I'm curious... how often members use their break-through medication?

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cogito
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Date Joined Oct 2010
Total Posts : 932
   Posted 1/23/2011 3:49 PM (GMT -6)   
Probably like most CP patients, I take a time-release opioid daily and also have a prescription for breakthrough pain.
In my case, I use Ultram ER 300mg daily (whose efficacy I think is waning) and Hydrocodone or Oxycodone for breakthrough.

I'm given 90 Hydrocodone 10/500 every six months and 60 Oxycodone 10/500 once a year (reserved for the worst days).

I keep careful records and just tallied up my use through 2010. I average 15.6 days per month where I'll use a breakthrough medication and 3.3 days per month where I will take a breakthrough med twice in one day. My longest stretch between doses was 7 days and my longest stretch of consecutive use days was 4.


I'm sure members' use vary widely. Some CP sufferers are in intense daily pain, others (such as myself) have just mild pain some days if I am careful and the weather is fine, etc.

But I am curious about whether for most people, their daily time-release medication controls their pain adequately and so can go days between needing breakthrough medication or whether breakthrough meds end up being used most days.

So, I'd like to take a poll: for those of you who are on a time-release opioid, how many days a month do you use break-through medication?



Thanks.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs)
RT hip and SI joint damage from car accident
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .5mg ativan as needed for sleep.

flower123
Veteran Member


Date Joined Apr 2009
Total Posts : 856
   Posted 1/23/2011 6:21 PM (GMT -6)   
Every day...but the amount I take depends on my pain.

Hugs,

Flower

Chutz
Veteran Member


Date Joined Jan 2005
Total Posts : 9090
   Posted 1/23/2011 6:52 PM (GMT -6)   
Hi!

I too use break-through meds every day in addition to timed release narcotic pain meds. Doc allows me up to 4 -7.5/325 percocets per day and I usually use that much or on good days I use a bit less. I have a wonderful relationship with my doctor and he understands how fibromyalgia impacts me and my life. We made an agreement a long time ago...He works hard at giving me the best quality of life he can and I work on living my life.

Hope this helps...
Chutz
Moderator on the Fibromyalgia and Chronic Pain forums
~*~*~*~*~*~*~
Daily Donnybrook: Fibromyalgia, Insulin Dependent Diabetes. Ulcerative Colitis, Rare form of Dermatitis, Collapsed Disk, Osteoarthritis (especially in right hand and neck) and a couple of other adjunct agitations.

"Gravitation is not responsible for people falling in love." Albert Einstein

Twinks
Regular Member


Date Joined Jan 2011
Total Posts : 66
   Posted 1/23/2011 7:38 PM (GMT -6)   
I too use breakthrough meds every day and have been since 2006 when I had my back surgery.

SmurfyShadow
Veteran Member


Date Joined Dec 2008
Total Posts : 2386
   Posted 1/23/2011 8:58 PM (GMT -6)   
I get 90 Oxycodone @ 5/325 a month and 30 Morphine @ 15 a month

I am allowed to take 1 morphine a day and up to 8 oxycodone a day.

I try not to though! It seems I take more than 3 or 4 oxycodone a day when I am in a flare up.
Don't Care Bout Nuffin No More, Guess I shouldnt even be in this world

uniquelyme
Veteran Member


Date Joined Nov 2008
Total Posts : 1037
   Posted 1/23/2011 9:57 PM (GMT -6)   
I have NEVER heard of a Dr. being that restrictive about pain medication....but I guess since you only take the Ultram ER daily he thinks you don't need a stronger BT med. I take 120 mg. Methadone a day along with 30 mg. Oxycodone (5 a day). I couldn't imagine NOT taking them every day... I have tried not to take them but that didn't work too well.... And Actually, at my next appt. in March, we are discussing other options for me....I have been on Methadone for so long that it really doesn't work anymore...maybe Opana ER? don't know yet...all I know is that it won't be a walk in the park....
Spinal Stenosis, DDD, DJD, HBP, Type 2 Diabetes

Methadone 120 mg. X daily
Oxycodone 30 mg. 5 X daily
Lisinopril HCTZ 10/12.5 2 X daily
Novolin 70/30 insulin 75 units 3Xdaily
Novolin R insulin 1Xdaily
Novolin R 0-50-0-0

That's all....but OMG!! isn't that enough?

stevie206
New Member


Date Joined Jan 2011
Total Posts : 2
   Posted 1/24/2011 6:03 AM (GMT -6)   
I take Oxycodone for breakthrough pain and I now have to take it every 6 hours in between my regular pain meds. I take Morphine first and three laters take the Oxycodone and have to do that all day long so that I am taking each one every six hours.

stevie206
New Member


Date Joined Jan 2011
Total Posts : 2
   Posted 1/24/2011 6:26 AM (GMT -6)   
I have Stage III Arachnoiditis.  I never thought that the body could experience so much pain.  I take 3-60mg of Morphine a day and 3 5/325mg of Oxycodone a day.  I get 90 of the Morphine and 120 of the Oxycodone as I can take two of them if needed, but I don't do it.  f I am having a good day, I don't think about taking any of them, but late on in the day, I pay for not taking them, as I try to do things I cannot do on a bad day.  My doctor said not to take them that way and not to wait until the pain starts getting bad.  I never have a complete day without pain.  There is no cure for Arachnoiditis.  I do not get good care as I go to the VA for treatment and because there is only one way to get Arachnoiditis, they won't recognize it.  I have Arachnoiditis, Neurogenic Bladder, Cauda Euina Syndrome, Gastro Paresis, Paresis in my legs, Incomplete Paraplegia, Paralytic Ileus, Loss of Female Function.  Before they found I had Arachnoiditis, everything was going with my body and I wound up having 7 major surgeries, then they realized I had this horrible incurable disease after everything is gone or affected.  Now they are pretty sure that I have Lupus and am going through a very bad outbreak of these hive like bumps.  I am also now a Diabetic .  I have these funny shaped tumors or cysts growing on my body and most right along side of my spinal cord, from my head, neck and dow n to the talbone.  I have complained about them but  nothing has been done to even see what they are.  Like I said I go to the VA. 
 
I just hope that none of you have this disease and condition.  My story goes back to 1972, but I did not want to bore anyone with all the awful details of what the doctors did to me.
 
I wish for all of you a blessed day.
 
Stevie

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16388
   Posted 1/24/2011 12:43 PM (GMT -6)   
Hi Stevie and welcome to Healing Well's chronic pain forum. Wow, you have been put thru the wringer from I have just read, how horrible. I am sorry that you have to be here but very glad that you found us.

Stevei, would you mind making your own intro thread so all of our members can see it and give you a proper hello and welcome aboard? Otherwise, I am afraid not everyone will see your post here. All you have to do is at the top on the left is click Post New Topic and type in something like hello, I am a new member or something like that. It is very easy to get around here.

Take care.
Moderator Chronic Pain Forum

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16388
   Posted 1/24/2011 1:06 PM (GMT -6)   
I have a pain pump and my dr does give me medication for BT pain. I only take it when the pain starts to get really bad or if I know I am going to have an activity that is really going to make me pay later. It is always best to stay on top of your pain rather than under it. By letting the pain get too far out of control, number one the pain meds always feel like they are not working well enough, and it just makes it that much harder to get the pain back in check. If you need the BT meds then take them, if you don't need them then don't take them. One thing to remember if you are taking them all the time then your body is going to get use to having that certain amount of medication in your system at all times and that will defeat the purpose of the use for BT pain.

Good post.
Moderator Chronic Pain Forum

Scarred_for_life
Veteran Member


Date Joined Jul 2008
Total Posts : 1560
   Posted 1/24/2011 1:23 PM (GMT -6)   
I have chronic back pain (Lower L4-L5 area), radicular leg pain and failed back syndrome.  I am in pain 24/7 there is no relief for me.  I take Kadian (Morphine) for my main pain reliever. 100mg twice a day. I take bt meds as well. Oxy 15mg 4 times a day.  Never go over what doc has prescribed.  I get a lot of muscle spasms and when I get one it hurts like I've never felt before!  So doc took me off of the Robaxin and put me on Baclofen 10mg to start 4 times a day.  This can be increased if needed.
 
So far I like the new muscle relaxer...it seems to take the muscle spasms down a notch, but I am still getting them so I will talk to my doctor about increasing a bit on the muscle relaxer.

MsBunky
Veteran Member


Date Joined Jan 2010
Total Posts : 1097
   Posted 1/24/2011 2:49 PM (GMT -6)   
I'm on long acting Oxycontin (60mg X 2 times per day) and Tramacet for breakthrough pain (37.5/325 mg) - generally every 4 hours. I need to make some changes to my meds, but my doctor is away until February, so I'll just continue like this for now.

Pam
DX: Fibromyalgia, Severe Myofascial Pain, Chronic Pelvic Pain, Surgical Adhesions, IBS, IC-PBS, Carpal Tunnel (both wrists), FAI, Type 2 Diabetes, Reynauds, Visual Migraines, Drug Related Hot Flashes, Hard Start for IV's, Unable to vomit due to surgery.

Meds: Oxycontin, Tramacet, Cymbalta, Cesamet, Flexeril, Clonidine + Vitamin D + Multi daily

cogito
Veteran Member


Date Joined Oct 2010
Total Posts : 932
   Posted 1/25/2011 12:00 AM (GMT -6)   
Thanks for the responses. Anyone else who would like to add to this thread, please do.


Uniquelyme, you were surprised about my PM being restrictive. I don't think that is the case. He's quite open to providing me with other meds and I've tried Opana, Nucynta, Dilaudid, etc. to see what works best for me, particularly for evening pain without interfering with my sleep (sadly, all opioids either keep me completely awake or at best allow a light sleep-twilight state).

I now think I need something stronger than Ultram, and we briefly discussed it at my last appt. I suspect this year we will move to something else. But for the quantity of BT, I think the amounts suit my needs. Actually, I am more concerned about using them too often rather than not having enough.

That is one reason why I wanted to ask this question: to see if others have their pain under greater control and need fewer BT meds. But I'm not really able to compare apples-apples since members here have different conditions with different severities.

From the reports of others, I suspect that many members here are in more pain than I am.
I am able to work, though I am fortunate enough to have a (full-time salaried) job where I can work at home most days and only need to be around others for about 6hrs per week.

The pain is just about constant, though rises and lowers through the day. It gets worse through the day and I cannot sit for long, especially leaning forwards, without it becoming severe (i.e. gotta stop whatever I'm doing, can't concentrate, must lie down and have to breath and let the pain dissipate). So my workspace is adapted and even at dinner, I will use a box below my plate.
However, I have a long commute and so cannot use any BT meds the days I have to be at work.
C4-T4 Scoliosis (disk degeneration, stenosis, narrowed neuroforamen, bone spurs)
RT hip and SI joint damage from car accident
Current meds: Ultram ER 300mg daily, breakthrough - hydrocodone 10-15mg, or oxycodone 5-7.5mg. .5mg ativan as needed for sleep.
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