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Suggest The Ideal Dosage For Dilaudid Taken For Pain Management

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Posted on Tue, 5 Apr 2016
Question: I am currently on oxycodone 80 mg morning 60 mg afternoon I'm not happy with it and want to try Dilaudid what would be the equivalent dose
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Answered by Dr. Dr. Matt Wachsman (1 hour later)
Brief Answer:
Several points

Detailed Answer:
first it depends why you aren't happy. if it is because two doses a day of a drug that charitably works for only 6 hours, you won't be very happy with another drug that isn't a lot different on duration.

if it is because of wanting more of an effect, this is getting to already a high dose and going higher than that is dangerous. if it is due to side effects shared by all narcotics like constipation or tiredness or queasiness, you might not find another similarly acting drug will be any different.

that being said 60 is about 16 and 80 is about 20.

never seen anyone on anywhere near that much and it seems dangerous


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Dr. Matt Wachsman (1 hour later)
Thank you for your reply, Firstly I am not happy because it takes about six hours before pain subsides and sometimes I am still in pain, I realise it will not relieve pain totally but that dose should come close. I might add that I used to be on oxycontin stamped OP which was nowhere near as good as the old OC tablets 80 mg per day, the oxycodone is Sandoz oxycodone which is about half the strength of Oxycontin, I am not a drug abuser, just an older guy who broke his spine at age 11 and wants to live a close to normal life as possible. My GP sent me to a pain specialist who put me on Physeptone after a 10 minute consultation, that's when everything changed for the worst, I am now trying to find the medication that is suitable for me hence the question about Dilaudid. Hopefully I will be able to get back on track soon, The original OC oxycontin was great for about 8 years before it was altered to deter the junkies which has now changed the effectiveness of this drug.
Regards XXXXXXX
doctor
Answered by Dr. Dr. Matt Wachsman (7 hours later)
Brief Answer:
I'm not doubting you

Detailed Answer:
and
" The original OC oxycontin was great for about 8 years before it was altered to deter the junkies which has now changed the effectiveness of this drug "
makes perfect sense. The way the drug dissolves changed with the formulation. How it then interacts with the gut, liver, blood brain barrier etc is going to be different when how fast it gets in and how high the level gets to (peak drug effect) is totally unregulated by the FDA and guaranteed to be different. The FDA just makes sure the total amount that gets in is within 80% of expected. And the 20% drop allowed would feel like 20% less.
This makes sense.

Short acting drugs leave the body in 6 hrs.
"Firstly I am not happy because it takes about six hours before pain subsides"
Doesn't make sense. I hit the on button of the computer. Taking 2 minutes to start up I can see why that might be. 6 hrs to turn on after hitting the on button? Something is not working. It implies the narcotics work only when they are not there. An addict would be LESS likely to say this, obviously. Your other statements are perfectly reasonable and there's every reason to believe that you are having the symptoms you say at the time that you do. It just makes no sense and there isn't any good explanation (and that includes psychological explanations, people who are crazy or lying to themselves or others wouldn't say this and wouldn't have this pattern).

There isn't going to be an explanation to make sense of a 6 hr gap til the pain starts.

If there were an explanation, it wouldn't get published because it wouldn't make sense with what is known about the drug. Like I could say, "Gee, this could happen to the people in my family because we don't actually have the wiring for the narcotics to do anything except make us feel bad (true). When the narcotic wears off, I feel better". But, I've never actually been on narcotics more than taking one dose (kidney stone) because the first dose felt so horrible I wasn't going to take a second dose. So, saying this applies to you is ..uh... overly imaginative.

I'd advise the same thing I did with the wife who had the computer act up. Stop everything and restart it. Whatever odd thing that is going on (and frankly, I would be making things up to give any explanation), will change with not taking the drug for a couple days up to 1 week. Then, yeah, switch drug. Dilaudid is a very different chemical shape. Fentanyl is also a very different chemical, more potent, and longer lasting than oxycodone, BUT it also has far more side effects, so, it isn't anyone's first choice.

Obviously, you've already tried other modalities than narcotics (physical therapy, chiropracty, massage, maybe accupuncture; amitryptiline, muscle relaxers, spinal injections), but I will list them anyway.

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dr. Matt Wachsman

Addiction Medicine Specialist

Practicing since :1985

Answered : 4214 Questions

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Suggest The Ideal Dosage For Dilaudid Taken For Pain Management

Brief Answer: Several points Detailed Answer: first it depends why you aren't happy. if it is because two doses a day of a drug that charitably works for only 6 hours, you won't be very happy with another drug that isn't a lot different on duration. if it is because of wanting more of an effect, this is getting to already a high dose and going higher than that is dangerous. if it is due to side effects shared by all narcotics like constipation or tiredness or queasiness, you might not find another similarly acting drug will be any different. that being said 60 is about 16 and 80 is about 20. never seen anyone on anywhere near that much and it seems dangerous