Dilaudid As A Oxycodone Replacement? (Top voted first)

Hi. I suffered a L1/L2 complete SCI injury some 4 years ago. After 6-7 weeks when the spinal shock wore off I noticed I had a burning pain in my lower groin area even though I can't really feel much below my hips, we thought maybe it was a UTI but all showed negative. It was diagnosed as chronic nerve pain and it never goes away, I get acute nerve pains in my legs on top of this chronic pain.

I have been taking 10mg Oxycodone four to five times per day and methadone 10mg once a day for the chronic pain + 800mg Gabapentin three times a day for the burning in my legs. The only way I have been able to keep my doses so low over the years is by being very hard on myself as to when to take the pain meds but as hard as I have tried I'm now going up to around 60mg total Oxycodone per day and 15mg Methadone.

I have a very good pain Dr and we always wanted to do a pain med rotation before levels of any one drug got too high so we have changed the Oxycodone over to 2mg Dilaudid tablets. I have been told to try anything from 2-4mg at a time, four times per day to replace my Oxycodone.

I have only just started to try the Dilaudid like 1day ago but even at 4mg it doesn't seem to work on my chronic nerve pain as well as my Oxycodone does, all it seems to do is make me sleepy and I can't have that. I work a professional demanding job where I can't be feeling out of it or tired. I was wondering if anyone here that has tried both maybe let me know if Dilaudid is normally a replacement for Oxycodone?

Should I be giving Dilaudid a few more days before throwing it off my list of pain meds? Or should it have worked straight away if it was going to work at all for me?

If it doesn't work I'll have to return to Oxycodone and hopefully find something that we can replace it with that won't have terrible side effects and also let me work normally. I guess we could increase the methodone to make the oxycodone last longer, I find the methadone great like that but that is not a real solution to replacing the Oxycodone so we can give my body a rest from that kind of opiode and hopefully reset the switch so after a short period on the replacement drug I can return to a lower dose of Oxycodone.

I would be greatfull for any advice.

Cheers.

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Hi Bob, I asked about Opana before going on the Hydromorphone (Dilaudid) but my pain Dr said we don't get Oxymorphone (Opana) in AUS, I'm not sure why that is... So we tried Dilaudid and it doesn't seem to do much for my pain even at 4mg which is like taking 13mg of Oxycodone if you convert it strength wise. I think maybe the problem with oxymorphone and hydromorphone is it's low bio availability of around 35% vs 90% for Oxycodone when taken orally.

I have returned to taking 10mg Oxycodone 5 times a day. I just wonder if anyone here can tell me of a good oxycodone replacement for dealing with chronic nerve pain?

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I also have recently been prescibed diluadid 4mg 2xs day. I have DDD, & 2 of the disc R crumbling, along with severe scoliosis( looking at surgery) 4 later. After trying all the meds. You all have mentioned, what has worked is MS contin extended relief 60-120 mg 2 xs day all I can say is it helps. But not the muscles which refuse 2 relax, it feels like my spine is a rubber band as ready 2 snap! So I also have xanax 1mg up to 3 xs. But I try really hard not 2 take,cuz U know u become tolerance leveled & it stops helping. Over the yrs a breakthru med needed & tried everything. Now he's added the dilaudid 4mg. ?? Doesn't really help or I just afraid of becoming addited 2 it & being treated like a drug seeker. God if I only had an option! But I just want some semblance of living, I need these meds. They allow me 2 get out of bed in the mornings. Go outside & use my scooter ( don't B embarrassed 2 use one guys!!) if it helps get it. The ms contin doesn't give u that drugged out tired feeling. This dilaudid has many side effects. I don' t know if I showed continue or as 4 other breakthru med?? Anyone else have this med troubles. Oh yeh & try getting your refill 3 days early beause your goi g out of town & your going 2 run out. My granddaughter grabbed my weekly plastic pill holder & dropped it in the sink!!! It only had 2 days worth in it,however all disolved! & yes it was stupid, yes I got balded out by more than I needed. Just thank God she didn't eat them. Yet trying 2 replace meds like this ?? Forget it. Every single mo. All I am lectured On Is the DEA. Also God forbid your Dr. moves, or switches HMO. Your records R all there along w/ what your taking... But the we Dr. wants not 2 reflill things & starts off like day one!!! Like I said I truly wish I had an option not 2 have 2 rely on meds. Just to live??!! Junkies have made it so hard 4 the person that truly needs it.

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Different pain medications work differently for different people and different conditions. What may help you is not necessarily what will help another person.

In many cases, finding the medication that will effectively manage someones pain is a process of trial and error.

If anyone else has more experience, please post!

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Leighster, I am not sure how you get your medication but typicaly, a pain mgt doctor will have a plan for you. You are not really suppose to get it off the internet or on the street. Doctors know what interacts with what. My point is that anyone on pain mmanagement for chronic pain should take the medication as perscribed whether you feel like you need it or not. For me, this was the key. I felt sooo much better after a few weeks. It did take a few weeks though. I have changed out meds so many times and i never could get any relief until i practiced this method. I apologize if i sound condecending to you but any one of us are not qualified to determine what is safe or not. Go to a pain management specialist....

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I am currently attending a Pain Management Clinic here in MPLS, MN. I have severe spinal problems. I have had three major surgeries to try to relieve the pain. I now have steel rods holding my spine together. I have been on almost every pain med you can imagine. I am currently using a 75mcg Fentenyl patch, Tizanidine, and 4 mg diaudid pills. Nothing really seems to work, completely, but dilaudid for me, does seem to be the breakthrough med that works best, once again for me. I am like most of you under pressure for DEA requirements, but my clinic is fairly good about it. The problem is after a while, my tolerance builds up so high, nothing really seems ot work any more. I think switching meds often is important, but I am met with skepticism when I suggest it, like I have some ulterior motive. Most people in America are treated like criminals and are held hostage with pain as the torture of choice and it is a sad state of affairs.

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Methadone will block the Dilaudid,oxycontin,Lorcet,peracet.If you are taking any of theses you don't need to take methdone.I have been on Methadone for about 16years.

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I have Alford Chiari Malformation Syndrome with a Syrynx as well as several ruptured disk that where fused due to degenerative spine disease. I too have central nerve pain. I learned that you should take pain meds regularly as perscribed,otherwise, you are wasting your time. I found the perfect combination for me. 2-10mg methadone 3 times day, 3 baclofin and 3-4mg dilauded as BT. I used to take meds when pain was too bad to handle yet never felt good. Changing to taking as TX was a blessing and I am not addicted yet as I go w/o meds for a few days every now and then just to be sure.

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I had a similar surgery and then had steroid injections that later i found out wasted both of my hips. So by my 40th birthday i have had one complete hip replacement and am waiting for the second to stop the burning and bone on bone in my hips.
What i found that worked for me was to take the long acting Dilaudid (brand name Exalgo) it's a 24 hr drug, one pill in the am and your good for 24 hrs, then take your oxy for any breakthrough that you may have, but this seems to be strong enough that you can really limit your breakthrough pain meds down to minimum.
The dose pill is a 8 mg, my Dr started me out on two every AM for one week to see how i tolerated that, then if that was tolerated fine i was to stay with that, if not i could add up to one pill but not to exceed three pills in 24 hrs.
I hope that helps, maybe talk to your Dr and see if you can give this a try. It is a spendy drug and insurance will cover it but most of the time will require a prior authorization.
Feel free to e-mail me if you have any other questions, i have tried so many different things, i feel i have a wealth of information to anyone who needs some help in this trying time of getting yourself some proper help in pain management.
I am disabled because of my injuries and so if there is anyone out there that could use my help to navigate through the medical field to get the help they need but don't know how to get there, please get ahold of me.
I spent years doing this by myself and i understand the frustration, anyway i hope this helps you and anyone that is reading this. Good luck my friend.
Miles

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I KNO HOW YOU FEEL THE NURSES TREAT YOU LIKE YOUR A JUNKIE ,RITE DOWN TO THE PHARMACY,IF ONE OF THEM HAD TO LIVE IN CRONIC PAIN FOR A DAY,I STILL WOULD NOT
WISH IT ON THEM EVER,KEEP THE FAITH

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After spinal fractures some 17 years ago I was put on morphine.I have been on MS Contin 200mgs, 8mg Dilaudid, 80mg Oxycontin as well as a stint on methadone. In my opinion, avoid methadone at all costs. It is what is used for heroin users when they withdraw. The stigma associated to it is abominable. Some countries will deny entry to persons registered to have taken it. (For whatever reason, legal or otherwise) It takes 6 months to come out of your system, you may also lose teeth, yes teeth. Oxycodone is ok but only lasts 4/6 hours, even the SR tablets. MS Contin are much stronger and last up to 10 hours,though working a job that requires attentativeness is not possible on them. Dilaudid are very fast acting and much more powerful than the Oxycodone, though wont knock you about like MS Contin. The Dilaudid are deceiving as they say 2,4 or 8 mg.This is not the same as it is HYDROMORPHONE, as doctors can tell you a very powerful morphine. Oxycodone are easier to come down off as they are codeine not morphine or the stronger hydromorphone. I have found the Diaudid to be the best to stop taking as the withdrawal is shorter in time, 4/7 days. But also the fastest at effecting sharp instant pain. MS Contin is addiction in a nutshell and makes sleep a big part of your life. Oxycodone is a waste of time as your dose goes up 10 fold in days, after a week you need 10x as much to do the same thing, even then it lasts maybe 90 minutes by then. Good for low end pain or pain that is not there all the time. It is codeine, thus the lesser of two evils.I hope this helps someone,if so then I havent wasted my time. Again, do not go onto METHADONE, it is for drug addicts to substitute heroin, you WILL be stigmatized.

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I feel for you friend, and all the others that are in similar situations, myself included.
We all must be strong and realize that we are the ones that have been "chosen" to carry this torch.
like it or not we are our own support group and we must keep reaching out to each other to help one anther to keep each other going when the going is tough and we are feeling that we cannot keep it up any longer.
Just try to look on the bright side and think that someday there will be a medication that will allow you to wake up and have a semi-normal day.
There will be a medication that will allow you to find that you can enjoy that walk outside, playing ball with your children, walking on the beach with your wife, the things we only dream of now.
But because of our struggles and our fighting spirit and our resilience, the people that can make that medication a reality, are working tirelessly to do so, because of your drive to push on every day.
Thank you and good luck.
I wish you a happy a prosperous future.

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True! I not only agree with most all you had to say, but I do understand. I have a silent disease "Secondary Progressive Multiple Sclerosis" among several other illness', back surgeries, ect. PAIN 24/7 disabled & opiod tolerant for ten years now. No One understands unless they too have worn my shoes, not Doctors & even caused my divorce. If ya don't Have a cast, brace or in a wheelchair then everyone has no clue. If you're like me & stay home, away from friends when you're the sickest cause I don't want pity or to addworry or stress to others lives I care about. Then I am judged by others as using disability & I have no health problems. Which I understand & don't care really, but it's my Doctor's staff who treat me rude, cruel & abusive if the MS causes my memory to fail me or my speach is slurred or I can't see very well or just anything that may cause them to be patient or take more time with me. That pisses me off!! Who are they to treat me or anyone so rude?! I'd be happy to be health & thankful to have their job in this economy! & I can't explain the stress of being treated like a drug addict or not prescribe medication I need to control my pain so I may have the best quality of life possible. South Carolina are the cruelest state about schedule II medications. The only state where a pt must wait 2 to 4 hours the moring your meds are due!! Unreal!! I will take my last dosage tonight, then I must waitl until 9am to give my RX's to the pharmacy & then wait another 15 mins to an hour to have them filled before I have my first dose of the day!! It is hard on me & many others here. My lower back & left hip is so stiff & painful that I can barely walk every morning, so once per month I must go thru hours of PAIN times 10. It's rediculous!! Anyways, I will stop complaining, cause I am very thankful for my life & forums like this where I can vent to others who understand ;-) Good Luck, Best Wishes & Take Care to all!! Peace

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4-18-2013
I have a legitimate need for prescription pain relief.
Was diagnosed with severe degenaritive disk disease, severe facet joint arthritis & sciatica. This was BEFORE a near fatal car accident greatly aggravated these chronic painful conditions. I can. no longer work, and have qualified for disability.
My pain doctor prescibes 30 mg of Percocet daily.
Not even close to what I need. Any attempt to discuss changing meds gets me the junkie lecture.
The pharmacy treats me like a criminal, they and the Doc are more concerned about following regs than relieving pain. I would like to get my life back.
WHAT AGENCY is protecting pain patients rights?
How do we stand up for ourselves? No one would ban insulin for diabetics. Why are patients with documented chronic pain issues treated so poorly?
Any comments, ideas greatly appreciated. This is a topic I would like politicians address!

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I honestly do not understand. I am not joking or making fun of anyone or anything. My question is: why are people so afraid of using opiates? What is so terrible about being thought of as a "drug seeker"? Some people need opiates for severe physical pain and some people need them for severe emotional pain. Believe me, life itself has been painful almost since birth. This is neither a joke nor an exaggeration. I am, today physically ill with a number of serious things. Therefore, I speak from my personal experience of both types of pain. I used opiates (dilaudid, morphine) for years. I was able to have a productive life. I have a Masters degree, three happy adult kids and a very happy relationship with my husband. He was an opiate user also. We both take methadone now, as we are too sick and too old to have to worry about being arrested. The only thing that allowed me to function for 43 years of emotional pain was opiates. I am asking you, and others who seem to have a fear of opiates, to consider what some of us experience. Also, opiates can HELP with pain if you allow them to! Obviously, the decision should be yours. I wish you lots of luck!

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I just made the switch my self and i have the same issue. it was suppossed to be a step but it isn't in fact feels like i took nothing at all. I will say this from experience! Methadone is not what it cracks up to be!!. It stays in your sytem up to 6 months and if you ever do get to the point where you can stop taking pain meds you will hate that you have to go off of the methodone with drawals will last alot longer with the methodone than with plain oxy codone. oxy is out of your system typically if your not on the larger side with in 10 days. and withdrawals lasted me about a month. I was on 400mg of oxycontin for 2 yrs and went of it gradulally over 3 months. You might try taking oxycodone for a week and then taking a day off and then back on.

Good luck

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Hi,

I too have chronic pain/nerve damage that truly almost put me under... Cannot do the Oxy/Percs etc.... My whole life turned around through my new pain specialist.. he has put me on Tramadol and Tramacet....... and as far as maintaining my pain they are miraculous.. and the very best thing about those drugs is I can work full time every day and not be a drugged out mess... probably not for everyone, but did an amazing job for me.

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My husband has been on dilaudid for 2 weeks for pain related to prostate cancer/bone pain. He has begun to lose his balance and has difficulty walking because of that. His unsteadiness caused him to fall last night and I am very concerned about leaving him alone at all now. Has anyone found this to be a side effect of dilaudid? He is on the long release tabs every 12 hours and has 1mg for breakthrough pain which he uses only very very occasionally (one every other day) Appreciate any comments. Thanks.

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Clarification to my question above: The unsteadiness began two weeks ago, shortly after beginning on the dilaudid and has been getting worse..

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I have realized that no one has mentioned Suboxone to get OFF of any of the meds once the pain has stopped. I was taking 300mg of oxycodones a day for 3 months due to an intestinal ulcer.

Once the pain had stopped and I learned stress reducing techniques, there was no need for me to carry on with the meds.

I'm sure everyone that has written has gone through trying to quit or have run out a little early. Obviously the withdraws are horrible and can last a while 3+ days.

I didn't want to quit the oxycodones after trying to go cold turkey the first time. Thinking I was going to be hooked forever I started making calls to people to ask if there was any other treatment besides methadone.

Suboxone is the cure! It can handle large opiate useage. I was amazed at how well it dealed with the PAIN, sweats, restless nights, sleepy days, etc... It was a life saver and made the withdraws very little and more or less a walk in the park! The two most important things I can stress about Suboxone is that you must not take it until you start to feel some pain from the withdraws, typically after 12 hours. The second, is to remember the first pill on the first dose will normally make users really depressed and should be under supervision for 8 - 12 hours, but it will pass and the rest of the time is wonderfully easy!

Best of luck and a speedy recovery of pain and pain of pills.

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I tried both because in May I had a blood clot in my lungs which made my chest be in unbelievable pain so they gave oxy 10 every 4 and 1mg of dilaudid every 2 hrs. Personally I felt better with the oxys. I had already been taking oxycodone for my osteoarthritis. I have no cartilage in my left knee and w/o it I can't get up in the morning. From what I can recall the dilaudid wore off too quickly. I can't comment on methadone because I've never taken it. I was always under the impression that it was given to detox of heroin. I have recently come to the conclusion that I'm a prescription junkie but w/o the oxycodone, neurontin, and the celebrex I would be in immense pain. So sir my advice would to keep taking what keeps u out of pain and what doesn't make u a complete zombie all day so u can be a fully functioning person.

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