Pain Management - 1265538

gn21
Posts:144

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

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Reply # - August 22, 2014, 04:55 AM

JimC
Posts: 2753

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
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Reply # - August 22, 2014, 06:22 AM

Dr West
Posts: 4735

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

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