Transition from OxyContin to Opana

IfItDoesTheTrick · #1 10-15-2009, 12:59 PM

Hey, I was wondering if anyone who was on a similar high dose of oxycontin (80mg 3 Tablets 3x per day) or higher have switched to another pain medication. I especially am looking for anyone who switched to Opana. I am kind of scared to switch because my DOC says that if I switch meds it would be to decrease my dosage greatly. You obviously cant start on a high dose, but what did you go through. Since I am on nine oxy's a day the Opana website says that I should multiply the daily dosage by .5 and that should be what I start on. That would be the same thing as taking nine 40mg opana. I also take 30mg roxicodone for breakthrough five times a day, do you multiply that in as well.

If I ask to switch, I don't want to completely screw myself and be stuck back in the same place I was in before my meds were regulated and leveled off to reduce my pain.

Are there the same problems with it not lasting the scheduled twelve hours as with oxycontin? what did you transition from, and how much were you on? how long were you on it? How much are you on now (how much was the dosage titrated from the initial dose you were put on)? These are the questions that I am looking for answers to.. Help me to figure out if I should bring this up to the doc, I want to make sure I cover all my bases so if I do bring it up i will know what to bring up to make sure it goes well.

Thanks,

Kevin

Robert_325 · #2 10-15-2009, 01:16 PM

Kevin ..... I really don't know your medical history so I have to ask some questions. Your dr has you taking three 80mg oxycontin three times per day? That's nine 80s per day by prescription? Plus you're taking five 30mg roxies each day for breakthrough pain? What is the reason/illness/injury that necessitates you taking nine 80mg oxycontin and five 30mg roxies if I may ask? That is a LOT of RX pain medication my friend.

I'm not judging you as at one time I was taking 900mg of roxicodone (thirty 30mg roxies per day) but my heart stopped beating eventually too. Plus I was taking about 30-40 lorcets on top of all the roxies along with a ton of benzos, somas, etc. I'm just trying to find out what reason the dr has for giving you such a high amount of medication.

Please fill me in. God bless.

IfItDoesTheTrick · #3 10-15-2009, 01:32 PM

Hey, I wrote in another earlier post why Iam on so much. It would probably be easier for you to just check that out. It is only a few down on the list I think the title is for chronic pain only or something like that. If you can't find it let me know and I can go through all of it but an overview would be at 15 I got a football injury and found I had spondylolelisthesis and I was on heavy meds for awhile. I then got my spine fused at L4 L5 and S1. It didn't go well but worked for six months no meds. Then one day I couldn't lift my legs, get out of the bed and had to crawl too pee. They put me back on meds, but because at such a young age I was one everything that existed, I had to be on a really high dose or it. I started out back on Oxy's but the only thing that kicked in and leveled out my pain was 80mg 2x/day. Over the last two years it has stopped working and my dose had to be adjusted. I am extremely tolerant to opioid therapy. Now it takes 240 mg to keep the pain leveled out, but it only lasts around 6-8 hours. I know that is 9/day but if they still made the 160mg it would only be approx. 1 1/2 3x/day. I try and think about it as total mg rather then the amount of pills, and I think my doctor does the same. He is a neurologist not a pain specialist, that is very well educated and not just a pill roller. He is extremely knowledgeable in many areas, but spent a lot of time in the beginning running tests to make sure I was actually in pain. Because I basically died on the operating table and they screwed up my body so much we both do not want me to get any type of surgery.

Cats Meow · #4 10-16-2009, 01:43 PM

It's very uncommon for anyone changing from OC to Opana to be happy with the transition, I've read very few reports of anyone being satisfied, and on your high levels it's basically unheard of, and the cost of Opana is astronomical, and I really doubt your insurance would approve it. Transitioning to Duragesic would make more sense along with a BT.
You're at the ceiling, something should be done to bring you down, but that's a topic for another post.

11Bravo · #5 10-19-2009, 03:59 PM

1st. The ceiling effect on opiates is made of proverbial glass and is easily overcome with a higher dose.

2nd:I can only say what I have heard: Opena ER is harder to abuse but in some cases people report significantly better pain relief. Again this is just what I have heard.

For serious pain..like pain so bad you dont care if you are laid out you just want the pain to stop...I would go with IV Dilaudid. I was taking dilaudid orally as well but its very poorly absorbed..its a much better IV drug if you are the hospital or have been taught to properly administer the drug intravenously. There are estimates that Dilaudid is 8-10 times the strength of morphine(I concur!) to wit there is Hydromorphone hydrochloride injection (high potency formulation) about which you can learn more about on this site.

This is the most powerful opiate agonist available in the US Carfentynal aside.But I can tell you from my own experience that even the carfentynal which is 10,000 times the strength, and blasted me out of my mind, did not give the same "feeling of relief as dilaudid. Most of time thought-at the end of the day-its just about needing a higher dose. Just remember that opiate addiction and the subsequent withdrawal does not discriminate between those who take it to get high and those who take it to relive pain...thats just my exp. I hope you have some strong laxatives because you are gona need them with all this stuff. Ive been off the dilaudid since feb and offf subs since about a month and can say for certain that my pain issues are way better now...most of the time. Good luck and god bless. None of what I said here is medical advice just my take on what you have said filtered through my experience.

Cats Meow · #6 10-20-2009, 01:54 AM

Quote:

1st. The ceiling effect on opiates is made of proverbial glass and is easily overcome with a higher dose.

This is true, there is no real ceiling, however, as you know, there's a limit that doctor's almost never cross, this is the ceiling I'm referring to.

11Bravo · #7 10-20-2009, 09:55 AM

copy that on the ceiling effect cats meow.

IfItDoesTheTrick · #8 10-20-2009, 11:06 AM

Hey thanks everyone for the information. And for some reason I don't have to use laxitives. I have been on high powered meds since I was 16. My doctor has told me that constipation is either hit or miss, either you get it or you don't and your diet and excercise habits have nothing to do with it.

I have really good insurance though. I am still a college student and my parents work for the company responsible for all those flu vacs. So meds aren't really an issue... YET!

Rather then switch me to opana yet, we have switched to 3 80's 4/Day. But my doctor isn't just a pill roller, he is worried about me being robbed at the pharmacy, because that amount has the ability to currupt the minds of many, to do horrible things. We have been talking strongly about opana, he wants me to switch because of the lower street value (DEA just doesn't know about it yet, it apparently is sold for more.) And because of its better time released mechanism. (When I asked about this he said hes had patients switch that need to take it at the same interval of eight hours.) So if we converted like opana says too I would still be on 12 a day right off the bat. (they say to multiply your total daily dose by .5 and then split that into two times a day of the correct Mg.) And because hes had to put it on an eight hour interval I could end up on 18 pills a day, within a month. I don't really enjoy taking pills all day.

I don't know if I would like taking anything Iv. That just scares me, I have never done anyhthing through a needle. I have, however, taken dilaudid before the 8 pill, but I needed that way too many times a day and I got some relief but it wasn't long lasted.

I have never heard of CARFentynl though. Any other ideas.

IfItDoesTheTrick · #9 10-20-2009, 11:45 AM

Oh yeah, I forgot. On friday when I was put on the higher dose of oxys (now at 240 Mg 4 times a day), I was switched from Oxycodone 30 mg for breakthrough pain too Opana 10 mg. The pharmacy had to order it so I haven't taken it yet, I am about to go pick it up. I ll let everyone know how well it works. It is kind of the first step to switch over, I wanted to make sure the chemical itself works for me. I know this is just the IR version, but I think that in comparison to the roxi's Ill be able to see how well it does. I lost out on the deal though, I was on 3 30's a day, but he put me on 3 10's a day of opana. (not quite the correct conversion). He said though that I might need to take two at a time but he only wrote me for 90. He just wanted me to give it a fair shot though first and only have enough for 3 10's a day at first and then I can call him if I need another perscription. Since telling him how 240 mg 4 times a day worked so well that I didn't have any breakthrough pain when I tried taking it that way, and that is why he bumped me up, He figured he could get away with lowering my breaktrough dose. Well see how it does. Iam sure many people could benefit from my findings, Iam sure there are alot of people out there that could use a med that actually works.

Opee · #10 10-20-2009, 12:32 PM

Quote:

Originally Posted by IfItDoesTheTrick

Hey, I was wondering if anyone who was on a similar high dose of oxycontin (80mg 3 Tablets 3x per day) or higher have switched to another pain medication. I especially am looking for anyone who switched to Opana. I am kind of scared to switch because my DOC says that if I switch meds it would be to decrease my dosage greatly. You obviously cant start on a high dose, but what did you go through. Since I am on nine oxy's a day the Opana website says that I should multiply the daily dosage by .5 and that should be what I start on. That would be the same thing as taking nine 40mg opana. I also take 30mg roxicodone for breakthrough five times a day, do you multiply that in as well.

If I ask to switch, I don't want to completely screw myself and be stuck back in the same place I was in before my meds were regulated and leveled off to reduce my pain.

Are there the same problems with it not lasting the scheduled twelve hours as with oxycontin? what did you transition from, and how much were you on? how long were you on it? How much are you on now (how much was the dosage titrated from the initial dose you were put on)? These are the questions that I am looking for answers to.. Help me to figure out if I should bring this up to the doc, I want to make sure I cover all my bases so if I do bring it up i will know what to bring up to make sure it goes well.

Thanks,

Kevin

Hey Kevin,

Wow, that's a hefty amount of OC's in one day. I have alot of Opana experience, but it's all recreational. I can tell you that I swallowed 5 or 6 20mg and felt nothing (but my tolerence is off the charts) but if I railed 1, I would get off (with 4-6 Norco's taken orally). Sounds like you take them as directed, though. I just caution you that I have a friend who had never done an Opana, put it up their nose (after putting a bunch of Ritalin up their nose - this is some time ago) and OD'ed and almost died. Luckily, the person they were with knew alot of stuff and brought them back from death twice. Stopped breathing, no heartbeat, clinically dead. Scary, scary ********. They haven't gone near one since, I'm happy to say.

From a proper medication standpoint, Opana did nothing for me, but it is supposedly good for breakthrough pain. If crushed up and snorted (I am NOT recommending this in the slightest - it's how people die) it can increase the potency by as much as 50 times (or more, depending on the web-site). Opana is nothing to fool around with or take lightly. I.E. Use as directed to the letter.

But, given the amount of OC's you are on, I imagine you also have a very high tolerence (Man 3 80mg Oc's a day is TONS - literally the equivalency of 48 5mg regular Vicodin's - kind of puts it in perspective). Opana worked for a friend of mine after back surgery as a means to control his pain all day, as it is extended-release, then he was given Norco's for breakthrough pain.

No idea if this helps, but Opana is a relatively new drug, one most people haven't heard of, and I seem to be one of the few with alot of knowledge and experience with it. Getting off of 3 80mg OC's a day is definitely the first step in the right direction. Best of luck and please let me know if I can offer any further assistance.

Opee

IfItDoesTheTrick · #11 10-20-2009, 03:42 PM

yeah I was actually on that amount three times per day, since then it has been increased to 3 tablets 4 times a day, so it would actually. It actually doesn't compare in any way to vics though percocet maybe but it would be the equivalent to 192 perc 5's a day. Thanks for your input though.

txrxman · #12 10-21-2009, 12:00 AM

If you're in college and under your folks' insurance, I'm assuming you're young. Since you're taking 9 oxycontin 80mg daily with several 30mg immediate release just to maintain control over the pain, I'm surprised you're so willing to try and convert over to the opana.

You probably don't realize just how fortunate you are. You're fortunate to have a doctor willing to prescribe such a dose. To consider changing to opana because you're worried about someone mugging you or steailing the oxycontin.......forgive me, but that's just ridiculous.

There was a time when I was in so much pain that I could not stand it any longer. I attempted suicide with insulin, but ultimately when I awoke I was in the hospital. At least at that point people finally started to believe that I was in pain. I mention it only to get to this point....it took months before we finally reached a combination of medicines that would enable me have quality to my life. Breakthrough pain is always a possibility, but when you're taking your breakthrough medicines on a routine basis, it's time to reevaluate the maintenance dose and possibly increase.

If you're able to attend college and the pain is controlled to a level that enables you to live as close to a normal life as possible, it would be a mistake to try to convert.

With the opiates, there is an equivalency formula, however how well you respond to one medicine can very likely be much different than another. Since it's clear you live with chronic pain, I have a feeling you can relate to the agony of trying to regain control over pain once it's lost.

I do wish you the best and look forward to hearing how you fared.

On another note I'm researching high dose oxycontin patients. Conventional thinking is that anyone taking such a high dose.....anything over 160mg twice a day....would be sleeping most of the day.

From the few patients I've had a chance to interact with, it seems as if there is minimal influence over cognitive function. In-other-words, most of the people taking such a high dose go about their lives in such a fashion that unless told, the people around them wouldn't even know they take oxycontin.

I've seen a few programs on television where someone was discredited after it was discovered they took oxycontin. One show had months of lawsuits overturned since the DA turned out to be addicted to oxycontin.

In the late 1990s there was a Walgreens pharmacist who was responsible for a mistake that is attributed to the death of an infant. Because it turned out he was taking pills from inventory each day, the family was awarded some ridiculous amount of money.....$31million.

If anyone knows of any studies assessing the 'side effects' experienced by those taking high dose oxy, I'd really appreicate.

thanks.

OxyLover21 · #13 10-21-2009, 12:05 AM

Hey people....I myself am a Roxy user. I am a former baseball player who started out taking vics & percs for a sore arm to keep playing instead of doing the smart thing and taking the season off and rehabing my shoulder.
Well...Playing on it with pain pills completly ruined my arm (stretched out all the ligiments and destroyed tissue) that surgery could not even help it. The tissue that provides cushin was basicly flapping in the wind. At that point though, after I retired from baseball I was an opiate addict. I was "only" taking approx. 120 mg of Oxycontin everyday but found it soooo hard to get off of. Long story short the god sent drug from heaven as far as my problem was concerned was released (Suboxone). I was able to detox myself rather easy. Practicaly no Physical pain but as you all probably know depression is a big issue for most after discontinuing opiates after year(s) of use. I used the Suboxone for 6 days to detox then took Prozac for the deression for 3 months and I was back to myself then just tapered the prozac.
I was clean for 2 years and as fate would have it I was in a car accident and hurt my back real bad, and at that point and still to this day I have no health insurance. My Doc is sympathetic to my situation and understands I can't afford surgery. I was so reluctant to do it but I had to go back to opiates to control the pain and keep working. I now take 1 Roxy 15 2-3 times a day. It doesnt sound like much but it doesnt matter if you take 9 80mg Oxycontin a day or 6 Percocets, If you are addcited which anyone i know will be if you take any opiate over a year the withdrawls are the same. I heard of this Chiropractor that is supossed to be AWSOME and work miracles. (Never had much luch with them in the past) but if he can help my back I am gonna try and detox again off the opaites or atleast try to get down to only having to take a vicodin or percocet once in while for break thru pain. I need to get off the daily use of Roxy's. Where I live (Pittsburgh) 90 Roxy 15's cost me $55.00 a month w/o insurance.
I realize my pain situation is probably so mild compared to what some of what your conditions are, but I just urge you & everyone to lower and/or get off of opiates if it is all possible in their situation. When I was in full blown addiction after my baseball days, I almost lost my family over it. I was living in hell and wouldnt wish it on my worst enemy.
Good luck to everyone and God Bless.

-Tom

Cats Meow · #14 10-21-2009, 02:04 AM

Carfentanyl is for large animals, like rhinoceroses, so you can forget about it.

Has your doctor not discussed Methadone with you? Given the choice I wouldn't go with it either, but...

OxyLover21 · #15 10-21-2009, 02:39 AM

I STRONGLY suggest no one get on methadone long term. I have not know 1 person who could get off it once on it. You only go up and end up a lifer on it, and from what I hear it doesnt kill pain too well at all. Way better with 2 Oxycontin a day then Methadone. The ONLY person I knew that got off it once on was because he went to jail. He said he crawled the walls for 6 weeks, then had mild withdrwals for another 3 weeks.

IfItDoesTheTrick · #16 10-21-2009, 09:25 AM

The only reason I say that I have fear of being mugged for my drugs is because it happens a lot where I live. Even though there are hippa (spelling) laws that are in place that protect you many pharmacists when given a prescription will say that they don't have 360 Oxycontin 80mg out loud, anyone that hears this turns an ear.

Not that I am paranoid, but it has happened many times around here and there are warnings posted in the office to keep your prescription information to yourself. There is an epidemic locally in my hometown and also the college town where I live, everyone is doing heroin or oxy's. You can find heroin faster then you can find milk. These addicts who spend so much on pills know the few pharmacies that carry oxy's because only a few are able to from past robberies. It only takes once for them to find out the date you get it filled (that doesn't change, thirty days is thirty days), and since you have to go to the same pharmacy every month so that you aren't flagged it is a very easy thing to do. Yes this has been an issue for me in the past, although no one would think I was on pills, because I look and act normal now with them, I still look over my shoulder. At one point when walking out of the store someone came running by and grabbed my bag right out of my hand. I had already put them in my pocket, but if I hadn't my whole month would have been destroyed for it is very hard to get a new prescription that same day...

The reason I want to switch, well its not my reasoning. The reason my doctor wants me to switch is for two things. The cheaper street value of Opana, an the fact that Endo Pharm. Claims to have the TimeX controlled release mechanism that supposedly really lasts 12 hours.

Yes we do have it under control and I can live my life normally, but the dosage always has to be adjusted. With cross tolerance you can stay at the same dosages but switch back and forth every few months so you don't build extreme tolerance. I simply need another med I can do that with.

I know that at my dose I have an extreme tolerance, but that is with opiates in general, not oxycontin. It actually works very well and I don't have too many complaints.

I am trying to respond to all recent replies in one message here, so sorry if I bounce from topic to topic, but there is a very large difference between an addict and a PATIENT that is managing a legitimate condition. Addicts takes drugs to hide from the everydays of life where a patient takes pills to manage chronic pain and live their life. I know patients can become addicted, but when you take them properly for a legitimate reason it is a lot different. I know that many people might disagree, but a lot of people take more then necessary or take them up the nose and that forms addiction.

Thanks

IfItDoesTheTrick · #17 10-21-2009, 09:59 AM

I didn't want to make that last post any longer then it already was and wanted to address all the questions and comments that were received. Thank you everyone for that, it is really nice to be able to talk to people about this stuff and to get views and opinions that I wouldn't have alone.

The Opana 10's that I had converted to for breakthrough pain were not as successful as I would have liked. The reason I went from oxycodone 30's to these was because I wanted to get a feel on how the chemical responded. Since my doctor wanted me to do a full blown switch to all Opana for ER and Ir I gave him the benefit of the doubt and tried the IR's first.

I was not very happy. First of all the whole hassle of taking on an empty stomach to avoid the pill absorbing in your meal or you getting extra side effects. You have to take them either 1hr before or 2-3hrs after a meal, and I dont know about anyone else, but my pain doesn't give a ******** when I eat. It might work for the ER control, but when you are using something for breakthrough it kind of sucks. My pain isn't the nicest person, it comes about at the worst times, and when I can only take it at these times, you know that I will feel it coming on with my first bite. And when that happens its a waste.

I followed these instructions to a "T" yesterday. (this is a weird saying, what does following a t even mean?) and I didn't really get any relief. I take them at the first sign of pain, and before I know it the pain is there and they didn't do there job. When that is the case it makes my oxy's not as effective and wear off alot faster.

Overall I was not happy. I don't think I feel confident on trying the Opana ER's anymore. I give them a 2 on the 10 point scale. Probably will be calling to get either some other formula or my 30's back. Although I might be forced to use these with a roxy 15. Well see, Ill let you know.

11Bravo · #18 10-21-2009, 12:32 PM

You are on a massive amount of stuff-you need to self controlled down cycle your meds or change to some serious high doses of fentynal. Bro carefentynal is what they gave me when they went into my heart and electrocuted it! I am neither a hippo nor a rhinoceros! LOL! Its IV push though and MUST be controlled by a anesthesiologist-this is a operating room and post up drug. Look into a combo of Fentynal patches 100mcgs combined with dilaudid and you will be sending me post cards from the moon. Thats a dumb ass amount of oxy your on. Like it was time to switch a long time ago. Dont you get heart burn from all those pills? that used to drive me nuts! I personally think fenty is a ********ty drug because it continues to depress your breathing after the pain relife. Thats just my 1 penny.

IfItDoesTheTrick · #19 10-21-2009, 01:30 PM

No heartburn, no bad effects. I can function though, and to me that is most important. I know if I gave a 1ooth of what I am on to anybody else they could die, but its not like that with me. I dont know why, and I didn't ask for it to be this way.

Before this amount of Oxy, I would crawl to the bathroom when I had to piss, and that's if I could get off the bed. It was the worst, until the doctors realized I needed a severe dose to level me off thats how I lived. Now that I am on this ... load of meds I can live my life. I know that its alot, but Iam not on the moon. Isn't that the goal of chronic pain management a balance between not suffering and not being loopy and deal with side effects. to me thats what it took, if they still had the 160mg it really wouldnt be that much only be 2 tabs 3 times a day. They just dont make that milligram anymore. There are many people on high doses and we are forced to take lots of pills because some idiot people took a hugh pill to get high and died.

Cats Meow · #20 10-21-2009, 02:49 PM

OP, one little trick that many aren't aware of with Oxycontin is to take it with a high fat meal (like bacon and sausage) and you get like a 20% increase in analgesia (it aids in absorption). This is reported directly from Purdue's own OC monograph. If this helps you even a little bit, that's great (but don't blame me if you get fat, lol).

11Bravo · #21 10-21-2009, 03:02 PM

I both understand and appreciate what you have said...and thats a small miracle that you have so few side effects. I only want to point out that some narcs are stronger then others, and are administered via different different mechanisms of delivery and as such would require far fewer pills a day, i.e. if you got on the high dose fentynal patches those oxys would hit you even harder and you would have to take less. And...I don't care how much oxy you are on-Fentynal paths/lolipops and diludid IV push(or even the diluded pills in combination with the oxy) and you are going to get pain relief far greater then just oxy alone. Thats my subjective opinion. I wish you the best of luck in your life and may god bless you. Have your dock watch your liver and kidney functions as these are the organs responsible for processing various opiates.

IfItDoesTheTrick · #22 10-21-2009, 05:30 PM

bravo,

I know that I have written this in the post somewhere, but I am allergic to fentynyl though, I had a reaction to the patch and am not allowed to wear them now unless I go to the hospital and put one on and sit there to be observed for 72 hours. Its not the actual fentynyl though its the other things in the patch/delivery system. What I was trying to say was that the pops use really well for bt pain. I was not talking about dilaudid IV though, I would never inject anything in my own body, that really scares me.

I have tried just about everything to relieve pain, and so far this is the only thing that has worked. I really need a second drug not to combine with currently, but so that I can switch back and forth too every few months so that my tolerance doesn't increase or hopefully decreases.

I would love to be on the patch though, it was so much easier not having to take pills all day and to put something on and that was it for three days. I hate the taste of the pops though, after a while you realize they are chemicals masked by sugar. they are really quite horrible, they just work the best for bt pain.

I thank you for your input though. I think those of us who have been in the situation where they would rather die then take another breath because the pain hurts so bad know what its like when you finally get on something that works. Yes it might be a ridiculous amount to others, but for me its the only thing that works as of now.

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