Pain medications

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kara487
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Date Joined Mar 2008
Total Posts : 637
   Posted 3/14/2008 4:17 AM (GMT -7)   
Hi Everyone, I wanted to get your opinion wish pain medications work the best ? Right now Im on lortab 7.5 up to three times a day  and soma 350 mg up to three times a day without any success.  I have a pm appt on thursday . I hear ultram er or ultracet are good medications. I was on ultracet  about 5 years ago for my cpp  and it worked but my insurance did not pay for it so I had to stop . I have limited choice in medication covered by my new insurnace. they are lortab  ,methadone,morphine,oxycodone and darvocet. But I can't take percocet because Im severely allergic to it .  so if I did pay for ultracet or ultram er  how much would they be ? I would appreciate any suggesstions. I don't think I formally introduced myself my name is Kim I am newly married and from Georgia . My husband and I have been married for 6 months. I hope everyone has a lpd and weekend.

kara487
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Date Joined Mar 2008
Total Posts : 637
   Posted 3/14/2008 8:08 AM (GMT -7)   
Thank you Gramps. I will bring the book with me what my insurance covers and have the pm decide. I hope you have a lpd.

blizzardlizzard
Regular Member


Date Joined Feb 2008
Total Posts : 23
   Posted 3/14/2008 8:13 AM (GMT -7)   
I tried ultram and had little success with it. I also was on methadone and morphine both of which helped with my pain but made me have nausea. I'm now on something called Opana which is a morphine derivative and have been having a lot of success with it although it is hard to get from Medicaid. I don't know what your coverage includes but these might be some meds you might want to ask about.
CRPS 1 in the right leg
Spinal Arthritis
Anxiety Disorder

One day at a time


Lakeside
Regular Member


Date Joined Jun 2007
Total Posts : 138
   Posted 3/14/2008 8:58 AM (GMT -7)   
Hi Blizzard! If you can tolerate morphine meds but they leve you nauseated, you could try dilaudid (hydromorphone) It's a type of morphine w/ whatever it is that makes a person nauseaed removed. I've been taking it 2'xs a day since my fusion, along w/ Valuim for muscle spasms, and it's wonderful. Really dulls the worst of it, leaves you with that nice morphine "happy" mood and no nausea.

It's been around since the 1920's and has few side effects, only a little sleepy-ness, but nothing major. It's cheap, too & comes in a generic as it's so old. I think the brand name is official "Dilaudid" but the generic name is hydromorphone. Look it up on Wikipedia--they do a good job explaining it.

You may find it does the job--it sure helps me!

Good luck !
~Lake
Nov. 06-- Lammy @ L4, removal of spinal cystic tumor @ L4/5(benign)
Dec. 06--Re-operation for post-surgical spinal fluid leak.  2nd surgery complications includied sciatic nerve damage & radiculopathy in R leg/foot,  increased instability (grade 1 spondy, 17%), epidural scar tissue binding nerve roots, damaged facet joints & DDD @ L4/5.
Jan.  08--PLIF fusion/discetomy surgery with pedicle screw instrumentation @ L4/L5, another lammy (@ L/5 this time)  & bone marrow harvest from left iliac crest for packing bone around disc cages after discectomy @ L4/5. OW!!!


Keah
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Date Joined Nov 2003
Total Posts : 7314
   Posted 3/15/2008 9:03 PM (GMT -7)   
Kara, 5 years is a long time. Lots of things in the insurance world change and you might just find that Ultram or Ultracet or the generic trammadol is now covered. Your Doc might even be able to give you some samples to try, so that you'll know whether trying to get it covered is worth it for you.

I didn't do very well with Ultram because it kept me from sleeping, but we all react differently to meds. If this works for you, it's one of the lower meds on the pain relief scale, so IMHO you'd be best off sticking with that. Why bounce up to a morphine derivative if something lower on the scale will help?

I hope you find something that works well for you soon.
Keah a.k.a. Wormy
 God helps those who help themselves.
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ricksdar
New Member


Date Joined Mar 2008
Total Posts : 1
   Posted 3/16/2008 8:48 AM (GMT -7)   
HI, my name is Darlene, I have been on pain meds for almost ten years now. I have slowly worked up the chain. I had ultram, but unfortunately I had progressed to far into my disease for it to control the pain. I have FOP. I agree with Keah. If you can find a medication that keeps your pain under control, without having to go onto something your body will get addicted to, then keep with it. It is a big decision to go onto any opiate that is strong. The longer you can stay away from them the better. Also, you might want to see if there is a medication program that the manufacturer of ultram has for those who can not afford it. A lot of times pharmaceutical companies have programs where they help people obtain the medications that they can not afford for free. It is worth a try. I do hope you find something that helps without hindering your life style to much. God Bless. Dar

kara487
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Date Joined Mar 2008
Total Posts : 637
   Posted 3/16/2008 11:43 AM (GMT -7)   
Ultram does not work that well for me but looking for a cheap alternative.

Keah
Veteran Member


Date Joined Nov 2003
Total Posts : 7314
   Posted 3/17/2008 12:17 AM (GMT -7)   
The "original" form of Ultram (tramadol) was a short acting pain reliever, meaning that it only lasted 4 to 6 hours. The patent has run out for the name brand and it is now relatively inexpensive in the generic form. So, Ortho-McNeil-Janssen Pharmaceuticals, the manufacturer, has not put Ultram ER, a 24 hour time released version on the market. This form might be MUCH more expensive. So, you might want to consider the generic and just take several pills each day.
 
If the Ultram didn't really cut it for you in he past, why consider going back to it now? If I were you, I'd be looking at Norco, Oxycontin or Fentanyl patches. The patches last for 3 full days, but may be the most expensive of these options. Since the elimination of generic Oxycontin, I don't have any idea what the brand name med would cost because my last refill came from the phamacy's stockpile. Here's what I can tell you about these three meds.
 
NORCO - This is probably the least expensive of the options I mentioned as it is readily available in generic form. It is Hydrocodone and acetaminophen (tylenol). These are the same ingredients in Vicodin, however, Norco comes in a higher dose. Vicodin usually comes as 5mgs/325mgs & 7.5mgs/325mgs, but Norco can be dispensed as 10mgs/325mgs. There are also doseages with higher amounts of acetaminophen too but this is only in there because it potentiates the action of the hydrocodone and I'm not too sure if you (rather, I) benefit from the additional tylenol. Your Doc might also be familiar with the name Lortab which is also Hydrocodone and tylenol and also comes in the 10mgs dose. Both of these can also be given in a liquid, for those who have trouble swallowing pills.
 
Oxycontin is usually the next step up the ladder when it comes to pills. I started out on 10 mgs twice a day and then bumped up to 20mgs and then 40mgs. I expect that I may bump up again soon because it's just not helping all that much right now. This med has been very effective for me and I'd be lost without it. Unfortunately, it's one of the most abused medications. It's not that it's any more addictive than other narcotics, but just a matter of the time release which can be broken by chewing or crushing the tablet so that the full dose is released all at once, resulting in a high. In the 3 years that I've taken Oxy, I've never once done that. Anyway, because of the abuse, many Docs are afraid to script Oxy and it's mostly given out by PM Docs.
 
The greatest benefit of Oxy is that the time release allows us a full 12+ hours of pain relief. I no longer need to stop, take a pill and wait for it to kick in while in the middle of trying to do something. I don't try to get up and discover that my meds have worn off and I am now in excrutiating pain and most imoportantly, I can get a full hours of sleep. My need for a longer acting med and a decent night of sleep was the motivating factor behind my first visit to the PM Doc.
 
The other great benefit to Oxy is that it does seem to last for slightly longer than the 12 hours per day. This means that if I take my meds on time (not late) I don't get that drop off of meds and increase in pain that happens with the shorter acting pain meds. This roller coaster effect can actually lead to more pain because once the pain is there, it is harder to treat. With the continuous meds, I am able to keep my overall pain level lower.
 
Many people have done well with the Fentanyl patches. I never got far enough into them to know if I would be among them. I started on the 25mcg patch, but that wasn't nearly enough to address my pain. One of the effects of my illness is excessive night sweats and that made it very difficult to keep a patch in place for 3 full days. I would just about sweat them off and I didn't want to continue on them after the first month. I would have ended up needing to change the patches early too many times and then be in a situation where I need to explain this. I am WAY too old to feel like a child called into the principal's office!
 
Although most narcotics have CNS effects and can cause mood swings, Fentanyl is well known for causing bad mood swings that turn the sweetest person into a nasty WITCH. Before starting the patches, talk to someone close to you, who you see everyday, about this and agree to come off them if this person tells you that they are seeing a nasty streak. To be forewarned is to be forearmed!
 
I hope you find whatever will be best for you.

notnu2cp
Regular Member


Date Joined Feb 2008
Total Posts : 138
   Posted 3/17/2008 12:46 AM (GMT -7)   
Ultram is relatively cheap now but there are others that are just as cheap and do much more good. I have to agree that if it didnt help then it probably isnt going to do much good now.
 
Methadone is probably the cheapest but a big leap for someone not taking mroe then a few hydro's or percs a day and the reason alot of Docs are reluctant to use it early out and it does have some getting use to periods that alot cant tolerate or ride out but usually go away.
 
It is really a matter of what they want to go with and most PMs have some protocol or meds they just like to use in an order they like to move up so dont be surprised if they give you little room for input here,some do listen to concerns of paying for and some wont care as they figure that to be your problem as how to pay for them and here is where I wil push the partnership programs although it is tougher if you have any kind of insurance or coverage it isnt impossible if you have tried other meds and that is the only one that you  can use and your coverage own pay even with pre-auth.
 
Good luck to you and I hope this Doc finds a way to help you find better relief. I would be reluctant to go in there and make demands as to what you want if this is a new Doc and just try to listen to wwhat they have to offer.
2 knee replacements & a hip.
spondylosis at L-4,5 & S1
arthritis,sciatica all that being a CPer entails!
MEDS:methadone,zanax,zanaflex,indocin,maxide,lexapro,K*,inderal,zestril 
If you stumble make it part of the dance!
 
Formerly Ruth Thomas


kara487
Veteran Member


Date Joined Mar 2008
Total Posts : 637
   Posted 3/17/2008 2:27 AM (GMT -7)   
Keah, I am severley allergic to percocet so that is out. I was on ms contin a year ago and it was effective that is why I was asking about it . Im on a limited income that is why im looking for cost effective pain med. My copay are outrages. I hope you have a lpd.

ryand
Veteran Member


Date Joined Dec 2007
Total Posts : 639
   Posted 3/18/2008 6:36 AM (GMT -7)   
Kara: Have you tried searching the web for coupons? In many cases, the companies offer these for brand name medications. You can just download and print them in some cases, or sometimes they have you give your address and they'll mail you the coupons. The discounts are applied to your co-pay, not to the total, so they really help. I have one medication now that has a $50 copay every 3 weeks, but I found a coupon on-line that takes $35 off my copay.

kara487
Veteran Member


Date Joined Mar 2008
Total Posts : 637
   Posted 3/18/2008 7:29 AM (GMT -7)   
Ryand, Thank you . Do you know the maker of lortab? So I can check and see if they have that type of program . I am having  a problem finding a pm that accepts my insurance I am getting so upset. I only have 9 lortabs left  and no one to prescribe more . My only option is to pay the 100 dollar office visit and we hardly have any money to afford that . I am so stressed out. I hope you have a lpd?

kara487
Veteran Member


Date Joined Mar 2008
Total Posts : 637
   Posted 3/18/2008 1:05 PM (GMT -7)   
thanks but no pm in the near future my husband refuses to take me because I had to change my appt. to friday. so no pain meds for me.

notnu2cp
Regular Member


Date Joined Feb 2008
Total Posts : 138
   Posted 3/19/2008 12:22 AM (GMT -7)   
So sorry honey. Is there no one else you can ask for a ride even if you need to be dropped off and picked back up?
 
You said your going to run out of meds and that will be awful and who knows how long it may take to get another appointment if you dont keep this one? How far away if this place and is it possible at all to use a public transpo? Check your insurance as well as alot of times they have some type of program to get you there,also check local organizations and churches as they are great for having people or volunteers lined up to help disbaled and elderly get to appointments and many times they dont even charge you for gasoline.
 
Please hunt out options to possibly getting to that appointment.
 
I will not get into why your hubby refuses to take you but I can relat eto how family doesnt get it and what this life of CP really means for us and how important getting relief is,been tagged far too many times by my own family as just trying to get meds thus reason for a appointment with a new Doc.
 
Use to bother me but now it let it ride and consider it their ignorance of chronic pain and hope each day no one I know or love will find understanding by finding themselves in this life one day.
 
Please let me know if I can help in anyway as I am fairly sure that I am too far away to come get you and give you a ride but I can do searches for you via the internet for places to go to for help in your area.
 
I have been reading about your co-pays and deductables and I want to also add that if you have not checked into the medicaid program in your state to do so as many of them have a program that is an adult medical thing that if your in a certain income bracket they will subsidize your private insurance and pay your co=pay and deductables for you and I have this and it actually pays my medicare premium each month to SS and it pays any out of pocket pay out I have not covered by my Medicare and medicare advantage plan. It is great and no one ever offered me this or told me it existed even when I left the medicaid program when I qualified for medicare. I had a friend who got this type of card and she asked me why I was not on it. I checked and sure enough I qualified.
 
Good luck to you and wishing I could do more.
2 knee replacements & a hip.
spondylosis at L-4,5 & S1
arthritis,sciatica all that being a CPer entails!
MEDS:methadone,zanax,zanaflex,indocin,maxide,lexapro,K*,inderal,zestril 
If you stumble make it part of the dance!
 
Formerly Ruth Thomas


kara487
Veteran Member


Date Joined Mar 2008
Total Posts : 637
   Posted 3/19/2008 3:58 AM (GMT -7)   
Hi Ruth, I went down the medicaid route  my husband maked too much money. I dont qualify. They also said I dont qaulify for disability eithier. which Im consulting a lawyer on.  My husband is sarting to come around. the fact is he took thursday morning off work and now my appt changed to friday  he got upset about that .  He told me last night he will take me friday but last night he came down with the flu  and has a 102 fever and I had to call in sick for him. I dont know if he will be able to take friday morning off  now. will have to wait and see.  I have the crud too but dont have a high fever as him. I think it is becuase I got my flu shot. and he didnt. I hope you have a lpd.

Keah
Veteran Member


Date Joined Nov 2003
Total Posts : 7314
   Posted 3/21/2008 12:23 AM (GMT -7)   
(((((Kara))))) Rats! I'm so sorry you're both sick. I hope that somehow you can get in to that appt. I know just how awful it can be to run out of meds. Just this past month my mail order script got delayed and I was out. I had tapered down and suffered in pain, but once I finally ran out, I had to go in and get a few days worth to hold me over. If you can't go today, will your Doc call in a script to hold you over until whatever day you reschedule for? Lortab/Vicodin can be called in by phone, at here in NY it can. I'd offer youa ride, but I suspect you're too far away.

I hope you're feeling better soon.

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