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Methadone conversion amounts when switching from Morphine extended release
by jbfickle, Jul 27, 2009 03:10PM
My PM doc is switching me from MSContin ER 60 mg, 2 tabs - 3 times day and dilaudid 4 mg. 4 x day when needed for breakthrough pain. His conversion is for me to take Methadone 10 mg., 4 twice a day. I haven't yet figured out the best times to take the meds. I;ve tried 4:30 a.m. and 4:30 p.m. I'm finding that the switchover hasn't yet been the best pain reliever I've ever had. This doc is new to me because my PCP handled the PM because I am not properly insured (I've got a crappy discount policy that barely covers RX's {gen. only}) and seeing a specialist is $ prohibitive for me. Since DEA is now the tail wagging the dog with DRs, I've been forced to see a PM doc and choose not to eat for a while or surrender the idea of driving and maybe walking everywhere. That's the trade off. I'm not working because I should be on disability and caring for my parents day and night with my hubby as they continue to fight cancer.
So this is the long way of asking this question, what is the conversion rate given what I've been on for at least 6-7 years? -- Same dose which wasn't usually effective for at least the last 4 or 5 years because my body became tolerant of it. Not yet having recieved all of my health records this new PM doc seems to be surprised that I was on such high doses of the meds and said it was the level expected for folks with endstage cancer pain. How can he determine that I may not need that much given my history. See, I started the pain meds at a pain clinic (well known and revered university hospital in Atlanta) due to chronic pain from non-stop kidney stones, then during this, I had bi-lateral TKR in that I had no ACL in left knee and bone on bone in both. I also have severe scoliosis and arthritis in both knees, shoulders and sternum. Chiropractic took care of the scoliosis caused pains for a while and now seems to have no good effect on minimizing the pain - not even for the sciatica on the left side.
Any one out there who has the knowledge about the right conversions - I would appreciate very much your wisdom on this.
So this is the long way of asking this question, what is the conversion rate given what I've been on for at least 6-7 years? -- Same dose which wasn't usually effective for at least the last 4 or 5 years because my body became tolerant of it. Not yet having recieved all of my health records this new PM doc seems to be surprised that I was on such high doses of the meds and said it was the level expected for folks with endstage cancer pain. How can he determine that I may not need that much given my history. See, I started the pain meds at a pain clinic (well known and revered university hospital in Atlanta) due to chronic pain from non-stop kidney stones, then during this, I had bi-lateral TKR in that I had no ACL in left knee and bone on bone in both. I also have severe scoliosis and arthritis in both knees, shoulders and sternum. Chiropractic took care of the scoliosis caused pains for a while and now seems to have no good effect on minimizing the pain - not even for the sciatica on the left side.
Any one out there who has the knowledge about the right conversions - I would appreciate very much your wisdom on this.
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Below is the conversion table that my Doctor has used in the past when I was converting.
I'm sure that you will find it useful. Please take care,
Mollyrae
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Equianalgesic (Narcotic) conversion chart. Provides dosage ... Health care providers online conversion chart for narcotics/opiates. ... Home back consumer links Drug Tables disclaimer Renal Dosing ...
www.globalrph.com/narcotic.htm - Cached - Similar