Oxy Results

A 40mg ER OC should take effect within an hour and last for about 6 hours

It's like taking a 10mg Oxycodone every few hours (stronger than HC)

It's different for everybody though

Only you can really figure out what works best for you (along with your DR of course)

-Makaveli

Most people that have cronic pain, and get opiates for it, are given 3 or 4 per day

So even though the chart shows 12 hours, it's more like 8 hours for someone that isnt used to opiates, and 6 hours for someone that is used to opiates

Allthough it may still be active in your body after 10 or 12 hours, in a real world situation, it would be best to take every 6 to 8 hours

Where as the 10mg Hydro, may only last 2 or 3 hours, and may not do quite as good of a job as the Oxy

I still maintain the idea of everybody is different though

-Makaveli

 Oxycontin doses at every 6 hours would deffinately raise eyebrows at the pharmacy and I highly doubt any pharmacists would even fill it at those numbers ( yes a pharmacist can refuse to fill scripts if they are out of line with normal prescribing practises and are actually required to report it to the proper state board). Every 6 hours is far lower than the prescribing frequency outlined by the manufacturer which is then approved by the FDA. Im pretty sure the most frequent dose that is considered acceptable is every 8 hours even though the manufacturer says "there is no clinical information on dosing intervals shorter than q12h" and " It is most appropriate to increase the q12h dose rather than the frequency" . Every 6 hours would result in basically double dosing, because half the medication is released within 0.6 hours and the other half of the dose is released at 6.9 hours.

"Oxycontin doses at every 6 hours would deffinately raise eyebrows at the pharmacy and I highly doubt any pharmacists would even fill it at those numbers"

I've known at least a dozen people (here in FL) that have been given oc 40's or 80's, 3 or 4 x's per day, as well as 30mg IR's for breakthrough, 3 or 4 x's per day, and had no problem at all filling the scripts (as much as $1400 a month)

You gotta figure the Pharm must be making at least 20% of that (at least $200 or $300) if not more, they would be crazy to turn down legit scripts from a real Dr,  IMO

-Makaveli

Is that if people would expect to get what they need, rather than think they can't get what they need, that its too much, or w/e

There might be more doctors willing to prescribe more Narcotics, because it wouldnt be such a big deal

Why should there be such a stigma attached to getting Narcotics Legit

-Makaveli 

I can assure you that this statement is incorrect:

"I would like to also repoint out that half the dose from Oxycontin isnt even released until 6.9 hours after being taken."

Anyone who has taken OC knows that that is completely untrue. Oxycontin is acutaully more of a biphasic drug than a true time release. My PM wrote my OC scripts for 4 times (qid) daily dose and I filled those for years without a bit of trouble from the pharmacist.

(edited by TeamPharmer) 

"Only a pharmacist thats already on the take would risk losing there license and livelyhood for the chance to make "$200" off of one person, when you can make well over $100,000 a year without doing risky business. Just because the script comes from a doctor that may still have his/her license doesnt make it right.  It takes a long time to become a licensed pharmacist, I wouldnt risk it filling questionable scripts with as many crooked doctors out there as there is"

While you may look at it like it's only $200 off of one person, I tend to look at it more like $200 x 10 is $2000, and so on, a pharm could miss out on alot of money by refusing to fill scripts, witch by the way I have never heard of anyone actually being turned down if everything was Legit. Since when does a pharm decide what meds are right for you ?

-Makaveli

It is a pharmacists responsibility to look at all these points before he/she decides to dispense medication.

(a) Lack of consistency in the doctor-patient relationship.

(b) Frequency of prescriptions for the same drug by 1 prescriber for larger numbers of patients.

(c) Quantities beyond those normally prescribed for the same drug.

(d) Unusual dosages.

(e) Unusual geographic distances between patient, pharmacist, and prescriber.

This is of course, only according to Michigan Legislature, but all states have similiar laws. 

I had an MD once, that alot of pharmacies absolutely refused to fill his prescriptions. But it was all of the "chain" pharmacies that didnt fill them, I could/did take them to the independant pharms and they did take/fill them.

The other pharms would not give me a reason as to why they wouldnt fill them. I still to this day dont understand that.

He was a local doctor.

The amount of drugs were within the norm.

in fact, everything from a-e fit in.

I was however traveling a state away to see this doctor, BUT, I live on the missouri-illinois state line, so that wasnt out of the ordinary.

IE: I was getting 180 10/500 hydrocodones, 120 2mg Xanax.

I do think this was an ordinary amount.

I then asked the MD why the other pharms wouldnt fill his prescriptions, and he replied that he has heard this from other patients, and simply told me to go to the independants, that he didnt know why.

Maybe someone could explain this to me or just have some comments or ideas as to why.

___________________________

KnightMetal

I am not an MD. I know by experience only. Consult YOUR MD 1st!

These rules are from the Michigan Legislature, not some random B.S. I made up. They are laws in place to guide pharmacists in doing proper business, and Im sure they are really in place to help weed out drug seekers and crooked doctors. I think what it means by

(e) Unusual geographic distances between patient, pharmacist, and prescriber.

Would be like me living near Detroit and driving an extremely long distance to go to a doctor, say in the U.P.(5-6 hours), and bring my scripts back to the Detroit to get them filled. A situation like that is kinda suspicious, dont you think? Seeing that there are tons of PM docs in the detroit area, and U of M is only like 20 minutes away where there are extremely good PM docs. The only feesable reason to travel excessively far distances would be to seek an unscrupulous doctor.

Also where you say "were talking 3 or 4 a day, not 8". From what I read 3 a day is starting to become the norm, 4 a day is over doing it when you look at how the medication works. Like I said before according to the manufacturer, if the dose doesnt last long enough your suppose to increase the MG amount, not the frequency.

And finally when you say " A pain management doc will always have a high number of narcotic scripts, no surprise there" What the legislation is referring to would be one doctor writting excessive amounts for the same medication usually for the same quantity to almost all of his patients. According to the DEA a situation like this is considered a "Pill Mill" and not proper pain management techniques.

Im not trying to "buts your *****" Im just trying to point out that Pharmacists have a lot more authority when it comes to dispensing medications than people think. And Im still a firm believer that QID dosing of Oxycontin is unjustified ecspecially seeing that its going to result in half double dosing. 

I can understand that distance from the MD, but in my case, it was a state away but in reality it was only like 5 miles. From where I am from, alot of people get the 180 - instead of the 120.

Hydrocodone and xanax are prescribed together alot. Atleast from my personal experience. Hydro and SOMA are routinely prescribed together - and that seems to be more dangerous than xanax, but I am not an MD.

Obviously these medications when taken as directed wouldnt present a problem.

I was getting a 10 every 4 hours, and a xanax every 6 hours. This is not the only doctor who has prescribed me the exact same prescription, due to me moving, and other reasons, I have had this prescription alot. Also, it wasnt a problem with the other prescriptions, it was only from that doctor. (even though, it was the same prescription)

Only thing I know is that doctors have thier own language, written and/or spoken.

________________________

KnightMetal

I am not an MD. I know by experience only. Consult YOUR MD 1st!

What is the revelance of this.  The pharmacist isn't making a commission on the drugs sold from the pharmacy.

Check with a licensed MD before you take any suggestions!

 FL does have a lot of retired people maybe that's why you see a drug store on every corner. as for xzanx and oxys being prescribed at the same time i've had both prescribed together as well as soma, zoloft & a steroid (can't remember the name) 5 day tapper down like 5 pills 1st day, 4 the 2nd  so on. i never knew thay could be bad together. my experience w/40mg er oxycontin was it did'nt work as well or as long as 2, 10 mg oxycodone every 4 hrs. i knew a guy that was prescribed 90 oxy, 30 mgs rapid relese (the blue ones) & 10 mg vicodins a week ! for a long period of time, seemed like alot ! 

   And I was rx'd 320 mg per day of oxycodone. It was in ER form but from my request I was able to get 240mg Roxy for the day time and 1 80 oxycontin to sleep. And I can tell ya there are people coming from as far as kentucky to these pill mills around here because its no questions asked if you have a legit problem, they will rx generally up to 4oomg's per day is what I been told. And havent had a pharmacist question me yet. Now I have detoxed so I am staying away from the stuff. Not worth it!

                                               .....MUD  ;)

I live in Kentucky . And its true . allot of people from here are going to other states to get pills. BUT , the drs around here are very leary of writing much at all ,WITH serious things wrong with you. . But never the less . I know of people going as far as Florida and Michigan just to see the Doc.

The apparent half lives of oxycodone is 0.6 hours for the first phase and 6.9 hours for the second phase.  The apparent effective half life for the first and second phase together is 4.5 hours.  I do not know what percentage of the drug is released in the first versus the second phase.  Most importantly, note that for the chart that was posted, the y-axis is a log scale.  Absorption can also be affected by a high fat meal.  I wish I knew how to easily draw a graph on here!

   I could feel the pain go down after 30-40 minutes but would not last that long 3-4 hrs. I could never feel the second phase of the med.

                                               .....MUD  ;)

"If you took the time to read it you would understand."

I wish it was that simple!  Pharmacology was not my strongest subject, but note that the chart King of New York refers to has a log10 scale on the Y-axis.  Why some people only get 8 hours of sufficient pain relief should be more apparent if you don't log scale it.  I had always imagined that 50% of the dose had a half life of 0.6 hours and the other 50% had a half life of 6.9 hours, but I can't find anything in the literature that says the phases are 50/50.  It could just as well be 75/25 or some other ratio.  Does anyone know off hand?