Opioids MS Contin in relation to Oxycodone

[Jessy_D01]

Hi, all. New here. Please forgive me if I do something wrong. If someone I know has a crazy high oxycodone tolerance, like 300 or 400mg plus a day, and all they could find was MS Contin, what is the relation between the dosage of these? If this person takes a MS 30 extended release, it's like taking nothing. Just as Oxycontin can be chewed, they would like to do this with the MS but not sure if 30 or 15mg is too much?

 

[phenethylo J]

ms contin is morphine which has about the same oral potency as hydrocodone so 30mgs of morphine will be equal to around 22-23mgs of oxycodone. Oral doesn't really work that good compared to oxycodone and hydrocodone.

 

[Nurse Ratched]

If you have a tolerance to 400 mgs of oxy ( or roughly twelve 30 mg blues ) which are IR I can understand why a 30 mg xr morphine feels like taking nothing. When I was opioid naive someone gave me a small purple 30 mg xr morphine ( or maybe it was 15 mgs not sure but it was real small and dark purple) and I felt nothing. Seriously. I even chewed it up and didn't catch a buzz at all. Bioavailability of oral morphine is very low. Plugging is better I heard. You would be better off getting any other opioid that is IR...even codeine would be better than morphine. A tolerance to 400 mgs of oxy will be hard to overcome with xr meds. You might get some relief from sickness but you certainly won't get high. At least I didn't and I really was opioid naive at the time.

 

[TryBlendz]

If you have a tolerance to 400 mgs of oxy ( or roughly twelve 30 mg blues ) which are IR I can understand why a 30 mg xr morphine feels like taking nothing. When I was opioid naive someone gave me a small purple 30 mg xr morphine ( or maybe it was 15 mgs not sure but it was real small and dark purple) and I felt nothing. Seriously. I even chewed it up and didn't catch a buzz at all. Bioavailability of oral morphine is very low. Plugging is better I heard. You would be better off getting any other opioid that is IR...even codeine would be better than morphine. A tolerance to 400 mgs of oxy will be hard to overcome with xr meds. You might get some relief from sickness but you certainly won't get high. At least I didn't and I really was opioid naive at the time.

After kicking for a bit, and then starting from scratch, will MS Contin even give a nice mild euphoria with the 15mg or 30mg or 60mg at all? Or till the 100mg or 200mg? OR NO Euphoria at all, with any dose amount? My Doctor may give me an option between MS Contin and Belbuca 450 or 600 or 900 .. so just want to choose the better one from the start, so I don’t waste much time. (I’m not really interested in beating the MS Contin (just taking it normally).. Would the MS Contin 30mg, have as much euphoria as one of the hydrocodone 10/325?, or not even as good as those? Thanks In Advance.

 

[Just a little pinprick]

Hi, all. New here. Please forgive me if I do something wrong. If someone I know has a crazy high oxycodone tolerance, like 300 or 400mg plus a day, and all they could find was MS Contin, what is the relation between the dosage of these? If this person takes a MS 30 extended release, it's like taking nothing. Just as Oxycontin can be chewed, they would like to do this with the MS but not sure if 30 or 15mg is too much?

I’d would depend how I did them , when on vacation if I asked for OxyContin at the pharmacy the person would either come back with 20mg OxyNorm ( oxycodone IR) or MS Contin 30 mg capsule and if I swallowed them I’d feel the oxy way more than the MS Contin ,but if I shot them they were pretty close.. I was just enjoy vacation time without a habit, I never tried them with a tolerance …

 

[Feretile]

Oral morphine has (depending on where you look) about 24% bioavailability. Oral oxycodone has 60-80% bioavailability. Sustained release formulations can lower this slightly.

I suspect one of the reasons why oxycodone was introduced is that their is no alternative ROA to increase bioavailability substantially. The UK saw people cooking up MST-continus because it was rendered x5 more bioavailable. With oxycodone, since most is available orally, the only difference (I presume) is initial distribution. That said, oxycodone is partly converted (O-demethylated) to oxymorphone by the liver. If you IV oxycodone, you reduce that O-demethylation so it may not provide any more mu agonism than by simply swallowing the tablets.

I THINK that was the idea. It didn't work, but that is because medicinal chemists presume that patients are rational.

What may be worth knowing is that GPs are taught that when they switch a patient between two different opioids, you reduce the equianalgesic dose by 25%-50% because opioids are not 100% cross tolerant. It may be possible to reduce overall tolerance/dependence by roating.

In the UK their are certain pain clinics that would rotate a patient between 2 or 3 different opioids to keep tolerance down. Generally it was between a phenolic opioid (morphine, oxymorphone, ketobemidone, phenazolcine) and a non-phenolic opioid (dipipanone, fentanyl, dextromoramide). Theory stated that phenolic and non-phenolic opioids bind at different sites. This practice has fallen into abeyance because GPs were not to keen on prescribing opioids they were not familiar with and the increased side-effects encountered.

Morphine is still considered as 'the gold standard' for action and safety. 400mg/day is a lot. That said, morphine has a T½ of only 2 hours whereas oxycodone has a T½ of 4.5 hours. That would suggest that with chronic administration, 200mg/day of oxycodone would equate to 400mg/day morphine.

If you really struggle to control redosing, methadone is still used as an opioid analgesic. When given for pain, it is only needed twice a day because the T½ of methadone and it's active metabolite normethadone is some 96 hours. Given that figure, a much lower dose will work. It's a very useful medicine but it's association with drug addiction has made people suspicious. In the UK doctors always use the term Physeptone™' Levorphanol (Levo-Dromoran™) is the only other medicine with such a long duration of action with a T½ of 30 hours but it seems that only one company makes it and I KNOW that their have been supply issues.

I have only ever experienced opiate withdrawal when my pharmacist could not obtain my medication. Even in that case, UK law allowed him to provide me with a 24 hour supply of Physeptone to bridge the gap.

 

[Realityquestioned]

Oral morphine has (depending on where you look) about 24% bioavailability. Oral oxycodone has 60-80% bioavailability. Sustained release formulations can lower this slightly.

I suspect one of the reasons why oxycodone was introduced is that their is no alternative ROA to increase bioavailability substantially. The UK saw people cooking up MST-continus because it was rendered x5 more bioavailable. With oxycodone, since most is available orally, the only difference (I presume) is initial distribution. That said, oxycodone is partly converted (O-demethylated) to oxymorphone by the liver. If you IV oxycodone, you reduce that O-demethylation so it may not provide any more mu agonism than by simply swallowing the tablets.

I THINK that was the idea. It didn't work, but that is because medicinal chemists presume that patients are rational.

What may be worth knowing is that GPs are taught that when they switch a patient between two different opioids, you reduce the equianalgesic dose by 25%-50% because opioids are not 100% cross tolerant. It may be possible to reduce overall tolerance/dependence by roating.

In the UK their are certain pain clinics that would rotate a patient between 2 or 3 different opioids to keep tolerance down. Generally it was between a phenolic opioid (morphine, oxymorphone, ketobemidone, phenazolcine) and a non-phenolic opioid (dipipanone, fentanyl, dextromoramide). Theory stated that phenolic and non-phenolic opioids bind at different sites. This practice has fallen into abeyance because GPs were not to keen on prescribing opioids they were not familiar with and the increased side-effects encountered.

Morphine is still considered as 'the gold standard' for action and safety. 400mg/day is a lot. That said, morphine has a T½ of only 2 hours whereas oxycodone has a T½ of 4.5 hours. That would suggest that with chronic administration, 200mg/day of oxycodone would equate to 400mg/day morphine.

If you really struggle to control redosing, methadone is still used as an opioid analgesic. When given for pain, it is only needed twice a day because the T½ of methadone and it's active metabolite normethadone is some 96 hours. Given that figure, a much lower dose will work. It's a very useful medicine but it's association with drug addiction has made people suspicious. In the UK doctors always use the term Physeptone™' Levorphanol (Levo-Dromoran™) is the only other medicine with such a long duration of action with a T½ of 30 hours but it seems that only one company makes it and I KNOW that their have been supply issues.

I have only ever experienced opiate withdrawal when my pharmacist could not obtain my medication. Even in that case, UK law allowed him to provide me with a 24 hour supply of Physeptone to bridge the gap.

Excellent post