Opioids Best Long-Acting Opiate to take with Oxycodone?? (going back to Dr. next week)

[mysocalledhigh]

I am currently prescribed 10mg Methadone for my long-acting pain relief & 15 mg Oxycodone for breakthru pain. I am prescribed 2 of the Methadone a day, and 4 of the Oxycodone. In 2 more visits, he wants to bring me up to 30mg of Oxy, and when I go back this month I told him I'd do some research with what my insurance covers, what pharmacies around keep in stock and which my insurance covered. He has offered the following long-lasting meds to choose from:

(these are the ones I can remember him listing.. i wish I'd written them down. I chose the Methadone because he assured me that they are covered by all insurance plans and almost every pharmacy keeps them in stock. My problem them Methadone is the worry of lose of bone-marrow after years of use which I'll likely face with my injury and daily pain level)


Ms Cotin (Morphine)
Oxymorphone (Opana)
Tramadol ER (Ultram ER)

Looking for suggestions on what will work with oxycodone the best, and how difficult it is to fill these scripts. (It took me 2 weeks and visiting over 50 pharmacies, both private and corporate before I found a Walmart that had 15mg in stock and didn't refuse to fill them)

Also tell me of any other long-acting pain meds you know of. Thanks, guys.

 

[fizzymk]

I would definitely not ask for the tramadol, that stuff is crap. Id take the Opana, but make sure your insurance covers it as these are SUPER expensive, someone I knew had a script he was trying to get money to fill, I believe it was 80 of the 40mg and it was around $700. to fill, with no insurance at all!!!

You are damn lucky to have a doctor willing to give you methadone PLUS opana or morphine!! LOL

 

[Nicholai]

The issue of bone loss is a concern with synthetic or semi-synthetic opioids, but not opiates, from what my doctor told me, so I'd try the MsContin...

 

[mysocalledhigh]

No, no.. he's giving me the choice of the three.

 

[mysocalledhigh]

I would definitely not ask for the tramadol, that stuff is crap. Id take the Opana, but make sure your insurance covers it as these are SUPER expensive, someone I knew had a script he was trying to get money to fill, I believe it was 80 of the 40mg and it was around $700. to fill, with no insurance at all!!!

You are damn lucky to have a doctor willing to give you methadone PLUS opana or morphine!! LOL

No no.. he is asking me which of the long acting ones I want. I have to chose one.

 

[SAMCRO]

You're taking Methadone 10mg + 15mg Oxy IR for breakthrough? For long acting pain relieve I think Methadone is probably one of the best ime so don't think you're going to find anything that works as good but maybe you just have to try a few different ones.

 

[Felonious Monk]

Definitely not the Ultram, it's pretty useless if you've been using stronger opiates.

The Opana might be really expensive, but would be effective (possibly too effective, you don't mention why you're in pain, or how much). MSContin, OxyContin, or Fentanyl patches would all be less effective, and in the right dose would be equally effective to Opana. (and might be a better choice looking forward, especially the MSContin or OxyContin, as they'll keep your tolerance at a more reasonable level, since as a chronic pain patient you have to think long term)

 

[tricomb]

1) Hydromorphone HCl ER capsules.

2) Morphine sulphate ER tablets.

3)Oxycodone HCl ER tablets*
*I don't think it's a wise idea to be on roxicodone in addition to oxycodone ER, In my experience I get much less pain relief and the ER tablets don't last a fraction of the time that the morphine ones do and morphine's duration for me alone combined with it's high potency and a good medication I've found to use in rotation with methadone (maybe you are on methadone now because you were rotating your meds, a common chronic pain treatment strategy to keep tolerances manageable and not have ever-increasing doses of oxycodone.

4)Avoid fentanyl at all costs. Trust me, when you're in extreme pain, dying, or sick, you're going to wish you didn't have a tolerance so high that your on the end of the line of medications we have available for pain, once you're tolerant to fentanyl you're really risking the inability to treat your pain in other situations when you will need it WAY more than a chronic-pain regimen, like a situations that may require hospitalization.

And further, the pain killers they give you aren't effective so they have to resort to more extreme measures which can complicate whatever reason you're in a situation where you need to have the hospital have the resources to use their desired and most effective opioids such as intravenous hydromorphone, and extremely careful use of fentanyl and fentanyl analogues such as Sufentanil, God forbid you ever require that medication...

5) Methadone really is a great pain killer for long-acting reasons despite the need to dose it 3-4 times a day at least, but I find it produces wayyyy more side effects than the first three options I outlined.