Changing to new drug

[KimRose58]

Changing from OxyContin 40 mg, 3x's daily to morphine sulfate 60mg 2 x daily!
I feel really drugged I have some chest pain, like spasms in my ribs, Is this normal? Could this be withdraw from Oxy, I've been on OxyContin for 12 years! I feel horrible, real shaky, nausea, crawling skin! Numbness Rt.side of my face& Lips.

[Weathergirl21]

Hi there.
I hope you come back to give us an update on seeing the Dr.

As Femmy wrote...most Drs. will start with a lower dosage of a new medication to account for cross tolerance and how our bodies respond to a different opiate.

I was Oxycontin for many years and then when I lost my insurance with my divorce, the patent ran out on the generic so I could no longer afford the medicine.

I was on 120mg of Oxycontin with Percocet for breakthrough and went on 90mg of MSContin. For me, I never had to move up in dosage even though it is less and have been on this for over 3 years now. I did move to OxyIR as the acetaminophen was starting to take a toll on my stomach with nausea and greater acidity.

It's strange that you feel drugged as that would mean too much medication for you....but the other symptoms are those that can be of withdrawal...but they can also happen with too much medicine.

So that is why it's important to contact your Dr. and have them advise.

Again...I hope you will update us how you are doing.

[femmy29]

Hi Kim and welcome to the pain management community.  

I am sorry to hear that you are having a rough time transitioning from OxyContin to MS Contin.  You were taking 120 mg of Oxycontin split up into 3 daily doses and now you are on 120 mg of MS Contin split up into 2 daily doses.  When I convert your current dose of MS Contin into Oxycontin equivalent, you are taking 60 mg less of Oxycontin through the MS Contin.  To get dosing equivalent to 120 mg of Oxycontin through administration of MS Contin, you should have been prescribed 180 mg of MS Contin based purely on the pharmacological conversion factor between Oxycontin and MS Contin as Oxycontin is 1.5 times stronger than MS Contin.  So a more appropriate dose would have 60 mg of MS Contin 3 times a day instead of two times a day as that would equal the dosing you were getting from taking the Oxycontin (this is a scientifical statement not dosing instructions!!).  Please do not change your dose without talking with your doctor first!  

Many doctors do this due to cross tolerance as your body is unfamilar to MS Contin and this unfamiliarity can make a lower dose seem stronger.  In your case (and also in the cases of my chronic pain patients that have had their dose reduced through opioid rotation), you have ended up in withdrawal from the Oxycontin.  

Do you have breakthrough pain meds that you can use to help ease the withdrawal symptoms until you can see your doctor Monday morning and get a titration (or increase in dose) of MS Contin?

I am so sorry that you ended up in withdrawal after opioid rotation.  That is just awful!  Be sure to go to the ER if your blood pressure gets too high or you have trouble breathing.  I hope things get adjusted quickly and that you end up with great pain relief and zero withdrawal.  

Please be sure to make an appointment on Monday ASAP to talk with your doctor about your symptoms.  Is the chronic pain controlled right now on the MS Contin?

femmy