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  • BDD Moderators: Keif’ Richards

Can you combine Oxycodone Instant Release with Oycontin Slow Release ?

Altered Perception

Altered Perception

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If my tolerance level is 40mg Oxycodone

and I take 2 of the 20mg instant release capsules = 40mg

but lets say I've run out of meds and I only have just one 20mg capsule left but then i get hold of a 20mg slow release oxycontin.

If i combine the 20mg INSTANT RELEASE capsule with the 20mg SLOW RELEASE Oxycontin tablet,

will that give me the same desired effect as me taking my regular dose of 2 X 20mg = 40mg of Oxycodone Instant release capsule?

I'm just trying to be cautious as I don't want to overdose so need advice quickly before I take it
 
You won't overdose from 20 mg IR + 20 mg SR if you're used to taking 2 x 20 mg IR.

Taking 20 mg IR + 20 mg SR won't be the same as taking two IRs, because the other one is SR (slow release).
 
The extended release preparation, as survival0200 pointed out, would not be the same as taking two 20mg IR tablets. Peak plasma levels in ER oxycodone occur at hour 3, while instant release is about hour 1, I believe. Also, it's incredibly common for people with chronic pain to be on a more "set" regimen of ER opiates / opioids (1 every morning, every evening, etc) while also having a prescription for PRN instant-release breakthrough pain management.

If you have predictable scenarios / activities that you know will end up causing an acute pain problem, I'd recommend taking the ER preparation 2 to 3 hours beforehand. This way, the pain will be lessened when it does come on, and you might find you don't need as high a dose of instant release oxycodone as a result.
 
Thank you both for informing me. Okay so the main difference is in regards to the Slow release is the speed of onset?

Okay in that case lets say I took the Slow Release tablet 3 hours before i added the 20mg dose of Instant release on top of it.

will that be closer to the effects of me taking 2 x 20 mg IR ?

I ask because I am trying to work out the full extent of its differences, so i know what to expect ?
 
Altered Perception said:
Thank you both for informing me. Okay so the main difference is in regards to the Slow release is the speed of onset?

Okay in that case lets say I took the Slow Release tablet 3 hours before i added the 20mg dose of Instant release on top of it.

will that be closer to the effects of me taking 2 x 20 mg IR ?

I ask because I am trying to work out the full extent of its differences, so i know what to expect ?
Click to expand...

Doing that will create, IMO, the relief you'd get from taking a 30mg oxycodone IR tablet. The main difference between the two is not just the speed of onset, but also the duration of plasma concentration, speed at which the drug enters and leaves the body, and subtleness of effects. The ER is essentially going to "dispense" itself over the course of 8-12 hours depending on how fast your body metabolizes it, while the IR will probably be processed in 2-4 hours.

The main reason I recommend taking the ER a few hours beforehand is that it will help prevent you from feeling like you "need" 40mg of IR due to your pain / situation. It acts as a kind of "backdrop" if you will, affecting your pain levels and mood while preventing the level of severity of your breakthrough pain. When you add the 20mg IR on top of this, it will likely feel less "potent" in terms of providing that rapid onset "nod" the IR can, but it will definitely still be noticeable.
 
Great advice and information. thanks very much. I understand now.

one last question:

I've been trying to quit or significantly reduce my Oxycodone for the last 2 years without much success. the problem has been that the IR Oxycodone which i have been on for the last 5 years i verys short acting and soon as my opiate level drops I start experiencing all teh discomfort and withdrawals.

So i managed to get hold of Oxycontin for the first time and can it be used to help me quit because I assume if i just take one i will be able to get through most of the day without too much discomfort and keep me going until my midnight dose of IR which will help me sleep. as opposed to the IR formula which wears off very quickly? What do you think?
 
Altered Perception said:
Great advice and information. thanks very much. I understand now.

one last question:

I've been trying to quit or significantly reduce my Oxycodone for the last 2 years without much success. the problem has been that the IR Oxycodone which i have been on for the last 5 years i verys short acting and soon as my opiate level drops I start experiencing all teh discomfort and withdrawals.

So i managed to get hold of Oxycontin for the first time and can it be used to help me quit because I assume if i just take one i will be able to get through most of the day without too much discomfort and keep me going until my midnight dose of IR which will help me sleep. as opposed to the IR formula which wears off very quickly? What do you think?
Click to expand...

I definitely believe it's incredibly necessary to switch to extended release oxycodone in order to begin a tapering process. If anything, your doctor would likely be happy to prescribe you an extended-release formulation with a lesser number of instant release tablets each month. Considering the reformulation and tamper-resistant measures added to OxyContin brand name tabs, plus the fact that you're on a decently high IR dose (relative to 5 or 10mg, that is) it seems like an extended version would really be best.

I know a bunch of people who have acute pain issues that ended up getting switched from IR exclusively to a combination of ER and a lesser number of IR tabs due to rebound pain issues, withdrawal symptoms between doses, faster buildup of tolerance, and less "stable" therapeutic affects. I highly suggest you request 2 extended-release tablets per day with one IR tablet per day PRN for breakthrough pain. I'd personally suggest not using IR to go to sleep, as it could end up causing you to wake up in the middle of the night with the temptation to take another, hence the 2 ER tabs a day recommendation.

Anyways, because everybody is totally different, I'd highly suggest talking to your dr about this further and asking if he believes switching to ER tablets primarily with prn IR tabs would help reduce the ups and downs of your day-to-day pain. Also, it should help make it easier to remember your meds, and will cut down on the number of times you take a tablet per day (most likely.)
 
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