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Oxymorphone Vs. Hydromorphone

Discussion in 'Oxymorphone' started by POLAR_BEAR, Feb 9, 2012.

  1. POLAR_BEAR

    POLAR_BEAR Silver Member

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    I have been in pain management for 4 years now and have gone through the steady progression from Hydrocodone to Opana. I am now on Opana. It is not working as well as when I first started it and it did take about a year to build up the tolerance. I have asked my pain dr about switching to Hydromorphone and they told me that you could only get that if you were in the hospital. I believe this to be an untruth.(May be wrong). I have been on Fentanyl Patches and this is some powerful stuff. My question in all of this is, why do they not want to prescribe Hydromorphone?
     
  2. jman1982

    jman1982 Newbie

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    Because in it really doesn't do that much to SWIM in pill form anyways. It's bioalv is not that good.
     
  3. POLAR_BEAR

    POLAR_BEAR Silver Member

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    Thanks jman. The meaning of bioalv is elusive. Once found, the relevance with reveal itself. Are there any other opinions out there? Quite a few views with no information being disseminated. Please express thoughts or desires if any are present.
     
  4. southern girl

    southern girl Newbie

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    I highly doubt that was the reason. There are many, many people prescribed hydromorphone. While it maybe true that its oral bioavailability maybe quite low, which is the same with morphine which is also prescribed all the time, I wouldnt think that would be a valid reason. Which I could be wrong but......

    ----------------------------------------------

    Hi Polar Bear,

    Welcome to the DF! I myself am I chronic pain patient so its nice to have another one of use on here. There is a chronic pain group if you're interested in joining. I'll leave the link to it at the bottom of this post.

    Unfortunately I have no insight on oxymorphone vs hydromorphone but can tell definitely tell you that the above statement is not true. I can also tell you it is not true that they only provide hydromorphone in hospitals, they can be and are prescribed. It is true that they do have a low oral bio-availability- meaning the most that is absorbed- is between 29%-50%, thats what the study I just read said anyway (source at the bottom). So maybe the fact you got on fentanyl is a good thing? Although it would probably have been nice if your Dr let you decide that.

    As to why your Dr told you that, one could only speculate. Maybe he just doesnt like prescribing it. I know my Dr says she only likes prescribing things she is familiar with and Dr's always have their "favorite" medications to prescribe. Though that is only what *my* Dr has said and her preferences and it might be different for yours- so this is only speculation. You could try asking him/her? Though you are already on fentanyl and it is stronger and pretty much the strongest thing you can get prescribed, which could be both good and bad, and if its already working for you than would you want to bother switching? Especially for something weaker?

    Anyway, I hope this helped you some and sorry I couldnt be of more help. Hopefully somebody will come along who is more educated and experienced on the subject.

    Much Love

    SG.xxx


    Link to the chornic pain & pain management group: https://drugs-forum.com/forum/group.php?groupid=123


    Source: The Journal of Clinical Pharmacology Vol. 27 No. 9 647-653
     
    Last edited: Feb 10, 2012
  5. Mick Mouse

    Mick Mouse Palladium Member Donating Member

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    Hydromorphon, or Dilaudid, Jurnista, and several other brand names, is not as strong as Oxymorphon (Opana) by a factor of at least two or three. It is available readily and is used quite often for chronic pain relief, and is NOT a "hospital only" drug. Hydromorphon is also the next logical step in pain control, as it is stronger than Oxycodone, but not as strong as Oxymorphon.

    Hydromorphon is also a drug with very high abuse potential, which may be why it was not offered originally. The rush from IV is said to be so intense that it is almost painful in itself!

    You do not mention the dosage of Opana you are on. Can you increase your dose? When I was on Opana, I was taking 1-2 10 mg tabs every 6 to 8 hours or as needed. I quite frequently would take 2,3, or even 4 of them every 4 to 6 hours, so I know what you mean about them no longer working effectively. You also say that you are on Fentanyl. Again, what dosage? Fentanyl will completely over-shadow other narcotic pain meds, due to it's strength, you are dealing with a drug that is 80 to 90 times stronger than morphine! Opana, on the other hand, is only about 10-15 times as strong. Check the opiate conversion calculator for an exact rate.

    In any event, it makes no sense to go from Opana to Hydromorphon, and certainly not from Fentanyl to Hydromorphon for purposes of control of chronic pain, you are going backwards. Unless you just want to use it for recreational purposes! Also, there is some serious over-lap there, if you are using Opana and Fentanyl at the same time. Be careful. Fentanyl will provide sedation, and NOT much euphoria, so it is not a first-choice drug of abuse, but it is so strong that people die from abusing it all the time. Excellent for pain control, as long as you don't plan on stopping its use. The WD's from Fentanyl are some of the worst out of all the opiates. I'm doing a taper now, trying to get off that shit, and it is VERY hard.

    There are several ways that you can potentiate the strength of your narcotic meds. Grapefruit juice works, as does Lyrica. Again, be careful! Have a non-user there with you when you try a new drug, especially an opiate! That way, if something DOES go wrong, you still have a chance. Make sure they are familiar with the signs of an overdose and that they are NOT afraid to call the paramedics if necessary. Embarrassment is ALWAYS preferable to death!
     
  6. jman1982

    jman1982 Newbie

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    Hey there guys, I didn't mean to sound stupid or anything, that is just what my doctor told me. I think he just was trying to scare me away from this drug so he could give me what he wanted. I of course knew he was wrong, I was just passing on what he said. I'm very sorry and shouldn't have posted that, sorry again. Good luck, Jeremy
     
  7. POLAR_BEAR

    POLAR_BEAR Silver Member

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    Thanks for the good information guy's. The Fentanyl patches worked well for a while. Bad allergic reaction meant they had to remove after 8 hours. They did a very good job on the pain. They were the 50 ones. Hydrocodone was used as an instant release. They prescribed 10/325 up to 6 a day and then the patch for 3 days. They prescribed Methadone and that did not work as well. When they switch the pain meds, they always do the minus 25% thing and there would be suffering for a couple of weeks. The last time they switched the prescription from Morphine Sulfate to Nucynta there was a lot of suffering. The pain was ranging from 7-8 for two weeks. Sometimes it would be worse, but not better. Talk about suck. That is why the prescription is back to Opana. If there was suffering, might as well be on something that does not work as good but still gives some relieve. It is not understandable why they have to drop the 25%. Doctors not understanding chronic pain came up with that one. The prescription is now Opana ER, 30mg twice a day and Opana IR, 5mg 4 times a day. The 5mg do not do anything and two of them at a time to get some relive and then suffer the rest of the day. Doctors are worried about getting in trouble with the law if they prescribe too much and make it easy to abuse.
     
  8. Mick Mouse

    Mick Mouse Palladium Member Donating Member

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    Go to the Opana ER 40's and the IR 10's. You might look into the BuTrans patch, which is fairly new. It is Buprenorphine, which is about 40 x the strength of morphine and comes in a 7 day patch at 5, 10, and 20 mcg/hr dosage.
     
  9. jarlaxle

    jarlaxle Mercury Member

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    hydromorphone is weaker then oxymorphone and it sucks big old hairy donkey balls if it is taken orally or snorted, its ok if its injected but it doesnt last very long at all.. if your really in pain you will need an injection every 2 hours....