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Thanks for posting the chart but essentially it's meaningless given the tolerance of different people to different drugs, I feel - I used to take 40 x 30mg Dihydrocodeine a day without getting pain relief of any great benefit. Then was allergic to Buprenorphine patches. The Morphine was fine at first but at 320mg + a day (sometime 500mg -600 mg) it gave me nightmares after I had mixed it with new blood pressure meds and paroxetine for depression. I'd like to hear from anyone who has switched from oral morphine to oral Oxycodone - dosages &c. just as a vague comparison. I was given the choice of staying on the Morphine or trying Methadone, Oxy or Fentanyl and chose Oxy. I take Morphine ER60s x 2 in the morning, hoping to get pain relief from my origial injury, and also oesophagitis and chest pain (I have a complex mix of asthma, angina and COPD - and still smoke (like a peabrain) and mornings are terrible. So what would taking Oxy be like ?

Bluesteel44

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Bluesteel44

Thanks for your help, gcdylan - I'd imagined from what I'd read (text books - never really much help !) that Oxy was about twice as 'strong' as Morphine. The Morphine gives me terrible nightmares but my consultant says Oxy doesn't usually cause this 'fairly common side effect'. Were you measured for 'cross-tolerance' when switching drugs ?? Did Oxy last the full 12 hours for you ? (If you took ERs....). I'm nervous that the Oxy won't be strong enough at 30mg ER twice a day and although I'll be getting Oxy IRs for b/t, I don't have a clue whether the pain will be dulled enough. I had a severe injury at the dentist when she slipped with the drill and took half my palate away (down to the bone) and scrambled the nerves, and the pain is extreme even after 5 years or so - nothing has settled down, bone and tissue grafts ruled out, neurosurgery pointless &c. Has anyone any similar stories ?

I'll hopefully get the Oxys next week and will report back with my experiences just as a reference for others. Thanks again, gcdylan - I appreciate you taking time to post ! 

My last visit I was told to call a specialist who deals with herniated discs in the back where I have 2 bad ones. I am supposed to go and get 2 shot's but I need to wait to see how my Gov't Medicare is going to pay ot % wise how much they are going to pay. I was told to make an apppointment but I am reaserching this practice These insurance companies IMO are close to the edge of collusion.(if that is the word I just woke up) These  are new problems and added up altogether makes me full of pain   Always. I have read all the posts and you are in a good position (IMO) with your primary doctor. I cannot stress how important that is. Best of Luck, I have a family memberr who thinks this is all being made up and conned my way onto Social Security disability although they will not admit it. This person has some serious health issues  and I think it is a way of stopping to think of their medical problems

Bluesteel44

Hi. Thanks for all the posts ! I know the Oxy dose is roughly half the amount I SHOULD be prescribed but 'cross-tolerance' has been brought into play and my consultant has suggested starting at 30mg ER Oxy twice a day plus Oxynorm 5s for b/t. I am worried it won't be sufficient as I reckon it should be around the 150-160mg a day mark - any thoughts, anyone ? I imagine though, my doc will titrate upwards if the Oxy doesn't work as well as it might at low doses. The Morphine dose I'm on is 120mg twice a day (ER) with M'10s for b/t - the latter I'm supposed to take 1 or 2 of, but often need 6 or 8 to banish the b/t, so I suppose I'm a bit 'irregular' - some days I have to take 6 of the 60 ER pills AND about 100mg IR, other days I get by on far less.... Still, hopefully the Oxy will be stronger and less needed...

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Bluesteel, It looks like to me you are on your way to working things out with your doctor. I do know for myself that the correct dosage was the hardest part and doctors IMO will go slower up the ladder by way of advancing your mg's needed. It might take a few months but I have no doubt, seeing what your morphine level is, your doctor trusts you, it is now just a matter of getting the correct amount of Oxycodone needed, for every patient med's can be much different. Nowaday's doctor's are very nervous to prescribe OXYCONTIN because of the stigma attached to it but mainly because of the federal gov't branch (name not needed) that oversee's doctor's prescribing method's. Here in the U.S. many think that this country overprescribes pain med's when it is just the opposite. IMO the country underprescribes for chronic or severe pain.

Cross tolerance is the term used to describe the fact that you build tolerance to certain opiates and yet all opiates at the same time. Say you were taking oxycodone and were to switch to an equal dose of morphine...you would have more tolerance to the oxycodone so the equivalent dose of morphine would work better because you dont have that much morphine tolerance. That does not mean that you have no tolerance to morphine as you do have a tolerance to opiates in general it just takes advantage of incomplete cross tolerance. I hope this made sense i am not always the best at explaining things.  

Just tell him the truth.  It sounds like you are almost there, so maybe he would add 1 more 80mg ER, or even a 40.  This is what I used to do (only with different doses).  I would take a 40 in the morning, a 20 around early afternoon, and another 40 before bed.  I worked pretty well, and I was able to lower my IR doses to 2-3 a day, instaead of the 5-6 a day I was using before.