What pain killer is egual to the Opana ER 40MG, A replacement?

No, it's not the same. Opana is roughly 10 times the strength of MS-Contin ( Morphine Sulfate Continuous release). Also taking MS-contin on an empty stomach will make you pretty sick feeling or worse. Just trying to help, please don't think I'm trying to be a "smarty pants!" Love ya all! in Christ! It's unfortunate also (I know this comment I'm commenting on is 2010) In 2012 Endo Pharm. changed the formula of Opana ER's to an abuse resistant drug, which is all fine and dandy but I started passing whole undissolved pills in my stool ! The pain management effect was decreased dramatically. Since it was an absorbtion and dissolving issue I took a 1/4 of a 40 ER, very cautiously and scared, but I was suffering greatly, Flattened it to expand the surface area and carefully sliced it with a utility knife into fine little threads (tough way to go but desperate) took it orally and low and behold, over 12 hour time release pain management.

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Thank God! I'm still changing to something else (hard to replace). They obviously went overboard on the time release mechanism, especially for those like me with a lower stomach acid PH. I obviously can't continue to manipulate my meds. Good bye Opana, Goodbye Endo Pharma. inc! Good bye your stock prices, simply obsurd!

Hey daddy01! Yes... Read about the "Exalgo" - no "ER" - just "Exalgo". I did my research before I answered the initial question... First, I called MY Pharmacist, (one of the top chain drug stores in the U.S.) who said "No one has ever even asked about it-you are the first person! We do keep a bottle on the shelf, but no scripts"... Second, I went to the Boards - I couldn't find 1 person who was "using" Exalgo. Found many who had questions, even people whose Docs were considering prescribing it to them, but again, no one was up to taking a 24 hour drug that was just okayed by the FDA on March 1, 2010... especially w/KNOWN respiratory issues, and Exalgo (unlike the Opana's) "primary" indication is for "OPIOID TOLERANT PATIENTS" - (below). THAT's when I went BACKWARDS - informing "R" of all the similar type meds I had taken - all twice - and what MY experiences were when I took the meds.

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Even included my friend who has RA - for 30 years - and takes Oxy & Dilaudid for BT - she's quite content w/her Oxy - but to many side effects for me! AND "R" would have to take 160 mgs./day - AND Oxy is NOT AS STRONG as the Opana's... Correct me if I'm wrong, because I'm recalling this from my PDR, Oxycontin is indicated "for moderate to moderately severe pain:; Opana is "for moderate to severe pain... "

Please read the statement below from the manufacturer of "Exalgo"... (IF "R" is Opioid Tolerant, then YOU can recommend it - I stand by Dilaudid - BECAUSE IT'S ALL WE HAVE IN THE U.S. AT THIS TIME! Palladone would have been Grand - a long acting HYDROmorphone was FDA approved in 2004 and removed by Purdue following the FDA's "recommendation" - less than a year on the market, about 12,000 people were using it at the time... The removal had NOTHING TO DO WITH EFFICACY OR RESPIRATORY PROBLEMS - it was because the people who use pain meds TO GET HIGH - found out how to "crack the nut" on the Palladone - thus enabling the entire amount of the drug to IMMEDIATELY flood the bloodstream... So, another one bites the dust - leaving patients, like me & "R", without BETTER ALTERNATIVES! However, there's always Mexico and Canada... and other European/Asian Countries that have loads of pain management weaponry... just might want to plan your next trip to one of those countries... just a thought..not U daddy01-whoever else reads this!)

This "statement/label" by Covidien (manufacturer) of Exalgo - March 2010.

"The indication for EXALGO is once daily administration for the management of moderate to severe pain in opioid-tolerant patients requiring continuous, around-the-clock opioid analgesia for an extended period of time. EXALGO is contraindicated in opioid non-tolerant patients, in management of mild pain or pain not expected to persist, in patients with compromised respiratory function or in patients with narrowed or obstructed gastrointestinal tract or with known hypersensitivity to any components including hydromorphone hydrochloride and sulfites. Concurrent use of EXALGO with CNS depressants, including alcohol, increases risk of respiratory depression, hypotension, and profound sedation, potentially resulting in coma or death. Not recommended in patients who have received MAO inhibitors within 14 days of starting EXALGO."

That CHANGED MY MIND about EVER asking for Exalgo (even if someday the Opana's stop working... ) And UNLIKE "Exalgo" - there's a FOUNTAIN of info about Opana ER and Opana - opana.com - even how to convert the opioid you are using now to a dosage of Opana - "must be" (hmmmm) a Health Professional to CLICK ON THAT... LOL... "just sayin'... " It'll tell U how strong your med is compared to Opana - .5 means 1/2 as strong as Opana - Oxycontin, Dilaudid 1:1 means "same as"... I went to the manufacturers site for "Exalgo", there was 1 paragraph in a PDF file! (Man, I should get some $ off - sounds like I'm promoting Opana!) Not, but when I made the comparison between the 2, I was amazed... and since it was my "drug of LAST choice" (nothing else working) IT SAVED MY LIFE! I now have a quality of life I didn't have before. Yet it IS temperamental; the food thing; NO ALCOHOL (don't drink anyway) - but still not 1/2 as many do's or don't's as the "New Kid on the Block" - love to hear back from someone who's using the new Exalgo!

No, haven't forgotten about "R" - who's the reason we're here! Please understand that there IS a difference between Dilaudid (Brand Name-MANY Generic's available) is HYDROmorphone and OXYmorphone is Opana's Brand Name - no Generic Available). However, the STRENGTH - or efficacy will be the same - or as close as you can get (everyone's different & most people do take other meds or OTC's. Most double blind studies do not include other drugs - it's just the Placebo VS the "Study Drug". w/Dilaudid, the BRAND NAME is KEY. Dilaudid Brand is about 5 times - give or take - stronger than Morphine - MS Contin/Kadian - morphine sulphate. Read too many people's stories about their "dislike" of the Dilaudid generic from "M" Co. - but understand Roxane Labs makes a "Dilaudid" - is 1/2 the price and is one of the few good generics - according to my friend who takes for BT, but used to be on it before Oxycontin came out!

Since "R" is taking Opana PO, there shouldn't be any problem w/Dilaudid, since Opana is the strongest PO Narcotic I've found. "Possible contender - Duragesic Patch - which I do not recommend because of the Sedative that they put in w/the Fentanyl and even the Fentanyl pill is listed as an "anesthetic" and "analgesic". Made me crazy... U can read your Doc's PDR next time you're in his/her office - OR local library - OR possibly your Pharmacist - if you're a regular... . I won't try generics AND none of my Docs would give them to me anyway. There IS a difference! - Last time I said that to a woman "Generics are not the same as Brand Names" - she said "Tell me about it - I have a son 8 years old to prove it - I was on The "Generic" Form of The Pill !!" LOL!

Okay-off topic - but I still stand by Dilaudid BRAND. Here's why. "R" is taking 80 mgs. of Opana ER. He can take 10 ... divide it into 4-6 hour dosages and manage his pain as he/and his Doc seem fit. It simply gives him more "wiggle room". He can take less, he could take more-if the pain became acute and the Doc agrees, he may just need it during the day or only during certain activities. If ANY of these makes sense - don't go to a 12 hour/24 hour pill - IT'S HELL TO GET OFF IT! Especially, if there's an operation on the horizon. Years away - I'd probably still go w/Opana, but my condition(s) again, cannot be fixed by surgery...

BTW, after 4 years of taking Opana ER and Opana, I cut down my daily dosage - w/o narry a side effect. Slight unpleasantness for 30 days - but nothing that was critical... And I'm Very Sensitive... Now THAT is the only drug I've been able to do that with. Normally you develop a tolerance - not so, I've become much more sensitive - even AFTER an INCREASE in PAIN and disease progression, I was still able to do this. I think it's amazing. Like I said earlier, I had had a "stomach" problem. ALL narc pain relievers are influenced by food PERIOD. Sometimes the efficacy drops even though the blood plasma level of the Active Ingredient(s) in the drug increases due to the intake of food - figure that one out! Food in your digestive tract and/or your stomach while taking Opana will raise the Blood Plasma levels, AND LESSEN THE EFFECTS AGAINST PAIN! Much much better on an empty stomach; plus, it hampers my appetite anyway!

So even if you don't have the "stomach" problem(s), it is best to follow the "Golden Rules of Opana" - Wait, at LEAST 1 hour BEFORE YOU EAT (after taking Opana ER or Opana) and wait AT LEAST 2-4 hours (probably more if you've been on narc relievers awhile as it slows metabolism/digestion) AFTER A MEAL before U take Food, Vitamins, &/or Herbs. If you have problems w/constipation, try a Probiotic - no matter what type of Opioid you're on - semi-synthetic or synthetic (Methadone) many people have constipation problems. Just ask your Doc first though... This "Tip" comes from Docotoroz.com - I watched the show - this was one of the mistakes most people make at the Drug Store. Buying a Laxative VS a Probiotic for Bowel Movements. Laxatives are Stimulants and even though I sometimes "skip" my daily Probiotic - for healthy intestinal function and immune function - I've NEVER EVER had to take a Laxative. Most Docs give you a script or tell you to get some Probiotics AFTER a course of ANTI-biotics. It's a good regimen, and even helps with GERD. MUST be Refrigerated OR specially coated so for this, I go to my Health Food Store, not the net. I take 20 billion/day-12 different "strains" of Good Bacteria! It helps! I take them 2-3 hours after my Opana ER's..So, FOR ME, I take my Opana ER's at 6AM and 6PM and BT's PRN; still have to follow the Golden Rule for the regular Opana's too...

I hope this helps Daddy01 understand WHY I didn't or wouldn't recommend Exalgo... And I, with due respect, the REASON I was given Opana was NOT due to Opioid Tolerance - it was due to the fact that Morphine did 0 - and is usually the 1st 12 hour drug any Pain Specialist gives you - it did nothing for me. And nothing for any one else I queried who were on "other meds"... There simply aren't enough drugs out there w/o side effects, that are long lasting... and we can thank "the abusers" for that one... For people with chronic or acute pain, cancer, etc.PAIN RELIEF can make us or BREAK US... Because all the Newer drugs don't get past the FDA or are pulled - some not even because of 1 death, but because of "the potential" for abuse - leaves us w/little to fall back on!

I really hope "R" gets all the help he needs... MORE than just meds - I'm extremely glad he has you for a friend - because he definitely needs you. Glad I could explain; hope I didn't offend ya - but I ALWAYS do my homework - and I do come from a medical background, along with my med experiences. People can gather their info from this response along with my initial response to "R"... Let them choose.

Just one more thing - when you take a 24 hour med - or ANY MED - know which "side effects" you may experience - and which ones "you need to call a Doc - As a "General Rule" if you have to call your Doc - he/she will send you to the Hospital. Don't be afraid. There they can assess you and make certain it is NOT LIFE THREATENING. They most likely will not give you anything if it is NOT Life Threatening - but you can "ride it out" in comfort and not worry as much, because you'll be surrounded by caring people. It's ALWAYS BETTER to be "SAFE THAN SORRY" - NEVER FORGET THE DOC WORKS FOR YOU! W/O YOU they wouldn't have a job. So even after hours, or weekends, CALL! God Bless you R and I hope you find the Best Solution FOR YOU!

Think U may have "Demerol" - meperidine - used in hospitals - (IV or IV push) confused w/Dilaudid. BOTH are used in the hospitals BUT Demerol PO is rarely, if EVER, prescribed as the pill lasts only 2 hours... Haven't EVER seen an RX written... except 40 yrs ago! Dilaudid is the "drug of choice" for the PCA's - for pt pain relief - at the pts bedside... following surg or whenever there is a pt, who is awake and coherent, who necessitates pain relief. Demerol is also used for many procedures - such as colonoscopies, dental, & post-op surg pts who don't get the necessary pain relief from Dilaudid.

All Covidien did was to make a 24 hour pill of HYDROmorphone (Dilaudid) and an 8 mg IR pill for BT pain - Both "Dilaudid"... 1:1 w/Opana ER & Opana - though the Opana's are OXYmorphone...

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So when I said "simply Dilaudid"... I MEANT "simply Dilaudid"... the 4-6 hour pill - which can be easily divided into appropriate dosages to control R's pain... since it seems like he simply stopped taking it! Plus I have no info on if he did that Cold Turkey OR had another drug to fall back on... Looking at his userid, I feel like he may have simply stopped! Do more research on Exalgo, read the boards, talk to your pharmacist, your doc - then, maybe you'll see why I DID NOT RECOMMEND IT for R! (And though my post is still not up - they're still reviewing it - Opana ER is indicated for around the clock pain relief for pts who have moderate to severe pain round the clock - Exalgo is indicated for OPIOID TOLERANT PATIENTS~

(I replied to your initial comment in more detail; guess they're still reviewing it - got carried away - think I wrote a book!) God Bless U & R - Hang Tough!