[klopper22]

Hi,

This is my first thread here. I've read some of the others and it appears that people want to help others, and I need help so here goes.

I have upper back problems - dorsal scapular syndrome, degenerative disc disease, a little scoliosis & arthritis. I am also around 60-70 pounds overweight which doesn't help me. I have lost 33 pounds though and I plan on losing more.

I started out taking Vicodin, then went to percocet 5mg and then on to percocet 10/325's. I've been taking 4 of the 10/325's a day for about 9 months now. I have noticed (as has been talked about in this forum) that you get a pretty quick and strong buzz from them. My goals are 1) to get through my day at work without hurting. 2) be able to come home and pitch in with household chores and 3) be able to work out moderately to continue my weight loss.

I am thinking about asking my doctor to prescribe oxycontin 40mg so I don't have to take 4 pills a day and have the surge of a buzz I get sometimes. I need to get some idea of what to expect.

Will 40mg oxycontin take care of the pain comparable to four 10mg percocet? That may seem like a silly question, but there may be differences I am not aware of. I know that oxycontin doesnt have APAP...does that make it less effective to where I might need 50mg Oxycontin?

Thank you in advance for any help you can give me.

[Cats Meow]

An OC 40 bump up is common from a 10mg Perc qid, but it would probably be dosed at bid, OC only last for 8 hours, the conversion rate from an IR to a ER is 15mg of oxy ir = 20mgs of OC, so it's a good bump for you. With OC you get roughly 40% of the dose immediately and the rest at around the 5 hour mark.
The apap really isn't a factor for how well oxy works, you could always take some OTC apap on top of it, but going to a 50mg isn't done for that reason. OC really should be Rx'd as a tid, but they like to make that a second bump.

I don't think I would tell my doctor that oxy gives me a burst of energy, that's asking for a sideways look, instead I would say "it works good (or use to) because it takes my pain away and I'm able to function at a higher capacity, I'm less productive when I'm in pain". Don't be surprised if he steers you towards a MS Contin, and don't discount it, but you know Oxy works for you.

[klopper22]

Thank you so much for your reply. I am going to make an appointment Monday to discuss with him and I will use your advice. I'll post how it goes. Have a good rest of the weekend.

[klopper22]

My doc gave me a script of sixty 20mg oxycontin. I get it filled at the end of the month. I am eager to see what all day pain relief will feel like. I am sure there will still be moments of pain, but probably not like when on a schedule of four 10's a day. What would you say?

[Cats Meow]

It sounds very reasonable, so 20mgs bid. You may find yourself a little sore and definitely ready for a pill first thing in the morning, OC doesn't last much past the 8 hour mark, some people after time find themselves having slight w/d in the morning until the pill kicks in. Your drugs blood plasma concentration- you will notice some difference in peak to bottom effectiveness in analgesia, the 10mg perc you'll notice- it hits harder at first then OC. If you can imagine graphing it out with the 10's (analgesia over time) after an hour you will peak and that will last an hour (a level line), then for the next 3 hours the line goes down hill, hours four to six almost to zero. With OC after an hour it won't peak as high as the Percocet, but the line will stay level for 3 more hours, then go down some and level off a little lower, then at about the 6 hour mark to 10 hour mark dropping drastically. Sorry, there's no way to graph it for you, but check out the OC monograph from Purdue Frederick to visualize what I'm saying.
I suggest you try and wait 8-12 hours before taking your second pill of the day. Be honest with your doc on how well it's working, there's always the chance of adding a breakthru (BT) pill or two of Vicodin or something, and maybe a bump to 3 pills after 6 months, it really should be prescribed tid anyway.
Many find (and it's in Purdue's literature) that taking OC with a high fat food (such as sausage) that analgesia is increased by roughly 25%.

[klopper22]

Thanks taking the time to put all the good info. I still have time to discuss it with my doctor since it wont be filled until the 28th. I'll go over all this with him. Please tell me if you think a better script would be 20mg tid or 30-40mg bid.

[Cats Meow]

20mgs should be fine for you, it's better to start off low. Do ask him about them only lasting 8 hours not 12, that is something to be concerned about, the President of PF even lost his job do to false advertising stating that they last 12 hours, doctors know that they don't.
Here is the monograph, but they're still using the 12 hour factor.
http://www.purduepharma.com/PI/Presc.../Oxycontin.pdf