mamasbabygirl Posted August 21, 2006 Share Posted August 21, 2006 So far, mom has been moved up to 40mg oxycontin (2 20s a day) and 10/325 percocets every 4 hours. I am curious if this alot of medicine or if by upping these doasges she will get some relief. If this is a high dosage, maybe we should try something else. If anyone knows, please met me know. Also, how high of a oxycontin dosage do they prescribe? Quote Link to comment Share on other sites More sharing options...
cindy0519 Posted August 21, 2006 Share Posted August 21, 2006 Lori, Not sure if the dosage you describe is "high" or not..my advice would be if it is not giving your mom the need pain relief then it is time to either try increasing it or try something else. I would talk to the doctor/hospice and not let them tell you that it all they can do... they can do more!!! One of our biggest battles with Dad was getting him to take his break through pain meds (oxycodone/percoset) as prescribed. He seemed to think that he only needed to take one a day. The problem with this is that the pain becomes so much that the medicine cannot keep up with it. It must be taken on the schedule prescribed to really have the desired/needed effect. We never could get Dad to understand this.. and it was a battle for us at times. Hopefully this is not the case with your mom. We also tried several different dosage combinations of oxycodone, percoset, and the fentanyl patch. Dad's dosages did need to increase as his disease progressed, so the correct dosage was somewhat of a moving target at times. His oncologist was wonderful about this however and we would just call and he would increase the dosage of Dads fentanyl patch as it is what seemed to give him the most constitant long term pain relief. Oxycontin come's in doses of 10mg, 20mgs. 40 mgs, 80mgs and 160mgs so you can see by this that there are more options for just the oxycotin. Also wanted to mention that if your mom is taking percoset and is experiencing any sort of naseau - the percoset also contains tylenol which can upset the stomach and has been found to cause liver issues as well. I know that the hopsice that Dad was in gave him the percoset in a liquid form wihtout the tylenol in it. It worked really well for Dad for break through pain control. Talk to the medical team Lori -- there is more than can do, they just have to be willing (or forcefully pushed ) to find the right medications in the right combinations/dosages! Hope they are able to do this SOON and your mom gets some pain relief. Quote Link to comment Share on other sites More sharing options...
Linda661 Posted August 21, 2006 Share Posted August 21, 2006 Lori: First, I have absolutely no experience with the drugs you are asking about -- all I did was do some internet searching to see what I could perhaps find to help you out FYI. Here's some data on oxycontin: http://www.medsafe.govt.nz/Profs/Datash ... tintab.htm In looking up oxycontin, I had also run across another pain management bboard that suggested if oxycontin isn't working well, to ask the doctor about either (1) changing the oxycontin to an 8 hour schedule rather than a 12 hour schedule or (2) changing from oxycontin to methodone (I think members here had already suggested that in another thread of yours). The percoset, on the other hand, looks high but I'm not clear on what 10/325 percosets every 4 hours means -- is that 10 pills of 325 strength every 4 hours or 10 pills per day, administered over 4 hour intervals? Percoset links for information: http://www.healthsquare.com/newrx/PER1326.HTM http://www.rxlist.com/cgi/generic/oxyapap_ids.htm Hopefully someone with the medical knowledge will chime in, but both of these appear to be fundamentally the same drug from what I can tell -- only percoset has some "Tylenol" in it as well; I couldn't find anything that warned against this combination (i.e. I was looking for drug interaction warnings or something related to the dosages of both combined). Taken together it sure sounds high, but the literature appears to indicate that doctors can go over recommended dosages -- the key is good monitoring by the doctor. And.....there are other options if this combo. isn't being effective at controlling the pain. Hope this helps, Linda Quote Link to comment Share on other sites More sharing options...
Carleen Posted August 21, 2006 Share Posted August 21, 2006 Hi Lori, I am not an expert, but it doesn't sound like those dosages are too high to me. Was on Oxycontin and Oxycodone during his 1st and 2nd years of treatment and was taking 60 mg of oxycontin 3 times a day, and then 80 mg of Oxycodone every 3-4 hours for breakthrough pain. From there he switched to Methadone for the long acting pain relief at 20 mg 3 times a day and that enabled him to drop to only 20 mg of oxycodone every 3-4 hours for pain control. Even at these doses, his pain management doctor would always tell Keith to inform him if that wasn't enough becuase he concidered these on the lower spectrum of medication dosages. I would talk to a doctor in the pain management clinic. The doses may not be something of concern, but if they aren't working to bring relief, then maybe there is somehting else available for her. Quote Link to comment Share on other sites More sharing options...
teresag Posted August 21, 2006 Share Posted August 21, 2006 I am not a hospice nurse so I am not familiar with "usual" hospice doses, but I do know that opioids like oxycontin, or oxycodone which is the opioid in both oxycontin and Percocet, are only limited in dosage by side effects. In other words, these drugs are not like acetaminophen (Tylenol), where too much can cause liver damage. In cancer pain, the "usual" doses are not all that meaningful. The drugs are titrated according to the person's need. The usual limiting side effects of oxycodone are oversedation, respiratory depression and GI side effects. Constipation is expected, as you probably know, so step up the fluids and fiber, and give her a stool softener if you aren't already doing so. Of course check with her health care provider to be sure, because my advice is general and I don't know your Mom. Quote Link to comment Share on other sites More sharing options...
ma's kid Posted August 21, 2006 Share Posted August 21, 2006 Lori, Great advice in all the posts..nothing to add except prayers and hugs! Libby Quote Link to comment Share on other sites More sharing options...
antoinettev3 Posted August 21, 2006 Share Posted August 21, 2006 For chronic pain or cancer pain this is not high at all. I currently take 10 mg Oxy 3x day and 7.5 -10 mg Percocet every 4 hours and somedays it barely keeps up. If she is getting relief and the side effects are not causing problems don't get hung up on the numbers. Also bare in mind that one develops a tolerance for all narcotics overtime necessitating raising the dosage even if the disease is not worse. If she is not seeing any difference or relief then she might want to consider other med combos like the patch for long acting and the fentanyl lollipop for immediate relief. I pray that she will get relief. God Bless. Antoinette Quote Link to comment Share on other sites More sharing options...
mamasbabygirl Posted August 22, 2006 Author Share Posted August 22, 2006 Rhanks guys. Sounds like mom is really taking much medicine at all, so maybe upping the dose will help. Quote Link to comment Share on other sites More sharing options...
Maryanne Posted August 22, 2006 Share Posted August 22, 2006 Sending prayers Lori, Maryanne Quote Link to comment Share on other sites More sharing options...
Ann Posted August 22, 2006 Share Posted August 22, 2006 Lori....I'm jumping in here a bit late on this one. Like others, I don't think the dosage your mom is currently taking is too high, based on what Dennis was taking. I do know that it is very important to take the "break through" meds every four hours, as directed. This will really help. Dennis hated taking so much medication and would almost refuse to take the four hour meds. Because of this, his pain would be almost unbearable by the time his Oxtcontin was due. When I finally convinced him to take the meds as directed, the pain seemed to really decrease. Quote Link to comment Share on other sites More sharing options...
Gwen, Daddy's girl Posted August 23, 2006 Share Posted August 23, 2006 A pain management team, if available, can consider a wider range of posible ways to control pain. My Dad found considerable relief from morphine tablets. Quote Link to comment Share on other sites More sharing options...
hollyanne Posted August 23, 2006 Share Posted August 23, 2006 Lori -- There is SO much more they can do. My mom had mets everywhere in the bones and was in terrible pain until we did Fetanyl (she was taking percocet every two hours and liquid morphine before this) -- and then the morphine pump was a God send. Your mom should not be in pain...should NOT. Please tell the doctors that this simply unacceptable. All my love to you during this so very difficult time. Holly Quote Link to comment Share on other sites More sharing options...
marym Posted August 23, 2006 Share Posted August 23, 2006 Hi Lori, I agree that your Mon should not be in pain. And taking dosages on time, so as not to get to the pain is necessay. I read that the long acting (12 hour) pills are really only steady for about 8 hours, then they taper off. So whe I had pain, my doctor had me on 3 times a day, instead of twice. The biggest concern would be that your mother is not in pain or sedated as her only states. Usually hospice can be of assistance, else see if the hospital has a pain management team. Mary Quote Link to comment Share on other sites More sharing options...
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