Pain medication questions

[amnlawson]

My Dr. called me in 20 hydrocodaone/apap 5/500 on wed 12/7/11 with instructions to take 2 every 4-6 hours needed for pain. How many days should they last? I have chronic IC (Interstitial Cystitis).  It is Sat. evening, I have 2 left and I am afraid to ask for more, I am new to this chronic pain situation and don't know whats acceptable.

[Weathergirl21]

Is this the first time this Dr. has prescribed an opiate?

The easiest way to figure this out is to call the Dr. and ask how long he expected these to last...

There is always a 'daily maximum' a Dr. and/or insurance allows...

So...none of us can tell you what is appropriate to take or not...

I do agree that if this is going to be a chronic condition...then get a referral from your Urologist to a Pain Mgmt. Dr...

The Dr. you see now is not meant to treat chronic pain...so going back to him time and time again for the same issue is futile...

This way the PM can have all your records and see what you have tried as far as all other treatments, injections, surgeries, medicines...etc.

A great PM will want to treat you as a whole person for a chronic issue...So a narcotic is just one small part of the equation...Even counseling is good to learn how to deal with chronic pain...

Good luck...

[femmy29]

Yes. I believe Ghilly would agree with me.  I think you need to go back to him to tell him how much you need to take each day to not feel on edge from the pain. Tell him, based on my needs for pain, I have x left and I am miserable trying to hold off taking the last two as after that I won't have any pain control.

Please let us know what he says.

Ghilly has a good point about seeking out a pain management physician for the management of your pain.  Keep this in your back pocket should things not go well with your physician.  Also, keep in mind that if he doesn't help you, you are not alone.  It can sometimes be an uphill battle getting medicines that allow YOU to the control the pain without the PAIN always controlling you.  Once you reach this point, you may find you are happier, have more energy, and just generally want to live life because pain will no longer be controlling your every move.

femmy

[amnlawson]

Thank you both for your input. Like I said I'm new to this chronic pain issue and not sure how to  handle this. I did tell my urologist I had high pain tolerance and it was noted in my records. However I did NOT anticipate this type of pain. I'm assuming he figure i could handle it with the 20 he prescribed. But I'm miserable and need relief. I was actually trying one every 4 hrs until I realized it wasnt helping. They tell you don't wait until the pain is so  bad that your meds aren't of any help. So I decided to take them as prescribed.  But I'm down to 2 and don't want to take them unless I  know it's reasonable to ask.  So is it your advice to do so?.again thank you both for your advice. It's greatly appreciated.

[Ghilly]

This is exactly the reason why I try to steer people who are in chronic pain situations to pain management doctors.  Doctors who are general practitioners are often afraid to prescribe pain meds because they are afraid of coming under the scrutiny of the DEA.  Doctors who specialize in pain management are pretty much expected to prescribe pain meds and, as such, are much more likely to prescribe them in quantities that are useful!  If someone has a chronic pain condition what good are 20 pills with instructions to take 2 every 4-6 hours?  Twenty pills is about a two and a half day supply!  Are you supposed to live at the doctor's office so you can get your refills every third day?  And then when these poor people try to find someone who will prescribe enough meds to help them they are accused of doctor shopping!  Definitely NOT fair!

[femmy29]

The maximum pharmaceutical dose of hydrocodone/apap 5/500 or Vicodin is 8 tablets per day.  The way your prescription is written, states that you can take up 8 tablets per day.  2 tablets every four hours max.  It should have also said, "to not exceed 8 tablets in 24 hours", as doing so could compromise your liver due to the amount of tylenol ingested.  Please make sure you limit your amount of apap by no more than 4,000 mg per day.  This includes OTC tylenol (apap/acetaminopen) containing products.

So based on what your doctor gave you and assuming you have been taking the max dose, you should be out of medicine by now as he gave you only enough to last two full days at the max dose.

Personally, I think that is a riddiculously low amount of medicine to give someone with instructions to take 2 every 4-6 hours.  Obviously, he is hoping that you will only take 1 or 2 tablets per day.  The correct amount that you should have gotten based on the prescribing instructions is 240 pills for the month.  

If you are still in pain, you will just need to ask for another prescription of medicine.  Hopefully, based on your usage, he will provide you with more medicine.  I am unsure what his intent was by giving only 20 pills and saying take 2 every 4-6 hours, but I can guess.  

Let us know what your doctor says when you request more medicine to manage your condition.  If he keeps giving you these riddiculously low amounts, it may be time to seek out another pain management physician.  Typically, 20 Vicodin are given to someone after minor surgery to manage post op pain.  It sounds like your condition is chronic and is going to require management over an extended period of time.  Another issue is I am sure that you have a lot you want to do other than call your doctor every two days for a refill.  Your doctor has prescribed you medication under very unrealistic terms.

femmy