Worse on the body, tylenol 3 or hydromorph contin??

[HydroCanada]

I get prescribed pain meds for my back. was using hydro before but am now on t3's. I do use both recreationaly and for my pain.. Im thinking of asking the doc if i could go back on hydro instead of t3's. because the amount of tylenol 3 i go threw as compared too the hydro cant be good. but mabey im wrong.. which is harder on the system?

 

[bronson]

The main concern with the T3s would be the amount of APAP you're taking in. When you're using those what would you say you average daily? Anything in excess of 4000mg is highly dangerous, and even at a lower dose a cold water extraction would be advisable.

 

[NeighborhoodThreat]

The T3s are worse on your body, especially if you're doing large amounts.

 

[smokemctoke420]

if your concerned about tylenol i would go back to the hydromorph but why such a big jump? why wouldnt you go to like roxicodone first or something? just some like a big leap of the ladder IMO

 

[TheLostBoys]

T3's to Hydromorphone is a big jump like mentioned above, why such a big jump? Why not try Hydrocodone next or Oxycodone? I would keep the tolerance down as much as possible because once its skyrockets, its difficult to get it down again.

As for which one is worse for the body, definitely the T3's because of all the Tylenol............

 

[Crashing]

3mg hydromorphone over 12 hours isnt really a huge jump, assuming that is his prescribed dosage.

The tylenols are worse for sure, assuming that dosage is particularly large..

 

[paranoid android]

Ok i assume your in Canada if your getting hydromorph contin. Tylenol#3's are not for chronic pain as thy have way too much acetaminophen in them. If you are eating abunch of them everyday your liver will be shredded pretty quickly. Also a CWE is not practical for pain patients as you loose some of the drug no matter how good you are at it and it does take some time.

Saying that i would not recommend jumping right to hydromorph contin. If you can get by on a instant release painkiller you could ask your doctor for the 30mg codeine pills without the acetaminophen. Since hydrocodone is only prescribed as a anti-tussive in Canada and not for pain the next step up would be oxy IR's which come in doses from 5 to 20mg. Some doctors still use Demerol if codeine does not work but i would not recommend Demerol as not only is it completely unsuitable for chronic pain because of it's toxicity but it's also very short acting and not that strong. As for suspended release painkillers there are codeine contins (i would not recommend these if you like taking a dump more then twice a month), the various morphine SR pills such as MScontins, Kadians and M-esslon's. There is also oxyneo but i have heard from more then a few chronic pain patients that they don't work as good as the oxycontins. However i think they are coming out with generic oxycontins soon in Canada. There is also butrans which is a patch with buprenorphine in it. It is prescribed for moderate to moderately severe pain not for really severe pain so it might work for you. However it is new on the market and costs a fortune so unless you have insurance that covers it or are rich then your shit out of luck on that one. Apart from that there is the fentanyl patch but that is way way to big of a leap and is only for people with a fairly high tolerance. I have been prescribed it before but i have been on everything from codeine to Dilaudid to control my pain and Ive been on morphine SR just about everyday since 2006 or so.

I am not a doctor so take this with a grain of salt but i would recommend trying the 30mg pure codeine pills before moving up to stronger opiates like oxycodone. I never found codeine to be addictive (it is but it's not nearly as addictive as oxy, morphine or especially hydromorphone) and it does work for pain if your tolerance is low. With the exceptions of (dextro)propoxyphene aka Darvon which is now off the market thankfully, tramadol and Demerol opiates/opioids are not harmful to the body at all. They do not cause organ damage or brain damage. So besides overdosing you only have to worry about addiction

 

[Crashing]

Why do you guys think that a 3mg hydromorphone continuous over 12 hours is a big jump? Just because the chemical itself is more potent doesn't mean he's going to be taking a dosage that is too high.

If he was to take 10mg morphines, 3X a day, that would be 30mg morphine per 24 hours. Convert that into 2 twelve hour time release capsules:

So, 30 x .02 = 6MG HYDROMORPHONE / 24 hours. That's 3mg hydromorph contin every 12 hours, and that's probably exactly how his doctor figured it. Therefore, switching to extended release hydromorphone is not a big jump.

http://druginfo.usask.ca/healthcare...witching opioids using equivalence tables.pdf

And yes, it's safer.

 

[Swimmingdancer]

Depending on what conversion chart you use, 1mg hydromorphone is supposed to be roughly equal in analgesia to about 60mg codeine (in reality it's going to vary substantially from person to person). The OP didn't say how much codeine they were taking, but using that conversion you linked, if they were taking the maximum dose of Tylenol 3, which is 10-12 tablets in 24 hours (not that that is wise to do chronically, even the prescribing information says you should not take Tylenol 3 for more than 5 days in a row, it's not meant for chronic use), at 30mg codeine per tablet that would be 300-360mg of codeine per day (and 3000-3600mg of APAP), so the conversion would work out to around 2-3 of the 3mg Hydromorph Contin per day.

If the OP is just taking lower doses of Tylenol 3 only as needed then that would be different.

BUT, I don't think that people were saying it was a big jump because they feared it would kill him. There is more to consider than just potency, it's not like all opioids are the same and the only difference is how many mg you have to take. 360mg oral codeine is listed as being of equivalent analgesia to ~10-12mg pure IV heroin, one wouldn't be surprised if anyone said it was a big jump to go from codeine to heroin, regardless of the dose. Obviously that's a more extreme example than switching to oral extended release hydromorphone, but just trying to explain that it's not like all opioids are the same aside from potency. There are plenty of opioids considered in between the ladder from Tylenol 3s and hydromorphone. If Tylenol 3 and Hydromorph Contin were the only choices, and constant opioid use was required then yes I'd go with the Hydromorph Contin. But in reality there are other meds in between. We also don't even know if the OP requires continuous pain relief.

 

[Pagey]

Tylenol would definitely be worse on your body. I (accidentally) took too much APAP a few weeks ago and spent the whole week-end feverish and throwing up; as bronson said, just be very careful not to take more than 4000mg daily and no more than 800mg at a time.