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Re: Oxycodone off formulary! FEAR! Oxycontin equiv.? » Fivefires

Posted by Larry Hoover on January 16, 2009, at 17:59:40

In reply to Re: Oxycodone off formulary! FEAR! Oxycontin equiv.?, posted by Fivefires on January 16, 2009, at 16:20:27

I've got to edit this down.

> > So, the 10/650 got you through the night, but a 20 mg Oxycontin doesn't? <Spock eyebrow>
> >
>
> Positively. I awoke a couple times last night too.

10 mg of oxycodone let you sleep throught the night before, but the new tablet of Oxycontin, at twice the dose, does not? You take it just before bed, or a number of hours before retiring?


> > I was referring to how cheap generic acetominophen (Tylenol) is.
> >
>
> Oh. I thought you were saying oxycodone is cheaper than oxycontin.

Well, that's true also.

> > > And too, I didn't feel this funky low depressive feeling with it. W/ oxycodone I'd always felt a bit of an 'it's okay' feelin', which was something I think 'understood' betw PCP and I, but not discussed.
> >
> > You don't get that with the Oxycontin?
> >
>
> No. At least not yet???? Melancholy w/ collective thoughts leading me back to that big bad thot.

That's a feeling I attribute to oxycodone withdrawal, which is why I brought it up (below).

> > How many hours after your Oxycontin dose do you feel the need for augmentation?
> >
>
> Yesterday, maybe 5, and even 6 would be stretching it.

That's not working for you, at all. When my Oxycontin wasn't lasting long enough, my doctors switched me to a lower dose of Oxycontin, but three times a day, to make the same total amount. I still had breakthrough pain, on an eight hour dose cycle. Sounds like the same problem you're having with it.


> > It sounds like you're in a mild withdrawal, which is a sign this isn't a good match for you.
> >
>
> I didn't think of it this way, but from the acetaminophen?

No, I don't know of an acetominophen withdrawal phenomenon. I was meaning the narcotic. Black mood is a characteristic symptom of oxycodone withdrawal.

> I chose Excedrin because Tylenol has always made me sleepy, and I sleep often or just lie in bed fatigued during the day.

Excedrin contains acetominophen, too.

> > Oxycontin stands for OXYcodone CONTINual release.
> >
>
> So, Side 2: 20 means the amount of the oxycontin. There's not a drop of acetaminophen in oxycontin. I'm crazy lookin' for answers.

That's correct. The 20 is the dose of oxycodone. 10 mg Oxy's are white, 5's are blue.

> > > oxycodone HCI 10mg 12hr (I don't understand.)
> >
> > That's sometimes called oxycodone IR, for immediate release. Similar to what you had, only no acetominophen.
> >
>
> Well might that have been considered v. oxycontin?

Hmmm. I didn't notice the 12hr last time. Sorry about that. There are a number of generic oxycodone hydrochloride products in the FDA Orange Book. Just straight oxycodone, all kinds of different doses per tablet.

> I'm beginning to think this all about extended release medication being considered a priority over immediate release meds. But, in a case like mine, where I metabolize most meds too fast, this could have me in a constant state of withdrawal huh?

I was. I gradually developed constant withdrawal symptoms. I had to discontinue oxycodone because of it.

> For those who metabolize properly, fine. I remember being on Effexor v. Effexor-XR and as I recall my life at that time, I was doing better, though don't recall life circumstances which may have come into play. (My pdoc doesn't want me on two diff' ben*os, reason for being on Xanax-R 1mg 3x a day and Xanax 2mg 3x a day.

Maybe you can find out if your insurance would cover plain oxycodone hydrochloride tablets. The 12hr notation you wrote above probably refers to an extended release formulation.

> > Yes, sort of. Same total daily dose.
>
> Well then my pain med has been cut in half???

No. You were getting 40 mg of oxycodone before (10 x 4). Now you're getting 20 x 2.

> That occurred to me last night and I called and spoke with a diff' pharm; not one w/ a very good counter-side manner. :( He said two 20mg OXYcodone CONTINual releases WAS EQUIVALENT!(?) to 10/650 oxycodone. In my exhausted state, just said 'oh'; hung up.

Equivalent to the 4 10/650s you used to be on, yes. Theoretically equivalent. Obviously, not clinically equivalent, as you're not getting the same effect.

> >You might be better off with the oxycodone HCl. That would be 4 times a day, as before. You'd have the option of taking some acetominophen with it, if you wanted to exactly match what you had been on before.>
> >
>
> That thought also occurred to me as I was typing this to you yesterday. It's oxycodone 5mg ?, hydrochloride ?, and 1 what ?

If you were prescribed 4 tablets per day of plain 10 mg oxycodone hydrochloride, you could then take it the same as before.....and add in Excedrin or Tylenol or Advil or whatever.

> Hope you catch this today and I hear from you. I'm sorta' a flake sometimes and apologize if I'm 'all over the place' with this.
>
> scratchin head, 5f

I hope this helps.

Lar

 

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poster:Larry Hoover thread:874056
URL: http://www.dr-bob.org/babble/20090104/msgs/874379.html