OxyContin vs. Dilaudid - 1260032

datgirl365
Posts:8

Hello -
My mom has been in the hospital since Thursday -- we have been trying to manage her pain. This followed 2 weeks of trying to manage her pain at home with oxycodone, hyrdocodone, tylenol, ibprofen, and tramadol. When we took her into the hospital - we found out that she had shingles -- it's just insult to injury and sudden increased pain. Since then, she has been put on Zofran, oxycodone, celebrex, gabapentine, morphine, and valacyclovir. Most recently, she is on Dilaudid drip to see how much pain meds she actually needs. Based off 36 hours of data, they put her back on OxyContin. As expected, she became dizzy and nauseous. So they added back Zofran. But, she is still dizzy and experiencing break through pain -- so now they added back the dilaudid. It's now been 24 hours - and she is still dizzy. They now want to increase her OxyContin -- and they believe in another 24 hours - the sideffects of OxyContin will go away. Dizziness will stop. Does this sound right? Why not just put her back on Dilaudid -- when she did not have dizziness or nausea from it? Of course - the goal is to get her up and about -- so they would give her pill form of dilaudid. But should would need to take the pills every 2 hours, as opposed to the OxyContin which lasts longer.. The other note to this is that my mom HATES taking pills. She hasn't successfully taken all the pills that they wanted her to take... By the way, this doesn't include all the other stuff that has been given for constipation. My mom is miserable.... any suggestions or thoughts to this? Dilaudid vs. OxyContin? Should we try for another 24 hours of OxyContin hoping that the dizziness will eventually stop?

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Reply # - October 23, 2013, 10:54 AM

catdander
Posts:

Yes, the dizziness can very likely go away and work as they hope. It has a tendency of causing less drowsiness than dilaudid and morphine so if she can get rid of the dizziness (which likely takes a couple of days) she may end up feeling more normal. Another thing to not worry about is the dose it takes to get her comfortable-of course as prescribed.

Sometimes a pain specialist takes over but whether the onc or pain specialist he/she will work to get the combos right for the individual.

When your mom's shingles subside she will most likely come off the gabapentine, one less pill...
My husband hates hates taking pills too. To get them down I took over putting them together, even handing them and a glass of water to him so he only had to "take them" especially since I went to all the trouble of putting them together for him ;) . That's what worked for him when he was feeling very bad and taking a crazy schedule of pills. Too, I got a good fix on how he was feeling so I could give usable input for doctors and nurses.

It all comes down to what works for your mom and her unique set of circumstances.

I hope this is helpful, If you need clarification I'll bring in Dr. Harman or Walko to answer any followup questions.

Janine

You've prob seen these but, http://cancergrace.org/search-results?q=harman%20pain%20management

Reply # - October 23, 2013, 04:49 PM

bobradinsky
Posts: 144

Every case is different but it is possible to take dilaudid via patch. That's how they handled my wife's pain plus oxycodone pills for breakthrough pain. Bob

Reply # - October 23, 2013, 09:18 PM

datgirl365
Posts: 8

Thanks Janine and Bob!

Bob - they have a dilaudid patch? How long does that last for? The doctors have sent us / allowed us to go home tonight via ambulance. Ironically, we went to the hospital in our own car, and we live in an ambulance. We have signed up for palliative / hospice care and they are providing nurses for us. We haven't decided whether or not to give up on the PDL1 trial.. we have a little bit of time to decide.

BTW reading your wife's medical history - I think my mom is going through a very similar experience. I haven't figured out how to show my mom's history in my posts - but it's under my profile.

Thank you for your help!
Gina

Reply # - October 24, 2013, 07:28 AM

catdander
Posts:

That's the "signature" that shows up at the bottom of posts. click your avatar datgirl to get to your "forum profile" and edit and submit your "signature".

Reply # - October 24, 2013, 08:57 PM

Dr West
Posts: 4735

Because OxyContin is long lasting, it can take a day or longer for levels that have built up to diminish, so yes, it makes sense that it could take extra time for that to wash out.

Unfortunately, there is really no predictable rhyme or reason to which drugs happen to be better for one person vs. another. Some people do well with just about every opioid pain medication, some have difficulty with some agents but not others (either significant side effects or inadequate efficacy, or both), and a few patients have a hard time with just about every opioid pain medication we try.

Good luck. I hope she's more comfortable and tolerating her pain medications well soon.

-Dr. West

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