Switching from Quick Release to Slow Release, PLEASE HELP!
 

Hi, I've had 5 knee surgeries and developed severe, debilitating nerve pain in both knees. I've been on daily pain meds for over 5 years now (excepting a 4-month stint of nothing). I currently take 250 mg of quick release ultram (tramadol) daily (two 50mg pills when I wake up, three in the afternoon). But with my kind of chronic, constant pain, I need to be on a longer-lasting medication. My doctor is going to switch me to either morphine or oxycontin (I was on the latter for about 2 years, from 2008-2010). I don't need to be talked away from this or warned about anything, I know the risks and the dangers; being bedridden and in agonizing pain and non-functional and suicidal vs. the relatively low risk of addiction = a no brainer.

My only question is, what would do you think is the appropriate dose of oxycontin SR (works better and with very mild side effects compared to morphine) to take the place of my current regiment of 250 mg/day of QR Ultram? I'll ask my doctor but he wants me to price it first, so I'd like to ask people who actually have severe chronic pain.

Thanks!

Even just a guess? An estimate?

Hi
It's the Independence Day holiday weekend, and summertime, and so many members are away or busy with family and not online. The forums are always slower around this time of year.
You only posted this last night so just a little patience and hopefully someone will have some input for you:)

This link gives some conversion ratios. These are not exact because people differ.

If you had poor metabolism of tramadol in the liver, to its active metabolite, you would have little relief from this drug. Hence your high doses. If that were the case converting directly to morphine or oxycodone SR would not be the ratio shown on this link. (you could overdose on morphine based on artificially high tramadol that wasn't metabolized.)

http://www.gha.net.au/Uploadlibrary/...011-Opioid.pdf

In general costs go this way:
methadone is less expensive dose to dose than morphine SR, morphine is less than oxycodone SR. The oxy products even if generic are the most expensive of the 3. Morphine is a moderately priced opiate.

Availability is also an issue. In the US there can be shortages of oxycodone at times.

In the US pharmacies typically will not give prices of opiates over the phone. You may have to go there in person.

There are other conversion tables on the net. If you Google
"tramadol to morphine conversion doses" you'll find others.

You may be able to get hypothetical pricing information from your insurance carrier or in-person from your regular pharmacist, however if you're in the US, Oxycontin will be the most expensive because, unlike morphine CR or SR, it is not available generically.

As far as dosage, those conversion charts & tools aren't even as good as a ballpark guess due to the many variables involved. Your doctor will have to titrate the dose.

Doc