A new Doctor took her off the Oxycodone and increased the Kadian. She is on 260 mg a day and she is still having breakthrough pain and the Dr said she could increase it every few weeks until she reaches a place where she does not have the break through pain. But she will not give her a prescription of Oxycodone. She says it will just take time until it will be controlled. Seems like a lot of morphine to me... The Drs have said due to her ankle necrosis she may have to be on continuous pain meds.
It is true that if the long acting drug is where it should be there should be little need for breakthrough except on occasion when activity is increased or an activity that really aggravates the pain. 260mg of morphine is a moderate dose. I've known of folks on a lot more. What amounts was she taking before? I would be able to tell more how big a jump that is if I knew her previous dose of Kadian and oxycodone. It does take time, especially with Kadian. Sometimes it can take a week or so between dose escalations to see an improvement because the blood levels have to build. Just watch her for increased sedation and any difficulty breathing. If her breath rate drops below 12 breaths a minute it is too low. Watch her especially when sleeping. If her breath rate seems low wake her up. If she is difficult to arouse then call 911. I say this as a precaution, not to say I think it could happen. Again, it would be helpful to know her previous dose and for how long she was at that dose. That would tell how her tolerance is.
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