Ms Contin And Breakthrough Pain (Top voted first)

I am taking 15mg MS Contin 4 times a day and I still have several periods of severe pain that come out of nowhere. They usually last anywhere from 20 minutes to an hour and can be so severe that they bring me to my knees. Could this be breakthrough pain? I have an appointment with my pain doctor in the morning, but I want to see what others think so I can try to be prepared when I talk to him. I want to ask for something for these periods of severe pain. What works best with MS Contin? Thanks for your help!

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Yes, breakthrough pain is quite normal for someone to experience, when they suffer from something that causes severe and/or chronic pain.

There are several medications that you can try to help with it, when it hits like that.

Most doctors usually use an instant release medication and the most common one is OxyIR, which contains an immediate release formulation of Oxycodone.

When I was on pain management, I was on MS Contin and had the OxyIR for breakthrough pain and it worked quite well for me.

https:/­/­rxchat.com/­wiki/­Oxycodone/­

https:/­/­rxchat.com/­wiki/­Morphine/­

Are there any other questions?

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I have had chronic neck pain for 10 years and use a variety of narcotics for pain management. I have also read many articles about the philosophy of narcotic pain management and have the following to offer to misabrooke and nan based on using oral medications:

Pain is best managed using a combination of extended relief (ER, SR, CR) meds along with immediate relief (IR) for breakthrough pain. If your pain is well managed by only using the ER meds, your dose is too high. A "rule of thumb" is your IR meds should be from 10% to 25% of your total daily equivalent dose. If your doctor will not give you medication for breakthrough pain, get a new doctor.

The serum level of MS Contin peaks in about 2 1/2 hours and then drops off fairly linearly. That means equivalent total daily dose, 3 times a day might be more beneficial. For example, 40 mg MS Contin every 8 hours might work better than 60 mg every 12 hours.

Another "rule of thumb" is Oxycodone is 50% more effective than Morphine. That means 10 mg of oxycodone has the same pain relieving effect as 150mg of morphine. However, this ratio varies from individual to individual, and also changes based on your cross tolerance to either medication.

I am not a doctor so I cannot give you recommendation but I can suggest you ask your respective doctors about the following;

misabrooke: MS Contin 15 mg 4 times a day to MS Contin 15 mg every 8 hours Qty of 90/month, plus 5 mg Oxycodone 1-2 tablets as needed every 4 hours quantity of 90/month. Try this for 3-4 days and call your doctor is you feel you should increase the MS Contin back to 4 times a day but expect the Dr. to decrease your Oxycodone to 1-2 per day.

nan: Perhaps 40 mg MS Contin every 8 hours will work better for you than 60 mg, twice a day? It's the same total daily dosage but it would be smoother. In addition, 5 mg Oxycodone* 1-2 tablets as needed every 4 hours quantity of 90/month for breakthrough.

* While the Oxycodone is listed as 1-2 tablets every 4 hours as needed for pain could add up to 360 tablets, the prescription would limit you to no more than 3 tablets per day. The reasoning behind this is when breakthrough pain occurs, you should wait 4 hours before taking another dose. If two tablets in the first dose and/or two doses in a day didn't help enough, the dosage of the ER medication needs to be increased instead.

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Hi I would greatly recommend finding another doctor.

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George

As a chronic pain patient for many years most doctors legit. Want to help if you truly "Broke" your back on 3 separate occasions by accident most doctors would be extreamly concerned as to why you would be in a position to have that same injury occur on three seperate occasions.I would recommend a consult with a rehabilitative specialist to prevent the risk of a 4 th " accident" from occuring and risking paralysis . 99 % of the population are blessed to never have a tragic accident even once so you can see why some would be Leary to treat with powerful narcotic meds for life. Just being realistic....

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Re: Annir (# 9)

Birdie (# 10) --
Everyone is different Hopefully you have been on opoids for awhile I'd advise if you feel anything weird or new to seek help Always be safe than sorry I've made mistakes also So I try to log my medicine so I can keep better track Same as with pain It helps my Dr seer what levels I'm at Be safe

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I am just about at my witts end. I have moderate to severe chronic pain. Every joint in my body is affected with my knees, back and hands hurting the most and the most often. I also get sudden severe sharp almost electrical feeling pain jabs. Add a whole spectrum of other health issues like incontinence and Hep C. Nobody seems to be able to find the cause of my pain which may be why my doctor won't help me with break through pain. He had me taking 30ml ms cotin which didn't help much. It took my friend coming to my appointment and explaining the pain she sees me in for him to increase the morphine to 60ml twice a day. It does help but it doesn't last 12 hours. By late afternoon I am usually in a lot of pain and mornings are terrible. My mom has been taking pain meds for years and is prescribed ms cot in 3 times a day because apparently some people do not metabolize the meds properly which is genetic. When I have talked to my doc about this he just says he will not increase my meds or add anything for breakthrough pain. That I just have to live with it. I am raising my 1 1/2 year old grandson so I need to be able to function in the morning. There are many days that getting him out of his crib or changing his diaper is very difficult. I don't know how to get my doc to help me

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CORRECTION:
A typo in the 4th paragraph above. 150 mg of morphine should be 15 mg:

Another "rule of thumb" is Oxycodone is 50% more effective than Morphine. That means 10 mg of oxycodone has the same pain relieving effect as 15 mg of morphine. However, this ratio varies from individual to individual, and also changes based on your cross tolerance to either medication.

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I have 3 accidents that have broken my lumber back each time and all I get are 3-30 ml of these things and it does not even touch any pain don't sleep eat nothing sucks

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I'm on five 10/325 hydrocodone - acetaminophen and I'm switching to ms contin on Aug 2nd. I can't take certain breakthrough meds because I bleed easily and am allergic to diflucan. Any suggestions on a breakthrough med? My doctor does not prescribe any oxycodone. Please advise.

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I take 30 mg ms-contin 2 x daily and accidentally took a third one a miniute ago after only 6 hours. Will I be okay?

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Re: Birdie (# 10)

Everyone is different Hopefully you have been on opoids for awhile I'd advise if you feel anything weird or new to seek help Always be safe than sorry I've made mistakes also So I try to log my medicine so I can keep better track Same as with pain It helps my Dr seer what levels I'm at Be safe

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I take 30 mg Oxycodone ir every 3 hours in between my 60 mg ms contin it helps my great. doctors usually recommend every 4 hrs not 3 though.

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