Pain Management

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August 22, 2014 at 4:24 am  #1265538    

gn21

Struggling to work out what question I have asked where with what response, about pain managemen,t. I need to know the maximum dose in a day of OxyContin, including breakthrough OxyContin. And what do do if if I’ve taken the amount, but am still crying out in in pain. Pain level is getting too much for me and I don’t know what to do.

I am currently prescribed 90 mg, per day, plus whatever is needed for breakout, which is about another 30 mgs.

Desperately needing help and and guidance. I am getting to the jumping off the bridge level.
Gail

August 22, 2014 at 4:55 am  #1265539    
JimC Forum Moderator
JimC Forum Moderator

Hi Gail,

I’m sorry to hear that you’re having so much trouble managing your pain. Your previous thread on pain management is here: http://cancergrace.org/topic/pain-management. (You can see all of your previous threads by clicking on your screen name below your profile picture).

The prescribing information for Oxycontin can be found here: http://www.drugs.com/pro/oxycontin.html Limitations are given for initial dosing, but as patients can become opioid-tolerant and require higher doses, an upper limit is not stated. Similar to what Dr. West said in your previous thread, the prescribing info states “Adjust the dose to obtain an appropriate balance between management of pain and opioid-related adverse reactions.”

It also states: “OxyContin dosage may be adjusted every 1 to 2 days…As a guideline, the total daily oxycodone dose usually can be increased by 25% to 50% of the current dose, each time an increase is clinically indicated.”

Of course, dose adjustments are something that should only be made by your doctor, so your best bet is to contact your doctor, describe how you are feeling and get his/her recommendation.

I hope you can bring your pain to a manageable level very soon.

JimC
Forum moderator


Jul 2008 Wife Liz (51/never smoker) Dx Stage IV NSCLC EGFR exon 19
4 cycles Carbo/alimta, 65% shrinkage
Tarceva maintenance
Mar 2010 progression, added Alimta, stable
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August 22, 2014 at 6:22 am  #1265542    
Dr West
Dr West

I’m sorry you’re having the pain that leads to your question.

There is no maximum. It is dosed to pain levels. However, using Oxycontin for breakthrough pain is not appropriate management. Because the active medicine in Oxycontin (or MS Contin) is released over 8-12 hours, it isn’t effective for shorter-term management of breakthrough pain. You are supposed to use the long-acting medication on a regular schedule every 8 or 12 hours, then add SHORT-ACTING pain medication (such as regular oxycodone, morphine sulphate immediate release (MSIR), dilaudid, etc.) to manage breakthrough pain. If you’re needing a lot of the short-acting medication (I’d say more than 6-8 tablets in a day), this suggests you need to move up on the long-acting pain medication, without worrying about maxxing out. Your dose is on the high side but isn’t breaking any records.

Good luck.

-Dr. West

August 22, 2014 at 7:32 am  #1265545    
catdander forum moderator
catdander forum moderator

Keeping you in my thoughts Gail.
xo love xo,
Janine

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