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  • BDD Moderators: Keif’ Richards | negrogesic

Switching from Oxycodone IR to Morphine IR for breakthrough pain

A

Angelgyrl

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Feb 9, 2017
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Hi everyone, this is my first post. Nice to meet ya'll!!! Question - I have been on Oxycodone 240 mg a day for breakthrough pain for several years. As I'm not getting the relief I used to get AND this is a hellava lot of Oxy to take and not get any pain relief, my doc is switching me to Morphine IR. With any new med she always starts me at a low dosage (safety first!), I'm afraid that a low dose of Morphine won't give me any relief at all. I also take 60 mg Morphine ER twice a day which works pretty well. So.....what do you all think? Am I going to have to suffer through a few weeks before I get to a dosage that actually helps? Thanks for any responses............
 
Hi, it is common for doctors to switch between opiates for pain management, I think because switching can help with pain relief. What dose is your doctor suggesting? I hope he/she understands tolerance and that if they drop you down too much you will experience withdrawals. Coming from 240 mg of oxy you should be taking, in my opinion, a pretty relative dose of morphine. It is smart to start small in case you are sensitive to morphine or something, but hopefully she prescribed you at least 100 mg of morphine a day considering how much oxycodone you take.

This could be a good thing for your pain, but you need enough morphine to keep your levels at what they are used to!
 
Your probably, more than likely going to need a lot more of the morphine for breakthrough pain.. I have always found morphine whether it be ERs or IRs to work terrible when taken in the way they were designed to be, orally just swallowing them... By far the most underwhelming ROA with morphine, or about on par with intranasal, Both of those ROAs to take morphine IR/ER aren't very efficient IME with them.. having taken over 300mg+(not recommended to take doses that high if not tolerant to the drug, or in general to start out with when you first take it.) while being addicted to oxy at that time of oral/insufflated, mostly oral morphine, which basically just got me well, after being in oxy WD which I was addicted to at that time, taking/doing (via other ROAs than oral) around 100-300mg a day of oxy, depending on how much money I had, and found the oxy to be much stronger, taken just about any way you can take a drug, except when I would bang it.. oxy is not as good IV, feeling wise, in my opinion, as Morphine is... The only ROA morphine is good for is IV, IME trying all of them, except plugging and IM(IRs only for the pills, ERs cant easily/safely be prepped/slammed, it is very risky even if you can get past the gelling up while prepping it..), and I don't really advise you to ever IV opioids, especially if you take them everyday for pain.. It is not going to end up well, in most cases when people do this with their meds, unless they also get other opiates off the street too, and just slam as much morphine as they want, run out, and are able to get more at all times from others.. SO when I said IV morphine is the only, actual decent way to take it, I didn't mean, go out and do it, its just facts.. IV is ~100% BA with morphine and oxy. Oxy for whatever reason, is way different than the majority of opioid pain pills, because they work ALOT better oral, than they do IV imo.. Oral oxy is like around ~80% more or less, IV Oxy is ~100% but doesn't last as long, doesn't give too great a rush if you IV it, in my experience with it.. Its there, but not like morphines is.. No opioids are really going to be safe to IV, as they are already very addicting when just taken as prescribed.. when abused, like IVed, sniffed, or etc.. etc... So I don't recommend people do it.. It may feel great at first, or all the time to them that way, and you may do them that way everyday like I used to with most opis.. I take subutex now.. Thankfully..

Anyways.. sorry, I kind of rambled off there. In short, I would totally stick with the oxy! I am pretty sure you wont like the morphine IRs if you take them as prescribed, orally.. alongside morphine ERs oral.. That is just MY experience with oral morphine, and the fact is, it is not a very powerful opioid at small doses, when taken oral. Something like 30-40% or less, is the BA of oral morphine ER/IR... SO, yeah.. I don't know if morphine is therapeutic to you and helpful for pain as of now, since you have been taking ERs with oxy IRs correct? I always found morphine to be a weak opioid orally.. oxy is the best one to take oral..
 
Jesus ^ meth post. U said a lot for not saying much.

OP would your doctor be open for suggestions? To me it would make more sense to take less of a more potent opioid. Like specifically (and you can do the conversion yourself, just Google opioid conversion chart) opana.

Opana aka oxymorphone is quite a bit more potent so you would need less . your liver will thank you.

May I ask what oxycodone you are taking? I'm not too experienced with that specific opioid but I know for instance percocet is loaded with apap and lousy for your liver.. 240mg is a very high dose so subsequently would mean a lot of apap.
 
To clarify, morphine is not so bad on your liver but you will still need kind of a lot to match your oxycodone dose. It would make sense to me to switch to something more potent.

I'm not a doctor at all just a fan of opiates and have many years of experience on the streets.
 
Hey everyone, thanks for responding. Actually my therapist is starting me at 15 mg of morphine IR several times a day!!! I'm so worried it won't be enough to manage my pain, but she always starts you really slow to make sure there are no adverse effects from the drug. Yes, I am also taking Morphine ER 40 mg twice a day and this has been working pretty well. I take it when I get up in the morning and about 10 hours later (before bedtime). I know she will up the dosage of the IR whenever needed, but I have to follow her instructions to start with a low dosage. I did get approved for Nucynta, which is a VERY expensive drug, but the copay was going to be $100 a month, tough for me to do as I live on disability, this is why she suggested the Morphine IR. Wish me luck, I sure hope I don't go through any kind of withdrawals......kinda scared.
 
I just sent my therapist a message with my concerns. I want to try the Nucynta first. I'm so terribly uncomfortable with the Morphine IR switch. I can afford the $99 copay and if it works well then I'm more than willing to pay it, just have to adjust my budget. She told me Nucynta works on nerve pain also, and I also have fibromyalgia, so hoping I get the relief I need from it. I won't be switching until the 20th when I receive my disability funds so will let you all know then how it's going. Thanks again for your responses and advice, really appreciated!!!
 
Agoraphobiaphile - I'm taking Oxycodone HCL. Don't think its mixed with APAP. If my insurance wouldn't approve the Nucynta, the next try would be for Opana, but as stated they did approve the Nucynta, so want to give that a try first instead of this itty bitty morphine dosing.
 
Have you or your prescriber considered trying Methadone out? Even if it's just for a trial run, it's known to possess comparatively less cross-tolerance than other Opioids. I'm a recreational user of Opioids and have been on and off Opioids for my entire life, since I was a child, but Methadone for straight-up analgesia is my first choice. It's easy to dose, fairly predictable and you have less of that "inter-dose anxiety" where you're wondering when your analgesia will wear off and if you'll have to take an early pill.

It's just an idea.
 
Keif Richards - thanks for the suggestion. I've read quite a bit on other forums about methadone and how well it works. I'll surely keep it in mind if the Nucynta doesn't work.
 
^I think Tapendatol (Nucynta) is probably worth a try for the same reasons Methadone is. It's an Opioid, but it also possesses properties of an SNRI that have also been shown to have the potential for analgesia. Keep us posted!
 
You won't feel as stimulated but chilled I feel oxycodone is better for fatique and morphine better for pain.
Might feel uncomfortable for first few days I did switchingf from morph to oxy and back.
but morphine instant aint as strong but lasts alot longer, if using for pain does last 4hours on a 10mg dose, if take higher dose lasts longer imo.
You could improve the bioavability to close to that of oxys then it is stronger by plugging it but I dont think is needed if just for pain relief.
 
Agoraphobiaphile said:
Jesus ^ meth post. U said a lot for not saying much.

OP would your doctor be open for suggestions? To me it would make more sense to take less of a more potent opioid. Like specifically (and you can do the conversion yourself, just Google opioid conversion chart) opana.

Opana aka oxymorphone is quite a bit more potent so you would need less . your liver will thank you.

May I ask what oxycodone you are taking? I'm not too experienced with that specific opioid but I know for instance percocet is loaded with apap and lousy for your liver.. 240mg is a very high dose so subsequently would mean a lot of apap.
Click to expand...

Lol total meth post
 
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