Hello, I was just put on Methadone and Oxycodone for pain releif. I am on Oxycodone 10mg six times a day and on Methadone 5mg 4 times a day. Is anyone else on a similar combination?
It makes me a little sleepy..will this go away when I become a bit more acclimated?
Is it true that the Metahdone will only block the effects of the Oxycodone if I take 80mg and upwards a day? Thanks

Methadone doesn't block the effects of other opioids any more than high doses of other opioids do. In other words, if you were to take 80mg oxycodone daily, you would probably not notice an additional 10mg. Methadone is very potent, so users often do not notice relatively small doses of other opioids if they are taken during methadone use. It certainly does not have antagonistic actions, and raises tolerance rapidly like typical strong opioids.

There is certainly no magic number for how much drug you would need to drown the effects of other drugs. It must vary considerably. Where did you get the 80mg figure from?

Hey Nephro, I did some reasearch and I consitently saw between 80mg and 120mg listed.

I've seen the same, but many of the sites discussing it are rather ghastly. Whatever you decide, be very, very careful.

Hmmm, that's odd. I've never heard of a doctor giving two long acting pain meds. Are the oxy Percocet 10/325???

Bruin7

Sounds like he's probably on percocet. When I was at my last pain clinic, I was on Methadone 10mg 3x a day, with 4 percocets a day for breakthrough pain. I was told to never go above 30 mg of Methadone a day.

I've read that people who go to Methadone clinics and take 100mg or 120 mgs or 200 mgs can't 'feel' any other opiates, which is the point. They are trying to get them to get off of other drugs like herion, oxycontin, etc.

But putting Methadone and percoets together was a common usage at my pain clinic. (with Flexeril and something to sleep). They did have to write "for chronic pain" on my Methadone scripts so my insurance would fill it.

Percocet, sorry for the confusion. lynx, thanks for the info

Seattle, I would trust your doc. Not that docs always have the correct answers, but your pain must be legit and he/she must have some experience with these meds.

The Methadone is undoubtedly for sustained pain control and the Oxys for breakthrough (pain always seems to breakthrough in my experience.)

Methadone can be a real bear to get off of, should that occur, but I have heard (read) good things about pain control. I sincerely hope that is true for you.

Follow your doc's orders, manage your meds well and consider yourself fortunate. I have a feeling your quality of life is better.

Take care.

Just keep breathing my friend. Methadone can be dangerous when mixed with other meds.

Hi,

if the methadone is holding the pain ya know ya don't HAVE to take to instant release oxycodone and nod off.

Thanks for your guy's info, its much appreciated. Prior to this I had little to no experince with Methadone for chronic pain. The tricky thing about the methadone is that its sometimes hard to guage the correct amount, you sometimes end up being too sedated - sometimes you dont feel a thing, but at the same time you dont want overdose because of methadones slow onset..Its not like anyother painkiller ( maybe the fentanyl patch).

I've also heard reports that methadone is only reliable for 6-8 hours of pain releif. So I always have to keep that in mind and try to plan accordingly.

So far I really like the effects of the combination but one thing that bugs me is that when I awake in the morning and am 10-12 hours past my lase dose I often am in ton of pain. And sometimes the pain is in places that I havent experinced it before (I havenet experinced this before with other pian med's).

Otherwise, positive feedback for anyone else considering this combination.

You can't expect to be pain free 100% of the time, while alive. Mrthadone is very strong. It may be affecting other things in your body or you may have arthritis.

Despite methadone's longer half-life, some patients can wake up in partial withdrawals if it has been 10-12 hours since last dosing. This can manifest in body pain unrelated to the underlying painful condition.
If this side-effect is a serious problem, it can be avoided by adding a dose 5-6 hours after initially falling asleep.

how long you been on it it will be a week or two befor the
methadone will work all night it has a long 1/2 life
but takes a while to get to theraputic dose level

It is often given every 6-8 hours during the early stages of dose titration, but on prolonged use not more often than every 12 hours, as the drug can accumulate over a period of time.

Thanks for the info. Its only been a week and a half. and as a precaution the doctor only had me taking 10mg total the first 5 days, now im on 10mg in the morning and 10mg in the evening. Im thinking that once it accumaltes in my body, like someone else mentioned things will be better. My pain m. doctor also said that methadone can actually deaden the nerve's in my hand ( thats where the injury is )over-time. Whos knows, I'll reamin optimistic... the only medication that I havent tried in my pursuit of being pain free is oxymorphone.

I dont know why they would give u oxy and methadone.. Methadone blocks Opi's... Thats why they have Methadone Clinics, to get people of of Opiads.. The Methadone is basically cancelling the Oxy's out..

Methadone does not cancel out any other medication. You're thinking of an opiate blocker, which Methadone is not. It's a legal replacement for Heroin, and a wonderful long term pain medication.

Suboxone blocks the Mu(?)opiate receptor in your brain, making oxycodone, hydrocodone, or even something like Dilaudid have little if any effect. That & its ceiling dosage make it preferred over methadone for opiate dependence nowadays.

In low-medium (i.e. analgesic) doses, buprenorphine doesn't block anything, and, in fact, behaves as a pure mu-opioid agonist. Naloxone (in Suboxone but not Subutex, Buprenex, Temgesic, Transtec or BuTrans)is a different matter altogether, of course, although I don't know what blocking effect (if any) it has in Suboxone. There was a long thread on this just a week or so ago, with lots of valuable info.

Sorry, I tried to edit my last post but the time limit was up. I just wanted to add that if the Suboxone in question was a high dose tablet (say, 16mg or 32mg) then it might indeed interfere with other mu agonists like hydrocodone or oxycodone, especially if the user were already dependent on high doses of these. I was thinking of the analgesic range (I always think of that automatically when buprenorphine is mentioned, given that I'm prescribed Temgesic for pain - I keep forgetting it's used mostly for opioid dependence in the US).

copied & pasted from another thread..

I just know that, in my experience, I have taken 32 mg Suboxone (the supposed "ceiling dosage") and felt nothing. That, and when I was in the ER being administered Dilaudid at least 48 hours after my last dose of Suboxone (aprox 8 mg at that point), I didn't feel a thing. The doctor, in his words, gave me "enough narcotics to kill three grown men," yet I was still coherent and completely sober.

That sounds about right. Doses at the 16mg to 32mg level for a person previously opioid dependent typically result in them feeling "nothing" although at times transient euphoria might be present. I guess that was what the person who made this quote was saying was lacking.
Using enough Dilaudid within 48 hours of 8mg of Suboxone would be a challenge to reach an effective painkilling dosage. If the ER physician was completely aware of the Suboxone situation, he should have titrated the dose accordingly or switched to a stronger narcotic such as IV Fentanyl.
Suboxone can be over-ridden for acute pain treatment but the doctor has to be fully informed about what he is dealing with.

It's sounds messy.
Knowing how many times I have seen dr's screw simple things up,I wouldn't want to make things any more complicated for them.

I know a number of people who took Naltrexone for months and they said they felt sick the whole time until they stopped.
(These were previously opiate dependant people).

It is somewhat different with Naltrexone but it can also be over-ridden much like Suboxone can.
And complaints about nausea being a side effect from Naltrexone are common.
I've often wondered, however, whether it was the drug causing the nausea or it was because of the effects of the post-acute withdrawal syndrome itself.

I too wondered about the nausea being part of the PAWS.I only know one of them that stopped and started again which showed the nausea only when taking the Naltrexone.This was also many months after tapering of opiates.

I've never taken Naltrexone so I don't know personally, but as you said, nausea is known as a side-effect.
On the otherside is the fact that some people report Naltrexone has helped them stop smoking and drinking among numerous other "addictions".

While I was on methadone for pain (I have MS) I hurt my back. My doctor prescribed me 60 percacet 10mg/325mg tabs for Break-through pain.

And it wourked too. Depending on the dose that you're taking of methadone it probably will BLOCK all the other opiates that yu would take for pain unless it's a large dose or your last dose of methadone has been over 24-36 hours and is not as prevalent in your body.

BUT Doctors DO prescribe this combination of drugs. Infact he also prescribed to me at the same time valium 2.5mgs which you would assume that NO Doctor would prescribe an opiate along with a Benzo. But is was a very small dose and I never had any adverse reactions thankfully.

Hmm, that's odd. Wouldn't taking the methadone block the oxycontin??? They should have given you a continuous medication like methadone and then oxycodone/APAP (percocet) as breakthrough pain.

Bruin7

That is absolutely not true that after awhile you only take Methadone every 12 hours. I have been on Methadone 50mg 4x a day for 4 1/2 years with absolutely NO problems. After 12 years of battling, trying to find someone who would not treat me as a criminal or a junkie -I finally found something that managed my pain like nothing ever had. I wasn't high - I just was not in pain anymore. Well when I say not in pain - I mean the pain I still had was very manageable. I was living in AZ then and going to a pain clinic in Phoenix. I came home to PA for Christmas and had to stay because I didn't have a home to go back to in AZ. So I had no refills or anything as I had no idea I would have to stay here. I went into horrific withdrawal in Feb and was hospitalized for 4 days. I had told docs and nurses in the ER when I was being treated for a urinary tract infection that I was scared of going through withdrawal. They just basically said 'Oh well too bad'. 2 weeks later I woke up vomiting uncontrollably. I called an ambulance and they took me to the hospital that had said 'oh well'. I didn't have insurance so the ER personnel cost the hospital thousands of dollars by ignoring me. Inpatient was wonderful. They found a clinic for me to go where I could get Methadone again. This clinic ONLY took patients with no insurance. I didn't understand that. I went and saw this doctor from Feb til May. I still had AZ Medicaid, but it covered NOTHING but a couple of prescriptions - not even the Methadone - no hospitalizations, no doctors' offices. I even told her this as well as another woman in the office who had called me once when she got a call from the pharmacy. Well the doctor found out and accused me of going to other doctors violating my pain contract. I had gone to the ER because the clinic didn't have on call drs. or evening hours. She made many false accusations and just dropped me. She had given me 3 prescriptions the last time I saw her before she discharged me. I went to fill one of them and the pharmacist this doctor had called and said that the prescriptions were NOT to be filled!!! What happened to the Hippocratic Oath - First Do No Harm. So I am in withdrawal again - just starting and I have NOWHERE to go. I am on PA Medicaid again, but nobody will treat me that I have called so far. I went to the ER last night and the P.A. that treated me talked to me like a junkie. He said they don't prescribe Methadone - why is that? He gave me a shot of morphine after me begging for it instead of taking the prescription for 10 tabs of Percocet which would be like taking an aspirin at this point. I told him all of the symptoms I was having of the withdrawal and he sarcastically said "Yep that's the withdrawal' like "Too bad - live with it'. I am in so much pain, so anxiety ridden, can't sleep, can't eat and I have NOBODY to help me find someone to treat me. I have to use Medicaid because I have no money. Does anyone know of a pain doctor/pain clinic that prescribes narcotics without making you go through the run around of injections, etc. I did all that for 12+ years. I cannot function with this pain. It is degenerative disc disease in my cervical and lumbar spine and the head and neck pain I get are indescribable. Does anyone have any suggestions? Please. I have been crying every day for 2 weeks. I went to a doctor last week and she was so mean - again treating me like a criminal and a junkie. I know this is typical - I went through it for 12 years.

What I was referring to in saying that Methadone could only be taken every 12 hours after a certain period of time was this post:

It is often given every 6-8 hours during the early stages of dose titration, but on prolonged use not more often than every 12 hours, as the drug can accumulate over a period of time