I went to my CP doc on Sept 4, and she mentioned that she received an approval for Exalgo (time released dilaudid) and 8mg dilaudid IR for breakthru pain. I was taking 90mg's of methadone daily for my long acting and using 15mg oxycodone 1 tab 4x daily and 100mg Nucynta 1-tab 3x daily for breaktru pain. I went to pick up my new prescriptions on Sept 10, for the new meds. She put me on 64mg's of Exalgo once in the AM for longterm relief and 8mg's of Dilaudid 1-tab 3x's a day for breakthru pain. I started it yesterday on Sept 10 and I really couldn't tell if it was even working, I think it was due to the methadone in my system. I will update how these med's work over the next week. I was really shocked at the price of the Exalgo 16mg tab's-120-count cost $2400-dollars I almost fell out of my chair,But my insurance thru medicare gave me an approval for 1 year..Amazing... BECK