Gabapentin and OxyContin

[I003046]

Hello,

i currently have stage 4 prostate Cancer which as mestasized to my spine and pelvic area. The pain is sometime unbelievable at times and it seems like I have tried every drug with little or no effect. Yesterday my doctor recommend me taking Methadone 10Mg HCL for pain relief, which I took but it had no affect. Today I took 2, 10mg of Methadone HCL which seemed to work somewhat, but after 4 hours I felt pain coming back in my back and legs and decided to take 1, OxyContin 40mg AND 1, OxyContin 20mg.

they still did not benefit any pain relief so now I'm thinking about taking 1, 300Mg Gabapentin with either of the two to see if there is any success removing the pain. Does anyone have any history on what these two drugs will do if taken together? I would like to know before I take it.

thamks,

i003046

 

[Johndoedoe.junk]

I would recommend staying away from the Gabapentin. First of all in my experience Gaba is not the type of pain relieving med that you pop a pill and feel relief within an hour or so. I had to take it for weeks daily before it helped with my pain. Secondly the side effects were horrible. My extremities swelled up, I was drowsy, it gave me incontinence issues, and my memory was horrible. I would frequently be in the middle of a conversation with my wife and all of the sudden I would have no idea what we were talking about and couldn't remember or the life of me. For me the side effects of Gabapentin far outweighed the benefit. Pain relief isn't even the drugs original intended use, it is primarily an anti-seizure medication that just so happens to help with pain. If the Oxycontin isn't working it may be due to it's slow releasing nature. Percocet, which is immediate release Oxycodone mixed with acetaminophen, may work better as it releases quickly as opposed to the Oxycontin. Opana is another option. It's stronger than Oxycodone and comes in both immediate release and time released versions. Talk to your doc and see what they think.

 

[I003046]

I would recommend staying away from the Gabapentin. First of all in my experience Gaba is not the type of pain relieving med that you pop a pill and feel relief within an hour or so. I had to take it for weeks daily before it helped with my pain. Secondly the side effects were horrible. My extremities swelled up, I was drowsy, it gave me incontinence issues, and my memory was horrible. I would frequently be in the middle of a conversation with my wife and all of the sudden I would have no idea what we were talking about and couldn't remember or the life of me. For me the side effects of Gabapentin far outweighed the benefit. Pain relief isn't even the drugs original intended use, it is primarily an anti-seizure medication that just so happens to help with pain. If the Oxycontin isn't working it may be due to it's slow releasing nature. Percocet, which is immediate release Oxycodone mixed with acetaminophen, may work better as it releases quickly as opposed to the Oxycontin. Opana is another option. It's stronger than Oxycodone and comes in both immediate release and time released versions. Talk to your doc and see what they think.

Thanks Junk,

The reason they prescribed this drug was due to my nerve being compressed in my spine by the cancer growth. This put enormous pain in my legs, and would cause my left leg to give out when I would walk. Next thing I know, I'm doing the splits in the ground, or falling and hitting my head against the bath tube. I will try what you suggest though. Taking the Oxycodone (fast acting). I do have the Oxycodtin (slow acting) too. It just takes longer to respond and now I have built up a tolerance and just don't feel them anymore. The GABA, though, does remove some of the neuro pain where I can bear to sit down on my ass without screaming. I have a doctor's appointment this coming Monday to see if Neurological surgery can be perform, but there are doubts due to radiation I took in that area. However, I still have Oxyies, Morphine, Hydromorphone, and Methadone to play with. Just have to wait until Monday and see of they can operate.

thanks,

 

[Epiper888]

I've used Gabapentin when I used it I could hardly feel any pain. When I mixed gabapentin and Oxycodone together the gabapentin sorta washed out the Oxycodone but still had amazing pain killing affects, I did this when I broke my femur(biggest bone in leg) witch hurt pretty fucking bad. Try it and see if it works. There aren't any dangerous interactions.

 

[Johndoedoe.junk]

Thanks Junk,

the he reason they prescribed this drug was due to my nerve being compressed in my spine by the cancer growth. This put enormous pain in my legs, and would cause my left leg to give out when I would walk. Next thing I know, I'm doing the splits in the ground, or falling and hitting my head against the bath tube. I will try what you suggest though. Taking the Oxycodone (fast acting). I do have the Oxycodtin (slow acting) too. It just takes longer to respond and now I have built up a tolerance and just don't feel them anymore. The GABA, though, does remove some of the neuro pain where I can bear to sit down on my ass without screaming. I have a doctor's appointment this coming Monday to see if Neurological surgery can be perform, but there are doubts due to radiation I took in that area. However, I still have Oxyies, Morphine, Hydromorphone, and Methadone to play with. Just have to wait until Monday and see of they can operate.

thanks,

Yeah pain sure does suck doesn't it? Sounds like you've got a decent supply of meds to hold you over in the meantime though. For me the slow-acting pain meds just never cut it. I don't know if my body doesn't digest them properly or what quite happens but I've pretty much always needed the fast-acting stuff for adequate pain relief. I hear you on the tolerance issue as well. My body seems to build tolerance to meds very quickly, more so than the typical person I suspect, so it's a struggle to make what the docs want to prescribe work at the doses they want me to take. Very frustrating. How nice it would be if the body didn't adjust and the same dose would stay effective continually. No more having to haggle the doc for a larger dose or a stronger medication. Oh well, nature of the beast I guess. Anyhow, good luck and let us know how things work out.

 

[I003046]

I've used Gabapentin when I used it I could hardly feel any pain. When I mixed gabapentin and Oxycodone together the gabapentin sorta washed out the Oxycodone but still had amazing pain killing affects, I did this when I broke my femur(biggest bone in leg) witch hurt pretty fucking bad. Try it and see if it works. There aren't any dangerous interactions.

You broke your Femur and mines is riddled with cancer. An hour ago I took 4, 4mg Hydromorphone with 2, 10Mg Oxycodone (fast acting) with 1, 300Mg Gabapentin. Wife served me dinner in bed and I'm laying there watching Leonardo Dicaprio "Catch Me If you Can" and the next thing I know, I nodded out for about 5 minutes holding my folk in my hand. Look MA! No Pain. The pain in my left femur hurts like hell when I would stand or set. The worst is trying to take an overdue bowel movement for fear of setting down and not being able to get off the stool. Nevertheless it worked for me. I even had about 8 hours left out of 12 from taking 1, 40Mg Oxycotin and 1, 20Mg Oxycotin, both long acting. That too might had something to do with it. Hell, what a formula for defeating pain. First night in a week I felt good.

 

[I003046]

Yeah pain sure does suck doesn't it? Sounds like you've got a decent supply of meds to hold you over in the meantime though. For me the slow-acting pain meds just never cut it. I don't know if my body doesn't digest them properly or what quite happens but I've pretty much always needed the fast-acting stuff for adequate pain relief. I hear you on the tolerance issue as well. My body seems to build tolerance to meds very quickly, more so than the typical person I suspect, so it's a struggle to make what the docs want to prescribe work at the doses they want me to take. Very frustrating. How nice it would be if the body didn't adjust and the same dose would stay effective continually. No more having to haggle the doc for a larger dose or a stronger medication. Oh well, nature of the beast I guess. Anyhow, good luck and let us know how things work out.

I'm surprise my doctor give me all those types of Meds without an armed escort. When I go in to take Chemo treatments, the best high I had was when I would ask the nurse for Dilaudid (Hydromorphone) IV into my power port, on my right chest. Man it felt so good going in. Unfortuately the ones in pill form just doesn't do the job unless you mix them. So below is my daily dose of pills I take. This of course change due to pain waking me up in the wee hours of the morning. But they never seem to do me any good until I started experimenting with the Gaba, which I take only once a day.

12:00 am Alprazolam 0.5 Mg - 8:00am Gabapentin 300Mg - 8:30am Hydromorphone 4, 4Mg with 2, 800Mg Ibuprofen and 2, 10Mg Oxycodone. - 9:00am 1, 10Mg Prednisone - 11:00am 1, 40mg OxyContin - 2:00pm 1, 10mg Methadone - 4:00pm 2, 800Mg Ibuprofen - 5:00pm 3, 4Mg Hydromorphone with 2, 10Mg Oxycodone - 9:00pm 1, 40Mg OxyContin, 1, 20Mg OxyContin and 1, 0.4Mg Tamsulosin - 9:30pm 3, 0.4Mg Hydromorphone and 2, 10Mg Oxycodone

 

[Johndoedoe.junk]

I'm surprise my doctor give me all those types of Meds without an armed escort. When I go in to take Chemo treatments, the best high I had was when I would ask the nurse for Dilaudid (Hydromorphone) IV into my power port, on my right chest. Man it felt so good going in. Unfortuately the ones in pill form just doesn't do the job unless you mix them. So below is my daily dose of pills I take. This of course change due to pain waking me up in the wee hours of the morning. But they never seem to do me any good until I started experimenting with the Gaba, which I take only once a day.

12:00 am Alprazolam 0.5 Mg - 8:00am Gabapentin 300Mg - 8:30am Hydromorphone 4, 4Mg with 2, 800Mg Ibuprofen and 2, 10Mg Oxycodone. - 9:00am 1, 10Mg Prednisone - 11:00am 1, 40mg OxyContin - 2:00pm 1, 10mg Methadone - 4:00pm 2, 800Mg Ibuprofen - 5:00pm 3, 4Mg Hydromorphone with 2, 10Mg Oxycodone - 9:00pm 1, 40Mg OxyContin, 1, 20Mg OxyContin and 1, 0.4Mg Tamsulosin - 9:30pm 3, 0.4Mg Hydromorphone and 2, 10Mg Oxycodone

Wow that's quite a regimen! And who is your doctor??? Just kidding, lol. Yeah, I've had Dilaudid before but IM not IV and it's some pretty good stuff. My personal favorites are hydrocodone and oxycodone. Actually prefer the hydro over the oxy (which might be interesting to some as oxy is stronger) as long as I have enough. For me the oxy has more of a rebound "i feel sick and need more" effect than the hydro. I take alprazolam .5s too although not on a daily basis even though I'm prescribed three a day. The thing with me is I seem to develop the tolerance of an elephant extremely quickly with whatever I take so it takes high doses to have the desired effects. Try explaining that to a doctor though, *sigh. I like my pain doc well enough but I had a hard enough time getting him to write me for 10mg Norcos four times a day. I need six at least but he didn't wanna do it. Wish my doc was a as liberal as yours with the pain meds.

 

[pillman1224]

the guy has stage 4 cancer addiction is not a concern. i am prescribed .5 xanax 3x per day too i just dont take them.

 

[Johndoedoe.junk]

the guy has stage 4 cancer addiction is not a concern. i am prescribed .5 xanax 3x per day too i just dont take them.

You make a good point. I guess when the problem is that serious they remove all the stops. As far as the Xanax I find that it does help a lot with anxiety as well as sleep so I do need it, I just try not to take it everyday to avoid total dependence. Been down that road before with Ativan and benzos are a pain in the ass to get off once you are totally dependent. Forget cold turkey unless you enjoy seizures or convulsions. Took a very slow taper for me.

 

[Kittycat5]

Let me start by saying I am truly sorry for what you are going through and wish you the best. From one of your posts, it seems you were finally getting some adequate pain relief but I am going to throw some info your way and you can do as you wish with it.

First, the gabapentin. The first responder to your thread had a terrible experience with gabapentin, and while their points are valid regarding the adverse reactions gabapentin may cause (especially used with some of the other drugs you take having overlapping side effects [drowsiness, confusion with the opioids, water retention, edema with the prednisone]), I would not be discouraged to use it in your situation. Overall, gabapentin is,fairly well tolerated for most and quite effective in treating all types of neuropathic pain. Since you did take it and found relief, I say carry on. I do feel 300mg once daily is probably not going to work forever, so remember the max dose is between 2400 and 3600mg daily in three divided doses. But titrate up slowly, and of course monitor for any new side effects you notice.

Now the opioids. From what I gather, your pain control seems less than adequate from your current regimen. For pain from cancer that has metastisized to the bone, triple opioid therapy, TOT, is very effective. TOT consists of an ultrafast absorbed fentanyl preparation for severe breakthrough pain, and intermediately fast absorbed immediate release opioid for less severe BT pain, and a long acting opioid for the "background" pain. You already have the intermediate and long acting drug (oxycodone IR and oxycontin) but perhaps,talk to your doctor about the fentanyl. There are several products on the market. Actiq is a buccal lollypop, Fentora a buccal tablet, Subsys an oral spray, Lazanda a nasal spray and a couple of others I cannot remember. While highly effective, these drugs do have several issues. They are extremely potent and adverse reactions and overdose are much easier to achieve. They all must have a risk evaluation management strategy in place, which is a formal protocol on how to use and avoid misuse of these drugs. This creates and extra hurdle that patients and doctors must jump over in order to get these drugs, which many prescribers do not want to do. And lastly, they are all extremely expensive and can only be used for cancer pain which often makes them require prior authorization from insurance companies and sometimes higher copays.
As far as your current opiates, I would stick with one drug, and adjust doses upwards as needed. Personally, I think the oxycodone is the best, as hydromorphone has rather poor oral bioavailabilty, but it really is a matter of preference.

Now onto the antiinflammatories. You may want to consider switching from prednisone to dexamethasone, as dex has less mineralcorticoid activity which means less salt and water retention than prednisone. This is even more important while taking gabapentin as it too causes edema and obviously putting the two together may have an additive effect.
You are on a max dose of ibuprofen which is excellent as the NSAIDs have been shown in numerous studies to greatly enhance bain cancer pain relief. I hope you are on a GI protective drug ( a PPI like Nexium or misoprostol) to prevent the ulcer NSAIDs are known to cause. Also it may not be a bad idea to ask your doctor for some Ketoralac. It is an NSAID that has analgesia on par with morphine and may be helpful on your really bad days. It shouldnt be used for more than 5 days due to GI and kidney issues, but just an idea that may help you in your worse of time.

Finally, there are a couple of therapies that may be quite beneficial. Zometa is a biphosphanate drug that is used by injection and a quite high number of patients found their pain relief much improved. (I dont remember the exact numbers but could find). Then there is radiotherapy. Radiotherapy uses nuclear medicine to deliver radioactive isotopes directly to the bones. While not without problems, some patients experienced increased pain relief for 3 or 4 months after therapy.

I hope you read this and at least get something out of it. Cancer is bad enough. There is no reason why a patient should suffer from cancer associated pain to a degree where they cannot try to have any normalcy when there are therapies that can help.

Again, I wish you all the luck. Keep on fighting my friend.

 

[backtrashed]

I agree with kittycat5 about your pain control being substandard - they're trying to put out a forest fire with a garden hose. I had good luck with 10 mg methadone (qty6) once a day) for long term pain, and whatever short term opioid works best for yoy. I'm not a fan of oxycontin - it leaves me with too much of a chemical "burnout" feeling, much more than the natural opioids. You might see about getting morphine for your long term ned, and fentanyl for short term.