Breakthrough pain

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New Member

Date Joined Feb 2012
Total Posts : 2
   Posted 2/15/2012 3:48 PM (GMT -6)   
I am on 40 mgs of methadone tid having gone from hydrocodone, to ms contin, then oxycontin. It seems I buid a tolerance after 3-4 months. In addition to the 40 mgs of methadone, I am given 30 mgs oxycodone 30 mgs q 4-6 h. I have been taking 15 mg for fear of of increasibg my tolerence. The 15 mg of oxycodone is not remediating my pain so I will have to deal with the here and now and deal with the future when I have to as the pain is reaching the 8-9 range. I have a communication problem with my pain doctor and have a feeling I am not taking it most judiciously. I take the 40 mgs of methadone at 7am., 3pm. and 11 pm. and the oxy 4-6 hours after the meth. I do not feel yjis is is effective. When should I take the oxy. The reason I try to go 6 hours is to cover the gap that the medadone provides no anesthesia and the oxy provides only minimal coverage.

Hi Ral, I took the link out for you.

Post Edited By Moderator (straydog) : 2/15/2012 7:14:00 PM (GMT-7)

Veteran Member

Date Joined Oct 2008
Total Posts : 2024
   Posted 2/15/2012 3:56 PM (GMT -6)   
So you are taking 120mg a day of methadone? that seems like a fairly high does I think.
Maybe your doctor could try a different med for you breakthrough. Have you tried percocet? that is oxycodone with Tylenol. Maybe dilaudid? Maybe there are other forms of treatment you need to try?

Sorry I see this is your first post so I must welcome you aboard. Glad you found us but sorry you are suffering. It would help us if you gave us a bit of history in regards to your chronic pain, different doctors you have seen, med or treatments you have tried.

Stay with us and keep posting.

Veteran Member

Date Joined Jan 2010
Total Posts : 3557
   Posted 2/15/2012 4:46 PM (GMT -6)   
Welcome to HW.... one online can tell you when it's appropriate to take your medicine or how much to take...

I'm also not sure why you have a link at the bottom of your post that is about Nucynta?

I will say that if your Dr. is prescribing 30mg of Oxycodone every 4-6 hours....this is a huge amount of breakthrough medication which will cause a roller coaster ride of pain/less pain....This can be causing your tolerance level to be so low.

Most Dr.s will have you taking your long term medication....and then the BT only as needed....not on any type of schedule...

Building up a tolerance to medicine at only 3-4 months is not the norm at all...I've been on the same dosage for almost 3 years...

Maybe it's time to either speak with your Dr. about how it's not working for you....You say you have a communication issue with him....Why is that? What happens when you try to speak with him?

If you've tried everything than it would be good to try and look for another Dr. who will listen...

The other thing about chronic pain is making sure that the narcotic is just one small piece of the puzzle in helping control your pain everyday...

There is everything from exercise, stretching, PT, aqua therapy, massage, injections, muscle relaxer, TENS unit, cognitive behavioral therapy, acupuncture, sleep med, antideppresant, nerve pain medication, not smoking......

Just to name a few...LOL...

We hope that you can come back on and give us a bit more of your background of what is your pain issue? How long have you had it? Have you had any surgery to try and fix things? Etc...

It's a great group of people on these boards...None of us are Dr.s or medical professionals....but we all can empathize what it is like to live with chronic pain...
SB and "the pup who snores loudly" 
ACDF C5-C7, (no hardware), with autograft bone Nov. 2001
(reabsorption of bone 2 years later...still lost in body..expect to burp it out at anytime..haha")) 
ACDF with hardware, allograft bone Nov. 2005 
Anterior and Posterior CDF, allograft bone with BMP, removal of old hardware, use of titanium plates, rods, screws, & kitchen sink (lol) Oct 2006

New Member

Date Joined Feb 2012
Total Posts : 2
   Posted 2/15/2012 4:53 PM (GMT -6)   
I think I understand now The long term meds is q 8h and the break through is q4-6h as needed. Becaude I was given such a large dosage I only 50% of the breakthrou sgsin thanks. The time on the break through is the outward limit only when required. The link is there only because I was looikng through break through meds Why it eas a limk is beyond d me
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