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Originally Posted by MissTT
I often noticed them floating in the toilet, so I thought perhaps they were not working due to not being digested.
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This is mentioned in the literature; it happens with some ER medications, and does not mean that they are not getting into your system.
There have been many complaints from patients about the new formulation since it came out. Most deal with efficacy, but some have been health-related. Reports should be made to your doctor, Purdue Pharma, and FDA (possibly others - ask your doctor & pharmacist).
http://www.fda.gov/safety/reportaproblem/default.htm
I wouldn't expect there to be any changes in formulation any time soon.
If you have been on a high dose for a significant time, it's possible that your adrenal hormones have been depleted/suppressed. Both chronic pain and opioid medications can have this effect. Suppression of these hormones can effect the way pain medications work in the body.
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adequate biologic testosterone levels are as critically equal to the female as male chronic pain patient.3,7 First, adequate testosterone levels are needed for satisfactory pain control as this hormone is intricately involved in endogenous opioid activity.8-10 Testosterone is also necessary for opioid receptor binding, maintenance of blood-brain barrier transport, and activation of dopamine and norepinephrine activity.11,12 Consequently, a lack of testosterone activity in the CNS may result in poor pain control, depression, sleep disturbances, and lack of energy and motivation. In the periphery, testosterone functions as a primary androgenic compound for tissue healing.
http://www.practicalpainmanagement.c...-pain-patients
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Another great misconception is that testosterone is purely a male hormone. Even in the female, an adequate testosterone serum level is necessary for libido. Further, all of testosterone’s CNS and androgenic-immunologic functions apply equally to females. The only difference and consideration with TR in females is that females carry a lower serum concentration and a lower dosage is usually required for replacement.
Ibid.
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You might ask your doctor about testing these hormone levels. Treatment and restoration to normal levels can improve pain and the efficacy of pain medications by up to 50%.
Testosterone Replacement in Chronic Pain Patients
http://www.practicalpainmanagement.c...-pain-patients
Testosterone Replacement in Female Chronic Pain Patients
http://www.practicalpainmanagement.c...-pain-patients
Hormone Treatments in Chronic and Intractable Pain
http://www.practicalpainmanagement.c...tractable-pain
Hormone Replacements and Treatments in Chronic Pain: Update 2010
http://www.practicalpainmanagement.c...in-update-2010
Doc