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HIV related neuropathy

In October, it will have been 11 years since I was diagnosed HIV positive (I'm now 37).  My viral load is undetectable and I have over 730 t-cells, so regarding my HIV, I'm pretty healthy and fortunate.  The only issue I deal with (and have for the past seven years) is peripheral neuropathy in my lower legs.  

Recently, my Pain Management doctor doubled my medication to 30mg Roxicodone, six per day which has greatly reduced my pain however I still experience times of break through pain, normally a few hours a day prior to my next dosage.  Being that Roxicodone is an instant release drug (I did not find MS Contin or Oxycontin effective - plus had nausea and tolerance issues), I do not know how to approach my doctor and ask for something for breakthrough pain.  

And, if I approach her - what should I ask?  What specifically would you prescribe in this situation?  Over the years I have taken everything from Neurotin, Lyrica, Vicodin, Percocet, Lortab plus the drugs mentioned above.  I have concern about APAP due to HEP C (also related to HIV) so I just don't know what I can be given for break through.  

Any advice is appreciated.  Thanks!
Darin in Ohio
2 Responses
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356518 tn?1322263642
Hi Darin,
  Well first of all you do not need a break through medication that your taking. What you do need is an extended release formula. There are others availble besides Oxycontin. You should be on an extended release medicine and then use the roxicodone for break-thru pain. This is the way it is traditionally prescibed. I am surprised your doctor has not done this for you. it will greatly decrease your pain levels.
I suggest talking to your doctor about changing your medication regimen to include an extended release medicine and this will help you alot.
Helpful - 0
1301089 tn?1290666571
Hi Darin:  I'm so sorry for your situation.  I am glad that your hiv seems to be under control.  I'm not going to suggest a medication because frankly, I don't know.

My best suggestion is to calmly relate to your pain management doctor what you said here.  Just let her know that you're still suffering too much pain.

I know it's difficult to approach.  When I do it, I always feel like a drug seeker although I certainly am not.  But just take a deep breath and let her know that you are still in pain.

Good luck to you.  I hope you find relief soon.

And hopefully someone with more experience and better advice will answer tonight.
Helpful - 0
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