My question this time is: Which brand of Methadone (sorry iI forgot the generic name) is the one with the highest amount of pain ingredient?

Also my answer also to your question about a blog would be YES also if you are so inclined. I keep having questions that only you or my doctor can answer. I really don't think my doctor could come up with the answer as fast as you so I ask you!

I have read other things you posted about this medicine and can understand why my pain specialist wants me to keep the dosage at the minimum. So I want all I can get from the amount I take. Thank you for your never-ending patience and educating us that you do.

I think I would lean towards the least amount you can get by with, if it were me... Not that I have all that much knowledge about Meth, but the 1 pill I took about knocked me into next week, not to mention making me throw up all night long... I could have gotten by with probably a fourth of that pill, maybe even less. The friend who gave it to me is on a VERY heavy duty pain regimen.

Besides, at some point you may need to be on a higher dose and I would think you would want to leave some room there in case you need to increase.

Cathie

The generic is methadone hydrochloride. There seems to be two different generics. The first is methadose, which comes in 5 mg, 10 mg, and 40 mg tablets. The other is roxane, which comes in 5 mg and 10 mg tablets.

On the old board a few years back, there was a long thread about the differences between the two types. The conclusion, based on a good dose (sorry 'bout that) of science and topped off by experience, was that roxane tablets contain more of the active ingredient, methadone hydrochloride, than the methadose.

I have been taking methadone for awhile now, and I have always had the roxane type, as that is what my pharmacy orders. I talked at some length with my pharmacist about this issue once -- he felt that the roxane was a bit superior but he couldn't really back it up with anything concrete.

I would just add that I do not think that Cathie's experience is typical at all for anyone starting methadone. Of course maybe she had that 40 mg tablet of methadose, in which case, her reaction was probably quite normal. An individual just starting would be prescribed a 5 mg pill to start.

I would just add that I do think that methadone can be a very good choice for pain management. However, there are a few clinical issues that need to be addressed. And prescribing properly is best done by an experienced doc.

There is more info on this site if you do a search. And if you are seriously considering starting, then you might want to post questions here . . . or just indicate such and I can add a lot of relevant stuff.

rafi

You are absolutely correct. I checked and it was a 40mg Methadone. No wonder I was so zonked...

My girl friend, who is maintained on this (3 times daily), seems to do OK with the drug regimen, although she still complains of breakthrough pain and takes Oxycontin for this. I worry about how all of this pain medication she is on might affect her liver.

Cathie

Thanks for your replys. I have been on methadose or methadone for quite a few years. My internist has no problem with prescribing me 80mg of methadone. It is my pain management doctor that wishes me to be on no more than 10mg in am and 10mg in pm. After reading some of what mrsD had to say about methadone I can see why.

To all the above, been sleeping all day,tummie pain so here i am in
in the middle of the night. I'm glad you got good advice from Richard
before your trip to pain Dr.

Cathie you have trouble with S Neuropathy don't you,i hate to but in on
other. But could you tell me more about it. The floods are now hitting Mo.
Thanks for letting me but in,and good luck Friday at the pain Dr. After
3 years i finally agreed to Morphine sr it works for me. Now Cathie right
to the bathroom,we will never let you forget that one,but i would be
worried about your friend as well. Hope your all sleeping. Sue

Have an EKG first, to rule out any heart rhythm problems (prolongation of QT).

All FDA approved forms of Methadone adhere to content. There has been
an internet backlash against Methadose by Mallincrodt but much of that hoopla was misinterpreted data on % of bioavailbility stats, and not actual content.

Some tablets are harder than others and dissolve slightly more slowly, and this
gives a perceived different effect to the patient.

Many people prefer Roxane brand, for this reason.

Also, people vary in their metabolism of methadone...some slow some fast.
So going slowly with small doses in the beginning gives you information as to
how the drug works for you. There are drug interactions with methadone...especially SSRI drugs. See the lists in the chronic pain useful websites that I posted here. Combining methadone with other drugs can be
dangerous. It can also be dangerous if you become depleted in potassium and magnesium for whatever reason (diarrhea, flu, diuretics, or poor diet).

HI Shiney Sue; You have tummy trouble. It might or it might not be related to your diabetes. I have a friend who is 63 years old, obese and never took her diabetes seriously. She would not go to Cornell with me (where she would have been put in a protocol and given all testing supplies and meds for free. She would say "Oh, it's too much trouble to go into NYC. I told her she could ride into the city on the Access a ride with me.

What I finally understood was that she was in complete denial about her diabete. She started to go to the bathroom in the middle of the night, than at 5 a.m. and then at all times of the day. She FINALLY went to a gastroentrologist who told her she had a diabetic stomach. That's all he said. He then said "lose weight". THAT'S ALL HE SAID.

When she came home and said "I have a diabetic stomach" I immediately said "you have gastroparesis", which is neuropathy of the the stomach. I had looked it up and gently explained the nerves are not functionally correctly in her stomach. I then said "are you on Regulan?" and she said "Oh that's what he gave me, so I'll take the Regulan and I'll be fine".

I said "listen to me, you have got to keep your blood sugar under control, that's the most important thing you can do. If you can do that, eat sensibly and lose some weight (please know that I KNOW HOW TO APPROACH PEOPLE AND NOT TALK DOWN TO THEM, and I've known this person for over 15 years. So we are talking and I tried to explain how if you have neuropathy, it can affect other organs of the body. She said 'well, I feel fine, and I only had a handful of pretzels last night". Now her handful of pretzels is like a normal person eating a whole bag. That's how she snacks.

I said 'what was your blood sugar this morning and she said "Oh it was good, then she laughed and said 'well, it's bad for everybody else but it's good for me". So I replied "oh, you mean, because it used to be 265, that when you woke up this morning it was 190 and you think 190 is a good number for you?" and she said "well, yeah, isn't it, I mean my doctor didn't give me any information on my diabetes". I replied "your doctor is not an endocrinologist, and YOU NEED TO SEE AN ENDOCRINOLOGIST.

She doesn't believe me. She is a heart patient and hasn't seen a cardiologist in about 5 years ever since he was arrested for medicaid fraud (now how interesting is that).

So all she does is go to the bathroom and sometimes she can't go to the bathroom. She calls me up and says "all I ate were some pretzels, why do I have this?

I give up. She won't listen, she won't take her diabetes seriously and after all, we HAVE TO TAKE OUR DIABETES SERIOUSLY.

Many people on these boards have neuropathy for other reasons, but it seems to me that if you know why you have neuropathy and the doctor tells you that you have a diabetic stomach, than the deniability factor has to STOP and a person has to start taking care of themselves, right?


Anyway, I don't know if there is a test for diabetic stomach but I DO KNOW THAT REGULAN (spelling??) does help.

Hope you feel better soon

Melody

Thanks mrsD. You are right on about the meds. I have tried both brands and I think the one being so soft and the other being a hard type pill is correct. I guess that certainly would make a difference. I have had a monitor test and in the past an EKG but it has been quite some time ago. I'll bring this up my next doctor's visit. I think it certainly rates another test. My husband lost a 16 year old niece because she had undiagnosed problems. So she died with long QT at age 16. Nothing else contributed to this, not even girlish strict dieting.

Good advice from you keeps me from taking the 80mg my doctor prescribes verses the 20 mg my pain doctor keeps telling me is the amount I should stay at. Unfortunately it just is not taking care of my pain. But I follow instructions from people whose opinions I respect quite well. I'm not happy with my quality of life but I don't want to lose it either.

Cathie - I am so sorry that you ended up popping a 40 mg methadone tablet like that - or half as I recall. Well, in any event, not fun. I am glad nothing more serious happened . . . altho it sure was no picnic.

About your friend . . . I understand your concern about her liver. Methadone by itself is not the problem - - it has a long track record. It is metabolized easily by the liver and thus does not cause damage. Of course other medications taken along with the methadone might cause such damage.

I think the greatest risk of such damage comes from non-opioid meds, the anti-depressants, antiepileptics, etc. With most of these, they have either not been around long enough or not studied extensively or both.

rafi