Vopac - even worth it?

[ssjTiamat]

Hi guys.

For those of you who have not heard my story recently in the other active threads... I am currently taking 3 (or 4) 40mg oxycontin daily. I just today had my month Dr. visit for my new script and I was finally able to convince him that a breakthru med would be of some help to me. So, in an effort to start low as he always does.. my doc prescribed me a bunch of vopac as my breakthru med.

From what I understand, vopac is nothing more than codeine. Maybe a bit stronger than your standard codeine, but codein none the less. I am not sure of the mg's of this particular script as I have yet to fill it. I filled my oxy's of course but I am having the wife fill and pick up the vopak on her way home from work. But what do you think. Is the vopac just a standard codeine? Is it stronger than that?

I will probably call my doc on Monday or Tuesday and tell him the vopac is not working or gives me an upset stomache or something esle so that he will write me a script for something better/stronger. But I am curious to see what you guys think about the vopac.

Thanks.

ssj

[Curio]

wow, i'd never heard of it before.....don't know the dosage...but it is apparently a codeine and apap combo

[jacky]

yeah, I dont know if that would really be considered a breakthrough pain treatment for people taking oxycodone?
In the past the people that I have known that recieved "breakthrough pain medication" while being prescribed oxycodone were generally given drugs that are considered stronger than the oxy, like hydromorphone, or fentanyl. isnt that the whole point? People are given a small amount per day of a stronger drug, usually 1-3 doses per day, but I have seen more in a few cases of terminal cancer or aids.

I have also seen the same folks I talk about be given things like ampules of promethazine, which apperantly can intensify the effects of some opiates.

hope it all pans out for you, perhaps the vopac will help, it is always worth a try.

I find codeine to be a great drug to maintain on for a few months at a time, but I suffer no chronic pain.
alot of people cant even metabolize codeine, or are allergic to it.

[ssjTiamat]

Yea.. and thats exactly what my perception of a breakthru med has always been. Something just a bit stronger than what your currenly taking to help with the pain that "sneaks thru" your standard med regimine.

I too have usually had issues with anything codeine. Used to get a pretty bad stomache ache from it. And when I mentioned all that to my doc, he just said.."Well try it and see how it does. If you have any problems at all just call me and we will try something else".

So needless to say that is exactly what I am going to do. My doc has always been really cool with me and never really questioned my drug requests. He knows my pain is real and also knows that I tend to educate myself on the drugs I take. By the way.. I suffer from two real bad disc buldges at T-6 and T-7 along with compression of the spinal cord, multiple large "schmorles nodes" and mild kyphosis (that is just a fancy word for "Yo damn back be crooked!").

I'll give it a couple days.. and say Monday or Tuesday call him up and ask for something else. And at that point I will bring up the fact that a breakthru med should be a bit stronger-I just have to word that correctly. My doctor might be cool, but he aint stupid either! What do you guys think would go good with the 40mg oxy? I mean I could ask for like 30 80mg oxy's but then I would be concerned about jackin my tolerance up too high (which is already an issue) and that would basically screw my 40mg tabs. So should I maybe ask for like what.. what is the immediate release oxy called? Is that the MScontin? Or maybe I should request some percs? And if so are 10/325's the strongest? Shit.. thats basicaly Norco then. Which I actually have coming from my OP next week - those are my backup against withdrawls in case I go nuts on my regular oxy script. And to be honest.. thats probably what I will use the vopacs for. Save them for when and if I run out of oxy early.

I dunno... gimmie some suggestions on a good breakthru med to go with the 40mg oxy. I sure would appreciate any input you guys/gals would offer up.
Thanks.

ssj

[satori]

Maybe he's looking at it from the point of view of just adding another opiate? Plus codeine doesnt work as codeine, it changes into morphine when you take it at abou 10%. So 100mg codeine is roughly = 10mg morphine. Plus just adding a second opiate when back is bad can be of help i would guess, even if it doesnt make u feel much higher having that second one added in could make a difference....but still if your taking that much oxy iunno.... A lto of doctors arent giving out any pain meds lately so im suprised he's giving u oxy if he isnt pain management.

[Curio]

Codeine= less potent than morphine since only about 10% of the codeine is converted.
Theoretically, a dose of approximately 200 mg (oral) of codeine must be administered to give equivalent analgesia to 30 mg (oral) of morphine (Rossi, 2004). It is not used, however, in single doses of greater than 60mg (and no more than 240 mg in 24 hours) since there is a ceiling effect.

[reddragon3668]

I take 160MG Methadone for my back pain and Morphine Instant Release (15-30mg) for breakthrough pain. The point really is getting a fast acting opiate to provide a synergesic effect to combat pain that spikes quickly and don't last very long. Regular ole Lortab works good for me, but I don't like the APAP and also, the morphine is a hell of alot cheaper.

Tolerance is a big issue. Once you get to a certain point, nothing given for breakthrough pain, and in breakthrough quantity, is going to do much in the euphoria department. I recently tried this, and I swear I think I could have taken enough morphine to kill me, but I don't think it would have made me high. I know some of this is due to the methadone, but I took Oxy for a long time too and it got to the point that getting high was not easy.

My situation is much like yours. I have been treated by a very good and respectful GP for the last 4-5 years. He will give me most anything I ask for. But, this relationship is so important to me that I would never push my luck with him. For instance, if I did not think a med would work, I would try my damnest to try and make it through until my next monthly appointment. The last thing I can afford is to be labeled as "drug seeking."

If you base dose is not working and you are running out, what they need to do is up your Oxy or try something new. What I don't think allot of people realize when dealing with chronic pain (and please don't be offended, I am not saying your in this situation), is that the euphoria only last for so long. When I first got hurt, the side effect of euphoria was a pleasant thing, probablly the most pleasant thing about being hurt. When it went away, the utitlity of medicine came to be about getting out of bed in the morning and feeling half way normal. Also, now, it calms me and helps me to deal with the things that chronic pain has done to my life. Where chronic pain is concerned, increasing tolerance is not really an issue. We do what we have to to function during the day.

Isn't the pure form of Oxycontin called Oxir? I had a sister in law that took those as breakthrough while she was on Oxycontin. She had cancer. If I remember correctly, they were a brown and beige capsule. Small.

[exitwound]

That's nuts. I mean, it's great that you're on oxy instead of morphine for your base med, that's a good start....but it's bizarre that he's giving you codeine which is a very undesirable pain medication -- particularly for someone who has pain levels that require oxycontin!

I figure you should fill it, and give it a try....but at your next visit, unless somehow it miraculously works well for you, tell the doc that it's not working, makes you too nauseous and you want to switch to something more effective that has less side effects!

Even hydrocodone would be a far better choice IMHO.

[ssjTiamat]

First of all, thanks for the info on the strength of the codeine. I knew it was week as shit.,. just wasnt sure about this vopac. My wife works at a local hospital as a registrar and they have a full service Walgreens inside the hospital. She was going to fill the script today at work and bring it home with her. Well, she came home and said that the pharmacist told her that Vopac is a brand new form of codeine that is much, much stronger than most any other codeine. But when I asked her, she of course was not sure of the mg's.. the pharmacist never mentioned that to her. But also, since it is new the Walgreens insode the hospital did not have it and they are ordering it for me. He called 5 other local Walgreens stores also apparently and they did not stock it either. I thought that was rather interesting.. maybe this stuff will be good.

As far as using it as my breakthru med. I will give it a shot. And I agree reddragon, I have a very good relationship with my GP as well. I absolutely refuse to jeapordize that relationship just for an extra "high". And generally I do not use my meds to get high, but rather to keep my quality of life "normal" much like yourself. Just "maintaining" a normal life and keeping the pain manageable as well as being able to function, get out of bed, play with my kids and do the normal everyday husband style housework is my main goal and attraction to opiates. However, I will attempt to obtain the "high" on certain occasions but I always have to be respectful of my tolerance when doing that. If I don't, then I screw myself and will never be able to attain that "high" again. So I have to be careful and only do that occasionaly. It sounds like your situation is very similar to mine - so I am sure you understand exactly what I mean by that. But it is because of all that and also because my GP will also give me whatever I ask for that I have to be careful and smart about what it is I ask for. And thats where all you guys come in. And why I love these forums/community so much. You guys "get me"

I am going to stay away from going UP in my Oxycontin dose for right now. I just recently was able to succesfully move down from 80mg's to 40mg's which as you can imagine was extremely hard to do and took about 6 months to accomplish. But it is for the better for a few reasons. So if I can, its for that reason why I am looking for something else for the breakthru. I know it's all "generally" the same shit, but something different would benefit my situation right now. Maybe I will ask for the faster acting, immediate release oxy. Not sure. I planned on calling Monday or Tuesday (prob. Tues) and ask for something else, even if it does work (I need some more backup meds to protect against any possible future withdrawls). I will cite the fact that the codeine does not agree with my stomache and makes me too sick and that codeine has always done that to me.. which is not too far from the truth.

But like I said, I have until Tuesday. What are your thoughts on me maybe asking for the following, and at what strength considering my current regimine of a base dose of 40mg oxy 3-4 times per day.

Mscontin?
Morphine?
The lolipop? (is that fentanyl?)
just plain old Norco? (which I also just rec. my final online refill from NWW of 120tabs)
Percs?

(damn, I just realized that after I order my next batch of pods in a week or so I will be sitting on a ton of opiates [my oxy, the vopac, 120tabs norco, the new breakthru med I get tues. and 50 large pods] shit.. i am going to have to be careful or my tolerance will be fucked!) - sorry guys.. dont mean to rub it in. At least i'm not posting pics of it all thrown across my table... lol.

Thanks for all the advice guys. I really, really appreciate all the help. It really is invaluable advice that people like us cannot really get anywhere else.

ssj

[reddragon3668]

I am glad to hear you were able to cut down on your base med. That is great for the tolerance issue. I have started lowering my dosage this week and will continue to do so for the next two weeks because my tolerance is just so high right now.

Morphine Sulphate Instant Release (MSIR) would probablly be a good choice for you. My doctor gives me 60 of the 15mg pills a month. You can take them orally, snort them, or push them through the back door. Mine are white and very tiny, so I don't think there is much in them but morphine. Someone else may know more about that than me. I started snorting them recently and that helps them out quite a bit for me. I have to purchase my meds and they are relatively cheap, compared to like percocet, etc. I would think that they would be a bit stronger than the instant release oxycodone (Oxyir). Good Luck and let us know how it goes!

Also, the lolipop sounds kewl... never tried it. Mscontin is time release morphine, I think, and it would not work for breakthrough if it is. Percocet has tylenol.... you need something not mixed with tylenol or nething that is instant release for those acute spikes of pain your talking about (or those intermittent urges ).

[ssjTiamat]

Well.. as it turns out.. the Vopac (according to the mfr.) is discontinued and no longer produced. So my Doc. switched it to Tylenol 3. Of course after I have the script for a day or two I am calling the doc and getting some percs. Then ill have th codeine for a rainy day.

Thx for all the help and info guys.

[shaunclo]

MsContin = slow release morphine
MsIR = instant release morhine

Oxycontin = slow release oxycodone
OxyIR = instant release oxycodone

actiq lollypop = fentanyl, instant release
duragesic = fentanyl, controlled release

Theres a whole bunch of other names for the morph and the oxy, but these seem to be the most common.

[ssjTiamat]

thx shaunclo.


I went back to my doc yesterday and he finally gave me some MSIR!!!


So I am now 60mg oxy 2x per day and 30mg of MSIR for breakthru or as needed in between oxy. Works for me

Codeine sux.. Im glad thats over with.