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880900 tn?1467270141

Oxycontin to Temgesic (Subtex) ?

I have been diagnosed with rheumatoid arthritis (RA) and fibromyalgia (FM) for more than ten years, therefore experience chronic pain which has increased throughout the years.  About four years ago, I reluctantly filled a prescription for 10mg of Oxy three times a day, because I couldn't manage the pain with Tylenol#3s any more.  A year ago, the pain had increased to the point where I was prescribed three 20mg tablets per day.  I was so afraid of becoming addicted that I forced myself to reduce my own dosage to only 2 tablets per day, taking three Tylenol#3s at the same time to combat the breakthrough pain in between Oxy dosages.  The Oxy definitely helped me feel human again.  I have no complaints about its effectiveness.

I am told by many other RA and FM sufferers that you can't be considered addicted to a narcotic analgesic unless you use it for psychological reasons rather than just enough to help with pain management.  In my experience, that's pure poppycock!  I had to stop taking the Oxy last year for a period of one week prior to surgery.  On the second day after stopping the Oxy, I was screaming in pain!   It was pain that I had never felt before; pain that was completely unlike any that I had experienced from my RA or FM symptoms. It was at that point that I realized I was physically addicted to the stuff.

Three months ago, I moved to Mexico to retire.  Befoe I left Canada, I was given a 3-month prescription for 20mg  of Oxy to be taken 3 times a day.  Remember, I mentioned that I have never taken more than 2 tablets a day, right?  So now it's four months later and I still have about 20 Oxy''s left.

My Mexican doctor says that physicians are no longer allowed to prescribe Oxy in this country.  Therefore, when I went to see him to renew my prescriptions today, he told me he would have to change my pain medication from Oxy to Temgesic (buprenorphine), which is the same as Subtex.

I am terrified that I will suffer the same withdrawal symptoms as I experienced before my surgery in Canada.  

How should I manage this change?  Can I substitute the Temgesic for one of my Oxy doses each day, thereby using half the Oxy I usually would?  Or would you taper off the Oxy altogether, first, before taking the first dose of Temgesic?  I'm asking you this because I have trouble explaining my questrion in Spanish, and haven\t got any acquaintences who have attempted to do this.

Sorry this was so long.  Any suggestions you may have would be most appreciated. I'm really desparate because of the language barrier down here.  Thanks so much!
8 Responses
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880900 tn?1467270141
Thanks Cathy and Ghilly.  Yes, they are the extended release type ~ Oxycontin.  Now what?  Miss every second dose, then miss two doses in three, and so on?  This is getting very complicated indeed.
Helpful - 0
441382 tn?1452810569
Are you taking oxycontin or oxycodone?  If you are taking oxycontin, PLEASE DO NOT CUT THE PILLS INTO PIECES!  I think it must be oxycontin you are taking, since oxycodone doesn't come in 20mg pills, it comes in 5, 15 and 30mg.  Oxycontin and oxycodone are the same drug, but the oxycontin is the time-released version.  If you break those pills, or even if the coating on one is chipped, it's dangerous to take them because you will overdose yourself.

If you cut an oxycontin into pieces and break through the protective coating on the pill, you will get all of the strength in the pill in one shot instead of having it dissolve throughout the day as it is designed to do.  Every part of those pills, from the coating right on through, contains the active ingredient.  If there's even a chip in the coating you can overdose because you will get the full strength of the pill all at once.  So please, do NOT cut your pills into pieces.  

Ghilly
Helpful - 0
340590 tn?1290952141
hi and welcome to the forum.  thats a great plan, as long as you are not on extended release (er) oxy you can cut them in 1/4.  i would start my three day weekend on day 2...day one is not really bad til late in the night and days 3 and 4 seem to be the worst for most.  check in the healthpages to the right of this page and get the thomas recipe and the amino protocol and use them for help.  also exercise..start now.   if helps the brain to produce endorphins on in its own again, since the pills have been supplying them.  this will pass and you will be so much better in just a week or so...you will be glad you stuck it out...
Helpful - 0
880900 tn?1467270141
What a great forum!  I cannot believe how many knowledgeable, experienced and caring people take time out of their lives to help.  You are truly a godsend!

For those of you who don't want to read my long original post, suffice to say that I'm trying to stop taking Oxycontin.  For the past year or so, I've been taking one 20mg tablet of Oxy twice a day ( one in the a.m. & one in the p.m.).

Okay ~ I just went 9 hours without taking any painkiller, Oxy or Tylenol#3 or Advil or Aspirin. I'm hurting, but not bad.  I'm thinking I could try to take half-doses of my 20mg Oxy's from here on in, until they're tapered to none (e.g. half a dose ~ 10mg twice a day for five days; then 1/4 dose ~ 5mg twice a day for another 5 days; and so on ), and then just make the leap off painkillers altogether, without taking any Temgesic (Subtex) AT ALL ... not even starting on it!

Once they are totally gone, I would just take the 3-day weekend to take the leap.  Does anyone think I'd feel well enough on the fourth day to go back to work?  Any suggestions?

Because I've never been involved in the "drug culture", I may sound terribly dumb, but here's a question that's not quite on topic, but close enough:  Is it okay to actually cut the tablets? (There's no scoring mark on them, so they may crumble.)  If so, in your experience, what is the best way to cut them ... with a small boxcutter? a special kind of knife? another device?

Muchas gracias!
Helpful - 0
880900 tn?1467270141
Thanks for the info, Worried.  My primary goal is to be free of narcotics AND find another method of pain control:  change in diet and exercise regimes with, at least at first, an effective pain reliever that is not a narcotic.

I think one thing a lot of folks reading this might be missing is that I have just 20 Oxy pills left, meaning 10 days' worth.  That's it ... no more.  I can't get them here, period.  So my problem is, what do I do once the Oxy's all gone?

Do I suffer 24-72 hours of withdrawal, then start taking the subtex (they call it Temgesic here)?  After reading these boards, it seems that starting the Temgesic would be just like starting Oxy again, and the withdrawal from Temgesic would be the same, if not worse, than the wothdrawal from the Oxy!

OR, do I just bite the bullet and suffer total withdrawal from any kind of pain medication, thereby leaving me crippled up and unable to work or do much of anything?  For the first time ever, I forgot to take my morning dose of Oxy last Tuesday, and by 11 a.m. I was writhing in pain and couldn't get up from my chair!

After reading the boards, I'm truly panicking about what's going to happen 10 days from now!!! I have responsibilities ... I can't just take days/weeks off to lie in bed and shake, rattle and withdraw !!  If I could, that's what I'd probably do ... just let the withdrawal run its course.

Gosh, if I'd known that one 20mg tablet in the morning and one at night were going to cause this much havoc, I would never have considered them in a million years!

Thanks again for your help!
Helpful - 0
401095 tn?1351391770
narcotics are not really recommended for fibromyalgia....treating the symptoms, lots of water, high fiber diet, omega 3s, heat, ice, stretching and gentle exercise..as wll as muscle relaxers when needed. nuerontin, lyrica/some rx cymbalta/are the 3 drugs recommended for fibro pain..and arthritis is best treated with an anti-inflammatory..not a narcotic
temgesic is a pain med in mexico...rx-d in 0.2 mgs doses and up....it is not recognized as a very strong pain reliver but does provide some pain relief/everyone is different tho.....0.2 mgs would not cover the dose of oxy u r on tho....2-4 mgs may keep u out of wds...sub was originally a pain med/and the usa adopted it as an addiction drug and here it is rx-d in huge dose compared to what mexico prescribed (RX-D) for pain...methaodne was a long acting pain med in germany/used during war time when meds needed to be long lasting due to time on the battle field etc..the usa took that drug as well and turned it into an addiction drug...altho methadone is also legal to rx for pain here and sub is not..methadone provides a very high amt of pain relief compared to sub...but both are habit forming and if used long term wds are almost a given with both...good luck to u..and as asked..is ur goal to be free of narcotics or to find another mode of pain control?
Helpful - 0
880900 tn?1467270141
Thank you Nick!  I thought it was just a change from one effective pain killer to another because the Dr. couldn't prescribe Oxy in this country.  Thanks for enlightening me to the primary use for Temgesic.  Now I feel I'm really stuck.  I guess I should just bite the bullet and withdraw from Oxy ... certainly not a pleasant prospect at my age.  

I have not found anything more effective in controlling my arthritic pain.  I have been prescribed Ibuprofen, and anti-inflammatory, but my stomach bleeds occasionally from the Methotrexate I take (to arrest the progression of the arthritis), so Ibuprofen was damaging.  I have used, as I said, Tylenol#3s, but they weren't even taking the edge off the pain unless I took three or more at one time.  For me, that was just outrageous, and it played havoc with my digestive system too.  I have also been prescribed other narcotic combinations, none of which has worked as well.

It's a new rule here that no C-III drugs can be prescribed for anyone outside of a hospital.  I guess it has to do with the government's desperate attempts to curtail illegal drug use and it's sociological ramifications throughout the country.

Unfortunately, this rule has left those of us who are vigilent about taking it for the right reasons, and responsibly, in a terrible bind.

Thanks again for your thoughts.
Helpful - 0
Avatar universal
hi there.
1st of all, you can't mix/substitute sub/temgesic for oxy. you will have to get off the oxy if it is illegal where you live. perhaps your dr gave you the temgesic to help you do this.
In my opinion this is uneccessary. you say that your oxy use is low. therefore i think you should consider quitting oxy cold turkey.
there is another issue of course. your pain. i assume it still exists?
you need to talk to your dr about getting adequate pain relief if it is neccessary.
these days sub is usually used to help people get off other opiates.
do you want to get off all opiates?
can you deal with your pain without them?
the problems you described above about the pain after coming off the oxy sounds like withdrawals, not addiction. any person who discontinues taking opiates(even for legitimate reasons)will have withdrawals.
this doesn't automatically mean you are addicted. it means your body needs time to react to the changes chemically in your body.
i hope this has cleared up some of your problems. if not, please ask more specific questions as i was slightly confused as to your intentions.
best of luck, take care,

Nick
Helpful - 0
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