My first day(s) on oxycontin

Hi All,

After 5 years on Ultram ER, and one year of expressing to my PM that it was no longer adequate (it used to be very helpful), he switched me to oxycontin (as I mentioned in a past email).

Right now, I'm transitioning from one to the other. I have stepped down to 200mg of Ultram ER and am using just one 12hr 20mg oxycontin in a 24hr period. In 5 days, I can move on to 20mg every 12hrs -- if needed. I'm hoping, though, that the one pill will suffice. 90% of the time, after lying down for 2hrs or so, my pain is mild and so usually don't need meds from 11pm-9am.

As for pain yesterday, I had two bad periods. I did the grocery shopping and came home in pain and then sitting through dinner. It seemed to me that the pain levels were about on par during those spikes, but they dissipates more swiftly. I also didn't take any BT meds, and endured.

Last night I felt very anxious and vaguely strange in the head. Perhaps that was because of the drop in oxycontin. Around 2am, after trying to fall asleep for about an hour, I took .25mg of xanax and that allowed me to sleep.

This morning, I woke up in more pain than usual, but it is damp here and even my wife (who has a stress fracture in one vertebrae) was complaining of back pain. I took my meds roughly 90 minutes ago and mentally fell fine, but still the pain is a bit on the high end for this point in the day). I'm going to write for the next hour or so, and then we're going to go out for lunch and a bit of walking around at the mall. I'll bring a BT med with me, just in case.

Glad to hear it's working to help with your pain as I had mentioned in a previous post....it's so wonderful your PM has made such a leap in prescribing and really wants to help you manage your pain.

It's really going to be up to you on whether it will work only taking one 20mg Oxycontin a day...

The other choice is to maybe have a prescription for the 20mg Oxys and then get 30 pills of a 10mg Oxy to take one at night. That way, you aren't going up another 20mg but only 10....

That would be 30mg for a 24 hour period. This is something to ask your Dr. about after you do your check in...

Personally, I don't like using any type of benzo to use for sleep or pain. They are meant for anxiety.....I understand that some Drs. use these off label but that is something my particular PM has mentioned (not for me...just in general) that too many people use this in the wrong way.

So...obviously none of us can tell you what you should do or what would work for us as it's your health, pain, and working with your Dr. on what will help you.

Just some thoughts....

I was just thinking that if it is true withdrawal issues....then the short acting Oxy...no matter the dose...would still wear off in the middle of the night and then you have the same problems..Especially upon waking, when you take the 20mg Oxycontin...it will take time to start working.

Again...certainly your choice but the 10mg would work all the way through the night to gradually have the medicine go through your bloodstream.

I have prescriptions for both 30mg and 15mg MSContins for this very issue when I need just a bit more of the extended release on some days or can add two 15mgs on the other days (bad days). I like having the flexibility so I am not tied to always doubling my dose.

I'm sure you'll keep us posted...

Hello Medhelper,

This move to oxycontin comes after 8 years of chronic pain, nearly all of which was being managed by tramadol. It, however, became progressively less effective and after trying a few other options during the past year (ranging from additional hyrocodone to low-dose morphine), I'm hopeful that this will make enough of a difference.

My pain is due primarily to my scoliosis, which has bone pressing on the spinal column as well as compressing nerve roots. Although I exercise, stretch, and have been seeing a physical therapist for years, these measures (as well as various injections into the muscles and the spine itself), have little impact on the pain. In order to work, I need to reduce my pain levels and so far, the oxycontin has been helpful.

Welcome to the chronic pain board.

Hi Cognito. I really think that the Oxycontin will be much more effective if you also take it at night. Maybe your doctor can add a 10 mg. or 15 mg pill at night (if you're reluctant to take two 20 mg pills)/ I think it will make a huge difference, as your medication levels won't be going up and down.

Hmmm...I've never had that. Maybe it will go away with time. Does it make taking the medication intolerable?

I remember that when they changed the formulation, it took me weeks to get used to the medication. It made me dizzy, nauseous, etc. It just took time. So maybe with time these side effects will dissipate.

I thought I would wrap up this thread with a few more observations.

I've now been taking oxycontin for a full week and today will be my first day without any tramadol.

I was worried that I would experience some adverse reactions to dropping the latter, but did not have any. On the 19th, I took 2x 50mg tramadol IR then on the 20th and 21st, just 1x 50mg. Although I've read here and there that tramadol withdrawal is much more severe than expected, I didn't have any relevant issues (or they were masked by the oxycontin).

In fact, since the 20th, I've felt great. My hip pain is almost non-existent. I've had zero pain from it except for a transitory ache once or two after sitting too long (or playing xbox-kinect bowling with my wife).

My back pain has gone down from a norm of 3-4 to 1-2 for most of the day. Pain spikes still occur, but are muted -- hitting maybe a 6 vs. a 7-8. They also dissipate more swiftly.

However, since I'm taking just 1 12hr 20mg oxycontin per day, I will have more hip pain in the evening, though still not as bad. Rather than taking BT meds daily, even multiple times per day, I've gone without any BT needs most days.

Headaches, head pressure, etc. have all gone away (at least for the past 3 days) -- and I am so thankful for that. They have been as much of an impediment to working as my chronic pain. My bowels even have gotten used to the medication. I was constipated for the first three days, took some citricil to help one night, and have since done fine just with my morning coffee.

From about 10am until 3pm, my energy is very good. The oxycontin is a bit "activating" at first, as it releases a fair amount of the full dose during the first two hours. It makes me feel a bit drug-loopy for a while, but it doesn't interfere with my concentration. So, not only have I been able to get a lot of writing done over the past few days in particular, but also I've felt up to going out more and taking care of a few things around the house.

Later afternoons, I start to feel a bit tired (but not too bad) and by 11pm or so, very tired -- more tired than I should be from the day. Because of the drug swings, I feel a bit crummy at night, and in the morning until I take my pill. But since I'm rarely in pain at night, I can likely do without a second dose.

Assuming the oxycontin continues to work well without side effects, and my PM is satisfied, it looks like this pill regimen will work out well. It would be nice to offset the crummy feeling I get once the oxycontin has left my system in the evening, but assuming it isn't dangerous or an impediment to daytime overall efficacy, I can deal with it. I'll see what my PM says.