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    Opana vs. MS Contin
    dillray1 posted:
    Hello all,,,I have been seeing a PM doctor for 4 months now for chronic pain(4 failed fusions,7 spine surgeries in all). The PM dr. put me on Opana ER 10 mg twice a day and Opana IR 5mg. 1x day for breakthrough pain. The 10 mg did not work so well,so he put me on Opana 20 mg 2x day with Opana IR 5 mg 1x day. This worked a bit better,but the breakthrough med has not helped at all,so on my last visit,he told me to take 2-5mg.Opana IR for breakthrough. That is not helping. The PM dr. advised me if that didn't work,he would put me on MS Contin and try that,and take me off the Opana ER and IR. Can someone please tell me the difference between the 2,and how the MS Contin helps with pain as opposed to Opana. Is MS Contin stronger than Opana,since he may want to try the MS Contin vs.Opana. Also,are there any side effects that MS Contin may have vs. Opana. I know that the Opana makes me tired,but that's about it for the side effects on the Opana.

    Thank You very much in advance for any and all replies. I just want to get my pain under control,and so does the PM dr.,but since i have never had MS Contin,i don't want to take a step backwards.
    annette030 responded:
    Opana is a synthetic opioid, and morphine is a natural opiate. They both work by attaching themselves to opiate receptors in your brain and on your spinal cord. I took a generic of MS Contin for about ten years, and did very well on it. I changed it recently due to insurance changes. I am doing fine on the new drug I am on now.

    The strength of the particular drug is not important because the doctor will prescribe it according to how you respond to it. They are not all prescribed in the same way as far as mg. per dose. There are equianalgesic charts available but they are not really totally specific for individual people. They are tools to use for trends for most people.

    I personally believe that it does not make much difference for most people which drug they take as long as they get the right dose. But, there are some people who just respond better to one drug over another. You may just not be the right person for Opana, perhaps morphine will work better for you.

    Although I have read many studies, I have found none that really show that any one opioid is better than another, or has fewer side effects than another. If anyone out there has a link to any study like that, I would love to read it.

    Another thing is that most people with chronic pain also take other meds for the pain, perhaps an antidepressant, a muscle relaxant, or an anti-seizure med. These help lower the pain levels in their own way. Also, what non-drug treatment methods do you use?

    Take care, Annette
    dillray1 responded:
    Hi annette 030, Sorry it took a couple of days to get back to you,but i wanted to thank you for your response,and what you told me was exactly what the PM dr. said also in reguards to the differences in the 2 meds. To let you know,i also take Zanaflex 4mg. 3x day,and Dalmane 30mg. to help sleep. I was switched Mon to MS Contin 30mg.3x day and told to switch from the Opana to the MS Contin on tuesday. I also was told that there would be no Withdrawal,but my pain levels may be all over the place for a few days,which it really is. In fact,it's at an 8 constantly. I was told to call if i have any problems. I wanted to call today,but don't want to jump the gun too early. Does it take a while for the body to get used to the MS Contin?????? Remember,,,I transitioned over from the Opana,and now i'm wishing i wouldn't have switched,as it seems the Opana worked better,but i have to give the MS Contin a chance i guess. I'm sure the PM dr. will switch me back to Opana,but like i said,i want to give the MS Contin a few days to work. Again annette,,,Thank You for your response. You were spot on with your answer. God Bless You!!!
    annette030 responded:
    I wouldn't give it any more than two days, then call the doctor and let him know where you are with your pain. I switched from morphine to methadone recently after ten years on the morphine for insurance reasons. It took a couple of weeks to adjust the dose, my doctor told me I could call her on the phone for that. I usually see her in person for anything, I feel I get better care that way, she prefers it also.

    Give it a chance, it usually takes some adjusting to get the dose right on the new med. I had no withdrawal either, just had to adjust things to best control my pain.

    Let the doctor decide when and if to give up and go back to the Opana. He will at some point probably ask you if you want to raise the dose or go back to the old drug. Is he giving you a BT drug that is short acting to use during the switchover? I did and that made all the difference for me. My doctor gives me a BT drug anyway, she just told me to use it as needed during the changeover.

    Do not wait until Friday or the weekend to get in trouble and not be able to get a hold of your doctor. Have a plan by Thursday night if possible.

    Take care, Annette
    30yrsouch responded:
    I was taking 40mg Opana ER and 10mg Opana ER twice a day and then 4 Norco a day for breakthru pain. I was finally living my life again at a pain level of 4 to 6. Due to a loss in insurance I asked my doctor for a cheaper alternative to the Opana (the 40's were close to $1600 a month and the 10's were $940--obviously it was ard to pay for them). Anyway, the doctor put me on MS Contin 60 mg twice a day and nothing for breakthrough pain. I now live the life of a hermit, take a shower at beast 2x a week because just moving around is so painful. I spoke to my doctor about it and he added another dose of MS Contin to bring my total to 60 mg 3x a day. The MS Contin does not seem to even lighten my pain slightly. My doctor will not put me back on the Opana---yes $1600 but I can actually hold a job when I take them. Since the switch I have lost my job, my oyfriend, my daughter speaks ill about me lazying around all day and my house looks like a war zone. Does anyone else have issues with the swtch not working? Is there another lower cost pain med I can ask for that will work better? Please help. I am not depressed but have recently considered skydiving without a chute.
    annette030 replied to 30yrsouch's response:
    Discuss this with your doctor. I take methadone now, which has to be the cheapest of all opioids, a month's worth at my dose is about $25. That is without insurance, paying cash.

    Whether you adjust your present dose, which is common after changing from one long acting med to another, or try a different drug entirely, or go back to the Opana, is up to you and your doctor. I continue to use BT meds for break through pain 1-3 times a day.

    Take care, Annette

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