Opioids Oxymorphone ER vs. Oxycontin ER for PM

[mc34952]

Whats up guys, I've read many threads on here and finally registered to post. I've tried searching this but I cant really find solid answers to help me. I've been in pain for 6+ years now, a herniated disc that i had replaced in 2014, which didn't relieve me of any pain. Fast forward to now and im told i need another surgery to remove the implant as well as a huge bone spur above it, and just do a traditional fusion. For the last nearly a year ive been on pain meds to help me get through the day (24/7 pain). I'm currently using 15mg oxycodone IR which works great, but doesn't last as long as i need it to. About 4 months ago i was also put on opana 10mg ER 2x a day, and this month he added one more, so 3x 10mg per day. Its just not working and im having to use more IR than I'd like. I'm curious, should i ask him to raise the opana to a higher dosage, or switch to oxycontin ER and try that? From reading up on opana, apparently taking it orally as intended, is very low BA. How does oxycontin ER compare?


instead of taking a 1 10mg opana 3x a day every 8 hours, i usually take all 3 at once. The other day i tried 3, then like 6 hours later i took 3 more, to try and get an idea of what it'd be like if i was on 30mg 2 or 3 times a day. Didn't really help much either unfortunately. The pain is really that bad...i need a long acting medication that works better than what im on, at least until after my next surgery and hopefully im pain free after i recover and then i can taper off all opiates for good.


i look forward to hearing from you all.

thanks!

 

[blazequietly]

In general Oxymorphone is much stronger than oxycontin but thats looking at it from a drug abusers point of view. Ive always injected the opana IRs or snorted the Opana ERs (i found snorting 20mg of opana ER to be equal to taking like and OC40.) I can't speak for taking it orally but you are correct I've read numerous times that the oral bio-availability is very low close to 10-15% and snorted is closer to 30-50%. I don't know the exact numbers and I'm not going to look them up now, but shooting one 10mg IR gets me 5 times as high as snorting 20mg opana ER. So I assume the bio-availability when injected is close to 100%

To answer your question, Yes I would probably ask your doctor to try using oxycontin ER instead, there are more options with dosing with oxycontins, for example if they find you need a very high dose than can give you the oxy 60s along with the oxy 40s and let you take 100 mg a day, or a number of other options that exceed 80 mg. You could say just keep upping the oxymorphone dose but if its not working for you even when you tried 30mg 3x a day than I dont think they are going to prescribe you any more than that.

There are many options you could look into for long term pain relief. Oxycontin would be a good place to start since the oxycodone hcl works well for you. if that doesnt work maybe your doctor would be willing to prescribe fentnyl patches, That is a very strong medication and comes in 50, 75 and 100 microgram patches. I wanna say one patch is supposed to last 5 days? I'm not sure about that though. I could see Fentnyl patches with oxy IRs for break through pain being a possibility for you. Other wise I mean you are up there with the strongest doses of opioid pain relievers available. Theres Morphine ER, Hydromorphone, Tapentadol , theres a lot of stuff you could try that is effective. Everyone is different so hopefully you find a medication that works well for you. Maybe you could try that new hydrocodone medication that has no tylenol and is extended release, it's called Zohydro. I don't know any one who it has been prescribed to but I've read a lot about it. I wouldnt suspect it would work any better than Oxycontin because hydrocodone is weaker than oxycodone to begin with but you never know until you try it I guess.

 

[mc34952]

In general Oxymorphone is much stronger than oxycontin but thats looking at it from a drug abusers point of view. Ive always injected the opana IRs or snorted the Opana ERs (i found snorting 20mg of opana ER to be equal to taking like and OC40.) I can't speak for taking it orally but you are correct I've read numerous times that the oral bio-availability is very low close to 10-15% and snorted is closer to 30-50%. I don't know the exact numbers and I'm not going to look them up now, but shooting one 10mg IR gets me 5 times as high as snorting 20mg opana ER. So I assume the bio-availability when injected is close to 100%

To answer your question, Yes I would probably ask your doctor to try using oxycontin ER instead, there are more options with dosing with oxycontins, for example if they find you need a very high dose than can give you the oxy 60s along with the oxy 40s and let you take 100 mg a day, or a number of other options that exceed 80 mg. You could say just keep upping the oxymorphone dose but if its not working for you even when you tried 30mg 3x a day than I dont think they are going to prescribe you any more than that.

There are many options you could look into for long term pain relief. Oxycontin would be a good place to start since the oxycodone hcl works well for you. if that doesnt work maybe your doctor would be willing to prescribe fentnyl patches, That is a very strong medication and comes in 50, 75 and 100 microgram patches. I wanna say one patch is supposed to last 5 days? I'm not sure about that though. I could see Fentnyl patches with oxy IRs for break through pain being a possibility for you. Other wise I mean you are up there with the strongest doses of opioid pain relievers available. Theres Morphine ER, Hydromorphone, Tapentadol , theres a lot of stuff you could try that is effective. Everyone is different so hopefully you find a medication that works well for you. Maybe you could try that new hydrocodone medication that has no tylenol and is extended release, it's called Zohydro. I don't know any one who it has been prescribed to but I've read a lot about it. I wouldnt suspect it would work any better than Oxycontin because hydrocodone is weaker than oxycodone to begin with but you never know until you try it I guess.

thanks for the detailed response. my next question was going to be what other long acting meds could i ask for, but you answered that for me as well. ill run it by him, i go this week, and see what he wants to do. seeing as how the oxycodone hcl IR works really good for me, i think the oxycodone ER would work well too (just not sure what strength). i have tried 30mg morphine ER and a single 30mg pill didn't do much of anything.

yea it sucks about the opana, its so strong but orally it sucks! and i'm not a recreational user so i will never take it other than how its intended to be taken, so i can't take advantage of the oxymorphone working better via a different ROA.

 

[Speed King]

I don't have a very high oxycodone tolerance, but a low dose Opana ER kicked my ass. I thought it was way better then the re formulated OxyContin .
I had a re formulated OxyContin 40mg and it absolutely was weak as 10 mg of Percocet to me anyway.
I just re entered pain management at a lower level than OP. So far to guage my pain, I was put on 4, 5/325 Percocet (20mg) a day. This is for my doc to gauge my pain. I like the Percocet IR, but they just don't last that long. 4 of them don't cover a day.
Many people in these forums, suggested a ER medication to cover all day/night, and IR meds for breakthrough pain.
Are those tamper proof OxyContin any good? I think I'd rather take the low starting dose, Opana ER simply because I know they work. I have no idea how IR Opana works at all.

If this can be answered, what's a 5mg Opana ER equal to oxycodone wise?

If I wanted a 20mg / 12 hour equivalent to oxycodone , how much Opana ER would that be.

I'm not trying to hi jak thread, but I figure I can learn here also, along with OP.

Am I right to assume that Opana has less stigma than any oxycodone or OxyContin product?

 

[mc34952]

yea see im curious if one's level of pain changes how a certain pill works. i feel that my pain is so high, that any pill i take has to work super hard to give me relief...i will say a year ago when i took my first oxycodone IR pill in my life, it was a half of a 15, so 7.5mg of IR oxycodone. my pain went away for about 3 hours and i felt great. a year later, 30mg of IR gives me about 40-50% relief for maybe 1.5 to 2 hours. the pain has gotten a lot worse, as well as tolerance build up of course.

im kind of curious how an opana IR works compared to my 15mg oxycodone IR i am prescribed, but the oxycodone IR works so well i don't want to waste time switching, then its a hassle to get the others back, have to get another script, bring back the opana IR's, contact my insurance, pharmacy, whole big ordeal, so i'd rather just stick with the IR that i know works good, im just going to ask him this month when i go if he can up me to 30mg IR now.

the ER im still not sure on, ill ask him and see what he thinks, maybe he will want to put me on the oxycodone ER and see how it works. its all worth a try. as long as i have the IR to relieve my pain if the ER's dont work, ill be able to manage my pain.

oh, and here is the opana "conversion" chart...keep in mind this isn't exact, everyone reacts to medication differently, tolerance, etc. it says 20mg oxycodone = 10mg oxymorphone. i can tell you 100% that for ME, that isn't true. 20mg oxycodone (IR at least) i will feel. 10mg oxymorphone (ER) i don't feel at all.

http://www.opana.com/prescriber/dosing/opioid-conversions.aspx

 

[Speed King]

That's funny. I felt what I'm sure was less than 10 mg ER Opana was stronger than currently taking 20mg IR Percocet.
I forgot to take into account that my tolerance has changed over the years. Maybe now I'll feel the same way as you do.

 

[mc34952]

Yea i think a year ago when i was first introduced to opiates, if i was started with an er too rather than just IR, i may have felt the same as you are now. Id consider myself pretty tolerant, i can take 60mg ir at once and not get sick anymore like i did 3 to 4 months into starting opiates.

 

[rokkinrollaa6]

i'd suggest adding in diphenhydramine and NSAIDS like naproxen or keterolac to boost the pain relieving aspects. some grapfruit juice to would help. with all this stuff added i usually cut my doses down dramatically, so i would try that first before constantly escalating. you may need to escalate, but you have a great doctor for giving you both opana and oxy ir, my doctors even with a diagnosed chronic painful kidney disorder which is one of the strongest pain sensations known, do not go above tramadol and percocet combos.

 

[mc34952]

Ive tried the GFJ and it doesn't really do much for me to be honest. Yea my doc is good haha

 

[AnnaBanana333]

If you want to boost the effectiveness of the oxymorphone orally, eat something fatty beforehand. I also take an antacid with it. I don't know how much it helps, but I do notice a difference.

Also, in my experience, after OxyContin was re formulated, I didn't feel it at ALL. Thus, my switch to Opana. I still use Oxycodone 15mg IRs, and find them very effective with minimal side affects. When I've needed to switch or try something new, I'll ask my doctor if I can substitute 1 of the new drug/day instead of my current. That way, if it doesn't work, I'm not waiting a whole month to go back, and I can try it at my convenience (ie, take 2 if needed to see if it works if 1 didn't).

 

[Kid Amine]

New name brand Opana* is virtually useless, it is more tamper resistant than OPs, and since the bioavailability is lower orally, you wind up with less relief. Since the original poster is looking for pain relief not abuse, Id go to fentanyl patches, however your doc is likely going to fk you on equivalent dose and # of patches. They do not last 3 days, more like two, and every single person Ive known on patches got at least 15 a month.

 

[mc34952]

What is the bio availability on the new style oxycontin pills?

 

[Kid Amine]

Still 85-90%, just takes all day for them to absorb

 

[mc34952]

See I'm fine with that, hes got me on 1 every 8 hours on the opanas, if he puts me on a high enough oxycontin every 8 hours i should in theory have great round the clock PM, with the oxy IR in between. The opanas for me seem to take long as well, and even taking 4 10mgs at once didn't give me any relief. I like the higher oral BA of the oxycontin so i think ima try those.

 

[tacodude]

Opana ER for recreational usage is shit, but for pain relief it is a very useful form. It has a 7-9 hour half life vs 1-3 like oxycodone and hydro/normal morphine/codine. Theoretically one pill at the right time will give near 24 hour relief for an ER formulation. IMO oxy/hydro/normal morphine has a more sleep inducing sedation while oxy/hydro/normal codeine at best leaves me tired somewhat making sleep harder to achieve, but at the same time easier. It is like they both induce sleep while the codeine variations somewhat interfier with sleep allowing pain relief without causing too much drowsiness for pain relief while active vs. resting.

I myself use oxycotin ER 30 mg 2x in the morning 1x at lunch and 1x at dinner for my matinance med. I use 12 five mg IR oxymorphome throughout the day via IV, which is more than most anyone needs honestly as I get 100% BA vs. 10% or 40% via other easier methods. I hope within the next few weeks to start weening down the oxymorphone then getting the oxy down to IR dosing then off both. Of course the IV ROA needs to stop there's just life changes I need to do that.... That being said OC ER for maintenance and OM IR for breakthrough is the best combo IMO. Also OC earlier when one needs to be functional and active while the OM is for resting pain when laying in bed or chillin on a couch or lazy chair.

edit:

See I'm fine with that, hes got me on 1 every 8 hours on the opanas, if he puts me on a high enough oxycontin every 8 hours i should in theory have great round the clock PM, with the oxy IR in between. The opanas for me seem to take long as well, and even taking 4 10mgs at once didn't give me any relief. I like the higher oral BA of the oxycontin so i think ima try those.

If you use oc ir you need to dose every 4-6 hours as pain relief wears off at four hours with the right dose while two low wont be nearly as strong pain relief and not even half of the duration while withdrawal at the right dose will kick in every 6 hours. Get the ER meds and take a full dose in the morning 0.5 at lunch and again at dinner as I find that leads to the most even release. If you need a breakthrough formulation more oc ir if it works, but since part of the pain relief, and in my opinion the greater pain relief at the cost of being sleepy, is due to the OC partially converting to the oxymorphone I think it could be a much better choice as long as you recognize it has stronger sedation so it is recommended to take when you are ready to retire for the evening or if you know you won't have any responsibilities requiring heavy activity.

edit 2: In case you wonder I take the brand name purdue oxycotin ER oxycodone 12 hour tamper proof plastic hard as a mofo plastic drug releasing matrix...... I take it with a glass of water as if I swallow it without liquid I will feel it sitting in my throat right behind the adams apple like a lump that no ammount of liquid or food will not help it pass just 10-12 hours. Besides that issue they work like a dream. I honestly prefer them to IR formulation for pain relief.

 

[Specter]

I would always try to keep that oxycodone IR med around-- whatever you do and/or say to the doctor do NOT let him get rid of that 15mg oxycodone IR. If you switch to the ER tabs the relief simply will NOT be there-- I don't know anyone that gets equivalent relief from the new OP Oxycontin versus a generic oxycodone IR pill. For me personally, I would need 60 mg ER Oxycontin AND two hours of time (versus 20 minutes) to get the same relief from that 15 mg IR. I know a lot of people think the ER med sounds like a great idea but the new OP formulation just flat out does not give the same relief. I am beating a dead horse but repeating myself for a reason because I know you'll be pissed at yourself if you talk your doctor into making the switch and then not be able to go back. Also, the ER tabs are name brand and are quite expensive even with decent to good insurance where the generic oxycodone is relatively cheap... and did I mention MUCH better??? LOL.

By the way, I am not talking from an abuse standpoint (although it does apply there as well, maybe even more so) but working for pain. The generic IR tabs kick in fast as I'm sure you know... usually less than 30 minutes for me on an empty stomach and when you need relief having those around seriously works wonders. If you start taking the ER tabs, you'l be annoyed checking the clock every 30-45 minutes thinking what the hell why hasn't this thing started working yet?

I get a script for opiates as well because of similar issues and severe back pain from multiple car accidents and playing contact sports at a high level that destroyed my body over the years.

As far as Opana goes, its the best pharmaceutical opiate for "getting high" in my opinion and the best ones to get are the Actavis brand that crush up easily. I absolutely hate snorting anything and 99% of the time I just eat my prescription but if you can stand it, snorting that brand Opana and it will work 10x better. Its phenomenal for pain relief and abusing...

IF you do not want to do that see if you can have your doctor drop the Opana and sub the Oxycontin ER to go with your IR meds. My concern with that is only that some doctors will not give you oxycodone in both ER and IR and more than likely why he put you on Opana to go with your IR oxycodone.

Whatever you do, don't lose that 15mg IR script because for pain and someone that wants quick relief and just wants to eat the medicine there is nothing better. 80+% oral BA... no brainer.

I would NEVER give up that doctor either if I were you, I would love to get a monthly Opana ER script. In 2015 its a blessing to get pain meds because its so hard to get doctors to script them even when you truly need them. My back is in shambles and I'm lucky to get what I get... which is the same as you-- #120 15mg oxycodone IR monthly. Two months ago he said he would give me a little extra and wrote me #100 20mg oxycodone IR and they were a PITA to find in my area in stock.... my normal pharmacy couldn't get them for 3-4 days.

 

[mc34952]

yea i dont plan to have him change the oxycodone IR. the only thing im talking about replacing is my 10mg oxymorphone ER, with oxycontin (oxycodone ER). the IR would stay they same as it is a life saver for me.

 

[AnnaBanana333]

Maybe it's changed, but the last time I took OxyContin, I didn't feel it at all, because it had been re formulated. The generic Opana ER work great for me (even when I take them as prescribed). I always take it after eating a fatty snack (cheese, bite of ice cream) and with a Zantac. I also use the IR Oxycodone 15s, and find they work well together.

 

[mc34952]

Well damn. Maybe 10mg opanas just aren't enough. I feel i need the 40mg x3 a day then.

 

[tacodude]

ER is best for maintenance management, but anyone who needs 24 hour matinance and chooses ER formulations to avoid the rollercoaster ride of over relief to under relief will of course need an immediate release formulation for breakthrough pain as no one has pain so stable that it is chronic, but never spikes or reduces. Whether one wants more of what is in the ER or the natural counterpart (morph to code, hm to hc, om to oc) that works in the opposite region (kappa - mu) both creating analgesia, but one having less sedating side effects and the other more sleep inducing.

I find 15 mg ir to be good while 30 mg er does me good while 60 mg can be much, but more gaurenteed to get me feeling well if I am not. I find the best plan to maintain without discomfort I take two 30 mg ER pills around 7-8, one pill at twelve to one, and the fourth and final pill at 8-9. Basically one full ER dose in the morning, half at lunch, and another half at bed time. I use up to three 5 mg opana to get up, up to four to get me through the day, and up to five throughout the night. I use quite a bit for my physical issue, but my case is unique where my pain levels are still quite extreme. This after a long time of going through alernative opiates and lower doses is the minimal amount to keep me out of pain and from seeking things like heroin..... Of course cause I have five mg IR opana that dissolve on contactvwith water requiring no precrushing (roxxane labs)