Oxycontin questions

[Pharmacist.steve]

I have not heard anything good about the new formulation.. in regards to be equally effective.

While the Pharma's promote their long acting meds to last 12 hrs.. which may be true in treating acute pain and/or minor chronic pain.. For mod-sev chronic pain..the "12 hr" meds tend to start falling off at about 10.5 hrs and the next dose will take 60-120 min to "kick in".

Personally, I would rather see a patient divide their total daily mgs over every 8 hrs as opposed to every 12 hrs... I would rather have the patient with a 60-90 min overlap of med rather than be at a sub-therapeutic blood level and having to regain pain control.. and having this happen twice every 24 hrs.

IMO.. a viable option is Morphine SR... ideally 1mg of Oxycodone will be equal to 1.5mg of Morphine SR.... again dosed every 8 hrs.

Morphine is a GENERIC ... so a patient's copays should be lower and it cost the insurance company <50% of Oxycontin.. so the insurance company should be more ready to pay for it... fewer prior approvals to deal with.

ideally... a base drug - long acting drug is used every 8 hrs... because the typical chronic pain patient's pain intensity will vary from hour to hour ... day to day ... they will need a break thru - short acting med.

As a rule of thumb... you shoot for a "good day" to be <5 on the pain scale and no break thru meds... a "so-so day" would need 1-2 doses a day... a "not so good day" would need 3-4 doses and a "really bad day" would need 5-6 doses..