Med change, looking for info

[brewmonkey]

My doctor has let me know that when my prescription for the oxycontin runs out this month he is going change me to Kadian. I did some research on the Kadian and found it is a morphine sulfate and if I read correctly is also known as MS Contin. I have no issue with the changing of the meds as long as it continues to provide the quality of life that the oxy has allowed.

He said the change is because of studies he has read that suggest oxycontin, though time released has a peak factor and may not provide the relief suggested. I have not had the euphoria that a peak might offer but I have needed meds for breakthrough pain as well on some occasions it seems to stop working at about the 10th hour, not often but about once a week (1 out of 14 doses).

My question for the docs is, do you have any information or can you lead me to a published study on the oxycontin that shows it peaks (I could not find one on google) and what are your thoughts on the switch from oxy to MS?

All of this is coming from the doctor. I have not asked for a med change and I had not told him about the breakthrough pain since he prescribed something for that when he first gave me the oxy. Actually I have not talked to them since the last visit when they refilled the oxy and I let them know that all was going good.

[swatsurgeon]

brew,
ms contin may be slightly longer acting but has slightly higher side effect profile....worse constipation, more nausea, all of which may be a moot point for you, i.e., side effects are different in everyone, less bioavailability in some people....
ms contin is recommended every 8-12 hrs, oxycontin can likewise be used every 8-12 hrs...ms contin is certainly less expensive. Not sure why the offer to switch...you'll develop tolerance to either. One thing he may want to try is rather than oxycodone for breakthrough, use dilaudid, it lasts longer.
How about methadone...slower to titrate but slightly longer effects for some people?????
just my 2 cents.

[brewmonkey]

I will certainly ask him why the change when I see him again.

I am curious though as what you would suggest for constipation. I have the over the counter pills and they are ok but if there is a chance for increased constipation is there something else I should inquire about?

[swatsurgeon]

1) a lot of fluid daily...urine should look like water
2) benefiber/metamucil daily
3) senekot (natural ) daily

do #'s 1 and 2 and if poor results add #3

[brewmonkey]

1) a lot of fluid daily...urine should look like water
2) benefiber/metamucil daily
3) senekot (natural ) daily

do #'s 1 and 2 and if poor results add #3


If I drink any more water... I will run to the store and grab some number #2 (no pun intended you sicko's).

[DoctorDoom]

x

[brewmonkey]

Sounds like he is switching you to MS Contin because you are having some periods of breakthorugh pain with OxyContin... sometimes a one drug will work better than another drug of the same type.

Makes sense. I also understand that they also have a 24 hour pill for the MS Contin which is great. That cuts out the twice a day for the oxy and then whenever for the breakthrough. I see him in the morning so I will give a SITREP when I get back.