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Dilaudid question

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Posted 10/29/2010 12:01 AM (GMT 0)
Hi all,

I was reading through some other threads and noticed someone mentioned an extended release dilaudid.  I take dilaudid now (alone with several other meds) at the 2 mg level (4 times per day).  It is prescribed for every six hours, but I take one in the am and the other three in the afternoon.  My PM is well aware of how I take the med because we discussed it thoroughly.  I explained that 2 mg helps in the am, but has relatively no effect in the PM and I need more meds to control the pain.  It's the opposite with the Ultracet...two in the AM, then one at lunch and one later in the day.

I don't generally tolerate xr or cr meds very well, but I am taking xananx 3mg cr and it works very well. 

I don't want to ask for a stronger opiate or to ask for an increase in meds because I don't want to risk having PM problems.  I was wondering if anyone had experience with the dilaudid controlled release and how it works with the body.  I tried Opana and it was WAY too strong for me.  I didn't like it at all and took it back to the PM after the first dose.  It worked WONDERFUL for the first six hours and then the rest of the med seemed to "dump" into my system at the same time.  It was not a good moment!

Anyway, the PM told me that the dilaudid and the Opana were extremely similar, but I do understand that one is hydromorphone and the other oxymorphone.  Any ideas about this CR dilaudid?  I won't be seeing the PM in person for a couple of months, but I would love to be more informed when I meet with him.

http://exalgo.com/media/pdf/EXALGO_FullPrescribingInformation.pdf

UPDATE:  I just found this site about the extended release version.  It's very interesting since I'm supposed to be allergic to sulfites.  Kind of makes me wonder about the whole idea.  Perhaps I'm not actually allergic to sulfites after all.  Perhaps I'm simply sensitive to some meds that contain sulfites.  I KNOW I'm allergic to sulfa, but I do understand that this is different.

 

Thanks all!

Posted 10/29/2010 1:31 PM (GMT 0)
Hi mom -
I sympathize with you because I am also sulfite intolerant/sensitive/allergic. I have dealt with this for years.

My allergist lumps sulfite sensitivity into the allergy group, but it's not like peanut allergy where any tiny amount sets off a reaction. With sulfite it's getting beyond your tolerance level that triggers a response. If your reaction isn't life-threatening you can test yourself (run this by your allergist!). My reaction is tachycardia, so I have to do some guessing based on past events.

There's a good explanation of how to calculate the amount of sulfite in foods at
http://www.readingtarget.com/nosulfites/
I know I can't have a small glass of wine, which that could run into thousands of micrograms, but I do tolerate an occasional slice of pizza.

I read the website you posted. There's no sulfite (SO3) hanging on the medicine molecule, but it apparently is preserved with the stuff. Your only recourse is to call the manufacturer and ask how much they put in each capsule.

I never take liquid meds without reading the literature carefully because they are often sulfited. Same for IV meds! I carry a list of meds to avoid and another list of meds I have reacted to with me all the time. Stay away from Demerol which has 2 sulfites on the molecule. Flu shots and other immunizations are routinely preserved with the stuff. Many meds, like local anesthetics are now available without preservatives. Always ask for no epinephrine when getting numbed by the dentist. I've had my tachy reaction to that in the past!

I'm currently searching for a new pain med, so your post was particularly helpful to me. I haven't worried much about pills and sulfites!
Posted 10/29/2010 5:00 PM (GMT 0)
I wish I could help you about the extended release for of dilaudid. I take the regular version myself, and I can relate to you how it works for me and maybe that will give you some food for thought.

My PCP started me out a 2mg 3x day and at that level I had some relief for about an hour or so and then a return to full pain. She upped it to 4 mg 3x a day and at that level I was getting a good 4-5 hours of solid pain relief (go from a 6-7 to a 2-3) and then would have my pain levels return to their normal levels over the next 2 hours or so. Of course this was before she insisted I do another round of PT which only caused everything to flair big time so now my normal pain levels are a 7-8 and go down to a 4-5 for 3-4 hours. Sadly that happened several months ago and my back still has not calmed down, but that is another story.

Anyway the entire point is that I did see a huge increase in pain control with going from 2-4 mg of the dilaudid both in quality and quantity.

A suggestion. if you try the er version and it does not work or your doctor does not want to try it you can try talking to him about going to the 4 mg either all day or using the 2mg in the morning and the 4mg (regular dilaudid) in the afternoon and see how that works out.
Posted 10/29/2010 11:58 PM (GMT 0)
By the way, dilaudid can have sulfite in it also. I would check any pain meds with the manufacturer, especially generics.
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