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My Dad Has Stage 4 Prostate Cancer That Has Spread

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Posted on Mon, 29 Jun 2020
Question: my dad has stage 4 prostate cancer that has spread to his bones. He is supposed to take 7.5mg hydrocodone every 4 hours. If he is sleeping at night do I wake him up every 4 hours? He often will wake up in extreme pain. He has yet to start cancer treatment and has been on these pills for about 3-4 weeks. He hardly gets any relief: so do I give it every 4 hours or wait until he wakes up?
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Answered by Dr. Aaron Branch (1 hour later)
Brief Answer:
Let him sleep

Detailed Answer:
Hello, I'm Dr. Branch, thanks for using 'Ask a Doctor'. Typically we say that if the patient is sleeping, don't wake him, because if he is able to sleep, then presumably he is not in too much pain. If he does have so much pain that it wakes him, then he could take the dose when it is due or after. If he does take the dose after it is scheduled (more than 4 hours from the last dose), then he should start the schedule from that point, and take the next dose 4 hours later, as he needs it (if the prescription says to take one pill every 4 hours, you should not take more than 1 pill in any 4 hour period, even if he takes a pill later; unless his doctor says otherwise).

It sounds like his pain may not be very well controlled though, so I would discuss with his doctor about using a longer-acting form of the hydrocodone, or to use a higher dose.

I hope that helps, please let me know if you have any other questions about that, and I would be glad to discuss it with you further.
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Above answer was peer-reviewed by : Dr. Nagamani Ng
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Answered by
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Dr. Aaron Branch

General & Family Physician

Practicing since :2011

Answered : 1223 Questions

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My Dad Has Stage 4 Prostate Cancer That Has Spread

Brief Answer: Let him sleep Detailed Answer: Hello, I'm Dr. Branch, thanks for using 'Ask a Doctor'. Typically we say that if the patient is sleeping, don't wake him, because if he is able to sleep, then presumably he is not in too much pain. If he does have so much pain that it wakes him, then he could take the dose when it is due or after. If he does take the dose after it is scheduled (more than 4 hours from the last dose), then he should start the schedule from that point, and take the next dose 4 hours later, as he needs it (if the prescription says to take one pill every 4 hours, you should not take more than 1 pill in any 4 hour period, even if he takes a pill later; unless his doctor says otherwise). It sounds like his pain may not be very well controlled though, so I would discuss with his doctor about using a longer-acting form of the hydrocodone, or to use a higher dose. I hope that helps, please let me know if you have any other questions about that, and I would be glad to discuss it with you further.