Methadone and break through pain
 

Everyone in NT land who takes Methadone.......

Do you mind me asking, how are your doses scheduled and how do you manage break through pain ?

I believe I will be starting Methadone soon.

I have been taking Vicodin 10/325 mg consistantly every 4 hours if I am out of bed in my home. If I am showering, getting dressed, going to a family event, etc I need 2 tabs every 4 hours. If I go to a concert, casino, beach, etc where I do not have the perfect chair to sit in and/or ice packs readily available, I need 3 tabs every 4 hours. On those days, I can get over the 4000 mg daily limit of Tylenol.......so, it's time for a change.

I am also concerned with expenses. My neuro is no longer covered by my health insurance, so I have to pay privately for narcotics. My pain clinic and primary doc don't write for narcotics. My neuro wanted me to try Avinza, but that is way too expensive. I was the one to suggest Methadone because I know it is cheap.

Now I am second guessing the change.

I have read Mrs D's Methadone posts before and am aware of the risk of cardiac death because of issues with QT wave arrythmias. It's not that I dismiss that concern, it's that I consider my risks of cardiac death are far greater from the severe high bp that comes with my increased pain. Unfortunately, now I see that the antidepressant that I am on , Zoloft, as well as many other antidepressants increase the chance of the QT wave issues. My neuro is off for the summer. I do have an appt with my primary this week to discuss possibly weaning off my antidepressant if she thinks that's a concern. I also worry about the fact that Methadone is longer acting/has a longer half life. With the Vicodin I know if I take one it will wear off in 4 hours so then I could drive. How long do you all find the Methadone lasts for ?

My script is for Methadone 10 mg q 6-8 hours. I'm planning/hoping that 5-10 mg 2-3x a day will do it. How much does everyone take for a break through dose compared to the regular dose ? How long do you all find a dose lasts for ?

Thanks for any input !

Be carefull with the Methadone...
 

I have run through all the long lasting medications over the last 6 years. Methadone is a good choose because of price and affectiveness, but it is very hard to come off just as all long lasting meds are. It is not a time release like Avinza, Opana and I believe the strongest of the group would be the Fentynal Patches. I am currently not on any long lasting medications they are just to hard to get off of. When I did take the methadone my doctor warned and explained that taking 2 at a time is not going to increase the effectiveness and can be dangerous. Methadone is not like the others it takes time to build up in your system before it begins to work. I don't have the answer of why but I believe it's chemical makup is different then other meds. of it's type.

Also, be carefull of the morphine based meds. like Avinza, Opana etc. they cause havoc on your teeth. It drys out your mouth which causes decay. I have had to do some dental work to correct that whole problem.

Us RSDers really do suffer in the search for relieve but after 6 - 7 years of this I truly believe the less you take the better you will feel. When I would read someone post a statement such as I just did I would say to myself they don't have that much pain. But I have read some really interesting studies on "pain meds. making the pain worse" and I think they may have something.

I truly wish you the best....

Hi Finz, I was started on 5mg 2Xday then gradually up to 5mg 3xday.(I also was on lyrica 200mg and cymbalta 30mg at the time). I didnt need any breakthru med. I was even backed down to 5mg 2xday. I called it my miracle drug not only to help with pain but it didnt cause side effects like other narcotics. I dont think you can take any other narcotic with it because it is like 10Xstronger than other narcotics and if mixed can cause respiratory depression. Hope it works for you! momof4

I've been on methadone for about 25 years.
Was put on it by Dr. S.' psychiatrist/pain specialist.
I was told to think of it as "blood pressure medication", as I'd probably be on it for life.

I've been from 10 to 100 mg, through the years (up at second accident), now, I take between 50-60 mg / day. Along with 30-60 mg Cymbalta, some diazepam, and occasional maigraine meds. (I know I'm forgetting something), oh, some lidoderm patches, cut in three, for my back/neck.

Methadone works well, but as even with Tylenol, (which will destroy your kidneys/liver), Respect it!

I wish you the best Finz!
(Is that a Buffett thing?)

Pete

methadone half life
 

please be very careful and take this medication only as directed by your doc and the half life tends to change from one person to the next and also changes the longer you take it. I have seen it do wonders for pain in my hospice patients but also have seen it do nasty things to ppl who think of it as a "recreational drug". Some of the docs I work with will not even try to use it unless the patient is hospitallized while it is titrated.
just a fyi from an old nurse