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Thread: Methadone 10 mg and Oxycodone 30mg

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    Methadone 10 mg and Oxycodone 30mg 
    #1
    Question
    I've been on oxycodone for years for injured and deteriorating lumbar, thoracic and cervical discs. Currently I take 30 mg oxycodone 4 times daily (sometimes more depending on the day).
    This works very well for my pain and restores (mostly) my ability to perform daily activities.
    My problem as of late is sleep. My sleep is interrupted due to pain - it affects my being able to fall asleep sometimes and without doubt gets me out of bed BEFORE I am fully rested.
    My doc prescribed methadone hcl 10 mg at bedtime to help w this.
    My question/concern: will this affect the relief I get from the oxycodone? Reading the various opinions on the net about the [question] vary widely right to left. I am 5'8", 155 lbs.
    Any suggestions, experiences will be appreciated.
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    #2
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    Nope, the methadone should help with pain from the time you go to bed through the morning hours. 10mg isn't a large dose, so it shouldn't raise tolerance making the 30s less efficient ,,
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    #3
    You'll be in a much better position - the long half-life of the Methadone will be perfect for night time. It'll carry you through nicely. However I'm curious if 10mg will be enough for you given that you take 120mg/day of oxy. Check out the opioid conversion chart at the top of the main Basic Drug Discussion page to do a little math and figure out what dose you'll actually need. I understand your doc is going to start you low. If that works, perfect, staying low on the Methadone is a better idea anyway. (My reasoning: I use oxycodone to self-manage my back pain while I get doctors to realize that someone my age can actually be in significant pain, and when I was taking 30-45mg/day of oxycodone, 10mg wasn't sufficient to do what I wanted, and needed 20mg. YMMV of course, best of luck!)

    At 10mg/day, you're not going to get any blockade effect due to dose - that kicks in around 60-70mg and up from what I understand.
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    #4
    It wouldn't be what I'd rx for you if I were a doc. Methadone is a rather strong opioid, and some say it blocks the effects of other opioids to some extent, or at least dulls them out. Since your pain is pretty well controlled, I wouldn't have started at 10 mg methadone, even considering your tolerance. I'd actually recommend Soma (carisoprodol) to be taken before bed. It is a muscle-relaxant, rather sedating, analgesic (painkilling), and often euphoric. When it is taken with an opioid, there is some nice potentiation, that allows for considerable pain relief and extra sedation, both of which you seem to need at bedtime. It is often rx'd for back issues, even ones in which muscles don't need to be "relaxed". The methadone will jack up your tolerance, even 10 mg. I can see why the doc did rx methadone, it is long-lasting, strong, and quite sedating, but it wouldn't be the best option IMO. If you do stick with methadone, I'd use only 5 mg at bedtime. I seriously recommend trying Soma, though. It is addictive, and wd's are potentially lethal, but that can be managed when the time comes (if it does) to come off of it. 350-700 mg would be a good starting dose.
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    #5
    For his purposes, Methadone would be more effective if for no other reason than the half-life of the compound.

    Soma = 8hrs
    Methadone = 15-60 hours
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    #6
    Quote Originally Posted by Pjkt2501 View Post
    For his purposes, Methadone would be more effective if for no other reason than the half-life of the compound.

    Soma = 8hrs
    Methadone = 15-60 hours
    Soma definitely is not as long-lasting in its effects, but along with an opiate, I could see it allowing for a much improved night sleep. It is more hypnotic, especially because he has an opiate tolerance, and it will help with the pain, too. Just my opinion.
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    #7
    Unhappy
    Quote Originally Posted by Alex000 View Post
    It wouldn't be what I'd rx for you if I were a doc. Methadone is a rather strong opioid, and some say it blocks the effects of other opioids to some extent, or at least dulls them out. Since your pain is pretty well controlled, I wouldn't have started at 10 mg methadone, even considering your tolerance. I'd actually recommend Soma (carisoprodol) to be taken before bed. It is a muscle-relaxant, rather sedating, analgesic (painkilling), and often euphoric. When it is taken with an opioid, there is some nice potentiation, that allows for considerable pain relief and extra sedation, both of which you seem to need at bedtime. It is often rx'd for back issues, even ones in which muscles don't need to be "relaxed". The methadone will jack up your tolerance, even 10 mg. I can see why the doc did rx methadone, it is long-lasting, strong, and quite sedating, but it wouldn't be the best option IMO. If you do stick with methadone, I'd use only 5 mg at bedtime. I seriously recommend trying Soma, though. It is addictive, and wd's are potentially lethal, but that can be managed when the time comes (if it does) to come off of it. 350-700 mg would be a good starting dose.
    Yea. I've tried Soma in the past. Didn't like it. Probably a good thing doc didn't offer it.
    I'm actually a bit apprehensive that the 10 mg might hinder my oxy effectiveness. DAMM!
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    #8
    @Alex000 Can't hurt to try I'm sure, but as you said, with his already-present opiate tolerance, I question how effective a normal dose would be.

    Regardless, it's still worth a shot (I'm just still in the boat that going to a lesser medication isn't going to largely help - I'm dealing with pain issues myself, and having a doc Rx something weaker makes them think you're not in the pain you are - but this is getting a bit close, if not too far, to the guideline restrictions regarding speaking w/ doctors; honesty is the best policy there).

    tjpilot - it's not going to effect your tolerance / oxy effectiveness much at 10mg, or even 3-4x that. In fact, what would happen, is that the analgesia would just carry through until it wears off. Methadone doesn't block other painkillers like Buprenorphine does - 'done just works by being damn strong (which a low dose won't prevent your oxy for working for breakthrough pain if it were that situation).
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    #9
    Quote Originally Posted by tjpilot View Post
    Yea. I've tried Soma in the past. Didn't like it. Probably a good thing doc didn't offer it.
    I'm actually a bit apprehensive that the 10 mg might hinder my oxy effectiveness. DAMM!
    In this case, I'd try 5 mg to start. If ineffective, I'd go up to 7.5 mg, then to 10 mg if needed.
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    #10
    Quote Originally Posted by Pjkt2501 View Post
    For his purposes, Methadone would be more effective if for no other reason than the half-life of the compound.

    Soma = 8hrs
    Methadone = 15-60 hours
    Wow. 15-60 hrs?!?
    So, how much time between dose of meth and when I can comfortably take my oxy?
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    #11
    Quote Originally Posted by tjpilot View Post
    Wow. 15-60 hrs?!?
    So, how much time between dose of meth and when I can comfortably take my oxy?
    I would take it as you normally take it, and if there are no dulling effects of the oxy, then maybe it is a good choice. But oxy is your primary med to control your pain, so I wouldn't adjust the oxy dosing routine too much. Another option is always benzos to be taken at bedtime. Just a thought.
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    #12
    Quote Originally Posted by Pjkt2501 View Post
    @Alex000 Can't hurt to try I'm sure, but as you said, with his already-present opiate tolerance, I question how effective a normal dose would be.

    Regardless, it's still worth a shot (I'm just still in the boat that going to a lesser medication isn't going to largely help - I'm dealing with pain issues myself, and having a doc Rx something weaker makes them think you're not in the pain you are - but this is getting a bit close, if not too far, to the guideline restrictions regarding speaking w/ doctors; honesty is the best policy there).

    tjpilot - it's not going to effect your tolerance / oxy effectiveness much at 10mg, or even 3-4x that. In fact, what would happen, is that the analgesia would just carry through until it wears off. Methadone doesn't block other painkillers like Buprenorphine does - 'done just works by being damn strong (which a low dose won't prevent your oxy for working for breakthrough pain if it were that situation).
    Okay... That makes me feel a little better. Is the done viewed as a lesser medication? Because I do not want to imply or condone in any way that my pain & discomfort is less than originally interpreted. It's much too hard to get a doc on your page nowadays... If you follow my concern
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    #13
    Quote Originally Posted by tjpilot View Post
    Okay... That makes me feel a little better. Is the done viewed as a lesser medication? Because I do not want to imply or condone in any way that my pain & discomfort is less than originally interpreted. It's much too hard to get a doc on your page nowadays... If you follow my concern
    Absolutely hear you 100% - I'm getting Tramadol right now and it's taking care of 50% - I still have to source my own oxy to take ~20mg/day (spread out - oxycodone has a 4hr half-life.. ).

    Methadone is actually one of the most powerful opiates, which is why it's used to prevent heroin addicts from relapsing (MMT programs). However, it's recently been able to be Rx'd for pain maintenance as well.

    Don't be scared by the half-life, in fact it's going to work in your favor. You can probably get away with taking your full dose on an "A" day, and on the "B" day, take a half dose (A/B schedule) and get by fine. Take your oxy as usual / as needed (you may even need less!).

    Good luck mate!
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    #14
    Exclamation
    I hear that brother...we all do that.
    What if I wake up in pain.... Can I take my 30s and expect my usual relief?

    Quote Originally Posted by Pjkt2501 View Post
    Absolutely hear you 100% - I'm getting Tramadol right now and it's taking care of 50% - I still have to source my own oxy to take ~20mg/day (spread out - oxycodone has a 4hr half-life.. ).

    Methadone is actually one of the most powerful opiates, which is why it's used to prevent heroin addicts from relapsing (MMT programs). However, it's recently been able to be Rx'd for pain maintenance as well.

    Don't be scared by the half-life, in fact it's going to work in your favor. You can probably get away with taking your full dose on an "A" day, and on the "B" day, take a half dose (A/B schedule) and get by fine. Take your oxy as usual / as needed (you may even need less!).

    Good luck mate!
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    #15
    Or another what if scenario ; what if I took the 10 mg. had pain, took a 30... Relaxed with a book, then took another 10mg. Over hours of course... Is this safe? Believe me.. Some days I'm good with three 30s, other days, I'll take 4 or 5 and still can't get off the TOLIET without help
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    #16
    Methadone takes roughly 60 minutes to take effect, and there's really no way around it. You're still going to need the 30's in the AM to kick in quickly.

    Given your tolerance, I would think that 20mg of methadone and 30-60mg of oxycodone should be safe, but I definitely would not mix another downer in (alcohol, benzos, etc.).
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    #17
    Wink
    Quote Originally Posted by Pjkt2501 View Post
    Methadone takes roughly 60 minutes to take effect, and there's really no way around it. You're still going to need the 30's in the AM to kick in quickly.

    Given your tolerance, I would think that 20mg of methadone and 30-60mg of oxycodone should be safe, but I definitely would not mix another downer in (alcohol, benzos, etc.).
    Here's any question; if I were to take them (30s) w the meth to extend my pain management... The oxy should be taken 1st?? Then the 'done how much afterward. I realize of course this is just an opinion I am requesting
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    #18
    If you're looking for long-term pain management, I would start with the methadone and use the oxy for BT pain due to rate of action, mainly. Orally, oxycodone takes about 1/3 to 1/2 the time as methadone takes (not meth, haha, gets confusing at times, at least for me; "wait meth? oh! oh, yeah").

    This also would be completely switching your schedule upside down, and is that something you're really looking to do? (This is something best discussed with your doctor.) At the dose you may need to take of methadone to keep you for a day, you might be running into blockage resulting in other IR meds not working. Worst yet - you may end up needing even stronger medication, such as Opana (oxymorphone). That is a road you really don't want to travel down...
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