Dilaudid As A Oxycodone Replacement? (Page 2)
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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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65

I was diagnosed with Reflex Sympathetic Dystrophy(it's a rare nerve disease) 6 years ago and I'm currently taking:
Dilaudid 4mg 4x/day,
•Hydromorph Contin 12mg 3x/day
Ketamine 30mg/day
Elavil 50mg/day
Lyrica 150mg 2x/day

I've been on the same level of hydromorph and Dilaudid for about 2 years now and it's completely stopped working. I feel no difference after I take it. As for the rest of the meds, my pain Doc and I have tried a few different combos. The help for a month or two then just stop. I know my tolerance is just through the roof but I need to find something that's going to help. I've tried morphine, gabapentin, fentanyl patches, oxys, Percocet but just can't find the mix to help. In 2012/2013 I had a Spinal Cord Stimulator implanted with hopes of even 5-10% relief but again nothing.

Does anyone have any ideas or suggestions?!?

Feel free to email me directly with info, opinion or just to share stories. {edited for privacy}

Oh P.S. I'm im Canada with full benefits so price isn't a problem or a factor.

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64

I have a rare degenrative dasease been sick ten yrs now im only 39 im was changed from 30mg of oxy ir 4 x a day and 40mg oxy er a day it workef like no other meds i was put on but now they put me on 64mg of dilaudid per day i cant even get out of bed i just pray for my life back hope u find what works for u good luck

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63

not all methadone comes with blockers
Some do some don't

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62

My doctor is being very careful with my meds. I'm taking 4mg instant release dilaudid 3 times a day. Also 6 mg every 12 hours of extended release hydromorphone. Is this a lot for a male to take?? I feel that it's not working so well. I feel I need more of the extended release for the 12 hours. The 6 mg is not strong enough but my doctor wants to put me on a antiflamotory to see if that helps as well.

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61

I was shot down in Laos by a Chinese or Russian missile during the American war on Viet Nam. I sustained about eight bullet wounds, three (3) to my head/face, two (2) to my right femur (thigh bone), three (3) to my abdomen/lower back -- beside the other injuries resulting from the nocturnal parachute drop. I was held as a guest (POW) for several years; where they played lots of question-answer games with me, hint, they (like we) play hard at questioning. I still have night-frights, PTSD, and the physical pain is becoming worse over the ensuing years, almost too much to bare at times.

Because my old injuries are catching up with me; I have been taking opioids for over ten years straight. I was first given prescriptions for Vicodin (tablets of Hydrocodone/Acetaminophen) together with another prescription for tabs of Methadone, I used these for several years, until I had to stop both, I had become very tolerant of both -- the Vicodin because it hurt my liver, (very bad liver pain). I also developed an allergy to the Methadone that manifested in serious peripheral edema, both of my legs and feet swelled up with lymph. It was so bad that I could NOT wear any of my pants or shoes. I had to be hospitalized for a week because of the bad side effects that included open sores that went through the layers of skin into the muscle, I nearly lost my right leg, and did permanently lose ALL of the hair on my fairly hairy legs. I tried many medications and other things to stop the swelling, they even got me a hospital bed that allowed my feet to elevate, this slightly helped but was NOT a solution. I also got so constipated that they had to take me to the ER and then a 110+ mile ambulance ride to Portland, Oregon and a hospital (Emanuel) where they did an emergency operation that cut me from near my sternum to about 4" -- 5" below my bellybutton, to clear out my bowels that were impacted/blocked from the EXTREME constipation.

I decided on my own to go "cold turkey", I stopped taking any opiates at all for about six months. The Methadone was a real beach to quit!!! It took over four weeks for my withdrawals symptoms to recede. I personally would advise folks to avoid Methadone, though it worked well to relieve pain at first, there are better and safer alternatives. The Vicodin caused liver pain stopped after about three weeks.

Now I am taking two 30 mg OXYCODONE (with NO acetaminophen added) four times a day, usually needed. I feel from experience that the acetaminophen is BAD and harmful (certainly for me). One of the main reasons it is added; is to make abusing the medication more problematic. Bad Idea for the folks taking it IMHO.

I become tolerant to the Opiates and used to alternate with Morphine but it is not strong enough in the strengths that my insurance will pay for. I am now about to alternate and switch to Dilaudid maybe every six months or so. I am going to request 250 8 mg Dilaudid in place of the 250 mg of Oxycodone, I am figuring in the calculation about 25% reduction for incomplete cross tolerance. This usually varies from about 25% ?75%. I was told that the Dilaudid is about 2.5 times the strength of Oxycodone.

When you takes an Opiate, you become "tolerant" to it after some time. When I first started the Oxycodone, I could take one 30 mg tab four times a day for some pain relief. Now I need to take 2-4 at a time to notice any pain reduction, I have to be very careful not to run out of the 250 tabs every four weeks. So when I alternate with the Dilaudid I will start out with one 8 mg tablet four times a day; after a few months I will very likely need to double up on that.

I work very hard to not take any more Opiates than I need to lessen my pain; I am never without pain. I can take 4-6 at once of the 30 mg without any bad effects. Occasionally I will do that if I have a particularly bad-pain day/night. I cannot recall ever feeling "high" from these 'meds', they barely help my pain. I do NOT take any drugs to feel high, only for some pain relief. I very rarely use alcohol, I do NOT want to get lost in the bottle, nor do I use tobacco, I quit it about 16½ years ago.

So my plan for the next year or two is to alternate between Oxycodone and Dilaudid; I tried Fentanyl patches (100 mcg/hr) and they DID help when I used TWO at a time as per my doctor's instructions, they stay on for several days at a time. My problem is that my insurance (medicare and another) will not pay for the Fentanyl Patches until I appeal the denial, they did pay for three boxes of five patches (less than my doctor prescribed) I hope that will work out.

Sorry for the ramble, opiates can be very dangerous and harmful, many side-effects; but they can provide pain relief when all else has failed.

On my horizon... my pain relief medication research has lead me to possibly try some RSO (oil)* or FECO (oil)**. I have read some amazing reports/stories/reviews, and talked with folks that have tried these with amazing results. I am glad that I live in one of the twenty states (and growing) that provide a path away from the harmful opioid analgesics, and those terrible aforementioned side-effects.

* ** Google for more information.

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60

Miles, more like "a happy and preposterous future". Not meaning any offence but this miracle analgesic won't repair the underlying damage that most of us on this forum have experienced. I could never chance riding a bike or even running without the threat of much greater damage. Nice thought though.
Peace.

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59

Ater 10 yrs on hydrocodone 10 then oxycodone for 6 months I have become addicted. I know it sounds bad but withdraws are terrible. I have a form of muscular dystrophy, CMT. I also had my S1 L5 fused and still have deep groin pain. I know to some it's taboo but with the new laws in Colorado, cannabis seems to help take the edge off, but you need the high THC stuff. Good luck, I hope your state decriminalizes it.

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58

I have ms and the back of a 90 yr old my doctor said..i was prescribed 90 4yr mg pills a month (3 a day)....well it wasnt killing the pain very well, so i researched it and found out that if you use them intraveneously, they really are supposed to help the pain better so i tried, and sure enough it helps the pain...i dont take more than prescribed or anything, the 3 a day do the trick as long as i IV them

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57

500 mg of oxycodone per day has been prescribed for YEARS to my girlfriend for treatment of her eds. She displays various symptoms tmj and hypermobility etc.. plenty of pain but never was never diagnosed. Frankly her doc is a damn quack. I am very worried that this medication is not only not helping because opiods do not treat the inflammation but obviously have such negative longterm implications for dependance etc.. she is in constant pain and stuck on this nonsense prescription. All I have found about oxycodone is that it is inappropriate for long term pain relief because it only increases tolerance rather than reduce the pain or even remotely adress the cause. The dosage is obviously rodoculous as well. My girlfriend is my world & I sincerely ask anybody who can offer any insight at least into what damage may be occurring & moreover advice on an alternative.. I see rhat suboxone is popular for chronic pain.. sriously 500 mg oxycodone indefinayely is the preserve of comic book quackery and malpractice. No names no libel. Please be honest with me.i'm going uphill to fight a doctor who has abused the family's confidence. Please help if you have any suggestions. Many thanks indeed.

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56

I'm really happy to see this forum is still active. For the last 5 months I've been taking Percocet 5-325; I was up to 5 a day. Saw my doctor yesterday; she said my metabolic drug analysis showed Percocet wasn't working well for me (I didn't think it was working well either). She switched me to 2 mg of Dilaudid 3 times a day, and 50 mg of Tramadol 4 times a day. I definitely feel more alert today, which is awesome ( and I was able to sleep last night--super exciting for me!) but I feel less pain relief. Do I need to give this some time to start working? I'll see my physiatrist next Wednesday to go over my MRI, and he will probably do IV's into my back. I can handle this pain right now because I've taken a few days off work, but I'm worries about Monday and Tuesday.

My other medications are Lyrica 225 mg/ day, Cymbalta 120 mg/ day, buspar 60 mg a day, Xanax 3 mg a day. These are all split into doses. I also take 300 mg of trazadone at bedtime.

My conditions include fibromyalgia, severe DDD, scoliosis, stenosis, and sciatic pain that extends to my foot.

I'm also taking lot of magnesium (Epson salt baths help!), as well as raising my vitamin D. Cinnamon and turmeric. High-quality multi-vitamins and minerals. I think that's all.....sure sounds like a lot.

Advice? I think the Percocet was also depressing me, so maybe I'm just more aware of the pain now that I feel more alert? I'm hoping Percocet was what was causing all my problems sleeping. Without sleep, I am absolutely hopeless at even showering....

Thanks,
Wendy

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55

For each of you that are taking high doses of pain medication. Please! Watch the intake of the additives: Tylenol (Acetominophen) or Motrin(Ibuprofen)....Your doses of the oxycodone, methadone, hydrocodone or oxycontin.... can go up as needed with your Dr's approval. BUT....take those medications WITHOUT taking the combination pills that include the OTC meds. Tylennol and Motrin can wreak havoc on kidneys, liver and stomach. (Percocet, Vicodin...both have Tylenol in them....be safe! Read your bottles and note if there are OTC meds in your pain medication. If there are, talk to you Dr about changing the Rx.)

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54

I think your doing it perfectly. We have to be proactive. I found when my meds are changed up it helps, an I have a Geer doctor who will work with me. I would sy if your on a job try an stick to the offs, they have a more speedy effect. I lost. Job once due to being on wrong meds thy made me like that. I wish we could have both and alternate ourselves. My problem is what's best for my liver. And the dulluded is already in its chemical form. Oxys
have to change in the liver.

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53

I have been on oxy 30 for 8 months now, just today my dr. switched me to dilliad 8, I have taken 2 already and nothing has changed I am still in horrific pain, I dont know what to do either, I think I would have been better off in the oxys just moved them up to 6 a day one every four hours instead of one every 6 hours, I had been taken 6 a day for 2 weeks and that worked better than the dilliad, if im mispelling it sorry. Taking one pill of oxy 30 every 4 hours is better than this stuff by far, well this is my opinion on the whole thing, im having my back surgery hopefully next month, but im gonna go see my surgeon probably next week and tell him what I think works better for me cause this sure isnt working, im still in horrible pain and the only thing I know that worked for me was 6 oxy 30 a day ,one every 4 hours, try that if u can cause u sound like u r having the same problem as me, so if no improvements by friday im gonna call my doctor and change back, but I need 2 extra a day, one every 4 hours instead of one every 6 hours, I hope I have helped u with my story, and maybe try what I am gonna go back to, its the only thing that seems to work for me, maybe it will work for u 2, at least its worth a try, it sure gives me alot more relief, thanks for your story and I hope maybe I have helped u as well, good luck

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52

I am an RN. My specialty is mental health and. more recently, chemical dependency. Though I have always been an advocate for my pts, i.e. I BELIEVE most of them if they tell me they are in pain, anxious, angry,
whatever, it makes me absolutely sick
to see health caregivers talk down to
anybody especially the pts. This is, in
part, because they ( caregivers) feel so powerless
in their own lives. I have taken
Darvocet for migraines and Lortab
and Oycodone for severe pain in my
left knee. I need surgery which I will
get. I decided a year ago that I no
longer want to be in such pain all of
the time and decided to get the Oxy
and SOMA, the latter of which I have now
stopped completely. From getting the
script to trying to find a place to get it
filled ( do not go to Hollywood with a
pain prescription in your hand) was
humiliating at best. I was accused of
being a junkie even though I
requested them to check the state (or Federal?) record to see if I ever had
Oxy filled
anywhere ever, to being accused of
being a dealer. I am a very large, white 60
year old female and I had a big
sunhat on. In this case it sure didn't
help matters. (Like the tourist look).
I don't really get the whole pain
thing. It is totally subjective anyway,
just as what medications work better
for certain people. I broke my hand
about 5 weeks ago and the radiology
tech said it just couldn't be broken
because I was not behaving as if I
were in pain. Guess what?! Yeah you
got it.
I want to thank you all for expressing
your views and sharing a part of a
very secret life with strangers. It
helped me go take a full dose of Oxycodone just now. My adult
daughter has been staying with me for a short time in a teeny apt, and
she hears me moaning (not fun moaning!) in the night. She just
strongly told me to take the full dose. She was correct.
I learned a lot from your info and comments, and, I must say, especially
after working with so many true
junkies, not one of you sounded
addicted. My sweet patients anyway
know why they are indeed patients
and are addicts.
To the one person who
periodically stops their pain meds for a certain period, you need to let your doc know. I know that you know not to do this. Ever. Playing with matches and seizures. Very dangerous. Please!!
I thank you all again. Good luck in your trials and tribulations.
Love and hope from Sherri

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51

ALL OF THOSE TYPE PAIN KILLERS ARE DEADLY MORE SO WHEN MIXIED DIDLUIDID HAS KILLED ITS SHARE ,WHAT IS DEADLY IS GREED AND IGNORANCE PEOPLE SHOULD HAVE TO HAVE A CLASS AND PASS A TEST BEFORE BEING ALLOWED TO TAKE HOME MOSY OF THEM

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50

methadone dont seem to help pain as much but works so long so its worth the trade off so it and a smaller dose of short acting seems to be the way to go but you have got to stay aware that you have the methadone in you at all times and there is nothing anyone can do about the ignorance of those that havnt been there and tha goes for DR too if your dr dont get it then get one that does & tell the truth ,you arent going to change a dr that dont or wont get it some are just cta and the other just dont get it and tune out the people there worse than the dr because they know it all and they have never been trained

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49

Opana may well help but it is not oxycondone hci by a long shot,Where as Diluadid is Hydromorphone HCI Opana is Oxymorphone HCI .they are both sch ll control substance Opana is a little stronger for a little while then it will take more also but going back to Diluadid wont be as helpful as before .the differance is siight in the molocule make up as with Hydrocodone hci & Oxycodone hci ,we all develope tollerance its good to have a DR that gets it Methadone seems to make things last longer be cause of its long 1/2 life but as you know you must be careful ,i try a drug holiday from time to time ,just a little as not to be sick but to lower my tol but it dont help long it only keeps it from climbing so fast but you have to be aware when coming off holiday well wishes and check on any info that you get yourself everyone is responsible for ones self

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48

I have exact same diagnosis...I fought and fought for my pain meds, as morphine did Not work period...n the oxyneos were ripping my insides apart! 3 80mg oxycodone controlled release, and 20mg oxycodone instant release four times per day, nuerontin cpl times a day, baclofen cpl times a day, antidepressant,sleeping pill at night...still my life is hell...no one understands...i think and have read meds need to be rotated, n i strongly believe i should have a different combination, but no, dr. Insists to stay on same narcotic for breakthru and round the clock...pain management here is a JOKE!!! You are on year waiting list,then they make you drive an hr each way to see them everyday,they use a pscychiatrist, exercise,nerve blocks,and try and take all narcotics away and have you on nonsteroidal anti inflammatories...or ive heard they put ppl on methadone for those insistant on pain meds. Its a joke,,,n not one single person understands or cares, no one cares, ive even been told that by gp over n over again...no one cares, you can write and complain, to whomever you want,but you are wasting your time, no one cares, i thought my dr. Cared...plain to see it was all an act all these yrs...n im expected to have a spinal fushion...so i can b in more pain...yeah...NOT! Seriously, id rather become paralyzed from not getting surgery, at least i would feel no pain!

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47

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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46

Ya I'm in a similar situation and was wondering if you are located in the sacramento ca. Area? I need a dr. ASAP and was wondering if u can help? Thank you.

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