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morphine er vs opana er
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morphine er vs opana er

I have been on morphine er 60mgs twice a day for my chronic pain among other issues. Yesterday I found out I had extensive nerve damage in my lower back. And my doctor changed my meds from the morphine to Opana Er 20 mgs twice a day. what is the difference? does anyone know? I tried to google and got nothing. I was just wondering if this is just a different brand name for morphine but stronger? thanks in advance for your help. Best wishes to all


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Avatar_m_tn
The difference is Opana is 2 different compounds essentially. OxyMorphone if I remember correctly, so it should work differently than just Morphine alone.
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547368_tn?1332173665
Hi Scaredmom,

I beleive that Opana is a brand name, it is very similar to Dilaudid. They are both opiates with the primary pain relieving substance being Hydromorphone. It is stronger than Morphine. Of course ER means extended relief.

I suggest you ask your pharmacist that can better explain the action of the drug as well as the difference between the two. It is my opinion that you should obtain better pain control on the Opana as compared to the MS.

I hope that helps and again don't forget to us the most valuable resource you have for information on medications, your pharmacist.
Peace, Tuck
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Avatar_f_tn
Hi Scaredmom,
I take OpanaER 15mg twice a day.  I can't tell you how it holds up to Morphine, because I'm allergic to Morphine, but I do get fairly good pain control.  I've heard that It's stronger than Morphine but I have also heard some people argue that it is not. The only thing that I would wonder is if you have anything for breakthrough pain.  I find that I do need breakthrough pain meds. Oh and the drug is oxymorphone hcl.  Hope that helps and good luck to you.
Lainey
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Avatar_f_tn
I was switched to Opana a few weeks ago from Morphine. It is oxymorphone and is stronger when compared mg for mg to Morphine. It is supposed to be 3x stronger. So if you took 60mg of Morphine, then 20mg of Opana should be about the same strength. I, however, went back to Kadian. I did not like the way Opana made me feel. It made me really nauseous. I only took it for about 5 days, so I can't really tell you if it is any better or worse compared to Morphine. It seemed to be about the same for me in that short time.
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Avatar_f_tn
A correction...ER stands for Extended RELEASE.  This is important for several reasons.  One of which is the medicines are released into your blood stream over an extended period of time.  One needs to be cautious in following scripted orders without deviation.  There is significant potential of fatal overdose.
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Avatar_m_tn
I was taking 6-10/325 Percs a day when my doctor switched me to 2-20mg Opana ER & 2-10mg IR daily. I have RSD/CRPS in my foot/ankle.

This helped a bit but I was still suffering pain at a level that I felt was too high. My doctor switched me to 2-30mg ER Opana with the same 2-10 mg IR for breakthrough and the difference in pain control is astonishing. Some days I don't even have to take both break out meds.Of course, everyone responds differently to these opiates.

I 've not tried the morphine in pill form, so I can't give you a comparison. I would try different meds suggested by your doctor until you find something that works for you. If I'd listened to the majority of people on these med boards concerning Opana, I wouldn't have given it a chance. There's no euphoric side effects, which may have something to do with many not liking it, it just melts my pain away. Like I said above, different people respond differently to opiates.
Good luck with the Opana or whatever you find that works for you.











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547368_tn?1332173665
Thank you for correcting my mis-type. I meant to say extended release instead of extended relief.....and you are correct. It is important as they stay in our systems for an extended period of time as compared to an IR (immediate release) medication.

Thanks for catching my typo.

~Tuck
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Avatar_m_tn
I'm on 300 mcg of fentanyl for pancreatits. it doesn't completely take carw of the pain but worse off - it causes urinary retention. what dose, if any of the ER would help? my dr's suggested it, but now i'm fighting w/the ins. company. Any ideas?
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Avatar_m_tn
hydromorphone (dilaudid) and oxymorphone (opana) different drugs
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Avatar_f_tn
Hi, Iknow it has been a few years since your post, i was wondering how you are doing on the Opana ER. I am switching from Opana 30 mg ER to Morphine 60 mg ER.The Opana gave me side effects, dizziness, being in withdrawl (withdrawal) if I missed a dose, and it did not help my chronic pain.. I have tried many ER drugs and I am having a hard time finding many of them. Plus my breakthrough meds are also hard to find. I am hoping the Morphine ER will lessen my side effects and cost, I was only on Opana for 2 months but it did not do the job for me. I know everyone has different reactions to meds. Please let me know how you are doning . Thanks ;)
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1326416_tn?1370930601
I sent you a message. Please check your inbox.
     shinty
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12479211_tn?1425501907
I am on Percocet 10's IR 3x/day and started off on morphine 15mg XR 2x/day & they were not working so he bumped me to 30 mg XR and they are not working either because I was taking 2 of the 15's by trying to get relief. I see him next week and want to suggest something stronger that the morphine 30mg XR because he will not increase my quantity of Percocet's. My cousin gave me a Roxi 30mg on night and it WORKED. I was not waking up in the middle of the night and taking another Percocet to fall back and stay asleep. So I am looking for what suggestions to give him. PLEASE HELP &THANK YOU
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7721494_tn?1421947223
You should remember the controlled substance agreement that you signed before opioid treatment was offered. I suggest that you reread that document very carefully. I read letters every day from elderly patients on long-term COT who have lost their access to medicine because of a small violation of their contract.

When you do not take your pain medication as directed, you are violating your contract, and put yourself at risk of losing your pain doctor along with access to your medication. Many others have lost their relationship with a compassionate pain doctor for doing less.

When one has signed a controlled substance agreement with a doctor to receive COT, one must abide by the rules of that agreement without exception. Accepting opioids from any source but that doctor, whether that second source be a relative, friend, licensed pain doctor, or your cat's veterinarian, is irresponsible, dishonest, and risky behavior.

While some pain doctors see this behavior within the context of pain management, most doctors see consider this "drug seeking" behavior as a sign of opioid addiction.

You just doubled your baseline dose, from 30mg to 60mg of morphine ER / day. You're being prescribed 30mg oxycodone / day for BT pain, which is already above average dosing for BT pain.

The ineffectiveness of your current medication and your desire to add 30mg oxycodone at night for sleeping, doubling your daily BT dose can mean a few things to your doctor:

1) Morphine is the wrong choice for your baseline medication. Perhaps you are a poor metabolizer of morphine. There are tests to assess your ability to metabolize various opioids -- perhaps your pain doc should follow up, or established the appropriateness of morphine via you urine scans.
2) your baseline dose of morphine is still too low to be effective.
3) your preference for IR medication may indicate developing opioid addiction.

Yes, #3 is shocking. IR opioids pass into the brain much faster than ER medications, and thus BT pain medications begin to work very quickly activating the  pleasure centers of the brain. Some people enjoy this feeling (called a rush or euphoria), and become conditioned to seeking this feeling.

One must ask themselves serious questions about their own behavior, and provide honest answers to determine if they are becoming addicted to their BT medications:

-- Am I taking my BT medication too early?
-- Am I taking my BT medication when my pain is tolerable?
-- Do I look forward to that next BT medication like someone looks forward to that first martini after work?
-- Am I taking BT medication everyday, not as directed, and running out of these meds before the end of the month?
-- Do I receive a good deal of pleasure from taking my BT medications?

These are just some of the self-exploration one must practice when it comes to the use of BT medication.

I'm not accusing you of anything -- I'm only sharing the benefit of my experience of counseling chronic pain patients, and from being a chronic pain patient for over 30 years.

We all enjoy the relief we get from opioids, no doubt. But we must all learn to control our use of them so that they continue to provide pain relief, today, tomorrow, and 30 years down the road.

If you are still having pain, talk to your doctor. He/she may propose other treatments that can help reduce your pain by a point or two, helping you get through each day with less pain.

One should never depend entirely on medication to control pain -- COT should only be one part of your treatment plan. Working with your doctor, pain psychologist, and other professionals in developing an effective pain management treatment plan requires a great deal of patience, practice, and knowledge. A successful pain patient learns a lot about the diseases underlying their pain syndromes, effective treatment options for those diseases, and where to get help. A pain psychologist is perhaps your most important medical professional for dealing with pain. I've had many good pain doctors in my medical experience, but only one pain psychologist for the past 20 years. Our relationship has helped me find effective new treatments, new doctors, has helped me to better communicate with my doctor, and has in general, helped me to get through some very tough times.

A final word -- say nothing about that 30mg oxycodone pill. Taking narcotics from outside sources is just the wrong thing to do. Do not mention it, and never do it again.

I believe it is time to begin a pain diary, where you make entries all day long, that track your pain level (1-10), activities including walking, exercising, sitting, laying down, and anything outside of your normal routine, when and how much medication you take, and your general mood. Note menstrual cycle if that is still relevant, any cold or flu, and other health issues.

Best wishes in getting your pain under control.
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Avatar_m_tn
Of course the Roxi 30 worked! And that's PRECISELY the reason doctors don't give them out -- because all doctors are sadistic, they want us in pain, and they want to keep us under their control.

Be honest. That's what ALL of us have thought from time to time.

But the truth is, nothing could be FURTHER from the truth. I'm going to explain.

It might be too late already...

But those of you who have been on a consistant dosage (e.g. 10mg Norco 3 times a day, or one percocet 4 times a day.... or whatever) and, for one reason or another (e.g. bad hair day, wife/husband yelled at you, extra sharp pain, counted your pills thought you had an extra one outta nowhere, etc., etc.) took DOUBLE the dosage, have probably noticed that you totally ruined/goofed-up your tolerance! And, like, really FAST, too! All of a sudden, that "one percocet" that worked so well suddenly doesn't have that "kick" any more. And, that's just from ONE slip-up! That one 10mg Norco pill that worked so well on your fusion pain suddenly just doesn't cut it.... All because you took a "double-dose" of that doggone OXYCODONE!

See, oxycodone is one of the WORST tolerance-ruiners if you don't take it absolutely *perfectly.*

And THAT'S the reason all these doctors you all think are so sadistic and "opiophobic" are so darn conservative when it comes to prescribing oxycodone. Many even prefer to give dilaudid (hydromorphone) or morphine or methadone, over oxycodone for this very reason.

So, yes, your 30mg of oxycodone is very, very powerful... and to compound the problem (making it worse) is that it ruins it's OWN tolerance, too! before you know it, that 30mg just won't cut it. There's something about that leap, going above 10mg. That's why so many doctors refuse to give more than 3 percocet a day.

Now there IS good news: oxycodone tolerance can DROP almost as fast as it shoots up. It takes a good 3 to 5 days of no oxycodone. But y'all know that's easier said than done. If you have a Safety Deposit Box at a bank, stick all your oxycodones in the Deposit Box on Friday, then because of the automatic self-sealing bank vault, you won't be able to touch them 'till monday... and 'voila' your tolerance will be back to normal.

If you really need more pain relief, and your doctor agrees that more meds is what you need, there's nothing wrong with more morphine. Just watch the side effects (i.e. ask your doctor if you can take miralax for constipation, etc.), but if I were you, I would thank my lucky stars my doctor doesn't prescribe more than 3x of the oxy a day...
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