I am currently taking 10/325 percocet. I have been taking 4 a day-never increasing my usage for about a year. I'm afraid to tell my doctor that I am tolerant to it and no longer receive the full duration of medicine because of the fear of him uping my dose or switching me to something stronger. I have been doing really well as far as not being addicted, but I am sure my body is dependent. I don't want it to become dependent on something stronger. what should I do?
The only other options you have is rotation to a drug in the same class that is equal to your daily dose of oxycodone (the opioid ingredient in Percocet) or you could also go to the long acting version OxyContin. It is the same exact drug, it is just time released. Since you take 4 10mg Percocets a day, that is 40mg of oxycodone, so you could take OxyContin 20mg every 12 hours and this would be the same exact amount of drug per day but the Oxycontin might hold you better because it is long acting. There are less ups and downs of pain. You know how you take a Percocet then you wait 30min for it to start working and it works for an hour or two then you are stuck in pain waiting for the next dose? OxyContin wont do that. You take it every 12 hours around the clock, not as needed, and it keeps ahead of the pain and it isnt allowed to get so severe. This keeps you under much better control. If you do decide to try a long acting drug, you need to give the drug a few weeks before you decide it isnt working because it needs time to build in your blood. You also have to be aware that short acting drugs like Percocet flood the receptors in the brain with the opioid and the long acting doesnt do this so you may not "feel" the medication like you do with the short acting. You have to judge your pain levels not go by "feeling" the drug kick in. You wont feel that rush or flood of drug when you take a pill so many people think it isnt working because they dont "feel" it. The other route I mentioned is going to another opioid in an equivalent dose like Morphine, hydromorphone or oxymorphone. The new drug itself may be stronger mg to mg, but they can give you a smaller dose of the stronger medicine to be equal to the strength of the oxycodone. This is called drug rotation and it works under the theory that even though you are tolerant to one opioid, in this case oxycodone, doesnt mean you will be tolerant to another opioid like say, morphine. So the Dr may start you out at a slightly lower dose than the true equivelent to plan for this cross tolerance. If you tolerate the smaller dose he can then raise the dose to equal the oxycodone dose or if it seems too strong he can lower the dose a bit.
You should talk to your Dr and let him know that your medicine isnt holding you like it used to. It could be tolerance, yes, but it could also be your condition progressing and that is something you both need to know. Honest communication between you and your Dr is the only way to go. He/She cant help you best if you are not completely honest with them. You can always let the Dr know that you dont want more medicine or a stronger dose, you just want to discuss other options. there are also non-opioid meds that can be added to help with pain. there are certain drugs that are classed as antidepressants and anticonvulsants that are actually also good for treating chronic pain. Chronic pain changes brain chemistry and these drugs help to regulate that chemistry therefore they help the pain. Then you also have the other disciplines like massage therapy and physical therapy that can be used hand in hand with your pain meds to help you with pain. there are other modalities like a TENS unit. See, there are many options other than just shoving more drug at you! There also comes a point in every chronic pain patient where you reach the level that no matter how much medicine you take you will never be pain free unless they make you unconscious and no one in their right mind wants that! We pain patients just have to adjust our expectations to having meds "keep you at a tolerable pain level" rather than "pain free"
- Percocet Information for Consumers
- Percocet Information for Healthcare Professionals (includes dosage details)
- Side Effects of Percocet (detailed)
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I would like to know if it is inappropriate to ask your pain management doctor for a change in meds?
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