Time-release meds, 2x, 3x, 4x, dosing experiences?

[mmglobal]

I was speaking with a client today. He's still in pain at a few months post-op. When I asked him how much he was taking, he answered with a substantial amount, but he's taking Oxycontin twice a day.

I told him about my experience with Oxycontin... I could use less medication with better pain relief if I took more frequent doses. Instead of 80mg/day (40mg 2x), I would do better on 60mg (20mg 3x.) It's less medication, but better coverage of the medication. In my experience, Oxy did not really last 12 hours and at hour 9/10/11, I was looking at my watch, wishing it was time for the next med. When I switched to 3/day dosing, I was much better off.

When I was tapering, I would go back and forth between 3x and 4x dosing to achieve smaller steps

Anyone else want to share their experience?

As always... I'm not a doctor... yada yada yada... you should only change your meds with the approval of your doc.

Mark

[tisury]

I had a similar experience with Duragesic (fentanyl) patches. I was on 100 mcg every 72 hours and they were not helping much and every third day was hell and a good portion of the first day of a new patch. The doc wanted to up it to 150 mcg, but I convinced him to let me try changing the patch every 48 hours instead. That is working MUCH better for me. Now granted, I am still in pain everyday, but at least I don't have the huge flare ups every 3rd day now.

[mmglobal]

Tisury, instead of taking 2 x 150 = 300 mcg every 6 days, you are now taking 3 x 100 = 300 every 6 days. Either way, you upped your dose by 50%, so it's no surprise that you are getting more pain relief.

My question is... and again... not a doctor... only change meds under your doctors direction.... my question is, how would you be doing on 75 mcg every 2 days, instead of 100 mcg every 3 days.

That would give you 3 x 75 = 225 every 6 days. That would represent a 12% increase in medication instead of a 50% increase. If you were getting enough meds, but less even coverage was making the third day difficult, perhaps 75 every 2 days would be a better solution. If you really need the additional opiates for pain management, then the 75 solution would not work. Again... just my lay-understanding, based on my experiences as a patient.

Mark

[tisury]

Yes, I see what you are saying. Over a week, I am getting more. I did greatly reduce the amount of percocet I was taking for break thru pain though. I didn't want a larger quanity at one time. The patches kind of scare me. I had an episode one time - a few hours after putting one on, I started to feel very strange and out of it. I took the new patch off and felt better a few hours later. I couldn't see any holes or anything, but I think there must have been. I think alot of meds don't last as many hours as they say - not just narcotics. Drug companies are trying to please the general public who want to have to take medicines less times a day. Just a thought. I wonder if taking 75 every other day back then might have worked. I doubt it would now since I have been on the higher amount for so long.

[Hucky :)]

When I was taking Neurontin, I was titrated up to 1200mg a day. I initially took 300mg morning, 300mg night then I increased to 300mg morning, 8 hours later and night. After another couple of weeks I was up to the 1200mg a day, which I took evenly spaced over a 24 hour period.

After a week or so on this, I found it a bit of a hassle and decided to take 600mg morning and 600mg night (12 hours apart) and the difference in pain relief was amazing. I would have thought that the evenly spaced doses would have worked better, but certainly for me, the two higher doses were a lot better.

Any thoughts as to why Mark?

Hucky


PS. I'm currently off any medication at the moment other than over the counter ibuprofen with codeine as needed. Being summer here, the pain is a lot better. I'm hoping to stay off the Neurontin during winter too. Although the pain relief was terrific, the brain fog wasn't.