Percocet, Vicodin, etc., tolerance question

[bluesteyes]

A family member with a pain condition has been prescribed 7.5mg of Vicodin, to be taken three times per day. He's been taking it at 7am, 1pm, and 7pm every day like clockwork. This appears to be a long term condition, so he maybe taking it awhile. Will he eventually develop tolerance and need to increase to, say, 10mg of Vicodin to get the same pain relief, or if he continues to take it as scheduled (never doubling his dosage, etc.), should his tolerance remain just about the same?

It seems as though the only time people around me have gotten into real tolerance issues with opioid painkillers are when they have consistently used more than what the script calls for. But I don't know tons of people who take these things.

 

[crzydiamond]

Most people's tolerance will eventually increase to a point they will need more to achieve the same effect. (I say "most" because there's always that outlier...)

The example you mentioned of increasing from 7.5 mg to 10 mg is a likely example. Those type of pills are taken every 4-6 hours (when not on an as-needed basis), so the frequency isn't really the important thing in that example. If someone took them 2x a day at 7.5 they would eventually most likely need 10 mg 2x a day. I say this specific to your question and not to those who will take 5 X a day for recreation ....

Basically what happens is your brain increases the number of opiate receptors so that over time a person needs more of the opioid to feel the same way they did in the beginning. (I'm trying to really really simplify the concept here; look into upregulation/downregulation of opiate receptors for a more thorough explanation)


For some weird reason though, methadone is sort of an exception in that people can be on the same dose for years and it's still effective, though that's a whole other ballgame and not what you asked about. It just happened to come to mind. But for Vicodin and
Percocet , yes , over time a person who doesn't abuse the meds and takes as directed would normally require an increase in dose as they become tolerant to the original dose

 

[SS373dOH]

He most likely will build up a tolerance, the honeymoon ends quickly, and you have to take a larger dose to achieve the same analgesic effects, then eventually switch to a heavier opiate.


- Hopeless..

 

[tricomb]

tolerance only goes up... Sooner or later it'll be time for a stronger opioid once they're maxed out at hydrocodone.... =\

 

[tricomb]

OD --> BDD

basic question