Just your average apothecary (pharmacist), feet firmly planted behind the pharmacy counter, whose mortar and pestle are hitched to a star.
The focus of this article will be on practical information. If you are a pharmacy or medical student hoping that this article will help you cram for your pharmacology exam, you may be disappointed. You will need to turn to your textbooks for information about the kinetics and mechanisms of these drugs.
I want to focus on real life, not the half-life. (Excuse the bad joke that probably only the students will get).
I will discuss each of these three drugs in depth and provide some of my advice and commentary. Below, you will find information on:
But first, I want to talk about my reasons for writing about these specific drugs.
Why Write About These Drugs?
Maybe the title of this article seems a bit strange to you. For those who are only infrequently acquainted with pain, or who have never had to consider treatment with narcotics, these drugs may seem unimportant. Worse than that, they may conjure up thoughts about drug addiction and abuse, pharmacy robberies, and stolen prescription pads.
But for those of us who work in pharmacies myself included, we are aware that questions about these three medications are almost a daily occurrence. Therefore, I give the following reasons for specifically writing about Oxycontin, Percocet, and Vicodin:
- They are very commonly prescribed narcotics for pain. If you have ever had major surgery or even dental work, suffered from bad back pain or headaches, had a serious and painful injury, or have a painful disease or condition like cancer or severe arthritis...you have heard of these drugs. You probably have a bottle of 1 or more of them in your cabinet right now.
- They are frequently interchanged over time, and, thus, patients often wonder, "What is the difference between Oxycontin and Percocet?" Maybe you were wondering that yourself: "Why did they tell me NOT to take Tylenol with Vicodin?" "How come my Oxycontin says 20 mg but my Percocet says just 5 mg?" Questions like this come up all the time. I would like to help you get some answers.
- Due to the stigma and image created by the media, I believe many patients are reluctant to ask important questions about these medications. Some people are embarrassed by the fact that they need these pills. They have been made to feel, albeit, unintentionally, that they are committing some sort of crime simply by taking Oxycontin, Percocet, or Vicodin. You don't want anyone to find out. You are afraid what they might think. By writing this article, I hope to be able to answer some of the questions which you may have been unable to ask.
- Information on these drugs is not as easy to come by as one might think. Many other prescription drugs have a whole website devoted to information about them. But for a variety of reasons, you will not find the manufacturers to provide any such website for information about these products. I won't go into all the reasons right here, but suffice it to say that doing your own research on these products is far from easy.
- Finally, I have decided to write about Oxycontin, Percocet and Vicodin because they are powerful drugs which are dangerous if mis-used, and often have a variety of side effects even when used appropriately. I am grateful for the education and experience I have received as a pharmacist, and consider it a privilege and duty to pass along what I know to help patients use their medication safely and effectively.
Note: These medications can only be prescribed by a physician.
|Drug||Active Ingredient(s)||Use||Dose||Generic Alternative(s)|
Chronic pain managment
One tablet every 12 hours
oxycodone and acetaminophen
Acute pain relief
One tablet every 6 hours
Roxicet, Endocet, Oxycodone/APAP
hydrocodone and acetaminophen
Acute pain relief
One tablet every 4-6 hours
Hydrocodone/APAP or Hydroco/APAP
Oxycontin is a narcotic pain reliever manufactured by Purdue Pharmaceuticals and is indicated for moderate to severe persistent pain. It is not used for pain on an as-needed basis but only for pain that needs constant management (i.e. chronic pain). In other words, your Oxycontin prescription should never say something like, "Take as needed for pain." It is only used for pain management that requires regular dosing (in this case, every 12 hours).
- Active Ingredient: Oxycodone.
- What is oxycodone? Well, think of it as a sleeker and stronger version of codeine. It is a synthetic drug. Oxycodone is the only active ingredient in Oxycontin. This is significant. There are other prescription narcotics for pain that contain oxycodone, but Oxycontin is the only long-acting product with just oxycodone. There are, by the way, short-acting products that contain just oxycodone like Roxicodone or Oxy IR, for example.
- Strengths: 10mg, 15mg, 20mg, 30mg, 40mg, 60mg, 80mg.
- Schedule: Oxycontin is a Schedule II controlled substance. The practical significance of this is that prescriptions for Oxycontin are subjected to more regulations and restrictions than other prescriptions. Schedule II substances have the highest potential for addiction or abuse, so they have to be managed carefully. For example, doctors cannot write refills for an Oxycontin prescription. You must obtain a new prescription every time. They may only be written for a 1 month supply, in most cases. Additionally, prescriptions for Schedule II drugs need to be hand-written and cannot be phoned in, except under special circumstances.
- Dosing: Oxycontin is designed to be dosed every 12 hours. It is a slow-release, or timed-release, drug. It is very important to NEVER break or crush an Oxycotin tablet, as this could cause a dangerous amount of oxycodone to enter your bloodstream too quickly.
- Generic alternatives: Oxycontin is not available over-the-counter at the moment. There have been some patent issues that have been contested, and there was a generic on the market for a short time. But, presently, only brand name Oxycontin is available. This product is quite expensive. Maybe your insurance covers it, and the cost is somewhat hidden to you. But, if you have to pay for it yourself, you may want to research other options, like immediate-release oxycodone, which is available generically and is far more affordable.
General Commentary & Advice: Okay, so here are my thoughts on Oxycontin. Oxycontin is not evil. Yes, it has created opportunities for some pretty scary stuff. Yes, it is sold on the streets—and people use it inappropriately and unsafely—but these facts only remind us that good things can be turned to bad uses. Don't throw out the baby with the bathwater.
I advise you to use the lowest effective dose, as this will make stopping the drug easier. Yes, if you do eventually stop taking Oxycontin, you will need to slowly taper down to avoid withdrawal symptoms. Remember, even caffeine can cause withdrawal symptoms.
Other over-the-counter products for pain, like Tylenol or Advil, can generally be used with Oxycontin, if necessary. Check with your doctor or pharmacist to be sure these will not interfere with anything else you are taking.
Do's and Don'ts:
Do organize your medication in a pillbox. It is very easy to forget if you actually took your pill, especially if it is part oof your daily routine. You must find some method to remember you took it, and a pill organizer is an easy and effective way to do so.
Do keep a pain diary. Write down some reflections on your pain levels every day. Bring this with you to the doctor. Your physician will be better able to help you manage your pain if they can get a sense of what you're going through. Keep it brief and as objective as possible.
Do stick with one local pharmacy. Hopping around to different pharmacies and filling prescriptions for Oxycontin looks suspicious. Not only that, but your prescription insurance plan might raise a fuss about this as well.
Don't crush or chew Oxycontin.
Don't give Oxycontin to someone other than for whom it was prescribed. I don't mean to scare you, but someone who is not used to taking it could die from the same dose that you take safely. This is very serious. Don't do it. Not to mention, doing so is illegal.
Don't allow yourself to run out of Oxycontin before trying to obtain a new prescription. Always discuss with your doctor, or his/her office, exactly how you should obtain your next prescription. If possible, pick it up in person. If they mail it, just be sure you have it in time. Trying to persuade a covering physician to call you in an emergency Oxycontin prescription at 8:30 at night will not be fun—and probably not successful.
Don't wait until the last minute to fill your Oxycontin prescription. My advice: Have the prescription in your hand and get it filled exactly five days before you run out. Not 6 days. Five days. If you will run out on the 30th of the month, then fill it on the 25th. Most insurance plans will allow you to fill it within 5 days of running out. Also, getting it filled five days early allows some wiggle room for issues like:
- the pharmacy running out of your strength
- your insurance company rejecting due to the need for prior approval
- your doctor forgot to write some critical piece of information on the prescription
- just about anything else!
Percocet is a prescription narcotic pain reliever manufactured by Endo Pharmaceuticals and is used to treat moderate to moderately severe pain. It is a combination drug typically prescribed to treat acute (short-term) pain, although, it is sometimes also prescribed for chronic pain. Percocet was originally approved for marketing in the U.S. by the FDA in 1976.
- Active Ingredients: Oxycodone and acetaminophen—the same ingredients found in Oxycontin and Tylenol, respectively. So is taking Percocet just like taking Oxycontin with Tylenol? Not exactly. The difference is that the oxycodone in Oxycontin has a slow-release formulation and is dosed every 12 hours. The oxycodone in Percocet is an immediate-release formulation and is dosed more frequently.
Because Percocet has acetaminophen, which becomes very dangerous to your liver at high dosages, it is important not to exceed the recommended amount of Percocet in any given day. This is very important!
Also, be very careful to not take any other pain reliever that may also contain acetaminophen like Tylenol, Excedrin, and some cold and flu products. As a rule, you do not want to exceed 4,000 mg of acetaminophen per day. This works out to about 6-8 tablets of Percocet maximum per day, depending on the strength you take (see below).
Overdosing with Acetaminophen is the second most common cause of liver failure requiring liver transplants in the US, according to a medical review study in 2009.
- Strengths: Percocet is available in the following six strengths. These are typically expressed in a way to show the amount of oxycodone on the left and the amount of acetaminophen on the right. Therefore, 2.5/325 means 2.5 mg of oxycodone per tablet and 325mg of acetaminophen per tablet.
- 7.5/500 (discontinued)
- 10/650 (discontinued)
The most frequently prescribed strength of Percocet is 5/325. It is so common, that doctors often forget to write the strength on the prescription, assuming that 5/325 is to be understood. However, the strength must be written on the prescription for it to be valid.
- Schedule: Percocet, like Oxycontin, is a Schedule II controlled substance. All the same rules and regulations for prescribing Schedule II drugs apply. See the comments above, in the Oxycontin section, to review those details.
- Dosing: The usual dosing for Percocet is one tablet every 6 hours. This can be adjusted up to two tablets every 4-6 hours, as long as the total daily dose of acetaminophen does not exceed 4 grams (4000 mg). See the chart below for the dosing recommendations of the manufacturer.
|Strength||Maximal Daily Dose|
- Generic alternatives: Unlike Oxycontin, Percocet is available generically. This makes Percocet far less expensive and a more affordable choice, especially if you do not have a prescription insurance plan. Because you will probably receive the generic Percocet from the pharmacy, your bottle will probably not say the word "Percocet" on it. Rather you will have the generic name. Here are some samples of what your generic prescription for Percocet might say for the "name" of your prescription: Roxicet—manufactured by Roxane Labs in Columbus, OH); Endocet—made by Endo Pharmaceuticals—yes, the same Endo Pharmaceuticals who make Percocet! Imagine that!; Oxycodone/APAP—APAP is an abbreviation for acetaminophen. The abbreviation is actually derived from the chemical name, N-acetyl-para-aminophenol).
- Side Effects: Percocet, like all narcotic pain relievers, may have certain side effects. Common side effects include lightheadedness, dizziness, drowsiness, nausea, constipation, and vomiting. Taking your Percocet with food may help reduce stomach irritation. Be sure to drink lots of water to help reduce constipation. An effective over-the-counter remedy for constipation caused by narcotics is Senokot tablets. If you develop hives or a rash, stop your medication immediately and contact your doctor.
General Advice & Commentary:
Percocet is a powerful painkiller. It is also likely to cause significant drowsiness.
Be aware that your prescription does not have refills on it. Additional prescriptions must be obtained directly from your doctor. They cannot, ordinarily, call in this prescription to your pharmacy. You must pick it up. Since Percocet is used for short-term pain, you may not need additional refills.
Do's and Don'ts:
Do take with food or milk to avoid an upset stomach.
Do discuss your need for another prescription with your doctor before you run out.
Don't drive or operate heavy machinery while taking Percocet.
Don't drink alcohol with Percocet as the added effects of drowsiness and sedation can be dangerous. Also, beware taking other medications which also cause drowsiness, like some antihistamines.
Don't take more than the recommended dose.
Don't share your Percocet with someone else. This medication is strong enough to seriously harm someone for whom this medication is not appropriate.
Vicodin is the last of our three pain relievers that I will discuss in this article. Like Percocet, Vicodin is used for moderate to moderately severe pain. It is a product of Abbott Pharmaceuticals, located in Abbott Park, IL.
Since it's approval by the FDA in 1984, Vicodin has risen to near-celebrity status amongst painkillers in the U.S. However, the addictive potential of Vicodin has been highlighted by the real-life addiction problem of conservative talk show host, Rush Limbaugh, and the fictional TV character Dr. Gregory House.
- Active Ingredients: Hydrocodone and acetaminophen. Hydrocodone is a powerful narcotic pain reliever, approximately equal in potency to oxycodone. Additionally, hydrocodone has been shown to be effective as a cough suppressant and is included in several prescription cough syrups like Hycodan. The acetaminophen is the same one found in Percocet and Tyelonol.
- Strengths: Vicodin, as such, refers to one specific strength, which is 5mg of hydrocodone with 300mg of acetaminophen. On the prescription label, this would look like 5/300 mg. However, the makers of Vicodin have also provided two additional varieties known as Vicodin ES and Vicodin HP. Here are the strengths of all three products: Vicodin, 5/300; Vicodin ES, 7.5/300; Vicodin HP, 10/300.
- Schedule: As of October 2014, Vicodin—and all hydrocodone-containing products—are now considered Schedule II, just like Percocet and Oxycontin.
- Dosing: Like Percocet, Vicodin dosing is primarily limited by the amount of acetaminophen that can safely be taken in any given day. The typical dose for Vicodin is 1-2 tablets every 4-6 hours, as needed, not to exceed 8 tablets in any given day. For the higher strengths (Vicodin ES and Vicodin HP) you want to keep it at just 4-5 tablets per day.
- Generic alternatives: Vicodin is available generically. When you bring in your prescription for Vicodin, what you will see on the bottle is something like Hydrocodone/APAP, Hydroco/APAP, or something along those lines.
This is the way the generic product is identified. If "Vicodin" is on the label, then you got the brand name product. Is the brand name more effective? No. There is no significant difference between the effectiveness of the generic and the brand name. You don't need to pay more to have the word Vicodin stamped on the pill. It really won't make it work any better.
- Side Effects: These include drowsiness, dizziness, nausea, constipation, vomiting and mental clouding. Taking Vicodin with food or milk should help reduce the irritation to your stomach. More serious side effects like hives or a rash should be immediately addressed with your physician. Stop the medication if you develop a rash.
General Advice & Commentary:
Okay, just a few things about Vicodin. I will focus on the practical stuff.
Addiction. Yes, it is possible to become addicted to or dependent on Vicodin. If you have been on it regularly, for any length of time, you will need to be slowly tapered off to avoid withdrawal symptoms. But, just because you take it regularly does not mean that you will become a narcotic abuser or criminal. It is strong medicine, but it is also very effective to reduce pain and improve the quality of life for those suffering acutely or chronically.
As for refills, since Vicodin is now a Schedule II controlled substance, it cannot be refilled. A new prescription must be obtained for every filling of hydrocodone products.
Never take more than the recommended dose, and never take Vicodin with anything else that already has acetaminophen in it. Seriously. Liver failure is not funny, and acetaminophen overdose is far too common.
Also, taking too many and then trying to get your refill early from the pharmacy is a sure way to get yourself pegged as an abuser and a problem. If the Vicodin dose you were prescribed is not working to control your pain, talk to your doctor, don't just eat more pills.
If the pain is still a problem after taking Vicodin, you can safely use ibuprofen with Vicodin until you are able to talk about it with your doctor, unless you have some other condition or medication that would forbid this.
Final Thoughts and Advice
Alcohol Use and Narcotics:
Is it safe to have a beer, a glass of wine, or some form of alcohol while taking these medications? Let me lay out the concerns and the issues for you:
- Alcohol, like narcotics, suppresses the central nervous system (CNS). Think of your CNS as sort of like the electrical panel in your home that controls all the electricity going through your house. Knock that out, and you are powerless. Your CNS controls basic actions that you have really gotten used to over the years, like breathing, thinking, and the pumping of your heart. Now, you don't want these to stop, so how much additional CNS depression is safe? There is simply no practical way to answer that question. Will one sip kill you? Probably not. In the case of a chronic medication like Oxycontin, your body may develop enough tolerance to allow for an occasional drink. But you should be aware of the risks.
- Acetaminophen and alcohol may not be a good combination for your liver. Notice I said, "may not be." I am fully aware that the medical evidence seems to suggest that one or two drinks will not likely pose a threat to the liver of an otherwise healthy, non-alcoholic individual who takes acetaminophen. Fine. If it were me, and if I could, I would skip the Vicodin or Percocet if I intended to have a drink. I'm not laying down a law—just giving my advice.
- Driving. Don't do it. If you chose to have a drink, and you also are taking Oxycontin, Vicodin or Percocet, don't drive. Please. There is no way to know for sure you can safely operate a vehicle. Your life and the lives of others are at risk.
Some strengths of Oxycontin are available over-the-counter, but not all. Generics of Percocet and Vicodin are available, but they may not be strong enough to manage your pain. One alternative, if cost is a problem, is to ask your doctor about OxyIR, which is an "immediate-release" formulation of oxycodone. You will need to take more pills and take them more often, but the cost is substantially less. You might also ask your doctor about switching to something different altogether, like a long-acting morphine product (e.g. MS Contin).
Addiction to painkillers is not uncommon. In an ABC news report several years ago, Fred Berger, medical director of a drug rehab center in California, was quoted saying. "What makes opioids—the class of common pain drugs like Oxycontin and Vicodin—effective pain relievers is also what makes them so highly addictive..."
Want to Learn More?
For a comparison of three similar pain relievers, see my other article: Vicodin vs. Lortab vs. Norco.
Disclaimer: The information provided in this article, and any subsequent questions and answers, are not intended to replace or substitute for the advice of your personal physician.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
pauline Douglas on January 31, 2019:
I need a physician who is willing to provide Norco or percoset Please help get out of chronic pain
Eddie on October 15, 2017:
My family doctor has me on 10mg oxycodone. I went to pain management and was given 7.5 Percocet, which is killing my stomach. Can I get my oxycodone back from my family doctor and fill it before the Percocet runs out?
Linda Wilkins on August 28, 2017:
Hi, I'm going to a pain management doctor, finally! For the first time, my regular doctor referred me, my doctor gave me a prescription for methadone, until I could get appt. With pain management doctor. Well I have an appt. With the pain management doctor, they want me to bring all my meds that I'm taking to appt. My question to you is, can they take my methadone from me for any reason at all? Thank you so much!! Linda
Keli Jones on August 04, 2017:
I have fibromyalgia and my pain is severe. If you years ago I was prescribed Hydro coda own aceta 5–325 mg tablet MAL, it is a white oblong scored tablet and it kills my pain just fine. Just recently I ask for a refill of the hydrocodone from my doctor and I received a speckled oblong white tablet from the pharmacy and after taking it I felt very Depressed and it didn't cut the pain as like my old prescription did. I mentioned it to my doctor and he said that the firs I mentioned it to my doctor and he said that the pharmaceutical companies have changed the formula because there's too many people addicted to the medication. I would like to know can I get the original formula because it does the job at supposed to do for me?
KEVIN B MULHALL on June 29, 2017:
YES IVE BEEN GOING TO THE SAME PAIN CLINIC WHERE I HAVE FOR 12 YEARS HAD EMERGENCY SCOPE SURGER AGE 18
Mandy on May 29, 2017:
Ivebeen taking hydromorphone and Percocet for years, for chronic pain from Rheumatoid Arthritis my doctor just recently stopped all Percocet is this right shouldn't I have been tapered ??!!
Stella on April 25, 2017:
So I realized that mis the of the posts are old and maybe Noone will see or answer to mine. But I have to respond to Bobby incase you see it. Yes total agree with you. Seriously I get so annoyed at how judgmental people are to those of us who suffer in pane. And then there's people that drink like a fish and they thump their chest saying oh I would never use any pain medand. First of all they are not 8n the seceremony pain that I am in I don't drink more then a couple of glasses of wine or a beer and when I do I don't take my medications. But I'm annoyed control the alcohol like you do meds. And my opinion is that people die from pain caused by Dr.s stopping the medication more then the overdose. People have to wake up. Be compationate one that doesn't have pain can't understand how people who have suffered for years like I have. And for my quality of life to demenish would just kill me. And if it sounds like I'm venting is that I am. I went to my Dr s today. Follow the rules that the office nurse informed to call 48 to 72 hours before next refill. I am only 2 days early and she said that I couldthink get my perscription because it was too soon. My Dr is on vacation and because she is so mean to everyone and she felt in power because my Dr wasn't there she was making me feel bad. I had to stand there and argue telling her I always get my meds 2 days early and the only time anyone has issues is when the Dr is away. And to end this. I wish there was only one thing wrong with my body. But no I have several issues maximizing my pain. I eat healthy stay fit exercise after all that I have gone through intelligent people like my Dr say if I didn't do all these things I would still be in a wheelchair over weight and seriously on depression pills. I'm tired of this ignorance
Stella on April 25, 2017:
I want to say thank you so much for all the information that to have provided us with. So much of it didn't understand or knew about before reading this article. For example the differences between the three pain medications. And only recently I found out about the patch. Because my Dr. Mentioned it to me. However I was nervous about it and side effects so I told her I would think about it. I have been in a very severe car accident 10 years ago I was in the hospital with 6 broken robs lacerated liver head trauma so I was in a coma my spinal injury was so bad that I couldn't walk. Only with time and surgery and determination I am now walking and active as much as I can be. I am on oxycode 10milligrams I do try to take less the perscibed but sometimes especially in the cold month I am super miserable and end up in bed crying and depressed. I was recently diagnosed with fibromialgia I have two herniated disks L4and 5 also degenerative bone disease in lower back. I had the neck fusion done last year and because my surgeon said my nerves were damaged I had a penalized arm after surgery and now it just tremmers all the time. I have been. Always healthy and very active all my life and to the extent that I can I still am I was introduced to yoga from my friend years ago after my accident after I went home. She has helped me with stretching and meditations. Even though at that ti.email I couldn't walk it helped me heal my mind and body. I believe in this practice so much that I practice daily and teach friends and family. I love the outdoors and spending doing activities with my husband friends and kids. If it wasn't for the medications I have I would fall into a deep depression. My life would loose all its colors.
I'm thankful for your article and the information. Because it's true that people tent to judge they don't understand the pain and how it effect the mind when it is constant for years like mine and many like on this post. I also have a question rules change all the time and at my Dr's office just recently they posted a flyer that people need to visit the Dr every month for an office visit before you can get an new perscriptions for pain like oxycodobe or Norco or any of the controlled ones. Can you tell me if this is just my Dr s office? Because I talked to other people that take the same medications and they don't need to. They get theirs refilled by just going in getting the perscriptions. 2 even three day before they run out. So I would like to know if it's correct.
Bobby on January 08, 2017:
Everyone is talking about controlling pain medication, because of overdose. The people that are really in pain are the ones that suffer because of what the pharmacies are doing and the system. How about alcohol. This is also a drug that is not controlled. Lets get everyone drinking , but don't take a pill for your pain. These people that overdosed did this to themselves. Taking more then what was written on the bottle. This is not the medicines fault or the doctors. You can't make people suffer in pain because someone took more then they should have. If this is how we are going to look at it, then we need to restrict how much alcohol a person can buy in a month.
Jason Poquette (author) from Whitinsville, MA on June 02, 2014:
Hi Donna DRO82957,
Lots of questions I could ask. But to begin with: Is your MD a specialist with migraines? There are lots of meds to try and prevent migraines, and to treat them, and Percocet is not typically one of them. That said...did it work? You used 14 in 10 days. Is the expectation that you will use them every day? These things have to be discussed. Feel free to shoot me an email to discuss further or give me more details if you like.
Donna DRO82957 on May 29, 2014:
Thank you so much for all the wonderful information! It is so refreshing to find such a well written and detailed article written by a very caring person who cares about patients with so many different conditions and without using a lot of medical terminology (which I get lost in). I spent hours reading and going back several years back on the hub to find something that was written similar to my situation.
I’m a 56 year old female who has suffered with Chronic Migraines for 42 years. For those 42 years I have tried to stay away from strong narcotics.
I also have some kind of facial nerve damage which is extremely painful (and on 5/20/14 my doctor (MD) said he would schedule an appointment for me with a Neurologist my appointment is on 6/26/14).
I saw my MD on 5/20/14 with concerns that three medications prescribed to me were not helping me with my extreme pain (Fiorcet, Midrin, Lortab), and in my opinion I was also taking too many pills. And I would like to take just one pill.
On 5/20/14 The doctor took me off the three medications put me on (generic) Percocet 10/325 mg, 14 pills with the directions of take one pill 2x a day as needed for pain. I’m now out of medication (5/29/14) my question is when can I call the doctor for a refill? Would it be wrong of me to ask for a slightly larger quantity of pills? Thank you for any help you can send my way! God Bless you and your family. Donna in TN
Jason Poquette (author) from Whitinsville, MA on April 13, 2014:
1-2 every 4 hours is the absolute maximum, and they should have told you to ordinarily try to stretch it to 1 ever 6 hours. Ask for a non-narcotic to hold you over.
chet thomas from Athens, GA on March 31, 2014:
Hi pharmacist - this hub is one of the ones I found copied at the site sarenvers(dot)com. You may want to check out this forum thread and file a DMCA request. The web host has not been very cooperative so far and I'm trying to get other hubbers to file with them.
KC on March 24, 2014:
I just had back surgery the 17 of March and I am almost finished with my pain meds which I could take 1-2 every 4 hrs,I called to get a refill on the 7 th day and they refused to refill it or give me another prescription until I go for my follow up the 11 th of April, any suggestion on what I need to do unroll the 11 th and why won't they help me manage my pain????
Jason Poquette (author) from Whitinsville, MA on March 15, 2014:
Sally, Depends on the state law where you are. According to Federal law it is good for 6 months from the date written. However, depending on your state, the law may be more restrictive.
sally on March 14, 2014:
I have a written prescription for norco from 3 months ago from my dentist and never filled it but now I am having severe tooth pain and cannot get in to see him until monday morning. Can I still fill this prescription?
email@example.com on January 15, 2014:
Hello I believe you're a pharmacist correct? My question or concern is that I have been prescribed by a licensed doctor of osteopathy, as well he is licensed as a pain management practitioner, a prescription from methadone 10 milligram 2 tablets every 12 hours, and a prescription for percocet 10 milligram / 325 and that's every 6 hours. I live in the state of Florida actually in South Florida in Broward County and I went last month so the doctor I got my prescriptions and I spent two and a half days going to 30 different pharmacies and none of them would carry it or order it. The pharmacy I had been filling it out for 3 years of said that their license was not being renewed by the state. So I went every 28 days to the pharmacy so after 30 days I was out of my medication, and I could not find anywhere in the three counties that are adjacent to where I live a place to fill the prescription for methadone, so unfortunately I had to start going to a methadone clinic where I have to go every single morning which is causing serious problems with my career. I could go into all my medical problems but I do have a a disease with my body that makes it required to take the medication ( one being Legg-calve perthes disease) I've had other surgeries as well for a knee replacement and my foot pinned and donor calcaneous for an injury falling from roof. So on the prescription the codes for the disease and other lower somatic dysfunction codes were printed on the prescriptions. I have actually written the governor of the state as well as the State Board of Pharmacy to find out what I can do about this because I find it absolutely ridiculous I have abided by all of the random urine tests and random pill counts and everything else that is asked by the DEA of my doctor, and still now the DEA has gone around telling pharmacies and pharmacists that if they fill any chronic pain medication scripts for patient unless it is a terminal patient they will revoke the pharmacist and pharmacy licenses and not renew them. So what to do now?
Ashley Nic on January 07, 2014:
Hi... ^^^ That is me that wrote the novel above, I just made an account so the name is slightly different... I guess I should have done that before the book. I apologize for how long it is, and it's entirely possible that you have absolutely no idea what I am talking about... To me, it makes sense...sort of. But, I'm not a pharmacist so I could be wrong. I am a court reporter and we are required to train for medial stenography, which is why I know what I do about the above issue. I've had enough medical training to know how these medications work in the brain and I understand that Vyvanse may not be working at 100% every day because the neurotransmitters are occasionally depleted and it may take time to build the dopamine and norepinephrine back up to normal levels... but this is not what I mean, somehow the medicine is not being metabolized fully, and a lot of times hardly at all. I am obviously over the Bronchitis and no longer need any medicine for the cough, but the day after taking 2 teaspoons I took it two different times, 2 teaspoons each time... also, nothing. After that I gave up... the hydrocodone/acetaminophen was only used as an example to explain the similarities between the way both are metabolized and the similarities to how I am reacting to them both. I'm very worried to have ingested a medication that is extremely powerful, effects would be impossible to keep from feeling... And yet, there was absolutely no cough reducing benefit, pain killing benefit, and the normal loopy effects were not present... It makes no sense to me when I have no tolerance at all... One whole year since I have taken it and I think a Tylenol would have provided more pain killing effects than the other, luckily I didn't actually need it for pain. But that's another reason I'm really scared... I'm no stranger to painful situations. At age 19 I had my first kidney stone, have had two since...at age 22 I had the shingles, age 23 had a baby, and I have suffered from migraine headaches all of my life. So, the sudden realization that I'm immune to pain medicine is pretty scary... One positive thing is that the only one I suffer from regularly is the migraines and I use an abortive medication called Imitrex for that because they are so painful that even narcotic pain medicine like above doesntt help much. But, if I had another kidney stone and wasn't able to get relief from any pain medicine I think I would literally die... Is there some other explanation that would explain my body being immune to this pain medicine? and if so, does that mean I'm going to be immune to all pain medicine? Have you even ever heard of something like this happening?
AshleyNicole on January 07, 2014:
Thanks for the info, maybe you can help me find an answer to this current, strange situation I am dealing with... I take Vyvanse for ADHD and I have been on it for the past 2 years, this last year it has been very inconsistent and some days it works while other days it doesn't work, at all. Just to add, by not working I don't mean that euphoric rush that stimulants are so popular (and also abused) for... I actually prefer vyvanse for it's prodrug delivery system which allows for a slow onset, it's the only stimulant that helps with ADHD without making me feel abnormal...I can take it and still feel like myself. I also understand that you aren't exactly supposed to "feel" ADHD meds working but any ADHDer knows when the medicine is active in their system and when it's not... I often skip vyvanse on the weekends and on these ineffective days I feel exactly as I do on the weekends when I skip. This hasn't been much of a problem and hasn't taken up much time in my brain because I do often skip days on the Vyvanse and find that even though I am highly unproductive, my mood is virtually the same (usually a good mood lol), food tastes so good, and I sleep like a baby... My recent concern is from a prescription I received for hydrocodone/acetaminophen 7.5/325 cough syrup due to a bad case of Bronchitis. I have taken hydrocodone before and it's effects on me have always been EXTREMELY pronounced... basically, I'm either in "la la land" or passed out cold sleeping. I have only used this medicine in the past for legitimate medical purposes at only prescribed doses... A tolerance is virtually impossible considering that and the fact that I haven't taken hydrocodone since last January when I was in a car accident. I'm a 110 pound female, and in the past the medicine has easily done it's job but it is also a narcotic and the effects are very strong. The night I got the medicine, I took one teaspoon (directed to take 1-2 teaspoons every 4 hrs for cough) right before bed... not only did it not help my cough, at all...but I was up all night with the cough and the medicine had zero effect on me, at all. Exhausted and extremely irritated, the next night I took the full two teaspoons (a full 15mgs of hydrocodone) thinking this should do the trick... once again, absolutely nothing. What I began to realize that night was that it was not only not helping my cough but I actually felt completely normal. This is extremely weird considering I have never been able to even stay conscious when the medicine was needed... again, for medical purposes only. This brings me to only one thing: my body is not processing/metabolizing the medication at all... Here's where I try to sound smart: Both vyvanse and hydrocodone are metabolized in the liver by the CYP2D6 enzyme; this enzyme metabolizes vyvanse 100%, and it metabolizes most of the hydrocodone into hydromorphone which is much stronger as an opioid. So, while some hydrocodone is active, it is much weaker than than the other and once it is converted by the liver enzyme mentioned above this is how the medicine gets its primary pain killing properties. Obviously, I could just assume I am one of those people who has a problem with this enzyme... sometimes I've heard it being called CYP-450, I think. But, there are people with some sort of issue making them unable to metabolize medicines that use this metabolic pathway... but, aren't they born that way? They don't just suddenly have this problem one day, it's something they have had their entire life. So, I'm scared. I don't know what to think and something is obviously off... what I'm worried about is that Vyvanse may be potentially damaging my liver. It is pretty new, studies are still being done and they don't quite know first hand the long term effects, is it possible that using Vyvanse for the past two years on a normal basis has somehow damaged that enzyme? Almost like it's worn it out, or something... I know that this particular enzyme/metabolic pathway is used to metabolize many medications and I don't want to do irreversible damage to something so important. I'm so sorry for how long this is...but I needed to provide you with enough details to hopefully get some answers. Thanks, in advance for any help you can provide. I appreciate it.
Jason Poquette (author) from Whitinsville, MA on December 21, 2013:
Thank you torrilynn!!
torrilynn on December 19, 2013:
Thanks for this hub it was very insightful and informative. I was previously on Vicodin due to extreme toothache. Voted up and useful.
Jason Poquette (author) from Whitinsville, MA on December 10, 2013:
There are non-narcotic approaches to pain management like tramadol. Also, there are lesser strength narcotics like Norco or Vicodin. Hope that helps.
Rozalia Singley on December 01, 2013:
Good evening. I am a 32 year old with trigeminal neuralgia and myofacial pain syndrome due to chemotherapy and radiation damage and its long term effects. I'd like to thank you for this article. I hate to go into a new physician's office or pharmacy because on the outside, I look fine. I've tried so many non-narcotic neurological medications in search of relief from this pain nightmare. Finally, I've found some relief, but it includes daily dosing of Percocet 7.5/325.
For those of us that fill a narcotic prescription regularly, thank you for being understanding. Most of us do not want to take them, it's just that they work. Maybe I only speak for myself, but I am always ashamed to bring in my prescription, in fear of what could be assumed of me just because I look ok on the outside.
Thank you again, for not only educating your readers, but for being a compassionate, caring, and non-judgmental human.
Krocmom on November 18, 2013:
Great article, I have one question...Is there a pain medication, that will relieve my pain, without the euphoria feelings? I'm currently taking 15mg of Oxycodone 3xdaiy, for Rotator Cuff tears., it's working fine, I just don't like that "high" feeling. I'm scheduled for surgery on 11/22/13, but, I'm thinking of canceling until I can find a different pain medication.
Julia on September 22, 2013:
Great article. I have read up on this topic of the comparative strengths and differences in the common morphine derivative drugs and this article summed it up in the clearest, most comprehensive yet succinct, interesting and relevant way. Thanks for putting it all together, and giving people a place to find the straight answers, rather than reading the "yahoo answers" and other such sources of misinformation and ignorance; i.e. blind leading the blind.
heffer2989 on September 16, 2013:
hello all, new to this website but have many questions regarding the issue of prescriptions from my current dr. who is california based. i recently moved to south carolina, and am totally confused about the laws regarding controlled substances. i have documented severe pcos, endometriosis, back trouble and debilitating migraines. for about three years now i have regularly been prescribed vicodin 5/500, xanax, fioricet, tramadol and norco. as i have yet to find a doctor in south carolina where i can resume obtaining my regular prescriptions that i have used RESPONSIBLY over the course of years, i am now concerned that my current dr. from the state of california will no longer prescrible these medications to me, because i am now residing in south carolina. as mentioned before, ive used these medications responsibly, however i have a small child i must care for and be able to function properly for. being cut off cold turkey with no warning is making me nervous, and i am not sure about the laws regarding these things. when i spoke with my current dr back in california today, he asked me to find out whether it was alright for him to prescribe these medications to me over state lines. well, i had some of them filled here in SC today at a walgreens and had no issues obtaining the medications. i guess what what im trying to ask is, is this illegal? am i doing something wrong here? the walgreens was in touch with my dr because refills are never on my scripts, i just have them fax the dr. when it is time to fill them again. never ask for them early, never do anything wrong with that. i just want to make sure im doing the right thing, and that i am not putting my dr at risk here as well. i plan (when i find a dr here, after getting INSURANCE) to continue my treatment, but im hoping that i wont be looked at as a "seeker". i am a young lady and it is unfortunate that i am in constant pain, and most of the young peole today with documented health problems STILL get treated as seekers. does anyone have any advice of what i should be doing here?
D King sham on August 08, 2013:
Pharmacist, Thank you for you woulderful informative post. Also thank you for sharing you faith with us. I am a christian and not God has not healed me.I will gladly except! I know this is an older post, but I just found it. I hope it's okay to comment with such a lasp of time. I have had the same Dr. for 26 years. I developed constant nerve & mussle pain about 7 years ago. I use to board and teach horseback rideing so I was quite active. I had to give all that up and sell our farm. We bought a motor home (I can manage most of the cleaning, my husband was doing most of the house & all the barn & yard work). He is retired now and I am 60 yr. and on a large dose of oxi. We tried everything elce first. Our retirement dream was to travel with our horses all over the country SLOWLY. Well the horses are gone, but we figured we could still travel. Also the cold cause major increese in pain and equily as much decreese in mobility. With losts of warm weather and Sun Shine I am fairly moble, during the winter I was in a wheel chair some of the time. I am just now trying to figure out if I can fill my scrips out of state. I thought I would be no problem since we had no them fulling in NJ when we were there for three months for my Husband cancer treatments at Slone Kettering 4 yr.ago. My Dr. gave me 3 and post dated two I filled one at my regular home pharm. Alway use the same pharm. Now I am trying to find out what state cooperates with witch states and everyone is acting like I have cootties. I have tryed serches on the internet, that gave me all kinds of info on how to get DRUGS, fake scrips, off DRUGS, and other maner of not helpful information. Your very right about limited information on OXI on the internet.I was hoping you could tell me how do I find out what states will fill out of state scrip. Or if there is a list of state recipraction. We live on the east cost are planing to travel to the west coast and travel in the warmer clmit in the winter & notheren in the summer. I have never had any missing meds or early request, take drug test,Never miss a Dr. apoint., use the same Pharm., follow all the rule. Evern refused extra meds when I broke my foot so not to get the RED FLAG. Can you tell how do I find that kind of information. My Phar. was going to get me some information, went back to get it and she acted like I had Cootties. Thank you for your help and concern. DKing Sham
Patricia Scott from North Central Florida on July 20, 2013:
This is filled with detailed information about these drugs. You did mention that they often conjure up thoughts of drug addiction.
I have had migraines since I was eighteen and spent most of my life crippled, literally with pain.
I was given percocet to take and it did help but not so much to take the pain away as to put me in a stupor which I remained in for years.
One day after about 15 years I woke up and said I can't do this any more. I am not living. I found a doctor who helped me find my way out of that nightmare.
I know others who are in the grips of addiction to the other drugs you have listed as well. The drugs are not the villain. I get that. But monitoring carefully those who get those drugs should occur. It is a two way street...patient and doctor...that I know as well.
I guess I am a little testy on this topic as I have seen lives destroyed by these drugs. When someone has chronic pain (and I still do...not only migraines but back pain due to an injury form a student running into me..the pain is so bad I could bite bullets but I will NOT, ever take another pain killer that is addictive.), all they want to do is escape it.
Sorry I have blabbed on and on...your points are well taken.
I am sending Angels to all who are in pain. ps
Stellar Phoenix Review on February 22, 2013:
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Roger Dane on February 20, 2013:
Excellent comparative article and compassionate in your comprehension of people needing pain meds. Thank you so much. Take care!
Dwight on February 11, 2013:
That was very informative, Thank you so much for understanding that all people like myself who has to take pain medication are not evil monsters like many people do. And for the compassion that you expressed for all that suffers with many types of chronic pain.. Keep up the good work:) Dwight...
David on January 05, 2013:
This information is great and especially for parents of teens.
Jason Poquette (author) from Whitinsville, MA on August 25, 2012:
Greener - always check with your MD if you find you need to increase the frequency of your dosage schedule. Otherwise you will run out sooner than expected...and that creates problems. They may want to supplement your pain meds with an NSAID like ibuprofen or naproxen, rather than increase the dose.
Greener on August 24, 2012:
I'm currently on Percocet or the generic one hydrocodone 5/325 I'm supposed to take one every six hours but that hasn't been effective and I've had to take it at 4 to 5 hours. I just had spinal fusion and I've been home this for my second night I've had some really bad hours of pain should I call my doctor and see if I can take more.
Jason Poquette (author) from Whitinsville, MA on July 09, 2012:
I'm not a lawyer, but I do know that some employment arrangements can refuse to allow you to work while on narcotics, even if they are legally prescribed. My advice would be to try and get onto a non-narcotic as soon as posssible. Best wishes.
Lokelá on July 08, 2012:
I am taking perscribed Vicodin 5/500 I am taking due to shoulder surgery. My doctor cleared me to work while using my judgement and making sure I don't do certain things. Now my employer has suspended me without pay due to giving a positive drug test for Vicodin. I advised them that I just had surgery a month and a half ago and my doctor still perscribes me this for the pain after working and while sleeping! This did not stop them from suspending me. I have no other problems at work meaning disciplinary acts.
This company is a "at will" company which means they are not union and can terminate for any reason.
Are they allowed to do this to me, and is it legal.
I have a perscription and I just had surgery not even two months ago.
(I work as a electrician)
Jason Poquette (author) from Whitinsville, MA on July 02, 2012:
You have nothing to fear. You were due for Norco and got Vicodin instead. No big deal. Then you waited to finish the Vicodin to get the Norco. Everything was done just right. Wish everyone would handle those situations so well. Good job.
cindylynn23 on June 25, 2012:
I was wondering if anyone could help me,I am absolute nervous wreck over a situation that was not my fault and I have not not for 2 weeks worrying over this. I am being treating by my Primary Care physician for stage 4 endometriosis and fibromyalgia,he prescribes low does-at my request because I am scared of high doses of actemenaphin and liver damage..Well 2 weeks ago a huge golf ball size and VERY painful lump came up unde left ear near jaw..I assumed it was a lymph gland and my husband called my dr to ask if I could be seen or prescribed an antibiotic..They informed him my PCP was out of town,nobody could see me or prescribe anything and if I needed treatment go to Urgent Care.By that Sat the lump was even bigger,pain so bad I could barely touch my face with water..I then went to Urgent Care (as they had advised) and the DR said it was something very rare,almost never seen-he diagnosed it as a Preauricular Cyst that was infected..I am still not 100% sure that is what it is since I still have lumps and pain 2 weeks after the in office 3 hour surgery he attempted to perfom on me to remove it..Then he admitted he could not remove it so in his words he would "bust it to H*ll and back" and break it up and put a drainage tube in my incision (one of the 2 incisions he had made) to drain the "cyst". He then said I would be in some pretty incredible pain once the anesthesia wore off and after what he had done to (imagine nearly 3 hours of pounding in my head with needles and scalpels)..so he then gave me several scripts to fill,one was for a 4 day supply of pain meds,stronger dose than what I normally take and also antibiotics..told me to come back in 3 days for drain removal and a week for suture removal. when I got in the car I looked at the 3 day script for vicodin and told my husband not to fill it just put it on file and pick up my regular norcos which I was due for that day anyway..He insisted I should follow the drs orders and get the 3 day supply of the stronger ones instead..The only reason he then went to a different pharmacy than I normally use was because we short on cash and my daddy was wiring money to us from Ga to California at Walmart that day to help cover drs visit and prescriptions,I normally use CVS..so when i used up the 3 day supply I got my usual prescription for Norcos filled at CVS. when I saw the dr for drainage tube removal they said it looked pretty bad and admitted he was not sure what it was and I should see a surgeon next..then they offered me a script for more pain meds and I REFUSED it..I am NOT dr shopping or trying to do anything illegal,.I am one of those people who worry too much about everything,especially since I worked in medical for 20 years I know how the think everyone is a "drug seeker",I am NOT and live in fear of them thinking that about me..Now I am have panic attacks thinking the Ca DEA division will "red flag" me or contact my PCP and tell him I was dr shopping,I was NOT..I only did what his office told me to do-go to Urgent Care because he was out of town.. I have not in 4 years seen any dr or got any prescriptions from any dr but him,so am I in trouble? I did not intentionally do anything "illegal" and cannot help the dr gave me the 3 day supply of vicodin 5/500, I was able to get my next refill for norco filled 4 days later with no problem..it has been over 2 weeks now and I am still having major panic attacks thinking my dr will dismiss me as a patient or the DEA will show up at my door and haul me to jail for 20 years.I keep thinking the worst possible scenarios. My family thinks I am totally nuts because I did nothing wrong and I keep trying to get him to call my PCP and tell him what happened and he says "no you have done nothing wrong,he will think you are crazy if you call him".He says if the issue comes up he will then help me explain the whoe situation to my dr with all the paperwork from Urgent Care.. please tell me if you think I am already "red flagged" for just a one time prescription from a differnt physician? thank you so much in advance.
Jason Poquette (author) from Whitinsville, MA on May 17, 2012:
Would need a few more details to try and answer your question. Not sure I understand. Would be happy to try and help you sir. Best wishes.
rocky on May 17, 2012:
oxys..my wife has been on them for 8 months now .she has had 7 knee surgeries in the last 2 yrs ..and still isnt right.....she sees her doctor twice a month...he writes she takes 2 to 3 day of the 60..my question is why when see went to get them filled ..they said it was illegal for them to fill them....a well known knee surgen is writing them ....wouldnt he know best .....think most of ya"ll think you are god .....
Nancy McClintock from Southeast USA on May 06, 2012:
I feel so sorry for you and your mom but there is a difference in taking a medication for pain or for addiction. If you have a need for a drug when your pain has passed you are addicted but if you don't desire, physically or mentally a medication when you are not in pain you are not addicted.
bondgirl99 on May 06, 2012:
My Mother is addicted to Vicodin. She was always addicted to some kind of pain killer since I was young. Valium was her choice when my sisters and I were growing up.
She has arthritis and degenerative disk disease but I find she rarely talks about her arthritis or her neck these days.
Now, she has foot pain, tooth abscess, pinched nerves in her lower back...
It seems every few months something new comes up.
She is 76 and her drug addiction has spanned all of my 40 years.
Her chronic pain has spread to parts of her body that requires a new doctor every time the last doctor refuses to prescribe her any more Vicodin.
My Mother is addicted to pain killers. Her arthritis caused the addiction but the medicine has exaggerated the pain in her mind.
When she can't get it from one doctor, she will go to another.
I never saw it when I was little but now as an adult, I take care of my parents, and I can see the addiction.
I wish I saw it when I was young...it would have explained a lot.
This comment is in no way directed toward anyone on this site. I am sorry for your pain. I rubbed my Mother's neck for hours when I was little just to get her to stop crying.
Degenerative disk disease is horrible. Arthritis is terrible. And the only solution is being addicted to pain killers.
I love my Mom..I just wished I could find something better for her so she can enjoy her life with my Dad.
Nancy McClintock from Southeast USA on May 02, 2012:
I have a strong belief that there is a tendency toward addiction. As a chronic pain patient I have kept that uppermost in my mind and I know that I have never needed a pain pill oxycontin or otherwise unless I was in pain. It is sometimes a choice to abuse medicine.
bryanbaldwin from Los Angeles on May 02, 2012:
Oxycontin has ruined the lives of many people I went to high school with.
Jason Poquette (author) from Whitinsville, MA on May 01, 2012:
plain & fancy,
Its my pleasure to be of service. Thank you for the kind words. Best wishes.
plain & fancy on April 30, 2012:
I just wanted to thank you SO much for all of the information! I have Severe RA, Lupus, a blown disc and now neuropathy from Shingles, and have been taking Percocet and/or Vicodin for years. My pain mgmt dr has suggested Oxycontin and I have been reluctant as many years ago I "lost" a loved one due to addiction. However after reading your info have decided that it is NOT the evil drug I assumed, and may make my life and pain more managable ;) I also REALLY appreciate the way you give advice--like a buddy or friend, not a medical professional. Thanks again!
md2b on April 30, 2012:
does anybody else know if soma or soprodol is available in canada?
any help would be greatly appreciated!
vicki on April 27, 2012:
ty-ty-ty--for a clear, concise explanation of pain medicine. I never have taken it, bit broke a wrist-surgery and thus pain.
MD2B on April 16, 2012:
you seem to have some info on medications here in canada...do u know if soma is available to us? Please do let me know asap! Thank you kindly...& I hope that all is well with you...take care...and thanks in advance for the help...appreciate it!
Jason Poquette (author) from Whitinsville, MA on April 14, 2012:
Ideally they should have tested your response to morphine before sending you home, but time constraints may not have allowed it. Oxycontin is sometimes hard to get quickly, as some pharmacies order it as needed. Let the MD know ASAP, and see if they can change it for you. Best wishes.
Jeff on April 13, 2012:
I just had knee replacement surgery, and am on Oxycontin 20mg x3 daily, with Percocet for breakthrough pain. After my sugery they sent me home with MS Contin 30mg X2 daily and it did nothing for my pain, and actually each time after I took it, I would feel very sick. Why don't I feel sick with the Oxy and Percocet? I would assume that all of the medicine I'm on is strong, but why did I feel so crappy when I took the Morphine sulfate?
GlendaH on April 11, 2012:
Sorry, it posted before I finished my ramblings. I am awaiting an exploratory laparascopy to see if there's anything causing my chronic lower right abdominal pain. As well I now have all over body aches. I am a type 2 diabetic, high cholesterol and depression. My Dr put me on 400 mg of tramadol and voltaren 3 times a day for breakthrough pain. When I had to go see another Dr, he told me to stop taking the voltaren because of my diabetes and the possibility of kidney damage. Then he gave me flexeril for my sore muscles. I am out of the flexeril, and have nothing for the aches or the breakthrough pain. It is such a vicious circle. As well I finally have an appt at a chronic pain clinic next month. I'm really hoping to get some answers at that appt. Anyway, there's the info on T1's here in Canada and thanks for listening to me vent!!!! It was really nice reading these posts and it will help me when I go to the hospital tomorrow morning to get something for the aches and breakthrough pain!!
GlendaH on April 11, 2012:
Acetaminophen with codeine is sold in Canada OTC. They are equivalent to Tylenol#1's. There is 300 mg of acetaminophen, 15 mg of caffeine and 8 mg of codeine phosphate.
I too am suffering from chronic pain and have had multiple tests with multiple drs. I am awaiting an exploratory surgery th
Jason Poquette (author) from Whitinsville, MA on April 06, 2012:
First, thanks for the clarification with respect to tylenol with codeine in Canada. Do you know exactly how much acetaminophen per tablet it contains? I am afraid I do not know if Soma is available in Canada. Anyone else? Thanks!
md2b on April 06, 2012:
just wanted to comment on something you said: i am from canada and we don't have codeine tablets otc...we have tylenol w. 8mg codeine per tablet otc..must ppl don't know about this though...u have to ask the pharmacist for it specifically as they have it behind their counter but u do not need a script for it...however, it has tons of acetaminophen in it...this means...if u were to try to take the amount that would equate to the amount of codeine in tylenol 3 you'd be taking a lot more of the acetaminophen...about 4 times the amount...thus ppl don't tend to do that bc it destroys the liver...so no ppl aren't happier w. just taking that (u thought 25% of ppl would be)...just a comment there for your knowledge.
pharmacist: is soma available in canada?
Jason Poquette (author) from Whitinsville, MA on March 20, 2012:
When most patients see the rx ads on tv - they want nothing to do with the drug! LOL. Actually, those ads are mostly for doctors - and to remind patients to refill their prescriptions. They really don't target new patients - even though that is the way they sound. Just an advertising gimmick.
I don't think OTC codeine is the answer.
I wouldn't dispense something that was written dangerously too high.
Doctors don't get paid for writing for brands. Most just want something that will work - and are happy to prescribe the cheapest effective treatment. When cheap don't work - then they move on to the $$ drugs.
Jason Poquette (author) from Whitinsville, MA on March 20, 2012:
Florida has some odd laws, particularly with respect to narcotics - since this state has historically been riddled with narcotic prescribing problems. Last year they eliminated the ability of a GP from prescribing Schedule II or III narcotics at all. Crazy. Your best bet is to check with your state board of pharmacy for clarification on this regulation. Or call Walgreens headquarters to get them to explain it. Best wishes.
recovered drug abuser in pain on March 20, 2012:
Hi. Instead of asking about my personal situation, I just want to ask about the "medicine" culture in general and what you've noticed as a pharmacist and insider.
Well my question pertains to this kind of consumer mindset we all seem to have, and I wonder if you find people coming in and asking about medications they've seen on tv, or even asking if they can have samples? You know, completely oblivious to the entire fact that these medicines require doctors diagnosis and prescriptions?
I just think it's weird to relay the message that patients are supposed to suggest a certain drug, because it automatically puts the patient in a position to self-diagnose...as I'm sure you've heard more of since the internet was born.
And I'm also curious about this: Do you ever feel internal conflict about filling prescriptions you know are unbelievably high dosages, whether narcotics or otherwise?
I mean, if somebody is taking upwards of 300mg of oxycontin a day, you have to ask yourself how that is allowable, and what kind of doctor would ever metaphorically imprison his patient in not only a small room, but one without any light...
Do you ever want to suggest they talk to their doctors about trying different drugs if you notice the dosages or combinations of drugs are either high or dangerous?
I simply have to believe that most drugs have diminishing returns once you've reached a certain saturation level, at least the ones we're talking of here...I'm no scientist though.
Finally, and specifically on the issue of pain control, I'm just curious on your personal belief on an idea that if America just brought codeine tablets, such as exist otc in Canada, to our otc markets, it would dramatically decrease the amount of pain patients going to doctors, and doctors would have more space to tell his patients to try otc drugs instead of immediately writing that prescription?
I'd wager that a solid 25% of hydrocodone patients would be perfectly fine with simple otc codeine/apap mix. The doctors just seem to always write hydrocodone first. In my personal experience, even if I just need a muscle relaxer or a weaker painkiller, they seem eager to throw those vicodin at me. I've had a doctor tell me he wouldn't give me Soma because he would concerned it would interfere with my job performance, but then wrote a prescription for 20mg oxycontins....I didn't even want them because I needed a muscle relaxer specifically, not a painkiller because my pain was coming because my muscles were hyperextended. It's easy to see how patients are so confused about these types of issues.
My personal story, I need a percocet about once around every 3-4 days, and I was researching why I have to go to the doctor every time I want a refill...now I know!
So one prescription lasts me for 3-4 months, but recently I've asked my doctor if she could write the prescription with ibuprofen in it instead of acetaminophen, and she wouldn't freakin do it! So yea...not a big deal, but I'm just confused as to why she wouldn't do it. She was reluctant to lower my dosage when I told her I was feeling a bit better too, and I kind of hounded her to do it and she did...but it was just weird to have to tell my doctor that my dosage is too high.
Do doctors get paid by pharmaceutical companies to prescribe name-brand drugs? I'm pretty sure oxycontin isn't generic yet, and I always wonder whether doctors recommend prescriptions based upon their paychecks rather than patient needs.
gmamcgraw from FL on March 19, 2012:
First let me thank you for all the valuable info you have shared. My question is due to Tricare making recent changes, I have had to change my pharmacy as well, I take Nucynta ER and Percocet for chronic pain, I use mail order on all my maintenance drugs as its cheaper. When I took my prescriptions to the pharmacy to get filled the second month using this pharmacy they told me they would write me a otc prescription for vitamins, or else they could not fill my pain meds, something to do with profiles and DEA? I am still confused as to how they filled them the first month? I used to use Walgreens, and I have taken the same meds for the last three years, well the Nucynta is new only just started taking this. I don't understand why they will not fill just my pain meds as I use mail order for my other 3 maintenance. So my question is? Is there a new law that they cannot just fill pain meds? Please let me know, since I am a new customer to this pharmacy I wonder if they are just trying to make more money from me, or is this really a legal thing they have to do. I live in FL. Thanks in advance for your help, I appreciate it.
Jason Poquette (author) from Whitinsville, MA on March 17, 2012:
Thank you for the kind words. Best wishes!
louromano on March 17, 2012:
Great Hub .Awesome Information. Great answers. You have a gift to help people.
Patti Hammonds on March 16, 2012:
Everything is addictive, sex, food, video games,alcohol, etc. ... , if it is "ABUSED". That is the problem I have with the doctors today. All they want to talk about is why they "don't" want to prescribe a narcotic. I have all these medical problems including herniated torn discs, fibromyalgia & Lupus, had a wonderful PCP Doctor who treated me with pain medication for the last 2 years & the new laws over narcotic pain meds came out & he had to send all of his patients he treated for pain, to pain management specialists. What a time I have had with these doctors... The one I am currently seeing is "tapering" me OFF of my percocet.. YES, that's what I said. I just don't understand. (scratching my head) But what can you do? They (the doctors) have control over your life when it comes to prescription pain medication. I have NEVER abused my prescriptions. This doctor says that the only people that should be receiving narcotic pain medicine are people with cancer.
Jason Poquette (author) from Whitinsville, MA on March 16, 2012:
I try to restrain from giving very specific advice, since it is impossible to know your case simply by reading this post. I do appreciate your difficult situation.
I would direct you to my article on MAO Inhibitors: https://healthproadvice.com/medication/What-Are-MA...
Also, my other article on Vicodin: https://healthproadvice.com/medication/Vicodin-vs-...
In addition to those, you may want to talk to your MD about using a muscle relaxer like Methocarbamol and possibly an NSAID (like ibuprofen). Acetaminophen is okay with Emsam. Other meds combined with the acetaminophen can be problematic. Hydrocodone and Emsam will tend to cause a lot of drowsiness. You found this out. Best wishes.
GeeLee on March 15, 2012:
Emsam and chronic pain
I have lived with chronic back pain for the last 15 years or so. Which was diagnosed FINALLY as degenerative disk disease C3-C7, about 6 years ago. I have also been diagnosed with severe CTS in my right hand (successful surgery has all but eliminated that problem) and moderate CTS and severe arthritis in my left hand. I am pretty much a bundle of pain, all day every day. All while working a full time job (up until about 2 years ago)and trying to maintain my marriage and friendships. I have been seeing a parade of Docs.....my PCP, Neurologists, Rheumatologist, Neurosurgeons, PA's, NP's, PT's and pain management specialists. They all have a test, an exercise, some injection, a follow up appointment or some reference to see someone else. It is a long and frustrating process. It can be months between a consultation and any actual treatment. And all this time I'm still in pain. Most of my Docs are very conservative in their approach to pain meds. Frankly, I feel like a drug seeker when I feel I have to push them to give me a real painkiller (instead of taking the handfuls of Advil which is my usual MO when the pain gets worse and they're not that effective, anyway). Finally my neurologist prescribed Tramadol and that was pretty effective. BUT, about 2 years ago I was diagnosed with severe atypical depression. Not surprising, since the cycle of chronic pain and depression is a vicious one. After many trials and failures, I am on the Emsam Patch (9mg) and it seems to be working. Of course Tramadol is a big no no with Selegiline. Also many regular MD's are not familiar with all the contraindications for Emsam, so I have tried to do a lot of research myself. Many online sources site Acetaminophen as contraindicated, while one pharmacist and the Psych doc thinks its ok - therefore Vicodin should be ok. SO, 2 questions:IS it in fact ok? ....and I have only taken Vicodin for relatively short periods of time (like right after dental surgery) and it didn't so much relieve the pain as make me too sleepy to much care about it, so is there something else that you can recommend that might bring better relief, but that will play nice with the Emsam?
So sorry for the novel length. Any light you can shed would be greatly appreciated
Jason Poquette (author) from Whitinsville, MA on March 13, 2012:
Sounds to me like the doctor's office and possibly the pharmacy both screwed up. No reason for 2 scripts for same thing from same doctor. Use what you have been given appropriately. Refill just 1 script. Disregard the other.
JPC on March 12, 2012:
My doctor faxed two prescriptions of Vicodin (same strength) to my pharmacy. Each prescription was 90. When I got my first prescription, I received 180. I have two refills on each prescriptions. However, the directions is to take them every 8 hours for pain...so that would ideally only be 90 pills a month. It also is a prescription for 30 days only. Now, when I go to refill next month, will I receive 180 again, or just 90. Also both prescriptions are different RX numbers...Im a bit confused. What do you think?
Jason Poquette (author) from Whitinsville, MA on February 28, 2012:
Great points. I have written on alprazolam, and you are welcome to share this information with anyone you like: https://hubpages.com/health/Alprazolam-Side-Effect...
Jason Poquette (author) from Whitinsville, MA on February 24, 2012:
Glad to have provided some support for you. Hope you are able to find a helpful local practioner to treat you. Best wishes.
Sharon on February 24, 2012:
Hi...I feel like I have found a caring friend or at least a good dose of common sense! In all of the online info., with the professionals and expects all fearing ...heaven forbid....PAIN RELIEF...you have helped me wade through the muck and mire to finally read some truth! yES.... I can ask for what I need....and I am in need of some very chronic pain relief. Thank you and God bless you. Sharon
Lynne on February 22, 2012:
Thank you for your answer. God bless you.
Jason Poquette (author) from Whitinsville, MA on February 21, 2012:
Not a dumb question. Very reasonable. The answer is no. Acetaminophen is metabolized by your liver and excreted via the kidneys. It does not build up over time.
Sandy on February 21, 2012:
This is a very useful article. I do have one comment regarding the Pharmacist's recommendation to not let your prescription for pain medication lapse before getting a refill, to get your new script "5 days" before it's due to be refilled.
My husband has been on sustained release morphine for almost two years. He has seven herniated discs, spinal stenosis and severe arthritis in his lower lumbar.
His physician WILL NOT refill his script 5 days in advance. The margin is two days at best.
If you want to go on vacation or have an emergency that requires going out of town, most Doctors, inclusive of my husbands Doctor, will not write your narcotic refills to accommodate your plans.
It's ridiculous to me, and when I questioned the Doctor because she refused to refill my husbands medication a few days in advance so we could go on vacation, received a tongue lashing from the Doctor.
My husband has never abused his medication. He's never "lost" it, "spilled it down the toilet" or given his physician any reason to suspect he's misusing it.
He is subjected to regular testing to make sure he's taking it himself and not "selling it" or doing anything illegal with his medications.
In this article, the pharmacist writes how pain medications are becoming embarassing for the patient, and it's no wonder to me that patients are loathe to ask questions about their medications because of the way they are treated by the medical community.
There's a stigma attached to using narcotics, and even the prescribing physicians treat their patients like they are second class citizens.
My own personal physician, after seeing the MRI done on my spine and diagnosed me with crippling arthritis told me he "didn't want to start me on the opiate road" although he realizes I'm in constant pain.
He wrote me a script for Lyrica despite the fact that I have high blood pressure and other conditions that the manufacturer warns may not be suitable to combine with that particular medication.
What it boils down to is that because of the people who misuse narcotics, the "baby" is "being thrown out with the bathwater" and physicians are punishing bonafide pain patients for the behaviour of the misusers.
The stigma has become even worse, in my opinion, after the death of Michael Jackson and now Whitney Houston. Rush Limbaugh was just the tip of the iceberg.
Lynne on February 21, 2012:
Another stupid question....I am the one who takes one Lortab and one Tylenol PM every day. As long has everything else is equal, as you say, is the aceteminophen "building up" in my body, or am I eliminating it? Thanks so much for your help.
Jason Poquette (author) from Whitinsville, MA on February 17, 2012:
I hear you. I wish I knew of someone in your area to help. I do know of a good church in Oak Ridge, NC....Providence OPC. The best way to find a good doctor that will help is to try and network with others who are in similar pain. There are online discussion forums in which you might meet someone locally who could help. God bless!
Devonna McLaurin on February 16, 2012:
I made alot of errors at 2:38 in the morning because I cannot sleep from pain and stress. Please try to read between the lines and make since of what I have said. Thanks for allowing me to share my experience and vent to stress.
Devonna McLaurin on February 16, 2012:
I had a hip replaccement in November of 2011 and still hurt severely and cannot sleep on either side. I also have arthritis in my lower back. Now,I have lower back 4th & 5th disc pain pinching the nerves down the side and front of my left leg, same hip that was replaced. The I have upper neck 1st and 2nd disc, arthritic and degenerating, arthritic and pinching the nerves in my neck, down my arm and last two left fingers are going numb. I am in grave pain and do not no what to do.Doctor's now look at pain as if it were nothing because they are not enduring it. I need help and a good doctor that understands pain and not afraid to get pain meds and I mean, percocet, ambien so I can sleep at night and due to my stress from losing everything in 2007 when our government became greedy along with Freddie Mac & Fannie Mae which destroyd my family business and my daughters, son-in-laws and husband worked for me. I have 5 grandchildren that were allowed to come there after school. Needless to say the economy caused closure for my company, and I havbe grieved myself to death pver this and watching my children and families suffer. no one came to our rescue, as they did the big car companies and banks. So now, i can only survie on Klonipin (Clonzepam), It is the only way i stay calm and deal with this ordeal that destroyed our lives. Yes, realize that it is only materialistic and God is protecting us, but explain that to your children and grandchildren that were raised in that home and it is all they know. My heart is still there and I just want to go home instead on living on Klonipin to get me through the day. I have tried herbal and antidepressants, but nothing works like Klonipin. It is awesome. If you know a doctor not to treat a broken heart and a lot of real pain in endure near High Point, NC please advise me of him. I could certainly use appointment very soon, as for my meds are getting low. Thanks guys for all the comments, I know there is a rainbow ahead on me. May God Bless you all in your trials.
Jason Poquette (author) from Whitinsville, MA on February 16, 2012:
There are 2 issues. You are correct that you may generally fill a prescription a few days early. However, the second issue is that a pharmacy is responsible for making sure you are not taking more than is prescribed. If you get it filled 5 days early once, then you try to get it filled another 5 days early the next time...the obvious assumption is that you are taking more than is prescribed. If you are using more than prescribed you need to discuss this with your doctor so that he/she prescribes this appropriately. Does that make sense? Hope that helps.
Jennifer Pritchard on February 16, 2012:
My insurance company allows for me to fill a script 8 days early. I went to walgreen's and I was 5 day's early and they refused to fill the script until the last day. I said I would go someone where else and went across the street to the Dillions pharmacy. However, Walgreen's called them to make sure they wouldn't fill my script either. I take OC - 40's x 3 a day. I have a high tolerance so my doctor prescribes them so I can take them every 6 hours. What I want to know is if it is legal for them to do this as a pharmacist? Even on the back of walgreen's information for oxycontin it says to fill it 5 days early to avoid issues. I usually just switch back and forth between the two every month to avoid this but today I forgot because Dillions was busy and just went to Walgreen's again. Obviously the standard is 5 days early so why is the pharmacist's refusing to fill the scripts. I mean if insurance covers it, and my doctor has already given the go ahead (She writes my scripts 1 month ahead of time in case I have to mail them in), then why are they doing this? I live in Kansas and as far as I know there is no law against filling a script 5 days early. We do have this KTRACKS system but Im not on that. My doctor checked for me. Any info would be great. Should I contact the management at the stores? How do I best approach this situation?
**On a quick note, my insurance company has a trigger finger on cancelling my benefits every chance they get, and because of this I have had to go through withdrawl before because I have had to wait on a script until the last minute. Trying to avoid that.**
Jason Poquette (author) from Whitinsville, MA on February 14, 2012:
The medications you list are not especially known for causing hair loss. However, many things can contribute to this like poor diet, diabetes, hormonal changes, certain hair treatments, etc. Best to make an appointment and begin to narrow down the cause with your doctor. In the mean time, take a vitamin and eat a good balanced diet. Use mild products on your hair. Best wishes.
Hair loss, meds, etc... on February 13, 2012:
I have Fibromyalgia, gall bladder problems that sometimes make me get pancreatitis... Severe pain is always an issue. However, I am haaving a horrible time finding a doctor as I have written before... Anyway, I had a colonoscopy and a couple of days later, I began to have severe abdominal/lower back pain. I went to a walk in clinic & nothing came back conclusive on my urinalyisis, but they prescribed Cipro for a UTI. I had been on it for at least four days w/o any relief... ended up going to hospital & being diagnosed w/ diverticulitis. I was in for 4 days, let out today, but I was not given any pain meds and I am suffering horribly. I didn't feel well enough to leave hospital, but it was not my regular GI & didn't want to argue. Besides, during a severe case of pancreatitis, 3 nurses told me the man was "a butcher", so you can imgine my confidence level with him, anyway... Now, I am waiting to hear from my GI as to what to do. Wondering if the Cipro/Flagyl combo may not be have worked? I'm in agony. I have diarrhea, also. My life has become a living nightmare... I need pain control for the Fibromyalgia & Vicodin seems to be Ok, but the doc is reluctant to prescribe ANYTHING, really. I am going Wed to see about possible Hepatitis C, which I truly believed I contracted in my last hospital stay. My question is now about hair loss. I have so many things going on and trying to tolerate so much pain. I tried to back track the hair loss to any new meds. I was on Oxycodone 5 for about a week and at the same time Hydroxyzine 50 mg. 3 x day, and Bentyl 50 mg. 3 x day. I never had this problem before. I am very, very concerned and this is adding to my anxiety... Would any of these meds cause hair loss? Also, are there other antibiotics used for diverticulitis? This is horrible... Sorry...
Lynne on February 13, 2012:
Yes, it does help. Thanks. God bless you.
Jason Poquette (author) from Whitinsville, MA on February 13, 2012:
Sorry. My fault. I just mean that I am "assuming" you have no other underying liver problems and that you are not taking other sources of tylenol and that you are thus otherwise healthy...then this seems perfectly safe. Hope that helps.
Lynne on February 13, 2012:
Sorry to seem stupid, but what do you mean by "all other things being equal"?
Jason Poquette (author) from Whitinsville, MA on February 13, 2012:
If you received a 30 days supply (150 tabs) 28 days ago, then you should be able to fill it today or tomorrow. The pharmacy must ensure you are using no more than 5 per day. If you need more, then you must discuss with your MD so that the prescription reflects this.
However, at 5 per day, these are no longer truly for "breakthrough" pain. In my opinion your morphine needs to be adjusted so that the norco is used less frequently. But there may be other issues going on which I am not aware of. I am truly sorry for your pain. Sincerely,
Anita on February 13, 2012:
I have severe arthritis in my lower back, a bulging disc in my neck, and polyneuropthy in my legs. I go to a pain doctor, he wrote me a script for morphine sulphate, 1 3xs a day, 60mg, & norco 1 5xs a day 'as needed' for breakthrough pain. My 'pharmacy' says it's too early to get my norco, it's been 28days. I want to know what I can do? Sometimes I am in more pain than usual and I need the norco, why is the pharmacy allowed to 'over ride' the doctor? Please help me, I am truly suffering!!!
Jason Poquette (author) from Whitinsville, MA on February 10, 2012:
Yes, ideally we want to use an ER pain reliever for daily chronic pain, and reserve Percocet for short-term or breakthrough pain. If you still need Percocet 3 times daily, every day, then your ER medicine may no be properly adjusted.
As for a less expensive option...the MS Contin would be an option...maybe they didn't have the dose appropriate for your pain. I'm assuming the narcotics are for now, before the surgery. Maybe after the surgery the pain will, hopefully, be reduced. Best wishes.
Mpathia on February 09, 2012:
Yes, it truly is a shame that people who are using narcotics in a "recreational" use have created the stigma you have mentioned... I can't even get my doctor to "try" narcotics. I am in pain 24/7... Michael Jackson's "incident" & the frequent abuse of meds in stars in Hollywood certainly does not help, either. I believe unrelenting "pain" from any conditon should be treated with compassion. It is awful that it takes a life-threatening illness, such as cancer, to be able to get pain relief. Some individuals are predisposed to addition. However, all factors of "pain" should be be "weighed" with the measure of quality of life, no matter the circumstances... Suicide should also be weighed... constant & unrelenting pain cannot be tolerated by any human or animal.
Alice on February 09, 2012:
Great information, many thanks.
I'm set to have rotator cuff surgery in a couple of months, and recently had my meds changed. Was on Norco 6 months ago, moved up to Percocet 10/325 and was taking too many about 7 a day, so my doc put me on MS Contin 15mgx2, twice a day. MS Contin did absoulty nothing to help my pain, so doctor suggested that I had to be on some-sort of ER pain med, with just 3 Percocets a day. So with much hesitation (on my part) she put me on 20mg of OxyContin twice a day, and the 3 Perc's only morn, noon, and night. This really has helped my pain, and allows me to function throughout the day, no doped feeling at all. Too bad that the wrong people have really created a stigmata with regards to OxyContin. When used properly at the correct doses, and NOT abused, it really is a wonder drug.
Although, it is quite expensive, is there another option for me, if I can't afford them in the future? What other types of medicines could help me, be less expensive, and give the same relief?
Jason Poquette (author) from Whitinsville, MA on February 09, 2012:
All other things being equal, taking 1 Lortab during the day and 1 Tylenol PM at night keeps you well below the recommended maximum of acetaminophen.
Lynne on February 09, 2012:
I take one Lortab 7.5 a day for arthritis pain. I also take a tylenol pm at night to sleep. I make sure it's spaced out well. Is this okay? Ly liver tests have always been normal. Thank you.
camaro dan on February 07, 2012:
Due to my crohns I cannot take anything other then tylenol or vicodin type pills because aspirin, ibeprofun and motrin type pills will cause massive intestinal bleeding(we've tried :( ) so its either tylenol with no relief or vicodin, which works well
Jason Poquette (author) from Whitinsville, MA on February 07, 2012:
It is unlikely, but hard to say for sure. Many people can use Vicodin for several weeks for temporary painful conditions and stop without any problems. Some people are more predisposed toward dependence. If you are really concerned, talk to your doctor about other non-narcotic options. Best wishes.
camaro dan on February 07, 2012:
I have crohns disease and RA. I was prescribed vicodin 5/500 pills. I don't take more then 3 daily. How many days does it take for my body to become "hooked". Meaning if I were to take 3 pills a day for a week and not take any for 2 days, would I go through withdraws.
Jason Poquette (author) from Whitinsville, MA on February 06, 2012:
You're welcome Pam. Glad to be of service.
Pam on February 06, 2012:
Thank you so much for this article! I have SLE (Lupus) and severe arthris and after cracking my shoulder a few months back, found that vicodin (7.5/750) actually improved the quality of my life with my other issues. After telling my dr. this, he gave me a prescription for 50 of them to have for a bad day (I see him every 3 mos.), so I space them out over that time (like 1 every other day) but after reading your article I feel like I don't have to be embarrassed to ask for more. I was feeling bad because of the stigma these meds have. Your article was very enlightening! Thanks!
Jason Poquette (author) from Whitinsville, MA on February 03, 2012:
Ideally short-acting pain meds should be used for acute pain or breakthrough pain. Many people are okay with time-released morphine (Kadian brand is a good one), and it is typically well-tolerated. Long acting oxycodone (oxycontin) may be another option.
Jason Poquette (author) from Whitinsville, MA on February 03, 2012:
What I meant, and I think I have said, is to get 1 FILL 5 days early. After that, they can be filled every 30 days and patients will always have a 5 day supply window. You are right, patients may not fill the Rx 5 days early every month. And no responsible pharmacist would continue filling them.
Krazyrph on February 03, 2012:
Encouraging people to fill Oxycontin 5 days earlier is not a appropriate recommendation since many states restrict early fill to 7 days per 6 months(6 fills of 30 days each).
laney on February 03, 2012:
Thank you so much for your help!! This is a great thing you are doing, i have always felt funny about talking to anyone about my meds since people usually act like i'm a drug addict when i tell them what kinds of meds i take. I live each and every day in pain and these meds are the only things that allow me to have any quality of life.Thank You for answering alot of questions i had and not making me feel like a junkie
Jason Poquette (author) from Whitinsville, MA on February 03, 2012:
Every state I know of will allow this. HOWEVER...you must give the pharmacy sufficient time to verify it is legit. If you use a chain pharmacy, try to go to the same chain in the other state. That will help. Otherwise, just drop the Rx off at least 2 full days before you will need it and NOT on a weekend when a doctor is not reachable. Best wishes.