Oxycodone/Oxycontin Question

You're at a highly opioid-tolerant dosage (an obnoxious amount, indeed). I don't have to tell you that these drugs come with a lot of side effects. Luckily, people tend to develop a tolerance pretty quickly to some of the really unpleasant side effects, such as somnolence, itching from histamine release, and respiratory depression. Unfortunately, as you seem to be experiencing, tolerance to the effect of analgesia will develop at a variable rate. So, if you have been at your present dosage of 450-550mg per day for awhile, respiratory depression, i.e. generally the cause of death in an opioid overdose, shouldn't really be much of an issue. An increase from 3.5x30mg to 4x30mg percentage wise is pretty minimal and shouldn't cause any problems, although at the higher dosage range of these meds there is generally a greater tendency for side effects. If you overdose, you would almost certainly be aware, because you first would have needed to take a much larger dose than you're accustomed to, and subsequently all side effects would be more pronounced.

Just think of your pain meds in terms of proportions. I'm on 70mg of oxycontin and oxycodone per day. It helps a little bit, but after a long day of being an active student and getting around in big city, I'm sore. 70mg isn't so much in comparison to your dosage, but it is definitely not appropriate for opioid-naive individuals for whom my dosages would likely cause some sort of issues, if only amplified side effects.

And I might as well suggest to you that you look into the fentanyl patch. I've never used it, but I think it may be a good recommendation for you if you're worried about dosing and using so much oxycodone.

Best,

Phil

Hey Ryan, welcome aboard. The first thing you would notice if you had OD'ed is shallow breathing and a tendency to have a real deep yawn then a long stretch with no breaths at all then another yawn. The #1 cause of death by opioids is suffocation due to repiratory depression. If you are taking any other CNS (Central Nervous System) depressants like Xanax or any other benzos, or alcohol, you are increasing your chances for an O.D. It sounds like you are one heck of a straight shooter Ryan so I doubt if that's a problem for you.

Phil, above reply, suggested the 72 hour Fentanyl patch . . . good call, Phil. I am currently Rx'ed the 100 mcg p/h patch along with OxycodoneIR 30 mg 3 X day and Fentora 400mcg 4 X day for BTP. This is roughly equivalent to 420 mg of oral Oxycodone a day so I'd say we're in a similar league as far as analgesics go. I switched from Oxycodone to Fentanyl 6 months ago and I'll never go back. The 72 hr Fentanyl 100 mcg p/h patch alone is the equivalent of 157.5-202 mgs of oral Oxycodone every 24 hours. The Fentora is a super-fast delivery system for Fentanyl, the 400 mcg is equivalent (roughly) to an OxyIR 30 mg, however it has a very short half-life for some people. These aren't cheap to say the least. The Fentanyl 100 mcg p/h patch in the Mylan (recommended) brand costs $490 retail for 10 patches . . . 30 day supply. The Fentora 400 mcg effervescent tablets are brand name only and retail for $3,790 for #120 . . . a 30 day supply.

     If you have adequate insurance I would look into the patch, 2 of the 100's and maybe 5-6 of the OxyIR 30's at 1 every 4 hrs would equal your present dose with no O.D. problems. I don't know about you, but the high dosages of OxyIR were giving me 3-4 hour long "charley-horse" type cramps in my feet and calves. That's why I switched. Oh yeah, I'm fighting terminal cancer, as long as my wonderful wife and I don't give up the fight we figure I'll make it another 20 years. I was diagnosed at 52 and I turn 55 next month. We are cheering you on too . . .

                                                                             Q