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Oxycontin, Percocet, and Vicodin Prescription Information

Just your average apothecary (pharmacist), feet firmly planted behind the pharmacy counter, whose mortar and pestle are hitched to a star.

Rx Test: How much do you know about your painkillers?

Rx Test: How much do you know about your painkillers?

The focus of this article is 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:

  1. Oxycontin
  2. Percocet
  3. Vicodin

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:

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.

A summary table highlighting the differences between the three painkillers. Always talk with a healthcare professional to find the best options for your situation.

DrugActive Ingredient(s)UseDoseGeneric Alternative(s)

Oxycontin

oxycodone

Chronic pain managment

One tablet every 12 hours

None

Percocet

oxycodone and acetaminophen

Acute pain relief

One tablet every 6 hours

Roxicet, Endocet, Oxycodone/APAP

Vicodin

hydrocodone and acetaminophen

Acute pain relief

One tablet every 4-6 hours

Hydrocodone/APAP or Hydroco/APAP

1. Oxycontin

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).

General Information

  • 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.

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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 of 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:

  1. the pharmacy running out of your strength
  2. your insurance company rejecting due to the need for prior approval
  3. your doctor forgot to write some critical pieces of information on the prescription
  4. just about anything else!

2. Percocet

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.

General Information

  • 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 not to 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 daily. 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.
  • 2.5/325
  • 5/325
  • 7.5/325
  • 7.5/500 (discontinued)
  • 10/325
  • 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.

Maximum daily doses of Percocet by tablet strength, provided by the manufacturer, Endo Pharmaceuticals.

StrengthMaximal Daily Dose

2.5/325

12 tablets

5/325

12 tablets

7.5/325

8 tablets

10/325

6 tablets

  • 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.

3. Vicodin

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 the conservative talk show host, Rush Limbaugh, and the fictional TV character Dr. Gregory House.

General Information

  • 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 Tylenol.
  • 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:

  1. 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.
  2. 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.
  3. 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.

Cost Concerns

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

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 as 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..."

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.

Comments

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:

Hello

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.

Thank you

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:

Hi Jason!

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:

KC,

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.

https://hubpages.com/forum/topic/120940

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?

gc536@nova.edu 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:

Krocmom,

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 medica