MS Contin questions

[Pamster]

Anyone taking this med at around 30 mg? I don't seem to be feeling it at all over an hour after taking it, like an hour and a half and am still in pain like I was before taking it. How effective is 30 mgs? I am thinking its not strong enough, or something. Also does constipation really happen with this medication? Any help with this is greatly appreciated. :)

[911]

well i started at 60 mg tid way back when and now am on 115 mg's with break thru meds and cymbalta and have been at this level for about 3 years without a tolerance issue so i wish you the best of luck , just be upfront and straight up with your doc and i am sure they will work with you ,,,,,,, best wishes ,,,, Dave

[NJPain]

Morphine Sulfate is POORLY absorbed in your digestive tract. Look it up, I believe it is like 35% actually gets into your bloodstream whereas 87% of oxycodone get into your bloodstream.

Like the other said, calmly go to your doc and tell him nicely you are still having problems with the MS Contin. LET THE DOCTOR BUMP YOU UP!!!! I can't say that enough. Last thing you want to do is tell him what you want or what you want him to do. Keep taking scripts of MS Contin from him until HE gets the picture it ain't happenin. Good luck.

[Pamster]

I called today and asked them what I should do, I still feel no relief, only from the lorcet I took because it was unbearable and that is what the PM Dr told me to do. He also said it can take up to 24-48 hours for the drug to 'get into my system' which strikes me as odd. But I can definitely call again tomorrow and let them know IF this isn't working for me still. They are going to be closed Thursday and Friday and I don't want to suffer an entire four day weekend with no relief. :( I am just frustrated. Thank you both for the great replies! :D

[Pharmacist.steve]

Anyone taking this med at around 30 mg? I don't seem to be feeling it at all over an hour after taking it, like an hour and a half and am still in pain like I was before taking it. How effective is 30 mgs? I am thinking its not strong enough, or something. Also does constipation really happen with this medication? Any help with this is greatly appreciated. :)

IF the dose is adequate... you may not feel it "kick-in" for 90-120 minutes. My experience is that the relief will start to wane around 10 hrs .. that is why it should be dosed every 8 hrs instead of every 12 hrs .. to get the best ATC pain management.

[NJPain]

He also said it can take up to 24-48 hours for the drug to 'get into my system' which strikes me as odd.


Your feelings were correct as this information he gave you is not correct. An opioiod like Methadone works like this but not hydrocodone (the narc in Lorcet). Sounds to me like he was giving you the blow off. Ahh, could mean anything so don't look TOO MUCH into it. Just be consistant and let him know you are still sufferring with the current regimen. Good luck and stay the course and hope your doc finally sees the light and properly prescribes you the correct meds.

[NJPain]

As you can see, pharm-Steve agrees that you should feel relief at around 120 minutes....NOT 24-48 hours like your doc says.

[Mark N]

I started at 15mg years ago then went to 30mg as my spine deteriorated but had to jump to 60mg for adequate relief. Your doctor is talking about getting your level of medicine in your blood leveled off which takes a day or two since the med is time released. I have found that three times a day is effective but twice a day doesn't get the job done.

It takes time to find the right dose. I have had very bad constipation due to nerve damage and the MS Contin slowing down the motility of my bowels so much. I use a daily laxative to improve my motility. I hope you get the dose worked out soon and get adequate.

[Pamster]

He said I need to wait longer, it's still too soon. I think I am going to cry if I have to go through another day like yesterday. I just know this weekend is going to be awful, because the office is closed for a four day weekend and I am out of lorcet...I can't take this level of pain for four days and shouldn't have to...*Sob* I am so upset it did nothing for my pain...

[shotspine]

Hi Pam....

First, you are so welcome! It helped me feel like I was actually accomplising something that day. There are so many threads that I don't respond to because I just can't add anything.

Please call your Dr. back and ask if he will, at least, refill your Lorcet for the long weekend. Don't keep on him about the MSContin not working if he insists it will work. Just explain as calmly (Geez, brain is dead, can't even spell that word correctly at the moment). Anyway, you get the picture. Just remind him that you will have no options for pain relief if the morphine doesn't work and a 4 day weekend can seem like eternity with pain levels screaming to the top of the scale.

I can't comment on that med. as it makes me sick sick sick. I am still on Dilaudid (short acting) which my PM hates, but have tried all long acting meds and can't tolerate any of them. My PCP is willing to let me try the patch, but was told my PM will never RX them so, until that gets worked out.....I am perfectly happy staying on Dilaudid forever, as long as it works. I was on methadone for about 2 years and last year I was nauseated constantly. PCP tried everything, meds, tests, ultrasound, etc. Nothing helped. Last hope was that the methadone was making me sick........yep.......after about 6-8 months of constant nausea, it was gone within 3 days of stopping the methadone.

I'm glad your appt went well, but if the new med isn't working, it's not much of a step forward.

Bless you and sending out prayer and good thoughts you can get some help before they close for the weekend.

ss

[mrsdoubtfyre]

I called today and asked them what I should do, I still feel no relief, only from the lorcet I took because it was unbearable and that is what the PM Dr told me to do. He also said it can take up to 24-48 hours for the drug to 'get into my system' which strikes me as odd. But I can definitely call again tomorrow and let them know IF this isn't working for me still. They are going to be closed Thursday and Friday and I don't want to suffer an entire four day weekend with no relief. :( I am just frustrated. Thank you both for the great replies! :D

I believe this 24hr comment has to do with steady state absorption from your MS Contin. (some drugs take longer to reach steady state)

http://64.233.167.104/search?q=cache:Lns8IehEV4AJ:www.purduepharma.com/PI/Prescription/MS_Contin.pdf+pharmacology+MS+Contin&hl=en&ct=clnk&cd=3&gl=us

Steady state is:
http://www.medscape.com/viewarticle/448250_3

In regards to absorption:
Absorption
Following the administration of immediate-release oral morphine products, approximately
fifty percent of the morphine that will reach the central compartment intact reaches it within
30 minutes. Following the administration of an equal amount of MS CONTIN to normal
volunteers, however, this extent of absorption occurs, on average, after 1.5 hours.

Morphine is extensively metabolized in the wall of the GI tract and liver.
This is why only about 40% reaches the body for use.
Many drugs are like this.