15mg. hydrocodone compound

[sissy1055]

I have been on many pain medications for over 10 years.  I have osteoarthritis in my spine, over 4 yrs ago discovered that I have degenerative disk dis. I have had 2 major back surgeries within the last 2 and half years, many different procedures with my pain mngmnt. dr. and just a month ago had a neurostimulator implant for my lower back done.  The stim is helping a great deal but I am not pain free, my question is my dr. just started me on 15 mg. hydrocodone compound with no acetm. or ibupf. he was concerned about liver damage,  I just recently came off 120 mg. er morphine daily and am opiate tolerate, I seem to have the tolerance of a few horses.  I don't feel much relief with this new med,, is it straight hydrocodone if there is not acetm. or ibupf?  I can't find any info about it.  I am suppose to take 3 daily, however I have been taking more than that trying to find relief.  Can you help?

[dr12n12]

Hi Siisy,
Hydrocodone is currently not available in a standard dosage over 10mg./dose, and as stated previously, in the US currently only available in a fixed dose combination with a secondary agent (acetaminophen, aspirin, ibuprofen). As so, it's a schedule -III (N) drug (up to 6 refills/6 months. Hydrocodone can also currently be compounded (made specially, by a compounding pharmacy)
in the specific dosage authorized by your practitioner. Doses up to around 80mg. are fairly "common", and I've seen ones up to 110mg./dose. If they do not contain a secondary agent or are over 20mg./dose the become schedule-II (N) products, which will require monthly, had written/hand carried prescriptions from your provider.
Currently in phase-IIIb drug development trials are larger dose, controlled release Hydrocodone Capsules. They are expected to be schedule-II and approved by late summer (assuming no problems).
Be careful about taking more than prescribed. As stated previously, it's a BIG issue with pain management providers. Better to get you standard regimen "tweaked" for adequate relief and discuss "rescue doses" for breakthrough pain.
Hope this was helpful. I'm a chronic pain sufferer, a physician (addiction medicine/pain management), and awaiting a neuro-modulator (SCS).
Namaste!

[Jaybay]

Hi sissy, and welcome!  One thing really caught my attention in your post and that's your comment that you are "not pain free."  While that's the goal we all try to attain, it rarely happens where chronic pain is concerned.  Remember, the pain specialty is called pain "management" and not "pain cure."  Any reduction in pain is considered successful treatment.  There's always a certain amount of pain that we end up just having to live with.  That doesn't mean we give up but more that we have to adjust our expectations of therapy.  If we put our lives on hold waiting to reach pain-free status, we stop living.

I wasn't aware that hydrocodone was available in a 15 mg strength with no tylenol or ibuprofen.  Hopefully someone who has experience will drop in and comment.  Your doctor is right to be concerned about your liver.  Count yourself lucky that you have a good one!

If you haven't tried therapy with a pain psychologist, give it a try.  No, you aren't crazy and the pain is not in your imagination.  Therapy is more about learning some mental and relaxation tricks to help you cope better with your pain.  Consider it as one more tool in your pain toolbox.  You'll want to make certain the therapist specializes in pain management.  Therapists who are not educated in opiate therapy tend to cause more harm than good because they believe those patients are addicts and treat them accordingly.  

Best of luck to you and I'm glad to hear your stimilator is helping.  Not everyone has such positive results right off the bat.  Congrats!

[mellie4]

I know how hard it can be to find good pain control.  I've been on a lot of different meds and have found it difficult to find relief.  But no matter how tempting it is to take an extra pill, please don't.  If your pain is still out of control, call your doctor.  Ask them about changing or increasing your medication.  If you do it on your own and you run out or the doctor finds out, you could be jeopardizing your treatment.  Did you sign a pain management contract?  Doctors are very strict (and rightfully so) about dispensing narcotics.  I'd hate to see you be dismissed from your doctor or lose trust.  Just call them and explain what's going on.  Maybe they'll increase your dosage or change your medication.