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Kadian...how long does it take to kick in?
Kadian...how long does it take to kick in?
I've been struggling with chronic pain for almost eight years now, having been on countless painkillers, anti-inflammatories,muscle relaxants, everything. Finally, after maxing out the dose on Norco 10/325s, my doctor sent me to a Pain Management Clinic, where I was given an epidural steroid pain injection. The doctor also changed me over to Kadian, a long acting morphine painkiller, to help with the withdrawls of Norco and to help with my constant pain. Here's the problem, he won't give me anything for breakthrough pain because he doesn't want me to abuse it. But the pain from the epidural injection is terrible and, he said, could last for up to four days. Then he said, the Kadian can take up to seven days to work.
So I have to go through these four days of sharp, terrible pain with no or very little relief because he's afraid to give me 30 vicodin to be able to go to work, take care of my child, do anything that requires sitting in a chair?
Has anyone taken Kadian? Does it really take that long to build up in the bloodstream and kick in?
You should get relief the first day after taking the sustained release morphine.Hydrocodone isn't a very good painkiller for chronic pain as it only last's a couple hours and your tolerence grows quickly with it.It should only take a couple days for your serum level to average out.You should still get some relief seeing that morphine is quite a bit stronger then hydrocodone.Give it a few days and I bet you'll find it to be a great pain killer.Good luck......Dave
Originally Posted by mpvt
Thanks so much. I know I have a high tolerance to hydrocodone, so I don't want to get back on that train, but this is fullday four of the Kadian and I'm only noticing the SLIGHTEST relief of pain. It's really frustrating. I'm over the withdrawl of switching from Norco to Morphine, but I still have very sharp and burning pain from my sciatica. Could this just be a matter of needing a dosage adjustment? Are rescue meds usually prescribed with Kadian?
Morphine is just slightly stronger the hydrocodone, I suspect taking the hydro you have a higher blood plasma concentration then you do on the Kadian, since it's a CR. If you graphed it out you would see over time a fairly straight line with the Kadian, whereas you would have more peaks with the hydro line over the Kadian line. It probably will take 4-6 days for your bodies tolerance to the Hydro's titration to adjust to morphine CR.
Rescue meds? Do you mean breakthru meds? When you say rescue meds, I think of Narcan, but I don't think that's what you mean. Yes, sometimes doctors will Rx a BT med, but probably not so soon after a med change, first he/she wants to see where your pain level has leveled off at. If you need a BT along with the CR, then the CR isn't doing it's job and you need something stronger, unless you only need a BT on occasion.
Right, I meant breakthrough meds. My GP calls them "rescue meds". When I was taking Oxycontin ER, I had like 60 Percosets on hand for terrible pain, like I was in yesterday when I unexpectedly had to walk a mile and a half. The Kadian did nothing. What I'm most frustrated with is that when I called the doc to tell him that the Kadian really wasn't doing anything and could he even just give me 30, I don't know, lowest dose vicodin so I can sleep through the night without getting up to put ice and heat and all that ********************... but he keeps saying "hang in there". I'm not going to see him for TWO WEEKS. It's pretty hard to hang in there. I'm not used to this much pain.
My fear is that since he is a new doctor, who doesn't know my life story, that he thinks I'm a drug seeker, but I'm not. I'm all but thrilled to take a CR drug once or twice a day...but I have to be able to function. And I know calling my GP would be doctor shopping, so I'm just taking flexeril to pass out at 7:30 and just be unconcious until I go to work. It's really frustrating.
My opinion of pain management has really dropped.
What you have to understand is, breakthru meds are meant to be taken only occasionally.If your taking them everyday then your not using them as breakthru and all your donig is building a huge tolerance to quick acting meds.Which overtime makes it harder for the kadian or whatever sustained release your taking to work.
So most doctors nowadays only order a small amount of breakthru.If you're having to take your breakthru everyday then you need your sustained release med increased.Breakthru should only be used occasionally..Good luck.....Dave
I have no desire to use a breakthrough med every day. But since I originally injured my back, the slightest thing can trigger an acute pain that needs immediate relief, not a low level "just take the edge off" relief that this Kadian gives. I'm not a junkie looking to get high on this stuff, I want to be able to pick up my kid, exercise, do physical therapy, live my life, do laundry. Two weeks ago I was taking Norco, 8-10 a day, and I felt perfectly fine to do all of these things and more...but I knew that that was too much tylenol and I was going to build too high of a tolerance.
Today I'm taking Kadian, going on my fifth day of it and I feel just this side of terrible. I can sit at work, but when I stand up it hurts, driving hurts, sleeping hurts. If this is all he's willing to do for me, I'll go back to my GP.
What strength Kadian are you taking? You definitely sound under-medicated. If you took 10 Norco 10's that equals 60mgs of morphine, that should be around your target dose now.
Meanwhile, try taking your pill with some fatty food, like bacon, it may increase analgesia, it does with Oxycontin, it's worth a try.
I'm taking 20 mgs of Kadian, twice a day. He says I 'shouldn't' need any more than that and i should just "tough it out". I go in for a second epidural injection next wednesday and i"m already terrified. They are extremely painful and the residual pain from them lasted about four days last time, and the Kadian didn't help too much at all. I just can't help but feel like he's trying to test me. The nausea has abated a bit. i take the pill after breakfast and after dinner, but I still get frequent headaches. Is it possible that by blowing my hydrocodone tolerance through the roof that opiate pain killers won't work for me anymore? That's my biggest fear.
i mighty know what you need to know
I have been on kadian for 3 year and i take 60 to 90 mg two times a day it should only take 30 mins to kick in you might be on to low of a dose talk to your doctor squeeks
Originally Posted by chijessi
Chijessi, 20mgs bid is way less then your were taking, no wonder you're not feeling good, I expect, and your doctor has to know that you're in semi w/d's right now, that's not very kind of him, idk why a doctor would do that, it's not like you have an addiction problem. What a lousy doctor, sorry to say (no I'm not). Right, you know that tolerance is the problem, eventually your tolerance will level off, but I guess meanwhile you're SOL.
I think you have good reason to refuse the epi, tell him exactly why. Those procedures don't usually work anyway, I've had 5 of them, the second time did work for me, but it only lasted for two weeks, then my pain came back. My doctor always gave me an extra bump in meds after I had the epi done.
Opioid meds will work for you if you're medicated sufficiently. Sorry, you got stuck with such quack, maybe you should talk to your GP?
I am no fan of Kadian. It does take a while. I took the medication for over a year in combination with Actiq; for break through pain. This was in combination with other meds and proved to be sufficient at the time. The side affects of the prolonged use of the Kadian was too much for me.
The Actiq though more than made up for it. Actiq in the 1200 & 1600mcg dose would alleviate the pain for the acute, breakthrough pain. Later, I changed from Kadian to using the Duragesic patches. I also lost the Actiq and ended up with Percocet. I found relief with the Duragesic, for the long term chronic pain. The Duragesic 100mcg patches would work effectively for about two days and I would change the patch early into the third day, give or take my pain levels. Of course with the pain relief comes increases in tolerance to the medications. I don't even remember where I started with such medications like Actiq and Kadian. I can tell you this after ten years later and having jumped around the entire pain mgmt globe of meds.
As useless as this might sound - my diet, ability to excercise (taking into account my limitations from my disabilty), and holistic therapies have been best when used with minimal usage of said medications. The physical dependency and adverse side effect issues relative to all of them - from Kadian, Actiq, Duragesic, Lortab/Norco, Percocet.. you name it, are tremendous over a prologed period of time. And the epideral injections were only temporary. There is also a chance of scar tissue buildup after having the injections a number of times. For me, over the years I have had around 9. They come usually in a series of three. I stopped after that and refused to have them any longer.
In the meantime, as with all medical issues, consult with your doctor(s). I am simply giving my two cents worth. My nonmedical professional opinion. Relative to simply venting and recalling my years of pain, like so many of us. Hang in there. I know where you are coming from.
Originally Posted by chijessi
Everybody is differant and doctors need to realize that. You are ENTITLED to pain medication unless he can prove you wrong (which they can't unless you really are seeking pain meds which you say your not and I believe ya) They can call pharmacies and see that your not getting any extra pain medication if I were you would demand better pain relief or you will seek help elsewhere. Thats what I did.
Originally Posted by chijessi
I can't comment on how long Kadian takes to kick in as I came here looking for that same information, but after all of the research I've done, especially on government sites, I will agree that you were SERIOUSLY under-dosed. I hope that since you've posted that either your doctor woke up and felt the pain or that you found a better one. Just because a doctor is a specialist doesn't actually mean they know what they're doing. Kadian comes in high doses meant specifically for opiod dependent patients. I'm not calling you an addict, but having been in the same boat with Norco as you, I know the body develops a dependency and it's a shame that doctors would rather think the worst of us than realize it's the meds. My newest pain management specialist (we've moved A LOT) had put me on Kadian 20's ONE time a day. I was back in his office the next day giving his little helper hell because not only did it do almost nothing for me, it aggravated my anxiety to the point of throwing things around the house before I had the chance to have withdrawal symptoms from Norco. I had my Norco for the day and was directed to take the Kadian just before bed, I did wake up with slightly less pain, but in less than an hour I was shouting at the kids and throwing things in the kitchen because someone left an unrinsed empty milk carton on the island. They put me back on Norco and 2 weeks later prescribed some other extended relief medication that I decided to research thoroughly before taking (I usually avoid reading the side effects in order to avoid a psychosomatic response, I'm prone to that). That med was under no circumstance to be prescribed to a patient with anxiety. It's right in my chart that I am under psychiatric care and am on medication for anxiety! Another point to show that being a specialist does not mean a doctor knows what he's doing: I have multiple herniated discs in my neck and mid back (it just happens, no accidents, they didn't happen at the same time - no one cares to investigate why this keeps happening). Since my previous MRIs had been 3 years prior, my doctor decided to order X-Rays and an MRI on my C-spine only. Even though that imagining showed 2 herniated discs that were bulging worse than the ones I knew about, the doctor refused to order an MRI on my back. I was in the office with one of my doctor's "mid-levels" when we got the results of the MRI and over the phone, my doctor discussed the situation with his mid-level and they decided to order epidural injections without consulting me. During my new patient questionnaire, I had made a point to note I had those injections before and that the outcome was pretty bed. All they could say was that they could go in from a different angle. First, the doctor that did the original injections was the only pain management doctor I have ever trusted, second, she was on the other side of the country and had done the procedure 3 years prior. How would they know what a different angle would be? I decided to put off the injections and wait the month to see the actual doctor. He took one look at my MRI and decided the injections wouldn't help anyway. They gave me trigger point injections in office that day, completely missing the spot in my lower back by a good 5 inches and told me that should last for a few months if not permanently because sometimes the body just needs to reset. Those were the shortest lasting trigger point injections I have ever had. Within 4 hours I was writhing in the after pain of the doctor digging around with the needles AND my normal pain had returned in full force. So as I said, just because they're specialists does not mean they know what they're doing. Sounds to me that you were better off with your GP. If that doctor has their licence allowing them to prescribe drugs like Norco, they can prescribe other pain killers as well.
My heart goes out to you..I live in Arizona and take opiates obviously for legitimate pain ..my pain specialist I have had for 13 years has a policy(law by dea) he relates every year that we sign as having read that he cannot prescribe any opiates but once per month.
Maybe that is why u have to wait..
In az. Since i see pain dr my gp says he cannot,nor hospital emergency prescribe any opiates..
These forums are great! Thank goodness u are well enough to ask the questions about kadian.
You have to get courage as when u are informed,.. speak up! Know that pain drs are being scrutinized because of dea as well as trying to do their best (we trust)to give us what we need...
these forums can answer questions that a dr in 15 minutes cannot.
Kadian being epidural, is great for discussion..
I am not a dr. Just retired and well enough to comment ESP about importance of having meds that relieve pain and enough to prevent withdrawal..
I hope you can get a gp that can look at all of your problems and respond accordingly.
I have 1 who sends me to specialists then ..duh!,,
He told my 13yr pain specialist to stick to stick to pain meds..told me he would help manage my addiction, then I asked him when he heard from my pain dr or discussed pain meds and he said 7 months ago..
I have to make sure every specialist he or another dr sends me to..
Send results to him but then he gets insulted...
Talk about anxiety..my husband is a basket case because of me!
Best blessings on finding a gp that will prescribe any pain meds...the dea is really on their rears!
Of course, I am not a doctor but I am thank goodness alert enough to research..buddy. We have got to keep good records and speak out..
It doesn't help to take opiates and meds for anxiety..I do..and they put us in their (stigma) file..
Oh, this guy isn't here to talk bull and get Viagra and testosterone or give me free tickets to the game!