I was prescribed Opana ER today -

[A.K.]

anyone else on it? It's the 20 mg, twice a day. I understand it's fairly new in the USA after about a decade of use in Europe for pain. I could only find one drug store anywhere near here that had it and I am a suburb of Atlanta.

[ErinENj]

A.K.: Wow! Finally someone else is on it!! I've been on my own since Christmas time! I was switched from 200mg of Kadian, every 12 hours, to the Opana ER, with a 12 hour doseage of 80mg. Unfortunately, the switch wasn't right and I went through 2 weeks of withdrawals and feeling like complete and utter crap (it's a fantastic was to go through the holidays. NOT!) until I could get back in touch with my doc, who closed his office between christmas and New Years. A little tip: Never switch your meds Christmas Eve!!

I was finally bumped to 120mg every 12 hours and it was working really well until my car accident Tuesday. I like it. It works well for me once I got my schedule adjusted to it, which took a few weeks, but works well know.

A few tips: First, I'm not sure if you've been told about the eating rules with this med. You have to take it on an empty stomach. So the rule is you take it either 1 hour before or 2 hours after eating. It's a pain in butt at first, but I've got it pretty figured out. I take it at 10-10:30 am and pm every day, so I know that I have to eat dinner by 8 or 8:30 every night and if I'm up for breakfast (it's the plus side to having almost all afternoon or evening classes) I have to eat by 8 or 8:30am. Taking it on an empty stomach caused some wicked heartburn for me though. It was that painful kind where if you try to drink or eat something when I have it, it hurts because my esophogus is trying to stretch to accomodate everything. Plus, it's just painful. So I've been taking Aciphex with it for a few weeks and the heartburn has been basically gone. I haven't had any real constipation issues with it either, especially compared to the Kadian.

Another thing. Make sure you take it at exactly the same time every day. I've found that if I'm off even by a half hour, I'll start hurting pretty badly and even get diarehha if I'm off my doseage by an hour. Like everything else with this med, once you get on and used to a schedule with this med, you'll be fine. I used to have to set an alarm on my cell phone to make sure I take it at the right time, but now that I'm comfortable with my schedule, I rarely forget to take it, unless I'm really distracted with something else.

I hope this med works for you! Yep, it's really new, but it seems to be a good one. The actual formulation has been around since the 50s as my doc told me, but this is the first time it was made into a pill form. It used to only be in IV form and only really used in hospitals. Because of that, I'm not too concerned about the long-term effects with this med. That's one of the dangers, I think, of being on these new meds because they haven't been around for ages like some of the others. At my age, I have to be worried about that, simply because I've got another, God willing, 75 years ahead of me of being on these meds (my surgeon told me a year ago that no matter what, I will be on these meds for the rest of my life and I will be in pain for the rest of my life...it stinks when your surgeon gives you no hope for a painfree existance. I kinda wish he'd lied to me, but can understand why he told me straight out. That's one of the reasons I like him so much.) and I have some concerns about whether or not I'll end up with a rotten kidney or liver, whichever one is effected by these meds (I can't ever remember) by the time I'm 50. But, we'll see about that. For right now, Opana ER really works well for me and I hope it does for you too!! And it's so great to finally have someone else on the board on it!! I felt so alone! :D Keep in touch and let me know how it's working for you!

OH, one thing, make sure, before you start switching, that you have a pharmacy that will stock it. When I went to fill my script, I couldn't find a single chain pharmacy that stocked it. I ended up driving about 2 hours, going to every pharmacy in Central NJ, and ended up less than a mile from my house at a tiny, hole-in-the-wall pharmacy that I was shocked had it! I only had to endure the intense questioning from the pharmacist there who took one look at me, a 25 year old, and said, "is this for you? You know, this is a very powerful narcotic medication." I think my answer didn't help much. I said, "I sure hope so." I had to follow that up by telling him I was on Kadian at the time and was switching to this one. He gave me about a dozen looks, and you could see he was thinking, "is this girl for real? Should I give this to her? Is it worth losing my job?" Then my mom walked in and gave me a hug because she knew I was hurting pretty badly, and we both looked over to the counter, where he immediately started fillling my script. It was totally like a movie! :D I guess he figured that if I was some drug addict, my wholesome looking mom wouldn't be okay with it!

[BrokenBladder]

This may be a dumb question, but does this medication have morphine in it. I have some terribl s/e with morphine, that's why I'm curious.

[ErinENj]

Lisa: The generic is oxymorphone, so I am guessing there's some morphine in it, but I could be wrong. Isn't it great how much I know about what's going into my body? hehe! :D :p I think morphone is a form of morphine, but I'm not really sure. I'm sure someone else, probably Steve, will know better than I do. :o

[A.K.]

Erin,
Thank you so much for the encouragement. I need to hear this tonight! I will get a set routine right away and I did read that about the food but if you hadn't told me I wouldn't have taken it so seriously, so thanks for that too.

I am concerned about my low dose compared to yours. It sounded really low when he told me but I'm not afraid to speak up if it's not enough. You sound very alert, so do you really feel as peppy as you sound? That would be awesome not to be dragging around all day feeling half here half spaced out and still wiped out in pain.

I am SO sorry that you are so young and dealing with this. You must be a really awesome and special person to have been chosen to carry this cross in life. Pain is a hard one but it's sure not the worst one and at 20 years older than you that is the sad voice of experience that knows I am speaking truth to you there!! You sound very courageous and I am really grateful you have a strong support system in your caring Mom - mine is not and I wish so much she were. Be thankful and let your Mom know you appreciate her.

Let's definitely stay in touch and feel better and better together. Maybe before it's over we can have the whole board going in and asking (no demanding) Opana ER from their docs. Take care.

[jena1225]

Lisa: The generic is oxymorphone, so I am guessing there's some morphine in it, but I could be wrong. Isn't it great how much I know about what's going into my body? hehe! :D :p I think morphone is a form of morphine, but I'm not really sure. I'm sure someone else, probably Steve, will know better than I do. :o

Lisa - you can always "google" it. I "google" everything! lol

[ErinENj]

Thanks A.K.! You're very good at flattery! :D I think I'd be peppy if I managed to get more than 7 hours of sleep per night and get to bed sometime before the a.m. hours. I know, 7 hours would be fantastic for many of the people here, but it's just not enough for me anymore. I seem to always crash in the middle of the day, somewhere around 3 or 4pm, and end up passed out for a few hours to be able to stay up until 12ish so I can finish my homework for the next day. I think the peppy comes from my very, very strong sense of humor and my dripping sarcasm. They're great defense mechanisms! But they don't work too well when you're typing. It's way too easy for my sarcastic comment to come over like a snide remark. So I stick with the humor bit. Being funny is just too much fun for me!! :D

I wouldn't be too worried about the dose. As long as it works. If you find that the 20 isn't enough, then I think you have every right to speak up to your doc and let them know it isn't at the right levels. Every new med requires some tweaking to get the doseage right. A conversion chart isn't right. What are you switching from and what dose were you on? For me, when he did the conversion, it was 80mg and he even rounded up, but once I got on it and got it into the system, it just wasn't right. I was actually shocked to see him jack it up so high so quickly. After 2 weeks, the withdrawal symptoms were dying down on their own, but the increase helped make me feel remotely close to human. I think, for now, just see how it works for you. I'd give it a shot. See what happens.

Honestly, I'd rather have this for the rest of my life than some of the other people in my generation or even younger have to deal with. One of my mom's friend's daughter has been suffering from a rare brain cancer for something like 5 years now. It's gone into remission twice, but has come back recently. There's nothing the docs can do for her. She's dying, and they doubt she has even a year left. She's only 21. I can't imagine what that's like to deal with. I'd rather have this pain than have to try to deal with something so horrible.

Yeah, this pain sucks. There's no question about that. But for me, it's just something that makes things more difficult, but not impossible. Many people told me that I'd never be able to finish college. I totally disagreed. It took me awhile, but I am doing it. I've got 1 month and 16 days left, and then I graduate. And not only am I almost done, as I say, I've done it in style. Ever since my first semester back after my first spinal surgery, I've been on the Dean's List, or all As and Bs for the semester, every single semester. I took my gpa from barely a 2.0 to a 2.9 and hopefully a 3.0 by the time I graduate in 4 years while carrying some horrible grades from past mistakes. I've been inducted into the National Communications Honor Society, put on the National Dean's List (something that no one at my school had ever even heard of, which could be good, or really bad!), and accepted into another national honor society, one that is so important I can't remember it's name. I was given an award for Excellence in Journalistic Writing from my professors. I even managed to pull off a 4.0 last semester. I went from being academically dismissed my sophmore year (2000) to being one of the best students in my major. I have a 3.8 in my major, which represents all of the work I have done since this all started since I changed my major right after the first surgery. And I'm really proud of myself. While this pain has made things really hard, and really depressing, and changed my life, it also has made things that much more meaningful. And, hopefully, through my career in journalism, I'm hoping to help open peoples' eyes about what exactly we go through and hopefully change peoples' ideas and opinions. There would be nothing better. So, I think that maybe, and hopefully, there was a reason for me to be hit with this at 21. Also, because I got hit so young, I don't have even a quarter of the worries many people have here. I don't have a family. I don't have a mortgage. I don't have so many of the things that make this life difficult for many people. I'm able to live with my parents, and they are willing to completely financially support me so I can finish college. My mom, who is a wonderful woman and I do my best to remind her of that (my graduation present is a trip to Amsterdam, that I've been planning since I went there in 2001 for the first time and wanted to see so much more of the city than I got to on that trip, and it's going to be hard financially. My father just lost his job, and while mom makes a good amount of money, this house cannot be supported on her wages alone. So she said that she wouldn't go to make it easier financially. I refused. I told her that she has worked amazingly hard to keep me in school and deserves this trip as much as I do.) told me once that she wants me to have a career, not a job I hate but do because I have no other option. There are no words for how wonderful my mom is. She would open a vein if she thought it would help me. And there are no words for how much I appreciate her and everything she does for me. I know that it's really hard for her to see me like this. She had her dreams for me destroyed too, and I know that broke her heart. And I could see in her face how hard it was to see me in that hospital bed when this all started. And she cried with me when I had an absolute nervous breakdown after my second surgery. And she just hugged me, because she knew that was what I needed, when I found out last year that I had reherniated all of the disk material from my 2 bad disks and when I was told shortly thereafter that this was going to be the rest of my life, confirming every worst fear I had. I could never explain in words how wonderful and how amazing a woman she is. She'd give everything if it could help me or even just make me happy for awhile. I just wish she would do that for herself. She deserves it.

Okay, you obviously can tell I get a little long-winded. What can I say, I'm a writer! It's what I'm good at. Definately keep in touch!! I really want to know how this all works for you. And I'm glad I gave you some good info. Definately remember that empty stomach thing. I've been told it's practically essential to make this med work. And it would be fun to start a trend! We could start a board "For Opana ER patients only" and then people would be flocking to their docs for this med so they could be special like us! :D

Jena: Do you know, Google has become such a synonym for web searching, that very rarely people say "I'm searching the internet" any more? Now, it's even in the dictionary, people say "I'm Googling something." It's an interesting trend.

[ASkicker]

My wife has been on Opana for disc and other back pain for over six months now, and it has been fairly effective for her. I think it would work even better if her doctor would up her dose just one level, but she won't even ask him, so that won't happen any time soon.

As for availability, I would echo what the others have said (she has lived in Michigan and Maryland while on the Opana and had trouble finding it in both states). None of the big chains carry it, and while all will order it, that is a pain. Your best bet is to find the hospital closest to you and go to the pharmacy there, if it is one that is open to the public (most at bigger hospitals are, not sure about smaller ones). Call first, of course, but I think you will have no problem finding it there--that's what worked for her.

Good luck.

[lobelsteve]

Oxycodone
Oxymorphone
Hydrocodone
Hydromorphone
Morphine
Codeine
Meperidine
Methadone
Propoxyphene
Fentanyl

These are the basic chemical (generic) names for almost all of the opioids prescribed in the USA. They are all unique drugs and an allergy to one does not mean an allergy to another one, even if they sound alike. Side effects vary between chemical, brands, doses, and the individual drugs.

Morphine is available in Oramorph, MSContin, Kadian, Avinza, MSIR
Oxymorphone is available only in Opana ER and Opana IR (there is an IV form available)
Oxycodone is Percocet, Tylox, Combunox, Oxycontin, OxyIR
Fentanyl is Duragesic, Actiq, Fentora, Bema
Hydromorphone is Dilaudid and Palladone (back in 08)
Hydrocodone is Norco, Xodol, Lorcet, Lortab, Vicodin, Anexsia, Vicoprofen
Meperidine and Propoxyphene I would not recommend for use in humans
Methadone is safer than the above 2, but less safe than all the others. It has a limited role in pain management and is popular because it is inexpensive.
Levorphanol is another little used opioid, but may play a bigger role in the future.

[Kathi49]

Thanks Steve!

I was just thinking about this over dinner; the various meds.

Personally, I prefer to take Vicodin over Norco. But I did want to ask about the Vicoprofen. And what is the ratio? Is it or would it be more troublesome to the stomach then say Vicodin and Voltaren? I was prescribed some Celebrex but it bothers me whereas the Voltaren doesn't. I guess what I am looking for is a combo in one pill.

Also, is the Fentanyl patch more potent than the Vicodin or Norco? If I could wear a patch, it would probably be better. Yet, I am afraid I will be tired all day.

[slipnslide]

Lobelsteve,


Hydrocodone is Norco, Xodol, Lorcet, Lortab, Vicodin, Anexsia, Vicoprofen
Meperidine and Propoxyphene I would not recommend for use in humans
Methadone is safer than the above 2, but less safe than all the others. It has a limited role in pain management and is popular because it is inexpensive.
Levorphanol is another little used opioid, but may play a bigger role in the future.

:eek: May I ask why you say that? Over the past 10 months since my surgeries, I've been on Meperidine (for a few weeks) and then was put on the Hydrocodone (Lortab). I only take the Lortab 5 four times a day. Should I be concerned?:confused: If so, why?:confused:

[lobelsteve]

Lobelsteve,



:eek: May I ask why you say that? Over the past 10 months since my surgeries, I've been on Meperidine (for a few weeks) and then was put on the Hydrocodone (Lortab). I only take the Lortab 5 four times a day. Should I be concerned?:confused: If so, why?:confused:

Meperidine (Demerol, Mepergan Forte) is safe for short term use in patients with normal kidney function. It has an active metabolite, normeperidine (metabolized in the liver, exctreted by the kidney). The active metabolite is a neurotoxin and it can induce seizures, causes delirium, hallucinations, psychosis.

Even for short term use- it should not be used in patients once they reach ~65 years old due to increased risk of reduced Cr clearance- a measure of renal function that declines with age.

[slipnslide]

Meperidine (Demerol, Mepergan Forte) is safe for short term use in patients with normal kidney function. It has an active metabolite, normeperidine (metabolized in the liver, exctreted by the kidney). The active metabolite is a neurotoxin and it can induce seizures, causes delirium, hallucinations, psychosis.



Whew!...Geeesh, don't go scaring me like that!:D ...LOL...Well, at least I now have an excuse for acting psychotic!...Just kidding!:D