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Help with Breakthrough Pain Meds

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Posted 2/21/2011 8:13 PM (GMT 0)
Hello all, I am new, and have a question. First off, I have 3 ruptured lumbar discs, fibromyalgia, spinal stenosis,fractured sacroiliac joint, arthritis in hips, knees, ankles, etc and am in constant pain without my pain meds. I am prescribed Perc 10/325 - 120 a month. In the past 6 months, my doc and I have been trying different drugs for breakthrough pain as the perc does not do the job many tiimes and I continue to be in pain even with the percocet (generic of course). He prescribed Roxicodone 15 mg, 120qtr for "pain not relieved by baseline pain meds" (that being the perc 10/325). Together, they are controlling my pain very much better and my quality of life is much better. My question is this: How often should I, or can I, get the breakthrough pain med refilled? Should I request it every 30 days just like I do the perc? Or wait longer? Any input would be most appreciated. Much thanks. confused
Posted 2/21/2011 8:34 PM (GMT 0)
it depends on when you run out....when you run out, you go get a refill.

and you only take the roxi, when your percocets don't cut it for the pain. just don't take the roxicodone if you are NOT in pain and you should not have any problems.
Posted 2/21/2011 9:06 PM (GMT 0)
Thanks for your response, I find myself needing the roxi most days, as I have a pretty active lifestyle, children to care for, and pain doesn't go along very well with that. I just don't want to raise any red flags with my doctor if I request a refill 30-40 days after first prescription for it. Before he put me on the roxi, he tried Panlor SS (which has WAY too much tylenol in it), and then Ultram (which is totally useless for me). This is the third breakthrough drug I have tried, and it does provide relief. FYI, I do not go to a pain clinic, my internal med. doctor prescribes all my meds.
Posted 2/22/2011 4:07 AM (GMT 0)
The roxidone is the same as the oxycodone in the percocet you are taking. You are basicallly more than doubling the oxycodone in the percocet. You have 10 mg oxycodone in percocet and 15 more in the roxicodone, ( another brand of oxcodone.) By doubling what the med was other than tylenol, I would expect that you have gotten much better pain relief. That is a lot of oxycodone, it would be better to take the long acting form oxycodone ER, that last for 12 hours, rather than the percocet which lasts 3=4 hours, twice a day, and use the percocet OR roxicodone for breakthrough meds. the dr not being a pain management dr may not feel comfortable prescribing the oxycontin, but it give much better sustained relief. I have not heard of using two short acting drugs in this combination. Youmight ask about a longacting or sustained release med, and use one of the two you have now for breakthrough meds.
Posted 2/22/2011 8:27 AM (GMT 0)
Hi JM and welcome to Healing Well's chronic pain forum. I am glad that you found us but sorry that you have to be here. There just seems to be more and more people out there that suffer with CP. At least by coming here you know that you are not alone with your suffering, there is a lot of us here suffering right a long beside you.

I have to agree with what Purple has said about you being on two medications that are the same except for the one with Tylenol in it. I have never heard of a dr doing that. That is kind of scary to me. Like Purple said both of your meds are generic Oxycodone made by different mfg. Perhaps you need a consult with a PM dr for medication. I have had 3 different PM drs explain to me that the BT meds are not to used every day, if they are being used every day then your pain medication is not doing its job in covering your pain. You have a base line for pain and then if the pain spikes thats where the BT meds come into play. If you take the BT meds like your regular pain meds your body becomes use to having that dosage in your system and thats not using it for BT pain.

Anyway, I wanted to pop on and tell you welcome aboard. Please keep us posted on how you are coming along.
Posted 2/22/2011 10:18 AM (GMT 0)
Stray:

I have a question for you...now you say that your BT med should not be used every day. That is what 3 doctors tell you. But what if you have BT pain every day? I mean with me I take a very strong dosage of Kadian 2 in the morn and 2 at night 200mg capsules. The Kadian lasts about 6 hours before I start to get BT pain. I know, I've been on it too long, its been 5 years since my original Pain doc put me on them, but my new pain doctor refuses to change it up saying that I am on the strongest long acting pain medication possible.

I cannot take the patch cause of the glue...allergic. So I take my BT medication every 8 hours and it seems to cover me pretty good. But here is the thing, if I'm active for the day I need my BT med a little sooner cause I seem to hurt every time if I'm more active.

So, anyway I just wanted to ask you that.

Scarred
Posted 2/22/2011 6:25 PM (GMT 0)
Yes, Scarred, this is what my own three PM drs have told me about BT meds. I understand the theory of what they are saying if the BT's are taken on a regular basis and the body becoming use to that amount of medication. These are all PM drs, including my current one. It sounds like you may be caught in the trap if you have been on Kadian that long and its not effectively covering your pain.

Sorry didn't see this one sooner to answer.
Posted 2/23/2011 2:34 AM (GMT 0)
Sorry for hijacking this thread a min, but I still don't understand. Do you not have bt pain every day? Cause I do.....every day of my life I have some sort of bt pain. I messed up on the amount of kadian that I take,btw, I take one 200mg capsule twice a day. The breakthrough I take every eight hours, so its usually 6 hours after I take my first Kadian when my bt pain starts. Then its another 6 hours before the pain starts again, but I can't take another bt pain pill for another 2 hours.

My pain doc will not put me on anything else for the pain because she says that I am on the strongest that we can find for my situation
Posted 2/23/2011 3:42 AM (GMT 0)
Once in a great while not often will I have a day of no BT pain, I have pain but not the big spikes of pain. As it was explained to me we all have a baseline pain to work off of. Then we have the spikes of pain that are beyond the normal baseline and I was told that is called BT pain. Mine is not always the same either in intensity, if it is something I can deal with then I do not take my BT meds, I save the BT meds for when the pain is way up there. I have done it this way for years as this is how my PM drs always instructed me on doing the BT meds. When I take my BT meds I do get a great deal of relief and maybe since I do not take BT meds daily this could be why my BT works better than yours. I am not left hung out waiting to take the next pill because the meds are keeping the pain in check. My body is not accustomed to that specific amount of medication around the clock 24/7. Like I said, I understand their theory with the BT meds, may not agree with it, but I understand it. I am sure having a high pain tolerance is what has saved me many times over the years.
Posted 2/23/2011 6:55 AM (GMT 0)
Perhaps, the Kadian is only working 8 hours or so, like oxycontin does for me, and I simply take it every 8 hours instead of 12 hours. I do not know if the kadian will /can be taken that way also, Perhaps, take the 2 in the am, 1 6 hours later and then the fourth 6 hours after that. By spacing them, it may help it from waning. Just a thought. It also does not increase the amount you are taking.
Posted 2/23/2011 3:30 PM (GMT 0)
Take my Kadian like that? I'd be kicked from my pain clinic! Seriously I don't take my meds like that. It's like clockwork usually, unless I have forgotten to take it cause I was doing good for the day, then I just wait for the evening dosage unless its still early. I figure that if I haven't taken my Kadian (which is my long acting med) by 10am then I won't take it until night, cause it screws my whole schedule up.

The oxycodone is my IR med for BT pain. I take it if I have a rough BT pain, like today. If I don't need it I don't take it, but it's usually (especially in the winter) a daily affair. To tell you the truth, I wish they would change up my Kadian, I think I have developed a tolerance to it. But, that one isn't going to happen since my doc says no each time.

Hell I would have still been on the percocet if my liver hadn't totally squalked about it.

Hugs

Scarred
Posted 2/24/2011 5:48 AM (GMT 0)
I did not mean to take the kadian on a different shedule without consulting your dr. I told my dr. that the oxycontin only lasted me 8 hours at most, so mine is now presribed to take three times a day, every 8 hours. It was a suggestion to take to your dr. that orders the meds for you. I also am at the point that I need my breakthrough med everyday, and that means I should go up on my extended release meds.
Posted 2/24/2011 9:08 AM (GMT 0)
Thank you for clearing that up for me purple. I wasn't understanding what you were saying. My Pain doc will not go up on my Kadian at all. She refuses to budge on that one. Says I am already on a high strength of medications and by pushing the Kadian to different schedule it won't help.

Maybe I will do some research and see if I can't arm myself with some facts before I go in next time. See if that works to change up my meds a bit.

Hugs

Scarred
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