Pain Med Dosage

Updated

I am retired early due to back problems. I have been on hydrocodone 10/325 for years-up to 6/day. I was given Opana 10mg 3/day by my pain doctor. I willingly decreased that to 2/day and it worked. My doc 1 month later switched to 7.5/2 day and I had to take more hydro in addition to 2 Aleve/day. I told her my problem and yet she then switched me to 5mg Opana 2/day and I still have the hydro 10/325 of which I take 6/day in addition to 3 Aleve PLUS 4-6 200mg Tylenol. I saw her last week and stated I am worried about my liver...she recommended some PRP which is NOT covered by ins. and didn't work other times I had it done. Her office is now doing injections/mess for weight loss as well as 'cool sculpting' and other 'cash' procedures including 'vampire face lift'. Every appt she tells me the DEA changed regulations and she can't give me any more pain meds. I am REALLY confused and hurting and wonder if I should ATTEMPT to find a new pain med doctor who actually may listen. Am I really over the 100mg equivalent morphine dosage with 5mg Opana ER and 10/325 mg hydrocodone 6/day?

11 Replies

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1

Hi Erin,

I'm sorry to hear about the trouble with your doctor. I was put on Opana ER 10mg 2x daily and hydrocodone 10/325 up to taking 4x daily. I do know there are many Doctors insisting on cutting their pain medication prescriptions due to the acetaminophen amounts contained in the pills. Now with that said my doctor recently cut my norco to 90 pills a month which could explain yours getting cut cause 6x daily is a lot of acetaminophen for you to take. I've seen pain doctors before and never have been prescribed over 4 hydrocodone daily. I'm not agreeing with your doctor because first off with 5mg of opana being a long acting medicine she should have put you on a stronger fast relief so you wouldn't have to take it 6x a day, you could take 3x day if stronger. Hope that makes sense and may be worth you asking your dr about taking a stronger medicine in place of hydrocodone but less times daily. It would put less strain on your stomach and liver as well.

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2

I would only say you should seriously consider the possibility of changing doctors. What you are going through is unacceptable. Also you may have to be more proactive in your communications with your doctors to let them know what has been effective in your history. Get an effective diet regimen for weight control. Good luck!

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3

Hi you probably dont want to hear my advise. I was on 280mg of pain killer a day for a accident with my back in 3 places . as you know you were not given the high dose to start . you were gradually increased to todays values in mg.
You are physically dependant once you took the 6 hydrocodone per day .not to mention other pain meds.
My advise is get detoxed by dr. Or by a inpatient rehab . its not painfull if done slowly under drs care.
Once your brain is recalibrated ?you may need no pain killers or a small dosage . nerve block injections are a option also along with prednisone pills for anti inflamatory purposes.
The high dose of opiut based pain meds your on worked until your brain and my brain and others became used to its daily use. So if you miss a dose now your feeling the pain of detox not your back pain .
Hope you understand the cycle of any opiut main medicine . we all become physically addicted to them then need to detox now and then to get the benefit of them again .
Goodluck.

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4

I am on Opana er 10 mg twice daily and oxycodone 15 mg 4 times a day. I was on hydrocodone but it wasn't strong enough to help my pancreatic pain so they switched me to percocet. But my liver enzymes were coming up too high with the Tylenol in the percocet. So they changed me to oxycodone without the Tylenol. The dose was upped and upped and changed over time until I am where I am now. And like one other person said our brains get tolerant to the doses pretty fast and they no longer work anymore. Since the new DEA and FDA stuff my doctor has discussed the fact that my morphine equivalent is way over the recommended for non cancer patients. So if I am way over you are more than likely over too. My doctor is very understanding though and willing to keep stalling on moving my medicine down and she said if they become agitated about my dose she will move it down very slowly. It had been 4 months now and she haany changed anything. I agree that making your short acting medicing stronger you can take less of it. 6 pills a day is a lot with the Tylenol in it and could lead to some liver issues. All doctors are different and do things their own way. Some people's doctors totally cut them off after these reports and other like mine have been completely understanding and haven't changed anything. So I you feel you doctor is not listening to you or helping you I think finding another doctor is the way to go, but with that being said be careful who you choose because you could end up in a worse situation. You could change to one of the stricrew doctors that will cut your medicine even more. Do very good research on who you change to, and make sure they will make your situation better not worse.

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5

I'm on a high dose of oxymorphome, but my Dr told me that the dea wants endo to take opanaer off the market because people were abusing it in Tennessee and getting aids and a rare blood disease. It's bs.i hope it's just the tamper proof they are trying to take off the market!!!

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6

What is best for night cough I have either a cold are respitory infection

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7

Yes change doctors. Best way is to ask people you know for recomdatjons. Check o. Line with licencing board if doc has had any complaints actions. Im disabled R. N. Manyyears speciality service. Your doc should listen do appropriate labs. You are not just patient your are a ccustomer paying for service. Helps to wright ? S before visit. If brushes off them does answer to satisfaction you need to change provider. Praying for you hope it helps

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8

Go,...you may have a problem communicating enough with your doctor...,if she not listening you habe to take matters in your own hand s.. I will explain ..... Most muy doctors shouldn't give me anything other than muscle relaxers..., that's a joke... So I bent over holding my back and made myself scream if I moved my back.. I mean when she asked me to sit down.... I, said I no I can't I'm Stu like this and then if you don't want to wait grab your chest once in awhile and say I'm having trouble breathing nowcouldn't

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9

Erin, the CDC Guidelines are not laws. It is up to each doctor to prescribe for each patient.

Is your doctor a Pain Management Doctor ? The reason I ask is it is unusual for a Pain Management Doctor to do cosmetic and weight loss procedures. If your doctor does not have specialized education and training in Pain Management, you need to change doctors.

You may not be able to find another doctor that will prescribe you 6 hydrocodone/acetaminophen a day. Most doctors have stopped prescribing more than 2-4 immedicate release pain meds a day for chronic pain. Based on what you said, you are taking the hydrocodone/acetaminophen for break through pain. You are not suppose to take break through pain medication regularly. If your pain is not being managed well by your extended release pain med, you need to talk to your doctor about increasing the extended release and not the immediate release.

You should not take more than 4,000 of acetaminophen in a 24 hours period. No more than 650 mg in a four hour period or not more than 1,000 in a 6 hour period. Your doctor should be doing a routine blood test to keep an eye on your liver and kidney functions.

The FDA has requested Opana ER be removed from the market. If Endo does not do this, the FDA will order them to.

FDA requests removal of Opana ER for risks related to abuse-
fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm562401.htm

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10

Molly, I haven't taken the time to read all of the replies, so forgive me if I'm repeating any info you've already received. I don't know where you live so I don't know how your laws may have changed. I live in Virginia and their law changes are designed around the CDC's MME Tables (Morphine Milligram Equivalents). On that table, Hydrocodone is a Conversion Factor of 1. So if you are taking 10 mg of Hydrocodone, the MME conversion would be 60 X 1 = 60mg of Morphine. Oxymorphone (Opana) has a Conversion Factor of 3, so your 10 mg of Opana per day would convert to 30 mg of Morphine (5X2) X 3 = 30. Based on the CDC's MME Tables, you are close, but not over the 100 mg level you mentioned. By the way, I live in Virginia. I am not a lawyer, but I have done a great deal of research on the changes in their opiate laws. My husband has a very painful disorder that has no cure and the changes in the law have caused us all sorts of problems. If I remember correctly, and I'm almost certain I am, in dealing with chronic pain patients, the MME's can go up to 120 mg and I believe the doctors can take it higher as long as they can document the medical necessity. In case you also live in Virginia, I thought this would be info you might need to know. I hope this helps in some way.

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11

Erin, I'm so sorry. I looked at the wrong name and I put the name Molly on my reply to you. The info is definitely for you. Sorry again!

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