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will concomitant use of Opana Er and Belbuca lessen the effectiveness of the Opana?

I have been on Opana for several years and do well on 5 mg q4-6. My Dr added Belbuca. I read the Belbuca will essentially cover the available opioid receptor sites and block the effectiveness. I prefer Opana and since Belbuca is really expensive I may not refill it. None of this makes sense to me and there is no real info out there to discuss the benefit ratios of concomitant use.
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I’ve read in 2017 that the FDA wanted to pull Opana ER from the shelves. Your doctor may know more about it. Did your doctor say why he’s adding a 2nd long acting medication? That doesn’t seem right, for him to want you to take both at the same time. I would certainly double check that ASAP. Normally, it’s a long acting and a short acting opiate.  Kind of like Methadone (long acting pain reliever) and Percocet or Norco ( examples of short acting pain reliever commonly used for breakthrough pain). I don’t know much about  Belbuca, but I believe it is similar to Methadone in the sense that it’s a long acting pain reliever and blocks euphoric properties other opiate have. It doesn’t change their effectiveness for pain. If Belbuca is expensive, you could ask your doctor if you can be switched to something more affordable like Methadone. Hope this info helps and you are able to get some guidance from your doctor soon!
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20803600 tn?1546262537
You are taking Opana IR not the extended release, correct? Belbuca may be your doctors preferred long acting medication with opana IR as a breakthrough med.
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no I am on Opana ER.
You are taking Opana ER every 4-6 hours?  Opana ER is meant to be taken every 12 hours, not every 4-6 hours. In fact, most insurance companies will not pay for extended release medications to be taken more than 2 times per day. I am very surprised that both your doctor and insurance are permitting the dosing schedule you stated.

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