Avatar universal

percocet vs roxicodone

My question is:  Does Roxicodone work as well as Percocet?
Background information-- I was in a near fatal MVA 14 years ago and now suffer with chronic pain 24 hours a day/everyday.
For 13 years I have used a durogesic patch and percocet together with lower to stronger strengths at the present.  For 8 years I have used a durogesic 75mcg patch changing it every 48 hrs.- due to BREAK THROUGH PAIN.  Along with the patch I use Percocet 7.5/325 mg 4 tablets a day.
Plus, through the years I have changed other medications but at the present  I also use:
Neurontin 300mg 3 capsules 4 times a day
Flexeril 10 mg as needed (up to 3 per day)
Valium 5mg q 6 hrs. for muscle spasms
Lidoderm patch.
NOW MY INSURANCE WILL ONLY GIVE ME "30" DUROGESIC PATCHES (not 45).  My doctor has changed my Percocet  7.5/325 to ROXICODONE 15 MG. to be used along with the Fentanyl patch.  On Days 1 & 2 I will take 2 Roxicodone 15mg and on Day 3 I will use 4 Roxicodone 15mg.  Plus I will continue the other pain RX.  Will Roxicodone be as effective as Percocet and what side effects should I be aware of?  Thank you very much for your input.
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12052179 tn?1423156604
I couldn't agree with Jerry more on this. If you were getting sufficient pain relief from the 7.5, I would absolutely chop that thing in half and continue with it in that way, then as soon as I could see the doc, I would explain to him the concern.

When your tolerance levels go up, the only way to get it back down is to be off of opiates for a while, or taper down for quite awhile, and even then, it will probably never dip below the threshold of the mg that you tapered down to.

In fact, if I were you, I would try to change from the oxy to hydrocodone. It is much less addictive, at least from what I've read. I don't know your previous encounter with hydrocodone, but it has helped me tremendously. And from my stance, I would only take oxycodone as a temporary way to alleviate extra pain that comes with flare-ups. Taking oxy on a regular basis is just asking for trouble, imo.

But, your question was only what the difference was. I'm simply agreeing with the others in terms of what we feel is safe for you. I will have to say, an immediate doubling of your dosage is probably not the best route for you to be on. Just a fair warning.
Helpful - 1
Avatar universal
Roxicodone and Oxycodone have the same basic ingredient. The variance is the strength of the Oxycodone. Percocet has Tylenol and Oxycodone. Roxicodone is only oxycodone (so no Tylenol). They usually come in strengths higher than 10mg. So, it is more likely that the Roxicodone would be stronger. Have you tried Tizanidine for Muscle Spasms? It may work better. The only way I love Flexeril is in a transdermal pain cream, used for musculoskeletal and myofascial pain.

As for the Duragesic patch, they are probably denying it because it is supposed to last 3 days. If they are falling off, try using IV Prep Swabs by Smith & Nephew (about 12 bucks a box, but they will stick much better)...Same with the lidocaine patches.

However, You may have better luck if some of this was compounded into a topical cream. I am not sure if they have tried that or whether insurance would cover it. US Compounding has some formulations that are much more reasonably priced. Some of the insurance companies say that it doesn't work, but that is because they are custom and so the studies may not show everything. Trust me... When you have the right combination of drugs, it works wonders.
Helpful - 0
The insurance company can be persuaded with a prior authorization called a Quantity Exception. This is CVS Caremark's version of the form, but you would meet the criteria for opioid equivalence.

7721494 tn?1431627964
Yes, you can take two 7.5 or 3 x 5mg tablets.

However, since oxycodone is a Sched II medication, your pharmacist can't fill an Rx written for 15mg tablets with three times as many 5 mg tablets.

So, ask your doc to write for the 5mg tablet (the most common) with directions to take 2 or 3 tablets as needed for pain on whatever dosing regimen he/she chooses, and giving you three times as many pills.

This may be a good thing -- if you can sometimes get by with 2 x 5mg tablets (or 10mg) instead of 15mg, you're ahead of the game. Always use as little opioid pain medication as possible to reduce pain to a more comfortable level to stay off opioid tolerance and delay dose increases.
Helpful - 0
Avatar universal
You'll do 100% fine with the 7.5.
If your usual dose is 15mg, but the pharmacy does not carry the 15mg, and you have to take 2 (two) of the 7.5, you will be just fine. The tylenol will actually help a bit MORE with the pain.

There is a small faction of folk who "believe" one is stronger than the other. I would challenge them. Have a family member "disguise" the pills. Have a family member stick a 15mg pill inside a brownie, and stick 2 of the 7.5 in another brownie (they'll have to get creative -- you don't want to be noticing "one lump" in one brownie, and "two lumps" in the other! -- but you get the idea!), and I am ABSOLUTELY SURE you will NOT be able to tell the difference!

Like those people that swear by the "energy" they feel from a "healing rock."

All you have to do is cover the "magical rock" with a handkercheif, and nobody but NOBODY will be able to tell the difference! :-)
Helpful - 0
Avatar universal
I moved and have really struggled filling my 15 oxycodone rx. Do you get relief with the 7.5?  I would also try the 10.  I did love that I didnt have to worry about tylenol. But pharmacies here dont fill it
Helpful - 0
7721494 tn?1431627964
Yes Caregiver222, oxycodone causes no damage to the vital organs,  but acetaminophen/paracetamol is toxic to the liver in high doses.

Currently the recommended maximum dose of 4g / day, however, some US internists are now calling for a lower maximum of 3g / day -- not because of hepatoxicity is found at 4,000mg, but because acetaminophen is included in so many OTC remedies for symptoms of colds and flu, sleep disturbance, allergy, and of course, pain, that many people are getting near or over the limit without realizing it.

In 2013 the FDA mandated changes in opioid formulations containing acetaminophen. Vicodin, Norco, and Percocet now all contain only 325mg of acetaminophen and known as 5/325 formulations -- 5mg of opioid analgesic with 325mg of acetaminophen. A few months ago with the law went infor effect, there was a shortage of 5/325 formulations in the distribution networks.

By the way, other drugs can hurt your liver. A couple of strong NSAIDs, an old inhalant anesthetic called halothane, and a few other meds are hepatotoxic and have been removed from the market

Alcohol use exacerbates the effect of acetaminophen on the iiver. And people with liver or kidney disease should be very careful with these meds.

Acetaminophen has proven for some to be an excellent pain medication, especially when given IV for certain diseases like CRPS II. Pain doctors are well aware of the deadly implications of acetaminophen on the liver and use a  medication to mediate these effects.

For anyone who is a regular user of Tylenol or its generic equivalents, see your doctor every 6 months for a simple blood test to check SGOT and SGPT levels. Elevations in the levels of these two liver enzymes are often the first sign of liver damage.
Helpful - 0
Avatar universal
Thank you for educating me. I know there's a concern about acetaminophen in some of the pain medications. That's I asked my Dr to be put on something that did not contain acetaminophen.
My sister has never drank alcohol. She has always had liver tests and they have always came back fine.
I agree with fntn. Of course none of should drink while taking pain medication. We also should have good pain management Drs. Some of us do and unfortunately, some of us do not.  
Helpful - 0
Avatar universal
The dangers of Percocet are inherent from the acetaminophen. So it's a simple additive issue ... let's not mix multiple liver insults on top of each other, in an additive way (alcohol or what else). So there's nothing at all "spooky" about Percocet (or other combined compositions), when used wisely of course - as all good pain management doctors know.
Helpful - 0
144586 tn?1284666164
The dangers of Percocet were not recognized until recently. The probability of death from irreversible liver damage increases when a patient also drinks alcohol. Percocet, has hepatic toxicity. The damage is cumulative and may not be revealed by a liver function test.

How many percocets are necessary to damage the liver is open to question. but in my opinion four a day is far too many, especially over an extended period of time.

You can do your own internet research and decide for yourself. It isn't rocket-ship science.
Helpful - 0
Avatar universal
I'm confused about what you said. That no own should take 4 Percocets in a day. I'm fairly new to chronic pain, only a year. So I'm still learning about pain medications. My sister, who has severe RA and other medical problems, took Percocet 4 to 6 times a day for years. I think she was on 10 mgs and went to 15 mgs. She's on a different medication now but I'm so worried after reading your comment. Yes, she has regular liver tests and they are always fine. I thought Percocet was used for chronic pain patients?
I'm sorry, I didn't mean to get off of the original posters question and ask my own questions. Your comment was confusing and also has me worried for my sister even though she no long takes Percocet. Like I said, I'm fairly new to chronic pain and I'm still learning about the pain medications.
Helpful - 0
Avatar universal
I'm confused about your patches. You said you change them every 48 hours so that would mean you need approximately 15 per month, right? Or, was this a 3 month supply? You were getting 45 and now your insurance will only pay for 30
I agree with the other posters about your Dr changing and doubling your medication. It sounds extreme. I can understand him thinking you need more pills because you will not be getting as many patches. I'm wondering why he isn't trying you on 10 mgs of Percocet, or changing it to 10 mgs of Roxicodone? Like the other posters said, Oxycodone does not have acetaminophen in it and Percocet does, which can be harder on your liver.
It sounds like your Dr is willing to work with you on these changes. Maybe try what the other posters said and cut your pills in half to see how you do on them. You might do just fine or you may need an increase but really think about doubling it right away.
I hope everything works out for you and you're able to get all of your doses right while keep your pain at a tolerable level.
Helpful - 0
144586 tn?1284666164
You should absolutely positively NOT be taking four percocets a day, and if a physician has been prescribing this I would find another doctor..

This is a recipe for liver damage.Do not pass go. Do not collect two hundred dollars.

Opiates may be addictive, but they do not damage the liver.
Helpful - 0
Avatar universal
Careful! Learn to break those Pure Oxycodone Tablets in half! Why? Because oxycodone will MESS with your tolerance BIGTIME unless you are super-careful! Okay I'll elaborate.

You know how on an aspirin bottle, it says "take 1 to 2 tablets..." etc.? You're NOT going to feel that much big difference between 1 and 2 aspirin.

BUT, when you go from ONE percocet to the equivalent of TWO percocet (your 15mg roxicodone), it will HIT YOU HARD.... (i.e. "zonk you out") and then -- this is the icky part... -- it will WEAR OFF FAST, and will "do a number" on your mind! Trust me on that. No fun. While it's wearing off after it's "peak" in one hour, your brain is going to CRAVE more.... (not good). Before you know it, you will "get used to" your 15mg of oxycodone, and you will feel AWFUL if you don't keep taking it 'round the clock.

Big world of difference between 7.5 and 15!

I can't tell you what to do (heck, please disregard *EVERYTHING* i am saying because I'm not a doctor), but even if you are prescribed a bottle of 15's, please consider RESISTING the urge to take one! Break them in half, and just take half at a time.

That's my 2 cents. Now, watch how everybody will disagree....

Oh, and one more thing... I'm not trying to scare you. And, if you NEED the 15mg to kill the pain, then fine, whatever. I guess if my post, here, has any point at all, it's to make sure to take ONLY what you need. Don't just gulp the 15mgs because you got a bottle full of them... Run all this by your doctor, too... don't do anything people say on the internet without checking with doc, first.
Helpful - 0
12052179 tn?1423156604
Roxicodone and Percocet have the same narcotic - oxycodone. The difference between the Roxi and Perc is the Tylenol, which is found in the Percocet.

Will the Perc work better? That depends on the person, honestly. They say coupling Tylenol with Oxy (or Hydrocodone) increases the effectiveness of the narcotic. Pharmacologically, I'm sure there is a valid reason to couple the two, but the reality is that i probably depends on the person using them.

So your Perc 7.5/325 is 7.5mg of Oxycodone and 325mg of Tylenol. The Tylenol is used for inflammation, fever, and general aches/pains.

So you have been given double the Oxycodone amount and have rid yourself of the Tylenol -- the Roxi will be MUCH more effective for the simple fact that you're getting a considerable amount more.

Unfortunately for you, the tolerance will now build up and in a few months time, taking a lower dosage (than 15) will have little to no effect on you. So just be careful because anyone that takes these medicines for an extended period will become physically dependent on them.

Oh, and the side effects will be the same except there will be less liver damage with Roxi since it has no Tylenol in it.
Helpful - 0
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