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No relief with ms contin extended release tablets for chronic pain after colectomy, what to do?

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Posted on Thu, 16 Jan 2014
Question: I recently had a complete colectomy and now have an illiostomy. I was being treated for chronic pain with ms contin extended release tablets. after 2 to four hrs, the pills are showing up in my drainage bag and they don't look like they have even changed much in size. also, my pain is no longer very well controlled. ive been told that extended release medications will not work correctly with an illiostomy, but when I told all of this to my physician he is very insistant that im receiving all of my medication and what im seeing in the bag is just a shell of the tablet. the tablet is a 100 mg time release tablet and I cut one in half just to see, and it was not hollow. so is my dr correct and im getting the medication like he says and what im finding is nothing to worry about? if that is the case, why is my pain not controlled anymore? is it just psychological from seeing the tablet exit into the bag?
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Answered by Dr. Shruti Rijhwani (55 minutes later)
Brief Answer: Follows. Detailed Answer: Dear Madam, Thank you for posting your query on XXXXXXX Well looking into the query I will like to tell you that in my view extended release tablet will be less helpful to you because it is generally made to work for long so several layers are there which dissolve one by one which requires time , since you have illeostomy they are excreted much earlier . I think you should take a second opinion over this issue . Injectable drugs will be the best for you . Other thing is you can dissolve the tablet in water and drink it which will give instant action but not the extended release one . Take care. Dr. Shruti
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shruti Rijhwani (2 days later)
if I dissolved the tablet, wouldn't there be too much medicine released into my system and cause an overdose? the medicine is ms contin 200 mg extended release tablets, Im not sure what too do, the pain is pretty intense and when I asked my dr he said that he thought I was receiving all the medicine and what I was seeing in the bag was a shell, but they don't have a shell, I split one in half just too see. also, everyone else, including the pharmacist agrees with what I have been thinking. doesn't this medication work by dissolving in the large intestine, and since I no longer have one im confused by the differing opinions.
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Answered by Dr. Shruti Rijhwani (18 minutes later)
Brief Answer: Follows. Detailed Answer: Dear Madam, Thank you for reverting back. For dissolving in water you should not use extended release tablets, use the normal one . Its only the doctor who can prescribe you that . In my opinion you are right . Its your decision now whom to believe . You can take a opinion from other doctor for confirmation . Dr. Shruti
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shruti Rijhwani

Rheumatologist

Practicing since :2008

Answered : 2366 Questions

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No relief with ms contin extended release tablets for chronic pain after colectomy, what to do?

Brief Answer: Follows. Detailed Answer: Dear Madam, Thank you for posting your query on XXXXXXX Well looking into the query I will like to tell you that in my view extended release tablet will be less helpful to you because it is generally made to work for long so several layers are there which dissolve one by one which requires time , since you have illeostomy they are excreted much earlier . I think you should take a second opinion over this issue . Injectable drugs will be the best for you . Other thing is you can dissolve the tablet in water and drink it which will give instant action but not the extended release one . Take care. Dr. Shruti