it , grab all the gusto you can if that's your thing......Q

 I know you don't want to hear what you don't want to hear. I've got it loud and clear, have fun now...Q

From that information about to 10mg ER vs 5mg x2 IR, 40mg would be like taking 20mg every 6 hours rather than 10mg every 3 hours. I think thats an important difference.

Someone else posted that the time release essentially releases half of the dose immediately and half the dose in anywhere from 2-6 hours. I was always under the impression that it would be like 10% of the dose per hour for 10 hours or something like that. Although my experience with the drug lends more support to the idea that it just does half and half.

I don't know about you but 6 hours between doses really pushes my pain into the 8-10 range. This is why a breakthrough med around hour 3 or 4 is really helpful.

Hows day 1 so far Matt?

good deal.

yeah i can relate to the constant shifting in the car. I need to get an outlet converter so I can use my heatpad while driving, that would make things easier. Perhaps I'll start a new thread later about how people cope with pain while driving....

have a good one