Switching from 10 mg Percocet to Morphine

[Julia930]

Hello,

This is my first post.  I am a cronic pain sufferer, I have a degenerated disk in my back (L5 I think?) plus arthritis in that same area.  I have not had surgery yet but look forward to the day when I am pain and pain-med free.  

Here's my question:  I have been on Percocet (10 mg 4 times per day, 1 pill every 4 hours) for about 4 months, before that 3 10mg pills per day.  My dr. just switched me to Morphine Sulfate ER 30 MG, 2 tablets per day (one every 12 hours).  I'm always nervous when I switch or increase pain meds.  I start these new meds tomorrow...can anyone tell me what to expect with regard to how this new medicine may affect me vs. the percocets I've been taking?

I had to switch because the percocets weren't doing the job very well.  I've built up a tolerance to them.

Thanks for any info or advice.

[Jennyj1933]

I'm a retired nurse and I used to work with pain management. 10mg of Percocet is equivalent to 15 mg of morphine. If you are taking 40mg a day, 60mg of morphine would be the equivalent. It is safe for doctors to go up on morphine if needed because there is no acetaminophen in it. Safer to use for tolerance issues.

[LadyDi1962]

Hi
I had back surgery in June, from T10 to S1.  It was a 10 hour surgery, with rodding and 26 screws into my spine and 4 anchors into my pelvis.  I would be very sure you want to have surgery. But yours does sound considerably less intrusive than mine... also right before my back surgery my leg gave out completely (middle of the night) I fell more than once.. I broke my shoulder. Since I was already scheduled for surgery on my back, the drs. thought it would possible heal on its own... it didn't, I had to have shoulder surgery to shave off the broken part of my shoulder and re-attach and repair the rotator cuff.  Needless to say this has been horrific.  Right now I am seeing a pain management doc. who has me on 30mg of morphine and 10mg of oxy.  I still am in considerable pain.  I go back in three weeks to have him re-evaluate my pain.  I am not sure what they can do,, but I hope it gets better than this.
Good luck to you

[ChronicPain1]

I've always believed Percocet is stronger than Vicodin, Oxycodone versus Hydrocodone respectively.

It's usually: Tylenol 3 w/Codeine then Vicodin then Percocet from low to high on the strength scale.

The morphine has been great for me, but I've developed a tolerance to the 60mg pills so I'm being moved to something else. In the beginning I had trouble sleeping, mostly because my thoughts were racing. After a month or so it became normal, and that "rush" went away and it managed the pain quietly in the background.

Let me know how you do!

[midnightdoc]

I think I am going to ask my doctor for a higher strength med too. At this point I care less about getting addicted to anything.

[nurseaudrea]

I would say it is in the moderate range, but slightly. They start out at 10 then 20 and go up from there to 100. I think they just came out with 200 for Kadian. Which form Of ER morphine are you taking? Do you know the brand name. I know when I took MS Contin I had to take it three times a day, but with Kadian it's only twice. Kadian is in capsule form. I have also read that 20mg of Hydrocodone is supposed to be equal to 30mg of Morphine. I don't know how they came up with that because to me that just does not seem possible.
The ER tabs may make you a little drowsy if you are not used to the effects. It's 30mg over a twelve hour period so hopefully you will not have too many problems. I never had problems with drowsyness until I got into the higher dosages.
As far as the Percs being the same strength as the Vicodin, in my opinion the percs were always stronger as well. They are also a C2 drug versus the Vicodin being C3 so you would think the percs would be stronger because of that as well.

Good luck with your switch.

[Julia930]

Thanks so much for your reply.  I was also wondering, I'm taking 30mg every 12 at this point, is this a large dose or on the small side in your opinion?

[Julia930]

Thanks for your response and the tip about it not lasting...I was wondering about that.  I have never taken the percocet at night because I can't sleep...I have to take my last one around 8 if I want to go to bed by midnight.  They keep me up.  

I'm hoping these morphine ER tabs don't make me too drowsey, if so I will need to go back to the Vicodin or Percocet.  One more quick question, my Dr. says a 10 mg perc is the same as a 10 mg vicodin but the percs seem stronger to me.  What's your opinion on that?

Thanks again for the help.

[nurseaudrea]

I have been on Kadian for several years.It is an ER  Morphine. It has been the best thing for me as far as how long it lasts. I only take it twice a day and I find that it works great. You might need breadthrough meds though if you get a flare up of pain.
It has never made me sick to my stomach, but it does cause constipation so you will need to take a lot of fiber or some kind of supplement to combat that.
It should not cause any adverse effects if you are already used to the Percocet.Hopefully the Morphine will control your pain much better. You also will not have the highs and lows you get with short acting drugs. You need to take your meds at the same time every day to make sure your blood levels stay constant.

I remember when I used to say that I could not wait til I was pain and pain-med free.That was in my early 20's. I still hope for that some day, but have come to realize for me I will always have some pain. I hope it works out for you and you recover well when surgery is needed.
Good luck and best wishes.      Audrea

[ChronicPain1]

Hi Julia, I can only tell you from my experience and remember, I'm not a Doctor nor health professional.

One benefit to Morphine over Percocet is there won't be any tylenol/acetominophen which over time can possibly damage your liver. Otherwise, you can expect constipation due to the extended release, and make sure you eat when taking them. I had to or else I got shaky and weak when it came into contact with my stomach.

Risk of dependence is always there, but I find with Percocet it's much worse because it's every 4-6 hours instead of every 8-12. Don't bank on the Morphine lasting the full 12 either, seems like it can last 8-10 at best for me. Hope this helps some!