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Hydrocodone equal or stronger than oxycodone due to incomplete cross tolerance?

Sentience

Sentience

Bluelighter
Joined
Oct 15, 2009
Messages
2,203
Is this possible or likely? Somebody going from 15 to 30mg roxis might get a comparable effect from 10 to 20mg Norco, due to incomplete cross tolerance with hydrocodone + the slight analgesia from Tylenol?

If this is the best available replacement, do you think you can save some tolerance by alternating between them?
 
15 mgs oxy=20 hydro seems plausible with incomplete cross tolerance, any more than that probably not. Certainly worth trying (even at 30 hydro) before jumping to 30 oxy. That will double your tolerance fairly quickly.
 
An equal analgesic conversion wont account for incomplete cross tolerance. I have 2 years tolerance to oxycodone, and have not used hydrocodone in that time.

Also, has anyone found that the Tylenol actually does help with severe pain somewhat?
 
Sentience said:
An equal analgesic conversion wont account for incomplete cross tolerance. I have 2 years tolerance to oxycodone, and have not used hydrocodone in that time.

Also, has anyone found that the Tylenol actually does help with severe pain somewhat?
Click to expand...
Certainly. Not nearly so well as opiates, but it definately helps.
 
Norco-10 is working surprisingly well as a replacement for Roxi-15. 2 years ago, before I had crazy specific tolerance to roxis, this might not have been the case.
 
No, not better, but comparable. 1 Norco is sufficient, maybe a little weaker. 2 Norco-10s makes me dizzier than 30mg of roxis, but hydrocodone has always been sleepier and dizzier for me, while roxies are more stimulating.

I also feel like the hydrocodone lasts longer for some reason, despite being weaker.


Dont underestimate incomplete cross tolerance. Switching opiates or rotating them can help slow down your tolerance.
 
I disagree. Many of the conversion charts have a variable section that modifies your dosage for incomplete cross tolerance, and the range can be from 25% to 75% or more.

Different agonists can bond with different parts of the same receptor, and not only will this mean that you will get a slightly different effect, but it also means that cross tolerance is not 100%
 
* While pharmacologic tolerance may develop to the opioid in use, tolerance may not be as marked relative to other opioids

* Incomplete cross-tolerance is likely due to subtle differences in:

o The molecular structure of each opioid
o The way each interacts with the patient’s opioid receptors

* Consequently, when switching opioids, there may be differences between published equianalgesic doses of different opioids and the effective ratio for a given patient

* Start with 50% to 75% of the published equianalgesic dose of the new opioid to compensate for incomplete cross-tolerance and individual variation, particularly if the patient has controlled pain

o If the patient has moderate to severe pain, do not reduce the dose as much
o If the patient has had adverse effects, reduce the dose more

* An important exception is methadone, which appears to have higher than expected potency during chronic dosing (compared with published equianalgesic doses for acute dosing)

* Start with 10% to 25% of the published equianalgesic dose
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http://www.pharmer.org/forum/discussion-prescription-and-otc-meds/incomplete-cross-tolerance

http://www.bluelight.ru/vb/showthread.php?t=404653
 
This is a fancy way of saying that different people have different tastes for drugs (based on biological differences). Some people prefer the effects of hydrocodone even on a mg for mg basis, though oxycodone is definitely about 1.5 times the strength of hydrocodone for most people.

PS- Your tolerance isn't actually lower, it's just that the hydrocodone is working better for you than for most, or that oxycodone is not working as well in you as in others.
 
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No, it isnt.

Its saying that you can build tolerance to one opiate and then later on you will have only incomplete cross tolerance to another opiate with a different chemical structure.
 
Well I'd still be just about as tolerant to opioids if I switched from one to another. If I were to have switched from my habit of 240mg of Oxycodone to 160mg of Hydrocodone (equivalent to the dose that you converted, 15mg of oxycodone to 10mg hydrocodone) I would have gone into withdrawals. That's just from previous experience of mine. I don't doubt what you said. It just would not have been able to work for me.
 
Read what you quoted, specifically this part:


* Incomplete cross-tolerance is likely due to subtle differences in:

o The molecular structure of each opioid
o The way each interacts with the patient’s opioid receptors

Neither of those states what you are claiming. I see where you are being mislead by the use of "incomplete cross-tolerance", but it's not being used in the same sense as with a benzodiazepine, for example.
 
I think you might be misunderstanding what those two points are saying. They are not only saying that each individual has differences in their receptors, though that might also be true, but that each drug is going to affect different positions on the same receptors....just because two drugs have an affinity for the same receptors does not mean that they will occupy the same positions on the same receptors, and if there are differences in receptor sites even on the same receptor, than this may affect tolerance if specific agonists cause certain bonding sites to proliferate on the same receptors more than others.

Also, we are not certain that different opiates affect all of the same receptors evenly either. They may have affinity for different areas of the brain, due to how freely they cross the blood brain barrier....or in the case of Methadone, some opiods may have affinity for the delta receptors which other opiods may lack.

Also, read this part carefully.

Start with 50% to 75% of the published equianalgesic dose of the new opioid to compensate for *incomplete cross-tolerance* AND *individual variation*
Click to expand...


Hydrocodone might not be different enough from oxycodone to give as much variation from incomplete cross tolerance compared to going from Morphine to Fentanyl or Fentanyl to Dilaudid.
 
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