My question. How long before it starts working so I don't have to take Norco for break-thru pain?
It does depend on the dose of OxyContin he put you on. I would guess he probably put you on 10-20 mg twice a day. They usually start low then titrate up from there. You want to start a little lower than an equivilent dose because of cross tolerance (just because you have tolerance to hydrocodone doesnt mean you have tolerance to oxycodone). They should take your total daily dose-in your case 7.5 mg x 9 is 67.5 mg per day and the direct equivilent dose for OxyContin is about 45 mg per day, so divide that by two and shoot a little lower for cross tolerance and you get 10mg twice a day for a conservative dose and 20mg twice a day for a less conservative dose (and that doesnt figure in your breakthrough meds so if he figures that in he likely went with the 10mg dose). It will take a few days for you to get a full therapeutic blood level going. I would say to give it at least 5-7 days and see how it feels before you go up in dose.
Hopefully, you can get to a dose of long acting medication to where you dont need to use breakthrough except occasionally. I would suspect you will do fairly well at 20mg twice a day, maybe a little more, maybe a little less. Remember with a long acting drug, you wont feel the rush of the drug hitting the receptors like you get conditioned to when you take a short acting drug. Short acting drugs flood the receptors with drug and people tend to equate this rush feeling with the drug "working". You likely wont feel a rush and may be tempted to think the drug isnt working because this is what taking a short acting drug conditions you to think. You have to truly think about your pain relief, not whether or not you "feel" the drug. Long acting drugs hit the receptors more slowly and sustain relief once you get to a therapeutic level. So the "feel" is different. (Not that I'm accusing you of searching for a high or anything-this is just the way these medications work.) If you get too sedated after a few days and you are nodding off then you are on too high a dose and need to cut back slightly. I have taken OxyContin for a number of years and it works so much better than chasing your pain with short acting drugs all the time and just get brief bursts of relief. It keeps you comfortable on a much more consistent basis without so many peaks and valleys of pain relief. With a short acting drug, you take the drug and it will start to work in about 30 minutes, it peaks quickly and may give you an hour or two relief then you are back to watching the clock for the next dose. With the long acting drug, you stay comfortable most of the time because, since you take the medication around the clock on a regular basis, you can stay ahead of your pain much better. It just takes a little time and patience to get to the correct dose. Do your best to rely on the long acting only. Once you are on the correct dose, you should only need breakthrough when you do the more physical activities. The long acting drug should hold most of your pain at bay.
ER stands for Extended Release, all Oxycontin are Extended Release so there is no such thing as Oxycontin ER, please tell me if I am wrong about this. I asked my pharmacist and he said that there is no such thing, there is just Oxycontin and it comes in the different mgs. but there is no such thing as ER when it comes to Oxycontin.
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