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Opioids Alternative to lortab

J

Jonathan13

Greenlighter
Joined
Feb 8, 2011
Messages
17
I hope I am posting this in the correct section- if not will a mod please move it. Thanks :)

Alright I must begin by saying that unfortunately I have a ridiculously high tolerance to opiates which sucks. I am currently prescribed lortab 10/325 twice daily for osteoarthritis. Due to the fact I was into opiates before I was diagnosed I already have a tolerance and the lortab doesn't work as well as it obviously would if I did not. I cannot tell my doctor that I have previously abused opiates or she will most definitely cut me off from anything (which I cannot handle unless I have a hip replacement which I am putting off until after college).

I ran percocet by her at my visit yesterday to have my medications refilled and she abruptly said no. She said that it is more addictive than lortab and is a schedule 2, etc.... She also will not increase my dose of lortab.

Is there any alternative that I could ask about that she would possibly not shoot down immediately? I would prefer something without tylenol in it but as I understand they do not offer hydrocodone without tylenol- least amount being what I am on now. This is why I suggested the oxycodone which obviously is not happening lol.

Any help would be greatly appreciated! Thanks in advance guys.
 
Have you tried supplementing with an NSAID (ibuprofen, aspirin, diclofenac)? You can safely combine those with acetaminophen, barring an allergy or stomach ulcer. OTC NSAIDS are just as effective for analgesia as prescription ones (celecoxib, indometacin). They should not be used long term though due to side effects, but perhaps when the pain is bad they could be of assistance.
 
Actually yes, They prescribed me naproxen 500mg twice daily as well. It does help with the pain somewhat but KILLS my stomach for some reason (I guess that is a down side to the medicine). Sometimes I take it when the pain is unbearable but I usually try to avoid it.

Also I get better relief from the pain when I take both medications on an empty stomach. Obviously due to it being absorbed instantly instead of fighting through the food. The downside to this though is that the horrible stomach pain arises. And when I take it with food I almost feel like I am wasting the medication because I can tell it does not work as well.



EDIT: sorry i forgot to mention my other medications as well in the post (might be helpful somehow). They are the lortab 10/325 twice daily, naproxen 500 twice daily, seroquel 25-50mg at night for sleep, and phentermine 37.5mg once daily for weight loss.
 
Yeah you're pretty much maxed out on anti-inflammatories. How heavy/recent was your previous abuse? Actually I guess it doesn't really matter. Clearly you don't want to slip back into the grasp of opiates but the easiest solution would be to compliment the prescribed dosage. Where are you from? Also maybe muscle relaxants if you're limping and getting spasms etc.
 
Why the fuck are you taking Seroquel for sleep? have you tried Ambien, Lunesta, Benzos, Anticholingerics, etc already?
Seroquel is a fucked up drug, especially when being used off-label like this.
Anyways, you could always ask her for NORCO (10/325 HC) which you can take more of, or for a compounded Hydrocodone capsule or Tablet that would have more than 10mg in it.
Alot of doctors have been prescribing Opana ER as it has the MOST sophisticated anti-abuse mechanism of any new pill, is 2x strength orally as hydrocodone, and is generally a good drug if not abused, so you could drop to 5mg Er twice daily and actually get all-day relief.

BTW Hydrocodone is not indicated for the treatment of chronic-pain, which it sounds like you have, so you may want to point that out to him/her.

Oh, and lidoderm patches are the fucking bomb, it's so simple, they aren't scheduled, and work great, even for muscolo-skeletal pain.
 
amapola said:
Yeah you're pretty much maxed out on anti-inflammatories.
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I wouldn't say that... naproxen isn't exactly the most potent versus options such as celecoxib (which has less gastric side effects), ketorolac, indomethacin and several others.

The standard protocol is to include a PPI such as pantoprazole with these medications when they are necessary and produce GI-irritation and this is quit effective.

One of the quickest ways to get labeled a drug seeker is to walk in, conveniently say you have all of the side effects of alternatives and request C-II opioids by name. You may not be, but imagine how this looks to the practitioner.

There are lots of different ways to manage pain between pharmaceutical options such as- tricyclic antidepressants, anticonvulsants, skeletal muscle relaxants, local anesthetics, NSAIDs, NMDA antagonists, etc.

And alternatives such as meditation, bio/neurofeedback, transcutaneous electrical nerve stimulation, epidural steroid injections, nerve blocks, massage, accupuncture, physical therapy, counseling and so on.

Also for the record- as far as I know, all lortab doses contain 500mg acetaminophen so I assume you're receiving norco or the generic equivalent (both contain hydrocodone).

EDIT:

Mu- hydrocodone is indicated for PAIN, its not differentiated between acute and chronic. One of the reason they developed the norco formulations was so chronic pain patients could take larger amounts with less APAP.

I was prescribed norco for years for chronic pain and from my understanding, this is a relatively common practice.
 
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I know it is common practice, but I'm sitting here with my 2010 PDR and Vicodin, Vicodin HP, Norco, and Lortab are all indicated for acute or p.n.r. pain and specifically NOT for chronic pain. They do work, though, and I rather prefer norcos to any oxycodone.

There is a caveat here in my PDR that states that compounded Hydrocodone with anti-inflammatory drugs can be indicated for treatment of chronic pain, but specifically says that drugs such as APAP and Aspirin not be used and more long-term tolerable NSAIDS be compounded.
 
Not really having any spasms.. it is just that deep dull ache in the joint that won't go away no matter what position you sit or lay in. I do have a pretty nice limp though.- most days I use a cane.

And as for the seroquel, unfortunately yes we have tried everything.. "Z" meds, benzos, etc. Seroquel is the only thing that allows me to sleep. I assume my insomnia is pain related because it hurts quite a bit at night. I would LOVE if they would prescribe me opana er... I have tried that before and it works fantastic for me. I just see that as one of the things my doc will say no to. And yes it is chronic long term pain, I have had surgery twice.

Yes I am on the generic form which is how I have the 10/325. I do not believe she thinks that I am a drug seeker- she has my xrays and whatnot and knows that I have constant pain. I think she just doesn't think the pain is as bad as I am describing based on my xray.
 
Jonathan13 said:
Not really having any spasms.. it is just that deep dull ache in the joint that won't go away no matter what position you sit or lay in. I do have a pretty nice limp though.- most days I use a cane.

And as for the seroquel, unfortunately yes we have tried everything.. "Z" meds, benzos, etc. Seroquel is the only thing that allows me to sleep. I assume my insomnia is pain related because it hurts quite a bit at night. I would LOVE if they would prescribe me opana er... I have tried that before and it works fantastic for me. I just see that as one of the things my doc will say no to. And yes it is chronic long term pain, I have had surgery twice.

Yes I am on the generic form which is how I have the 10/325. I do not believe she thinks that I am a drug seeker- she has my xrays and whatnot and knows that I have constant pain. I think she just doesn't think the pain is as bad as I am describing based on my xray.
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1 word: psychiatrist.
I went back to a psych because my pain was super bad but I was still not getting relief, and was just like, listen if i'm not going to get relief I might as well not be on anything, he tapered me off with suboxone and sent a letter of reprimand or concern or something to the state board regarding my PM doctor and sent her a copy, too. Changed her tune quite a bit (but not for long)
 
Jonathan13 said:
I hope I am posting this in the correct section- if not will a mod please move it. Thanks :)

Alright I must begin by saying that unfortunately I have a ridiculously high tolerance to opiates which sucks. I am currently prescribed lortab 10/325 twice daily for osteoarthritis. Due to the fact I was into opiates before I was diagnosed I already have a tolerance and the lortab doesn't work as well as it obviously would if I did not. I cannot tell my doctor that I have previously abused opiates or she will most definitely cut me off from anything (which I cannot handle unless I have a hip replacement which I am putting off until after college).

I ran percocet by her at my visit yesterday to have my medications refilled and she abruptly said no. She said that it is more addictive than lortab and is a schedule 2, etc.... She also will not increase my dose of lortab.

Is there any alternative that I could ask about that she would possibly not shoot down immediately? I would prefer something without tylenol in it but as I understand they do not offer hydrocodone without tylenol- least amount being what I am on now. This is why I suggested the oxycodone which obviously is not happening lol.

Any help would be greatly appreciated! Thanks in advance guys.
Click to expand...

They do have Hydro preps that don't have APAP.. Vicoprofen(Hydro/Ibuprofen) for example. With the NSAID in the pills, I would heavily suggest taking them with a little food because without the food, your stomach will hurt. But will take the hydro a little longer to kick in.

Also, Percocet is not C-2.. it's a C-3 preparation. Oxycodone-only formulations are C-2 (Roxicodone).. I understand it can be hard to get proper pain management. Why not try talking to your Dr about how you've been on them for some time and they aren't working as well as they use to. I mean, every doc (smart ones) should know that prolonged use of opiates will cause a tolerance and switching to a more powerful medicine is going to have happen.

IME, hydro is just as addictive as oxy. Though oxy is usually the more favored of the two. They both have the same potential for addiction.
 
I agree, I felt that oxy and lortab have the same potential for addiction. And the lady probably just doesn't know what she is talking about in regards to her telling me they were C-2... I just didn't want to disagree with her and seem like I was "being a problem." Talking to her about it was what I attempted before suggesting the percocet. I said I know it is probably because I have been on the lortab for a while but it just seems a lot weaker than it did in regards to taking away my pain. She just nodded her head and wrote in her notebook and said nothing. I would try the vicoprofen but there are no generic forms yet and my insurance picks and chooses how much it wants to pay depending on how they feel at a particular time I think lol so no name brands for me unfortunately.

muvolution- That is pretty awesome that you fought the system and actually got something done, even if it was only temporary.

And no I haven't tried any OTCs because I live in the US and the only opiates you can buy over the counter are anti-diarrhea medicine and in some places a 4oz bottle of cheratussin cough syrup with a tiny bit of codeine. :(
 
And no I haven't tried any OTCs because I live in the US and the only opiates you can buy over the counter are anti-diarrhea medicine and in some places a 4oz bottle of cheratussin cough syrup with a tiny bit of codeine.
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Yeah I figured it was worth a mention. There is kratom if you are looking for a herbal opioid though.

Regarding your dosing do you feel better after taking the drugs and it is in between dosing that you feel pain? If so you could try 5mg four times a day which would keep a more consistent level in your system. I'm guessing you don't have much problem sleeping otherwise how could you be expected to have one pill last you 12 hours.
 
Swerlz, all oxycodone formulations, apap or not, are schedule II in the US.

To the OP, is this a pain management doctor you are seeing or what?
 
^Stupidly enough, the Schedule II for Percocet is correct... APAP and ibuprofen formulations of hydrocodone and other opiates are Schedule III and I see no reason that a 7.5mg Percocet is more illegal than a 10mg hydrocodone, but I guess drug laws aren't meant to make sense... 8)

I recommend taking your opiates as prescribed if you're hoping to get long-term relief from them. Those times you are taking more to get high are making all of the other doses significantly weaker in effect.
 
^Stupidly enough, the Schedule II for Percocet is correct... APAP and ibuprofen formulations of hydrocodone and other opiates are Schedule III and I see no reason that a 7.5mg Percocet is more illegal than a 10mg hydrocodone, but I guess drug laws aren't meant to make sense... 8)

I recommend taking your opiates as prescribed if you're hoping to get long-term relief from them. Those times you are taking more to get high are making all of the other doses significantly weaker in effect.
 
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