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I tried search but so much came up that is was hard to navigate. Plus most of what came up wasn't relevant to what I was asking. So, moderators, sorry for technically posting a duplicate topic of sorts.
I've started to have really bad back pain. I don't see my doctor until next Monday and I have just enough Oxycodone to last me until I see him (I take one 10/325 a day as late in the day as I can handle). With the pain increasing, I can certainly take more but then I'd run a few days short until I see my doctor. I have about 5 or 6 5/325 hydrocodones from my last RX. Can these be combined with my Oxys? I actually saw my doc about 3 weeks ago and he gave me a script for Hydro 5/325 to replace the Oxy 10/325 but I'm not going to fill it since my pain has increased. I'm waiting until I see him next Monday and I get my reassessment and perhaps my meds will be changed all together.
Further complicated by the fact I'm currently on Clonazepam 1 mg (usually only take 1.5 mg in 24 hours) for anxiety related to the death of my husband (and now my best friend just passed away, too :'( ). So, I have a lot of meds floating in my relatively small 5'7 110 body. I've asked the pharmacist about the Clonazepam and he said I don't need to worry about mixing he benzos with my pain meds.
Anyways, thoughts on taking hydrocodone with oxycodone? Any contraindications?
Combining them is ok, as long as you know your dosages (and make sure your not taking more than 1g APAP, or 3 tabs, at a time). 10mg Hydrocodone = 5mg Oxycodone approx with similar bioavailability. This begs the question, why has your doctor given you something that is approximately a quarter the strength of your current tabs (10mg Oxy should equate to 20mg Hydrocodone)?
And your pharmacist isn't being entirely accurate. Combining benzo's and opiates can be fatal in high enough doses, its just pretty darn safe on the dosages you are on is all. The pharmacist should have told you that in the interest of harm reduction. How does he/she not know one day you might be in particularly bad pain and anxiety and take a double dose of both? Its still a pretty small dose and relatively safe, but it should have been mentioned to you none the less.
If you take both of them orally, you should feel about the same amount of pain relief. When I take Hydro or Oxy orally, I find them pretty similar in strength. Everyone says that Oxy is About 1.5x stronger than Hydro, this is certainly true when it comes to other ROA's(route of administration). But I don't find it to be true, not for me atleast, when both are taken orally.
Like Numpty said, all I would really watch out for is your daily APAP intake. The low dosages that you're at doesn't seem as though the drugs would have negative effects on eachother. Just make sure you listen to your doctor and don't up your dose without discissing it with him/her first.
If worst comes to worst, for harm reduction purposes, you can always do a cold water extraction on your meds containing APAP if your pain level increases to the point at which you are taking more than 1,000mgs in one dose or 3,000mgs within 24 hours. But only after discussing the dosage with your doctor or with someone highly educated in that area first.
Thanks so much. I'm never anywhere close to my max on APAP. Even I were to take the 10/325 Oxy and the 5/325 Hydro, that's 650 for the entire day (24 hours since I typically wait until he end of the day to take my pain meds).
My doc is trying to ease me off the Oxycodone I guess, hence the RX for Hydrocodone 5/325. The thing that didn't make sense is that RX reads TWO 5/325's. I actually posted a thread about that and not really understanding the change. I'll ask when I see him next Monday. The Oxy is really the only thing that takes the pain away. I've never taken it as prescribed, I've "under" dosed as it says every 6 hours as needed and I take it only once a day.
As for the Benzo, I take that usually in the AM (1mg) and an a half dose (.5) at bedtime which is usually at least 4 hours from my pain med dose.
A lot of people "underdose" thinking that it will make their meds last longer or that it will prevent dependence. This is not true. You should take them EXACTLY as prescribed so the correct amount of Oxy/Hydro is built up in your system to aleviate your pain. Otherwise, you will be taking the meds, getting no relief, yet still risking dependence with daily use. Also you may end up taking MORE than prescibed on occasions just to take a break from the pain that you're always in. Taking them as prescibed is best.
My sick deviant puppy wondered why you wouldn't fill your current script immediately, then discuss your RX concerns with your DR at next appointment--when he/she (not saying your Dr. is an actual he/she... ) can adjust dosage appropriately. I am curious as to why the fear of the Oxy? If doc/you are concerned about dependence--that may happen intentionally based on your medical condition (and may need to be something you "accept" until there is a better way to manage your pain)--switching from Oxycodone to Hydrocodone isn't going to insulate you from such a potentiality--or even reduce such a potentiality. This is wholly my opinion having a decade of experience managing pain--or as I like to say when people assert truths that are based solely on their experience, it was "Published in the Journal of Anecdotal Experiences"...Still, I'm pretty darn sure (99.9%) what I say is accurate.
I would be marginally concerned with your proposed "switch" in meds on a different level though. That is, I'm a proponent of reducing the total # of pills taken as part of a "routine" vs. on an "as needed basis". I feel taking fewer pills daily is better for people because it: a) reduces the amount of fillers you ingest like APAP/Tylenol which can sometimes lead to liver toxicity, and b) does less to reinforce the scheduled "popping" which for some people (addicts) is or has become another facet of their addiction that they have to break. FWIW...My puppy has had success breaking her habit, but the "routine" associated with the daily regimen was a constant source of frustration and a challenge for her--and others she congregates with.
I truly hope your meds are adjusted and you manage your condition successfully. Good luck!
I am curious as to why the fear of the Oxy? If doc/you are concerned about dependence--that may happen intentionally based on your medical condition (and may need to be something you "accept" until there is a better way to manage your pain)--switching from Oxycodone to Hydrocodone isn't going to insulate you from such a potentiality--or even reduce such a potentiality. This is wholly my opinion having a decade of experience managing pain--or as I like to say when people assert truths that are based solely on their experience, it was "Published in the Journal of Anecdotal Experiences"...Still, I'm pretty darn sure (99.9%) what I say is accurate.
I'm not fearful of the Oxy.. that is what I think works best actually. My last RX, still unfilled, (instead of the Oxy which will run out in 6 days) is for 60 tabs of Hydro 5/325, 2 tabs every 6 hours as needed. I didn't fill it yet because I thought once that's filled it my pharmacy won't let me fill another narcotic? I'm in more pain than usual so my real question in all of this was is it okay to take:
-One 10/325 Oxycodone and One 5/325 Hydrocodone at the same time to better manage the pain (while conserving the 5 Oxy's I left).
Some people think it's all the grief I'm dealing with the two back-to-back deaths that is actually making my perception of the pain stronger. Could be. Lots to ask the doc next Monday. There was even a discussion of switching to Tramadol which I have a script for as well. But, he decided to not go that route when I started having some more issues with sciatica pain intensifying and kept me on the Oxy. Seems like he definitely wants to get me off the Oxy hence all the switching around. Interesting thing is I looked up the Tramadol and it seems to have a serotonin effect? Might be better with all the depression I'm dealing with my losses recently.
We'll see what he says Monday. Thanks to all for your feedback.
PainCA added 2 Minutes and 40 Seconds later...
Originally Posted by dlsdrd
I am curious as to why the fear of the Oxy?
Whoops, my bad. You meant my DOC's fear of the Oxy, not mine. Misread that, sorry.
Last edited by PainCA; 05-03-2013 at 04:05.
Reason: Automerged Doublepost
Interesting thing is I looked up the Tramadol and it seems to have a serotonin effect? Might be better with all the depression I'm dealing with my losses recently.
Yes, Tramadol has some SNRI activity, and some have reported it indeed having a positive effect on their depression. Certainly something worth looking at.
Your current doses of Oxy are reasonably low. Normally i would say after Oxy, Tramadol isn't going to touch the pain, but in this case it might. To give you an idea 100mg Tramadol = 5mg Oxycodone (approx), and the bioavailability of Tramadol is marginally lower. This does mean though that you would have to be on pretty much a max dose of Tramadol to start off with and would leave you little room for tolerance build-up or break-through pain.
PainCA: Sure, one could effectively manage their pain with the dosage you mention absent most reasonable concerns...I wouldn't worry in the slightest way if my puppy took that amount...
..."J.A.E." reported last week that if your doctor has you on that low of a dose, then based on where many others before you have ended their travels, I'd recommend toughing it out like a man/woman for your own good...