I Have A Herniated Disc At L5s1 And Am Taking 8mg Dilaudid 1every 2 To Three Hours As Neede For Pain First It Was Working Well Now Doesnt Last (Top voted first)

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need info on 8mg dilaudid and what might be a good medication for breakthrough pain while taking this med every 2 hours. please help. ive been on oxycontin & roxycodone and cant find them anymore thats why i changed to dilaudid. please help.

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7

Your pain is not being treated correctly. Your primary analgesic should not be administered every 2-3 hours. Rather, this is what your treatment regimen should be:

-Use of long-acting opioids around-the-clock for baseline management of persistent pain.
-Use short-acting opioids PRN (rescue) for breakthrough pain.
-Strongly consider using the same drug for both baseline and rescue doses whenever possible (e.g. long acting morphine + short acting morphine, or long-acting hydromorphone (Exalgo) + short acting hydromorphone (Dilaudid)).

Rescue Dosing:
-The rescue dose should be 10-15% of the 24 hour total daily dosage.
-Oral rescue doses should be available every 1-2 hours; parenteral doses every 15-30 minutes

Adjustments of the baseline/rescue doses:
-If taking consistently 3 or more rescue dose daily, consider increasing the baseline round-the-clock dosage--being sure to recalculate the rescue dose whenever the baseline dosage is changed.

Example:
Calculate rescue dose for patient on baseline coverage of Exalgo 16mg q 8 hours:
-First Calculate total daily dosage: 16mg x 3 = 48mg hydromorphone/d
-Second, establish rescue dose:10-15% of 48mg = 4.8-7.2mg short-acting hydromorphone
Therefore:-
>>>Oral rescue dose is hydromorphone 4.8-7.2mg PO q 1-2h (Use hydromorphone syrup or solution for oral administration to achieve an exact dose).
>>>Parenteral rescue dose, though not applicable here as this individual is on oral medication, the parenteral rescue dose, would be based on a continuous infusion where in 24 hours, 48mg hydromorphone is being delivered: calculate the rescue dose based on 25-50% of hourly dose: 48mg / 24h = 2mg/hr; thus 0.5mg to 1.0mg per rescue dose.

NOTE: Where price is a factor, consider using methadone. Equivalent levels of analgesia can be obtained for pennies on the dollar. Hydromorphone / Oxymorphone / Morphine are preferred as they possess no analgesic ceiling dose, it is safe to continue increasing the dose of these medications until relief is achieved or side effects develop. Demerol is not suggested for anything but certain analgesic purposes, and should not be used for either acute or chronic pain.

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6

Please take my advice. My wife suffered with a herniated disc l5-s1 for 5 years. She was on every medication combination you can think of. Very strong ones too. It all lead the same direction. No matter what you take, it will wear off in time and you will need more at some time. She finally did back surgery and fusion in May. The same day her leg and back pain were gone and it has been gone ever since. Don't let failed surgery stories online scare ou away. The failed surgeries are because people do not follow surgeons strict instructions afterwards. Go see a NueroSurgeon. Have faith and believe that you will be healed. I stood by for years and saw my wife in agony while she popped pill after pill. Do your research. No more drugs! Get your life back today!

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12

i have herniated l5S1 and nerve compression also and im on 2 dilayded 80oxy er and oxy 30 max dosage i can take and i can barely move- i can relate to how severe the pain is - im living on the couch and i dread waking up everyday - i feel for you . i wish u had my Dr he cares

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1

Opana Ir Or Er im sure an Opana 40 Er would would cover your pain if not try Morphine, I prefer morphone. Hydro-morphone= dilaudid. Oxy-morphone=Opana. I say Opana is ATLEAST equal to an Oc 80. Fentayln patches also work great as well as liquid Morphine Sulfate. Mainly for Iv but can be ingested.

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8

Normally i would agree but i have chronic pain, nerve damage in both arms and legs, as well as degenerative disk disease. Having had 27 surgeries im familiar with meds not working, as has been my case. Everyines pain receptors work differently. Even just for a sprain...it may seem like an amputation. No disrespect to hou and yiur voiced opinion.

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11

I take 8 mg dilaudid and MS Cotin sulf ed 60mg for break through pain

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3

thank you for that info.

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4

i will speak to my dr. about that. thanks for the info.

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10

Please may I ask where you are? I moved to north east PA from Jersey and I am having the WORST time finding a doctor I am in constant pain from injuries to my knees and back I don't have the money to keep going back to Jersey to see my old doctor, I was on 30 mg Roxicodone but I'd be willing to try something else if I can't get that. I'm beyond frustrated and in a world of pain

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13

May I move to your state? Impossible in RI.

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14

I have been on 4mg 3xs a day I recently lost my script my chronic pain is awful but I can barely walk n since being of Dilaudid I feel better.withdrawls are so hard n my chronic pain is awful .I just found my script my husband wants me finish withdrawals n stay off Dilaudid but my pain ontop of withdrawals I don't know if I can go till the 7th. But it's ruining my body.please be so careful

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15

Many people are unaware that Methadone isn't only used to treat opiate addicts. It is actually used for acute and chronic pain. I don't know what state you live in or if each state has different laws concerning narcotics prescribed for pain relief. If you don't already, you may want to get a referral to go see a Pain Management Doctor, who should be able to prescribe a medication or medications that will relieve your pain, as well as prescribe something for breakthrough pain. I've been under the care of a Pain Management Doctor Specialist since 2007, and I've always been very pleased with my treatment and the medications he prescribes are working well for me, though I will always suffer with some amount of pain but not nearly as bad as if I didn't go to my Pain Management Doctor. He understands pain and specializes in the treatment of pain, so in my opinion one couldn't ask for anyone better or more knowledgeable of pain, both acute and chronic. In my case it's "acute on chronic", where the acute goes hand in hand with the chronic. I had tried many other pain medications with little success, until I was prescribed Methadone, and as long as I follow my prescribed dosages, I have very little pain, and it took me years to find the right medication. I suggest that you ask your doctor to prescribe Methadone for your pain, and if he or she isn't legally or professionally able to give you a Methadone prescription, then ask to be referred to a Pain Management Doctor who specializes in the treatment of pain. Then when you see the Pain Management Doctor, he or she may have something else in mind besides Methadone, perhaps a medication more suited to your individual treatment plan. I certainly hope this has given you some good suggestions. I feel for anyone who is in excruciating pain. I hope you find who and/or what you need and that you will be feeling much better very soon! Hope I've helped, and passed on a lot of hope ;) Take care & be well.

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16

Seems like your a drug seeker.
Be thankful I get what I do !!!

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17

Re: cyndi (# 9) Expand Referenced Message

I agree, as much as i'd like to get more narcotic pain meds myself for a herniated disc, you gotta try other options in conjunction. I have found torodal to be way more effective for breakthrough pain. Instead of taking more and more opioids, try to stabilize those and add other meds like better anti-inflammatories, gabapentin, electronic muscle stimulation, inversion table therapy, muscle relaxers for spasms as a result of the pain. The comment about problems down the road are very accurate and hyperalgesia is a real thing, don't ruin your pain receptors now as you need to have an option for pain control when you do get cancer for example down the road. In the meantime, don't do things that make it worse and get it surgically fixed! I am currently in a similar boat awaiting surgery, but have elected to keep the opioids at a reasonable level. I have very bad pain at times, and really try to save the narcotic pain meds only for pain when it is in the forefront of my mind or keeps me from sleeping. It's very easy to keep escalating narcotic pain meds if you are trying to reach an unrealistic level of relief. I'm happy to keep my pain at a "5" and just need to hang in there until surgery.. which at times is frustrating as I wait in bed for the wheels of medicine turn very slowly. It's been 2 months of waiting... I hear yah. This is an old post, but hopefully it will be helpful to others reading through, and i hope that you have found relief since you posted a few years ago.

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2

YEs, if you're on the regular release formulation, you may want to ask your doctor about using the time release formulation for longer pain control.

As was already mentioned, it's called Opana ER.

https:/­/­www.medschat.com/­wiki/­Opana/­

Does anyone else have any ideas to add?

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5

Damn, you get dilaudid for a herniated disc? That's sound like over kill. I have 3 herniated discs, spinal stenosis, and numerous other problems. And I don't get dilaudids and oxy or opanas..youre not in that much pain. Over exaggerated, I mean come on, I have friends who shattered legs or lost limbs do too diabetes, and they don't get that.

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9

Diladid is for break through, 1 to 2, 8 mlg every 3 hours is an extreme amount for a cancer patient let alone one bad disc. Sometimes it is psychological That you think you need more. Take some advice its a never ending circle, find a more responsible Doctor. If the day comes you end up with a debilitating disease Such as cancer nothing is going to work for you. Im not saying you are not in pain, im saying your doctor is not doing you any favors. You would be better off taking long term medication with a much smaller amount of short term. Just because someone has a medical license Doesnt mean they have your best intrest.

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