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#858841 - 03/13/09 12:15 PM Hydromorphone???
RonAllen Offline
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Registered: 08/28/07
Posts: 150
If this oxycodone shortage contiues, I might have to try hydromorphone and was wondering if anyone here has tried hydromorphone before.

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#858925 - 03/13/09 02:25 PM Re: Hydromorphone??? [Re: RonAllen]
pillar Offline
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Registered: 11/07/06
Posts: 1902
Loc: The Doors of Perception
Hydromorphone was a major letdown. I took 4, 2mg tablets and felt less pain relief than I would from 2 10/325 Norcos. IMO it's a waste of money. Oxymorphone was slightly better but the Opana (15mgs) seemed to wear off after only 6hrs. Don't know if you take an IR form of Oxy or an ER, but I'd pass on the hydromorphone and try for Morphine or Oxymorphone. All 3 (hydromorphone, oxymorphone and morphine) have poor gastrointestinal absorbtion %. If it were me I'd take IR morphine or ER morphine as a comparible oxycodone substitute.
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#858974 - 03/13/09 03:51 PM Re: Hydromorphone??? [Re: pillar]
Khilee Offline
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Registered: 03/02/07
Posts: 1682
Loc: TN
Hi pillar,
My pain Dr. told me Morhine also has low bio-availability.
Khilee
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#859061 - 03/13/09 06:15 PM Re: Hydromorphone??? [Re: RonAllen]
RonAllen Offline
Member

Registered: 08/28/07
Posts: 150
Well, someone told me a 30mg oxycodone = 11.5 dillaudid (hydromorphone).

Your 2 10/325 is 20mg oxycodone and I assume about 8mg dilaudid. You said you took 4 2mg hydromorphones. I probably would have taken a few more than that.

I ended up going back to doc and getting scripted Morphine Sulphate and when I heard a months prescription was gonna be $20, I knew right there they were gonna be [censored]!! Oxycodone must really have all these meds beat with a stick. It's all about bioavailability.

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#859074 - 03/13/09 06:45 PM Re: Hydromorphone??? [Re: RonAllen]
nephro Offline
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Registered: 09/04/06
Posts: 10301
Loc: NOT 40!
IV morphine is around 6 times more potent than oral morphine, which shows that it has low oral bioavailability. Yet some doctors who treat patients with 10mg IV morphine will prescribe 10mg oral morphine to the same patient, and then wonder why the patient reports that it is insufficient.

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#864019 - 03/23/09 01:54 PM Re: Hydromorphone??? [Re: nephro]
RonAllen Offline
Member

Registered: 08/28/07
Posts: 150
Just wanted to report back that the MS(morphine sulphate) pills were horrible. Not even close to the oxycodone IR they were supposed to replace. Even when I took the equivalent doseage.

The hydromorphone seems to be the most promising IF this shortage keeps up. App is coming up in a few days and it's now been over a month since this saga started. Hopefully they have it all straightened out.

Fortunately, I drive past my pharmacy literally on the way to see my doc. I will stop by and ask if they have rectified the situation and if not, I will ask to see what they do stock.

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#864136 - 03/23/09 06:32 PM Re: Hydromorphone??? [Re: RonAllen]
ThomasHuss Offline
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Registered: 08/17/04
Posts: 53
Opana is hydromorphone and is close in compisition to dilaudid. Hydrocodone 10/325 is not anywhere near oxymorphone, it's hydrocodone with a low dose of tylenol.

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#864272 - 03/24/09 01:43 AM Re: Hydromorphone??? [Re: ThomasHuss]
Milvus Offline
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Registered: 09/13/07
Posts: 281
Loc: the depths of East Asia
Opana is actually oxymorphone, not hydromorphone (the most well-known brand of which is Dilaudid, in the States, at least). Do they still use Palladone (an ER formulation of hydromorphone) in the US? I know it's available in the UK, but seem to recall it being withdrawn in America.

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#864274 - 03/24/09 02:01 AM Re: Hydromorphone??? [Re: ThomasHuss]
rzr Offline
Member

Registered: 11/12/07
Posts: 127
Loc: AL
Has anyone heard that Mepergan Fortis is being taken off the market? My wife is a nurse and she said that one of the DRs in their office wrote a script a couple of weeks back and the patient came back to their office to say the pharmacy would not fill it.So she called the pharmacy and they told her that it has been taken off the market temporarily so the FDA and DEA can look into how it is scheduled or something like that(isn't a schII anyway). She could not remember for sure the reason. Anyway the DR had to write two seperate scripts one for demerol and one for phenergan.The pharmacist said he thought it would be back in a couple years. The good ole DEA what would we do without them? LOL Sorry to be off topic.

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#864285 - 03/24/09 03:19 AM Re: Hydromorphone??? [Re: RonAllen]
nephro Offline
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 Originally Posted By: RonAllen
Just wanted to report back that the MS(morphine sulphate) pills were horrible. Not even close to the oxycodone IR they were supposed to replace. Even when I took the equivalent doseage. Even when I took twice the equivilent doseage!!!



Do you mind me asking what equivalent dosage you took? There are quite some differences between sources.

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#864479 - 03/24/09 11:37 AM Re: Hydromorphone??? [Re: rzr]
martind Offline
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Registered: 05/01/08
Posts: 2741
 Originally Posted By: rzr
Has anyone heard that Mepergan Fortis is being taken off the market? My wife is a nurse and she said that one of the DRs in their office wrote a script a couple of weeks back and the patient came back to their office to say the pharmacy would not fill it.So she called the pharmacy and they told her that it has been taken off the market temporarily so the FDA and DEA can look into how it is scheduled or something like that(isn't a schII anyway). She could not remember for sure the reason. Anyway the DR had to write two seperate scripts one for demerol and one for phenergan.The pharmacist said he thought it would be back in a couple years. The good ole DEA what would we do without them? LOL Sorry to be off topic.


I think very recently the FDA initiated a review of Mepergan Fortis under its drug Efficacy program (DESI) to determine current status as a medication that is "less than effective" than its original approval way back when. As a result of this, hospitals have been notified that Mepergan Fortis has been withdrawn from the market for the time being. Usually these DESI medications can remain on the market pending review but it sounds like this one did not.

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#864487 - 03/24/09 11:52 AM Re: Hydromorphone??? [Re: martind]
nitemoon Offline

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Registered: 12/01/04
Posts: 1445
Loc: AL
 Originally Posted By: martind
 Originally Posted By: rzr
Has anyone heard that Mepergan Fortis is being taken off the market? My wife is a nurse and she said that one of the DRs in their office wrote a script a couple of weeks back and the patient came back to their office to say the pharmacy would not fill it.So she called the pharmacy and they told her that it has been taken off the market temporarily so the FDA and DEA can look into how it is scheduled or something like that(isn't a schII anyway). She could not remember for sure the reason. Anyway the DR had to write two seperate scripts one for demerol and one for phenergan.The pharmacist said he thought it would be back in a couple years. The good ole DEA what would we do without them? LOL Sorry to be off topic.


I think very recently the FDA initiated a review of Mepergan Fortis under its Drug Efficacy program (DESI) to determine current status as a medication that is "less than effective" than its original approval way back when. As a result of this, hospitals have been notified that Mepergan Fortis has been withdrawn from the market for the time being. Usually these DESI medications can remain on the market pending review but it sounds like this one did not.


Total bummer. It has always worked great for me. When I had my wisdom teeth cut out, it was the only thing that worked for the pain. Granted, it wore off really quickly, but it still did it's job.


Edited by nitemoon (03/24/09 11:53 AM)
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#864494 - 03/24/09 12:12 PM Re: Hydromorphone??? [Re: pillar]
EDinNC Offline
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Registered: 03/23/06
Posts: 875
Those litte tabs (2mg dilaudid)are so small and "tight" I find it helps to crush them and mix with warm coco with lots of sugar, there is no time release component so I don't think the Doc would have a problem they dont last long so I use for breakthrough pain only. JMO

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#864548 - 03/24/09 04:02 PM Re: Hydromorphone??? [Re: EDinNC]
FangZ Offline
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Darn, when did mepergan get taken off the market?
It was a great 'emergency' pain med for me. I don't get it rx'ed very often. I actually have some from a small script about 9 months ago left over.

My doctor will write it for me as a backup emergency med to go to if nothing else works and he's not in office, or it's the weekend.

I know it's not a great first choice med for a lot of folks, but I'm like the poster above, it works great for me when I need it.
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#864558 - 03/24/09 04:19 PM Re: Hydromorphone??? [Re: ThomasHuss]
OldandWorn Offline
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Registered: 09/21/03
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 Originally Posted By: ThomasHuss
Opana is hydromorphone and is close in compisition to dilaudid. Hydrocodone 10/325 is not anywhere near oxymorphone, it's hydrocodone with a low dose of tylenol.


hydromorphone is dilaudid's generic.

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#864561 - 03/24/09 04:21 PM Re: Hydromorphone??? [Re: EDinNC]
OldandWorn Offline
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Registered: 09/21/03
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warm coco with lots of sugar



They used to liquify them of other purposes I will not mention. Dils were very short acting but the real thing.

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#865008 - 03/25/09 01:18 PM Re: Hydromorphone??? [Re: FangZ]
rzr Offline
Member

Registered: 11/12/07
Posts: 127
Loc: AL
 Originally Posted By: FangZ
Darn, when did mepergan get taken off the market?
It was a great 'emergency' pain med for me. I don't get it rx'ed very often. I actually have some from a small script about 9 months ago left over.

My doctor will write it for me as a backup emergency med to go to if nothing else works and he's not in office, or it's the weekend.

I know it's not a great first choice med for a lot of folks, but I'm like the poster above, it works great for me when I need it.

I guess you could get the two meds. that were in mepergan (which is demerol and phenergan) scripted seperate if you needed it that bad, but that would be more trouble and also cost more I'm sure. Don't yall just love the good ole DEA

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#865115 - 03/25/09 04:05 PM Re: Hydromorphone??? [Re: ThomasHuss]
ThomasHuss Offline
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Registered: 08/17/04
Posts: 53
OPANA IS AN ER MEDICATION BUT YOU CAN GET IT IN LARGER DOSAGES, AND OF COURSE, IF YOU BREAK, CHIP OR CHEW THEM THEN YOU WILL GET THE FULL 40 OR WHATEVER MG ALL AT ONCE. ALTHOUGH MY CO-PAY FOR OPANA IS $60 SINCE THERE'S NOT A GENERIC FOR IT YET, IT'S STILL WELL WORTH IT. JUST FOOD FOR THOUGHT.

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#870087 - 04/04/09 10:26 AM Re: Hydromorphone??? [Re: OldandWorn]
ThomasHuss Offline
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Registered: 08/17/04
Posts: 53
Slight correction - Opana is Oxymorphone not Hydromorphone. Just as "Oxy"codone and "Hydro"codone are composed. Oxy is a more synthetic medication than the Hydro meds but they're supposedly more potent (although I like the Hydro's on both meds better.)

For those of you who need to find more information on drugs, try WebMd.com it offers a wealth of info on each drug - the site has pretty much everything you'll find in a PDR (physician's desk reference).

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#870167 - 04/04/09 01:54 PM Re: Hydromorphone??? [Re: ThomasHuss]
jpbp Offline
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Registered: 09/23/07
Posts: 997
Loc: okie
My insurance requires that I pay for my script and they reimburse me for 80%. Opana went up from $400 a month to almost $600 a month. That took it right out of my price range.

Insurance takes their sweet time about paying and I refuse to pay that much up front for ANY meds.

I am going to talk to my doc about hydromorphone because that's all my pharmacist seems to have. Well, morphine, but that did nothing for me.

What is up with this shortage of meds and then raising prices of what is available? I guess that's for another thread!
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#870203 - 04/04/09 02:59 PM Re: Hydromorphone??? [Re: jpbp]
Spencertracy Offline
Member

Registered: 11/07/04
Posts: 116
I have heard may reports saying opana is not that good taken orally , oxycodone is better is this true ?
Is there any more effective way of taking it excluding injection ?

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#870221 - 04/04/09 03:32 PM Re: Hydromorphone??? [Re: Spencertracy]
Khilee Offline
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Registered: 03/02/07
Posts: 1682
Loc: TN
Spencertracy, I take Opana and it just doesn't do much for me. I am going to ask my pain doc if he will swith me to Roxicodone.
Khilee
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#870234 - 04/04/09 03:56 PM Re: Hydromorphone??? [Re: Khilee]
funkybreakz Offline
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Registered: 01/24/04
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 Originally Posted By: Khilee
Spencertracy, I take Opana and it just doesn't do much for me. I am going to ask my pain doc if he will swith me to Roxicodone.
Khilee


wait a few months... now is not the time to switch.

there is a nationwide shortage of 5, 10, 15, & 30 milligram oxycodone IR. unless you are going the time release route (oxycontin) you will be hard pressed to find any pharmacy that has stock to fill your Rx.
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#870299 - 04/04/09 06:26 PM Re: Hydromorphone??? [Re: funkybreakz]
Khilee Offline
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Registered: 03/02/07
Posts: 1682
Loc: TN
Thanks funkybreakz, I forgot about that.
Khilee

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#870354 - 04/04/09 08:27 PM Re: Hydromorphone??? [Re: Spencertracy]
ThomasHuss Offline
Journeyman

Registered: 08/17/04
Posts: 53
Hi - Opana is an ER (extended release) medication and it's chemical name is Oxymorphone, not hydromorphone. It comes in various strengths and is very effective if taken properly with any/all other medications you are prescribed.

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#870503 - 04/05/09 12:01 PM Re: Hydromorphone??? [Re: ThomasHuss]
BoogieWoogie Offline
Old Hand

Registered: 01/20/07
Posts: 454
 Originally Posted By: ThomasHuss
Hi - Opana is an ER (extended release) medication and it's chemical name is Oxymorphone, not hydromorphone. It comes in various strengths and is very effective if taken properly with any/all other medications you are prescribed.


There is IR instant release opana also.
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#873440 - 04/10/09 03:40 PM Re: Hydromorphone??? [Re: BoogieWoogie]
Oxy80 Offline
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Registered: 03/30/08
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My doctor prescribed me Hydromorphone in replacement of Oxycodone. I definitely like Oxy better by far. These 4mg tabs of Hydromorphone seem extremely weak. I suppose the bio-availability is low.

Also, the script was written take 1 tab every 8 hours? Is that a normal count?

I can't wait until Oxycodone is stocked on the shelves again.
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#873482 - 04/10/09 04:42 PM Re: Hydromorphone??? [Re: Oxy80]
NotBillGates Offline
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Registered: 01/15/04
Posts: 2800
 Originally Posted By: Oxy80
My doctor prescribed me Hydromorphone in replacement of Oxycodone. I definitely like Oxy better by far. These 4mg tabs of Hydromorphone seem extremely weak. I suppose the bio-availability is low.

Also, the script was written take 1 tab every 8 hours? Is that a normal count?


Normally, it's Rx'ed as 1 tab q 3 to 6h prn. Eight is really stretching it.
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#874354 - 04/12/09 04:45 PM Re: Hydromorphone??? [Re: NotBillGates]
Oxy80 Offline
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I just knew something was wrong the way it was written to me. Thanks for the knowledge, you rule!
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#874620 - 04/13/09 12:24 PM Re: Hydromorphone??? [Re: RonAllen]
Prohibition Offline
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Registered: 12/07/08
Posts: 24
I was recently seen in ER for severe pain related to a herniated lumbar disk. They injected me with 1 mg of hydromorphone, which worked great on my pain... for 20 minutes. Another IV dose proved the same. They gave me 2mg oral dilauded to take home with me, and I feel far less effects from the 2mgs than from 10 mgs of Norco. Even 5mgs of dilauded just barely gives me relief, and only for about 2 1/2 hours. I am really unhappy with the dilauded, especially because I was told not to take any other drowsy-inducing drugs with it, which means I only get 2 1/2 hours of relief but then have to wait the full 6 hours before I can even take a Soma or something as simple as an antihistamine for my seasonal allergies. I have read that people have better luck with the hydromorphone in higher doses, but I would advise you not to get your hopes up if you are used to something like Norco or stronger and your doc prescribes any less than 8 mgs of the hydromorphone. All it does is make me swimmy, depressed and pissed that I have to wait for it to get the heck out of my system.

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