I have been taking 12 mgs of Dilaudid for 6 years due to ruptured discs, degenerative disc disease, bone spurs, buldging discs and 4 back surgeries. It doesn't seem to be working like it use to and someone told me that since I'm taking so much Dilaudid that I cannot take any other pain medication with it. Has anyone ever taking another form of narcotic with Dilaudid? I also suffer severe muscle problems.
Can I take any other pain medications while taking Dilaudid?
- 17 Mar 2014 by Angelace
- 18 March 2014
- dilaudid, pain, chronic pain, medication, bones, pain medication, disease, bone, bone spurs
Added 17 Mar 2014:
I forgot to mention, I take the 12 mgs of Dilaudid every four hours.
If you have chronic DAILY severe pain, you should be on a LONG acting medicine, NOT a short acing one like Dilaudid (hydromorphone) Tolerance often builds rapidly to short acting immediate release medications like Dilaudid and this is how you got to such a high dose! Unless you have absorption problems, like a history of bariatric or bowel surgery to remove bowel/intestines, you should be on around the clock, long acting medication. The long acting form of hydromorphone (the active opioid ingredient in Dilaudid) is called Exalgo. Exalgo is taken usually once a day, or twice a day, twelve hours apart. Using long acting medications is a much better way to manage chronic persistent pain because you stay on top of the pain to prevent it rather than chasing it with a short acting drug. Long acting drugs are made to release medication slowly over the 8-12 hour period (or in the case of some, like Exalgo and Avinza, which is a long acting morphine product, are made to release for 24 hours and have a once per day dosing) so this keeps pain under much better control rather than conditioning the brain to equate a flood of drug across the opioid receptors as pain relief which is what immediate release drugs, like Dilaudid, do. Short acting or immediate release drugs (these are interchangeable terms) build tolerance quickly by flooding the receptors with medication then wearing off quickly. Is your Dr a pain management specialist or is your PCP managing your pain? Treating chronic persistent pain with immediate release medications like we do acute pain is a mistake many PCP's (and PM docs that dont have proper training) make. So since you are taking 60mg hydromorphone in a 24 hour period, they would probably put you at 32mg Exalgo twice a day (so you'd be getting 64mg hydromorphone per day) or two tablets once per day. If you experience breakthrough pain, they could give you small doses of immediate release product like Dilaudid 2mg or 4mg 2-4 times a day as needed for breakthrough pain. Talk to your Dr about using a long acting medication. I just used Exalgo as an example. There are many long acting drugs available and you may actually do better rotating to a different opioid since you have been on hydromorphone a while. Perhaps Opana ER, or Fentanyl patches may work better. Fentanyl is a very very strong medication that is worn in patch form and is absorbed through the skin. The patch is changed every 48-72 hours (so on the second or third day). Morphine comes as MSContin, Avinza and Kadian in long acting forms (they are all morphine but the way each releases is a bit different) Oxycodone has the long acting form in Oxycontin. I know for me, the long acting drugs have done wonders for keeping my pain under control. I'm not constantly watching the clock to see when the next dose is due. There is no "ceiling effect" on these kinds of medications meaning there is no upper limit beyond what a person can tolerate without bad side effects but the dose your on is quite a high dose and it is probably the upper limit your Dr feels comfortable giving. Giving high doses of immediate release drugs get them noticed by the DEA. This is likely why he wont add anything to it. Next time you see him, ask if using a long acting pain medication is an option for you. If you are seeing a PCP to manage your pain, you may do better to see a pain management specialist. My personal opinion is that they did you a disservice by putting you on this high of an immediate release drug. You are getting poor pain control as a result.
- Dilaudid Information for Consumers
- Dilaudid Information for Healthcare Professionals (includes dosage details)
- Side Effects of Dilaudid (detailed)
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