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  • BDD Moderators: Keif’ Richards

Medication help (oxycodone+tramadol vs. hydromorphone)

O

outoftown

Bluelighter
Joined
Aug 2, 2011
Messages
67
Hi everyone - I am new to BL - enjoy reading the posts. I hope I'm posting this question in the right place. I searched and couldnt find a topic covering this.

Anyway - I am a pain management patient. I have 2 severe injuries in my neck. I've been prescibed and taking percocet 10/325 since Dec 2011. I take it to help the pain - but to be honest, I enjoy the "feel" of it as well. I usually take it in doses of 2...sometimes 3...never more than that and only orally. Over the last few months, its begun to not work as well...for pain and the "high" is not as noticeable (I know tolerance builds up). Last month, I told my doctor this and he added ultram to my percocet. I'm prescibed to take up to 4 of each per day. I usually take the percocet at night (lasts longer for pain through the night and at night I can enjoy the "high" more). And I've been taking the Ultram through the day...not going crazy with it (I have ultram 50 mg...and I take 1 pill usually 3 times a day). I experimented a little with the Ultram - taking 2 at a time just to see...I barely noticed anything. But I could tell it does help the pain...and I can "feel it" - mostly a sedated feel to it. I'm prescibed to take the 2 together - I've done that a few times...does seem to make the percocet slightly more intense. But I also like to save the percocet for night time, and weekends/days i'm off when I'll take maybe 2 doses in a day (2 in the am, 3 in pm). Ultram also helps with the withdrawals from percocet - and helps me to make my percocet last the entire month.

So my question...when the doc gave me the Ultram...he said if this doesnt work he'll take me off ultram and percocet and prescribe me dilaudid. Now the Ultram and Percocet combo has worked - its relieving my pain better than just the percocet was (and the other advantages I explained above). However, I'm reading horror stories about taking Ultram (the seizure issue...and that Ultram is a bare to get off of when the time comes). So my question is...should I continue on the combo I'm on...or at my next appt should I have the doc prescribe me dilaudid (dont know what dose he will give me). Anybody have experience with dilaudid? How does it compare to the percoset I'm taking? Will dilaudid relieve my pain AND provide me the extra euphoric/high I get from percocet? Plus the percocet "high" I was experiencing is no where near as good as it once was...and I dont wanna take more than 3 at a time...is Dilaudid better for this? I've heard that taking Dilaudid orally does very little?

Thanks!
 
Hey outoftown, welcome to Bluelight!

What you've heard is right, oral Dilaudid (hydromorphone) isn't very effective at all - and for some people, its completely ineffective.

As far as painkilling abilities, hydromorphone is more effective than Percocet (oxycodone) or Ultram (tramadol) for sure. Again, however, oral hydromorphone isn't really that useful at all.

You also asked about the "high" of the two, they're both opiates, but oxycodone's "feel" is different from hydromorphone's, the hydro being much more sedating than the oxycodone.

I'm going to edit the title of your thread for easier searching in the future.
 
Thanks for your response!! Thats kinda what I figured. Ive had Dilaudid in an IV in my life (when my appendix burst) and it was incredible LOL But not since then - and never had it orally.

So I guess best thing to do is continue on with the ultram and percocet. Is it safe to take Ultram in a varied daily dose (ie...3 one day...2 the next day...back to 3) or should you take it scheduled everyday? I dont ever go over 200mg a day in 4 doses...just dont wanna mess with the ugly side of that drug. Plus its not really giving me anything more than added pain relief and relieving any withdrawal symptoms from the percocet.

Haha and I guess your saying to prevent the doc from prescribing dilaudid to me anyway I can?
 
^I agree. That's something you gotta discuss with your doctor, and we can't really tell you what to say to your doctor but be aware that (at least orally speaking) oxycodone is much more effective.

You can always try and Dilaudid and see if it works for your pain, however. Your doctor and yourself will be able to find what works best for your pain (everybody is different, you may get more effective pain relief from Dilaudid/hydromorphone than oxycodone, its hard to say for sure). Good luck!
 
Hydromorphone is available in the following tablet dosages: 0.5 mg, 1 mg, 2 mg, 3 mg, 4 mg, 8 mg

The 8 mg is equivalent to 21.33 mg of oxycodone orally according to this site.
http://www.globalrph.com/narcotic.cgi

I would certainly continue taking the oxycodone/APAP (Percocet) and tramadol (Ultram).

I am somewhat curious to know why your doctor skipped all other preparations containing oxycodone. My first thought was Roxicodone. They are available in 15 and 30 mg. They also do not contain acetaminophen which could slow the beatdown your stomach and liver are taking. (EDIT: hydromorphone would slow the beatdown as well) My next thought was OxyContin.
http://en.wikipedia.org/wiki/Oxycodone#Other_preparations

I would not suggest mentioning these to your doctor and I cannot provide tips on talking with him. I would even suggest that you don't mention because he might get suspicious.

I guess I was just typing a needlessly long post...
 
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I was curious about that as well. I had been taking the percocet for 7-8 months - it started to not work as well. i mentioned this to my doctor and he prescribed tramadol to me to take in addition to the percocet...and said if that doesnt work he'll "bump" me up to dilaudid. not sure which dose he had in mind. I was kinda surprised as well - but didnt know a lot about Dliaudid. I wont mention any of the drugs you said to him. He doesnt seem to concerned about liver haha - for the first 3 months he had me on percocet 10/650 - 4 times a day...which seemed like a lot to me to be taking 4 a day. I mentioned it to him after taking it for 3 months and he switched me to the 10/325 without discussion. I've never taken Roxicodone or Oxycontin...but it sounds like they would help more then the percocet/ultra combo. oh well. thanks for the reply!
 
That's 2,600mg of APAP a day, which isn't exactly the safest thing to be taking daily as far as your liver is concerned, its a good thing he switched you down to 1,300mg of APAP a day (still a lot, but safer than 2,600mg).
 
Yeah thats what I was thinking and why I mentioned it to him. 2600mg a day seemed like a huge amount. I know 1300mg is still a lot - does the tramadol compound the affect on my liver at all?
 
So the doctor ended up prescribing me 2mg dilaudid. If I take 2 or 3 of them (which is as prescribed), then it does help some. honestly, the percocet still works better (and I still have some left).

So my question...I took 2 dilaudid (4 mg total) about an hour ago. If I wait another 2 hours or so - can I take my usual percocet dose? Is that safe? Early today I took dilaudid and 5 hours later I took percocet (3 10mg pills) and it worked GREAT. And obviously i'm fine...is this safe though? Before I waited 5 hours...would it be ok to do this after waiting only 3 or 4 hours?
 
Oxycodone (the opiate in Percocet) is more orally active than hydromorphone (the opiate in Dilaudid). That's probably why the oxycodone is still working better for you, assuming your route of administration is oral for the hydromorphone too.

If you're at 4mg hydromorphone, I wouldn't take your Percocet unless you were sure that the hydromorphone wasn't working at all. Hydromorphone is pretty short-acting, so if you wait a total of four hours or so, I'd say it would be even safer. The oral bioavailability of hydromorph is very very low, in my personal experience with hydromorphone, nothing happened at all when I ate 2-4mg (this was back when I had a much lower tolerance to opiates), but snorting 1.5-2mg was a completely different ballgame.

Rambling aside, if you wait a solid 4-5 hours after dosing your hydromorphone and aren't feeling any effects from it (again, are you dosing it orally?) then it is most likely safe for you to take your Percocet.
 
Yes, my route of administration is oral for both meds. The Dilaudid hardly works at all at a 4mg dose. I feel very little europhic feeling from it (which I know - I've read about the low BA for dilaudid and difference in oral vs iv, etc). But it also isnt helping the pain as much as percocet does. Would it make a difference if I took 6 or even 8 mg? Orally speaking...

Earlier in the day when I took the percocet 5 hours after taking dilaudid...the perc REALLY worked! Better than it has in months...is this due to the dilaudid I took earlier in the day? could it have something to do with it? it literally has been months since percocet has given me such a good feeling and pain relief. But you are saying to wait at least 4 hours...I can do that...I was thinking to wait at least 3 or 4 hours. I'm hardly getting anything from the 4mg Dilaudid.
 
You may experience better relief at those higher dosages for the hydromorphone (6-8mg) but I wouldn't push it, esp. if your Percocet is working for you.

I'd say the fact that the hydromorphone was still in your system when you took your oxycodone earlier probably enhanced the effect (both medically for pain killing and recreationally speaking) of the Percocet.

Mixing opiates is a potentially dangerous situation because even if you don't feel anything from the hydromorphone doesn't mean its not still in your system. Tread with caution. I would let your doctor know that the Dilaudid wasn't effective, as theres no point in being in pain because a certain medication doesn't work for you.

Good luck!
 
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