Kadian (new prescription). Have not started yet because very confused?

[Guest guest]

Hello everyone,

I wrote a question on Yahoo Groups, and my hand are *really* hurting bad from

the arthritis, so I hope it is ok to copy & paste it

here because originally I thought maybe someone could give a quick answer there

without bothering all of you on the list here,

but I am really desperate.

Again I'm very sorry to 'double post' as I know that isn't usually good

netiquette but hope that it's ok in this situation since it hurts

to type so much right now. Here it is:

I didn't start the Kadian yet, but want to at least try the Kadian soon to see

how well it works. I tried Oxycontin a while back and it

didn't help much more than Norco, and made me feel a bit queasy. Also it didn't

last nearly the full time it was supposed to, and

since it is so controlled now, it made it really hard to control pain with all

of the hours in the day where it would wear off too

quick.

I then tried the Fentanyl patches, but got horribly sick. I don't know if my

doctor started on too high a dose, but it made me kind

of fear " long acting " medications because once you take it, if you have a bad

reaction, you can't really do anything except wait a

LONG time, not like short acting meds like Norco and such. But I do see the

potential benefit of them, if they work as hoped.

So anyways:

On the Kadian website, it says things about being able to be dosed for EITHER 12

or 24 hours.....but it seems from anything I can

tell, that they just offer different strengths of the medicine, and NOT 2

separate types of medicine; like a 12 hour one and a 24

hour one.

This seems like they mean that some people only take it once per day, have it

work for 12 hours or so and then hurt for the last

12 hours of every day? Even more, I don't know yet obviously, but would guess

that you don't really get a full 12 hours of relief

out of each pill, probably more like 8-10 or less, if it works like the other

long acting ones I've tried.

Or is there really a secret '24 hour' separate version of Kadian? I really can't

figure it out from their web site at:

http://www.kadian.com

Their web site's intro says " Polymer-coated pellet technology allows for once or

twice a day dosing. "

To me, that would seem like there would be 2 different types, but I don't think

there are?

Ok, I'm typing for real this time to the CP group

I guess I'll go ahead and post this part, and then add a small follow up posting

in a few minutes, because I'm going to go get the

prescription bottle to put the info I have. I know there are members here that

take this medication, and others that take MS Contin

which I think is basically the same thing. And I was really hoping that anyone

that has experience with this medicine could offer

even the smallest bit of help or info about it. I'd be so grateful for anything

at this point, and thank everyone here in advance.

I have not posted on here for a while because things have been so painful. I

have a really hard time on the computer, it seems to

aggravate the discomfort. But I do log in to read as much as I can and know lots

of you are having lots of trouble, I'm so sorry.

I hope EVERYONE here is doing as good as possible, but know that so many of you

are in much worse situations than I, and I pray

for you all every day. We all know it, but just have to remember that when

things get very bad and seem like they couldn't get

worse, that's almost always when they always get better. So I wish you all the

best, and even though I don't know any one here

very well personally or have ever met in person, I feel closer to most of you

then I do with my best friends; because they just can't

understand what our lives are like. Of course it isn't their fault, but all of

our horribly unfortunate, and very different

circumstances which brought us all together on this group have made a big

difference in my small life. And that includes my

shrinking social life, if it can even be called that. Every one here is so nice

and compassionate and understands the overall

dilemma we all face every day we wake up. I know probably most every one here

doesn't feel that they know me much at all, but

however sad this sounds, you all have made a huge difference in my life and I

wanted to say thank you for that from the bottom of

my heart.

The other biggest thing that is so comfortable here is when we all feel bad,

like extra very bad and just need a place to vent about

anything. I think most of us have done it at least once on here, and I so

appreciate the fact that those types of messages are

allowed on this group, it is part of what makes the CP Yahoo group so

comforting.

Geeez, I did it yet again. Posted a novel and my fingers are really hurting, I'm

sure everyone reading this if they made it this far is

smiling with joy LOL.

Ok so I will stop here I promise!

But my question is still really important for me if any one out there can help

me with it. Real quick after this I will post the info on

my prescription and then shut up for the day

Thanks so much,

[Guest guest]

My prescription, which I picked up and have here is written like this:

Kadian 30MG CR

Take one capsule by mouth in the morning for pain. May increase to two capsules

after 1 week.

....the biggest problem is that I am in lots of pain right now (currently taking

6-7 Norco

10/325mg; and 4-5 Soma 350mg every day). And my doctor just went out of town for

about a

month, so I can't get any info from him. He told me far in advance, so it isn't

his fault because I

called the day before he was leaving and told him about my worse pain; and he

left a prescription

for this (he is a neurologist & knows my issues. I've been seeing him for many

years).

I couldn't really get a clear answer from the pharmacist, I just needed to sit

very bad and wanted

to get home to lay down. I don't know what to do?

If I start it and it works for only 10 hours and then stops, I wouldn't be sure

that it wouldn't 'start

up again' with more 'extended release' medication and would be afraid to take a

second one,

especially right away.

One thing I forgot to mention before, and I'll make it fast!

Before he left this prescription, I told him my worries about being sick and

such so he also left a

prescription for 6 Morphine Sulfate 15mg tablets, just the instant kind. Which I

THINK is the same

thing, just morphine, inside the Kadian capsules; just wrapped in some slow

release casing or

whatever.

So I tried those the other day, and it was ok. The prescription said take 1 or

2. I took 1, waited

about an hour and it didn't really help at all. So I took another one, which

after about another 45

minutes did relieve the pain a little bit more than the Norco I take now.

But that was 30mg instant release. The way I understand it is that that would

have been about

30mg of morphine in my body all at once, and it just barely took care of the

pain level. Yet with

this Kadian, it is also 30mg, but again the way I understand is, there is 30mg

TOTAL in the

capsule that is released slowly throughout the 'extended release period'; be it

12 hours or 24

(goes back to my first posted question though).

So it seems to me that if that is how it works, then over even 12 hours wouldn't

that only be

release about 2.5mg??

If so, that obviously wouldn't help I don't think at all since the 30mg morphine

instant ones was

just enough to help. Or am I just completely misunderstanding everything about

this?

that got long again, I'm so sorry once again. I'm just so completely confused

and only have 1 day

of Norco left or else I have to call the 'on call' neurologist since mine is

gone for so long. I am

really scared. If any body can help I would be so beyond grateful. thank you

again for reading all

this.

[Guest guest]

-

What are you going to lose by trying the prescription? I'm not sure

why you are causing yourself so much stress worrying over this. Just

try it. You'll know then whether or not it's going to work for you.

You've already seen that morphine doesn't make you sick, so you

aren't at a high risk for suffering because of it, and it may just

make you better! Quit panicking and just try the med. You have

nothing to lose and everything to possibly gain.

BTW, it is NOT correct that a 30 mg extended release medication is

the same as using 30 mg of immediate release of the same drug. The

extended-release med is designed to keep that level of dosage in your

system for the entire 12 or 24 hour period that it is designed to

work. That's why breaking/cutting/opening an extended release

medication is DEADLY - because you're not getting 30 mg of the drug,

you're getting a MUCH higher dosage all at once!

But you won't know if this dose is enough until you try it, so

there's no point in avoiding it because you think it won't be strong

enough - you have to try the dose before you'll be able to tell your

doctor that it did or didn't make a difference, and then he can

adjust your dosage as necessary. With any medication it often takes

several dosage adjustments to get it right, so don't expect every med

to work perfectly on the first try.

Also be aware that with many long-acting meds, it may take two or

three days to get a full dose in your system consistently so that

you're getting the best pain control, so don't give up after just one

pill. As long as you're not violently ill, any minor side effects

will disappear with continued use, and it's worth sticking it out to

see if the med will improve for you with time. Give it at least a

week.

And make sure you take it very consistently - every day at exactly

the same time, so that you give it the best chance to work for you.

Pain meds in general, and especially long-acting pain meds, do NOT

work well trying to play catch-up to relieve pain that is already out

of control. They do their best job once pain is under control to

keep it there. So give it time to get to that stage.

As to why Kadian states it can be prescribed either 12 or 24 hours -

that is because the drug manufacturer was very smart and made the

request to FDA to allow it to be prescribed either way depending on

the doctor and patient. If a med is FDA approved for only a 24-hour

dosing schedule, often insurance will not pay for it to be prescribed

any more frequently. By having FDA approval for 12-hour dosing, your

insurance has to pay for it to be prescribed that way. Some people

find it works fine to take it once a day, others need it twice a

day. It just depends on the individual.

I take Kadian (every 12 hours) and find it is the very best pain

medication I have ever taken. It is better than generic Morphine

Sulfate. It has VERY consistent pain control - no more of that

roller-coaster pain cycle that I got with even other long-acting meds

like Oxycontin - it never lasted one moment past eight hours. I can

go hours past my next dose on the Kadian and not get a spike in

pain. It does not make me sick, whereas Oxycontin made me terribly

ill.

I applaud you wanting to know everything you can about a medication

before taking it - I'm the first one to say " knowledge is power! " -

but it sounds like you're working yourself up into a panic by finding

all the potential faults and failures, when the only way to really

answer all your questions is to just try it. Everyone reacts

differently to every medication. We can tell you all the stories you

want to hear about how it does or doesn't work for us, but that won't

tell you a thing about how it will work for you. Relax, try it, and

be grateful you have a doctor who is listening and willing to give

you options for treating your pain.

I hope you find it works beautifully for you. Keep us updated.

Also, if you decide to stay on Kadian, go to their website -

www.kadian.com - and sign up for their discount card. You don't have

to qualify for it - it is free to *anyone* prescribed Kadian, whether

or not you have insurance, no matter your income. You get it in the

mail a few days after signing up online and then you just hand the

card to your pharmacist with your prescription every month and they

take up to $50 off your cost - even if you only have an insurance

copay. The card lasts for a year, and they gave me a second year's

worth when my first card expired. Since my copay is $40 a month,

that means my Kadian is completely free! Can't beat that!

Cheryl in AZ

Moderator

[Guest guest]

,

I totally agree with going ahead with taking the medication.

I take 120mg of Avinza, which is an extended release of morphine,

everyday and it works wonderfully. Except, when my pain is getting

out of control. I suffer from RSD/CRPS so I truly know what pain is

and wondering if some doctor really knows what he is doing.

My pain specialist is truly a gifted man. I have stumped him all the

way. If I can get my pain specialist to help me get my orthopedist

that it is okay to go ahead and take care of my right knee by doing a

replacement, my world would be so much better.

My pain specialist sent me back to my orhtopedist (and I had him

give my ortho a call also) with my pain specialist saying that my

RSD/CRPS pain is under control, and therefore the terrible pain and

trouble in my knee are mechanical. That means that my orthopedist has

to fix it.

I went to my orthopedist two weeks ago (the day after I called his

office and told them that my pain specialist said that I needed to

get in). He was going to order another MRI to look inside my knee.

I had to remind him that I can't have an MRI because I just received

a spinal cord stimulator about six weeks before.

He decided since that wasn't an option, he is sending me to physical

therapy for a month. I don't know if that is going to be tolerated to complete.

I cry almost the entire time during therapy. It hurts so much that I

truly want to scream out in pain. So, instead, I cry and fight the

screaming. I hurt so badly today after therapy that I can hardly move.

I took my Avinza about four hours ago and it is helping me move

around again. The moral to my misery, please give the medication a chance. It

may be exactly what you have been needing.

Wishing you success,

Lori

--- wrote:

>Yet with this Kadian, it is also 30mg, but again the way I understand is, there

is 30mg TOTAL in the capsule that is released slowly throughout the 'extended

release period'; be it 12 hours or 24

(goes back to my first posted question though).

[Guest guest]

Hello all,

I am not feeling well at all so this will be a quick post. Mostly wanted to

thank every one for the hugely helpful info,tips & advice. I know my post was

hard to read in itself and then many of you wrote such long detailed responses.

I thank you from the bottom of my

heart!

A quick summary of the last week: I took the Kadian early in the morning, the

30mg pill. After 5 hours I was in so much pain

I couldn't take it any more & took a second one. The prescription was for 1 pill

a day for 1 week & then 2. So I figured it would hopefully be ok & to be honest

at that time it hurt so bad I didn't care much either way.

That entire day was absolutely terrible. Horrible pain & felt just not 'right'.

But I knew every one's advice on here that it needs to build up in your blood

stream & can take a few days to really work. So after barely making it through

the night I took another 1, and 1 more about 4 hours later. But still the pain

was unbearable.

and as said in my 1st post, my doctor was and is gone for at least another week.

Not good timing but I was hoping for a miracle I guess, like always.

After 2 full days and waking up on day 3, hurting just as much I couldn't

continue. I went back to the Norco & Soma. Which helped me after about an hour

at least get to where I was before all of the Kadian mess. That was a bit more

then 1 week ago & am just sticking

with the norc/soma until I can see my doctor, which isn't until the end of next

month.

I do not know if my dosage was just way way off, too low? or if it was a

reaction to morphine, or if it just doesn't work for my type of pain. I have no

idea at all at this point, but as before, I'm just very discouraged.

There is one more thing I wanted to ask but since my posts keep coming in

unformatted & very hard to read for whatever reason, I'm going to post this &

start a new one to make it easier to follow.

But thank you so much every one!! I can't begin to tell you all how much your

help & real world experiences have helped me & also very glad to hear that the

Kadian works so good for some of you,that's great!

[Guest guest]

This one is my big burning question that is driving me crazy & scaring me.

After trying Kadian, it just doesn't seem to me that my type of pain [caused by

Lupus & is muscular and some joint] is going to be relieved by ONLY the opiate

part. Like I wrote before, at least so far the medicines that have worked the

best for me have been Norco and Soma. The Soma, generic is 'carisoprodol', is a

muscle relaxer.

BUT and a huge but here is that my doctor doesn't seem to want to continue

prescribing it, and overall when looking online I have found many blog posts

from pharmacists & doctors & such that are for whatever reason, very 'against'

prescribing hydrocodone + soma together because it can be 'addicting' and/or can

be 'abused'.

My question though is, probably everyone on this board takes a medication that

is 'addictive' and can be 'abused'. That's any opiate & many others. The recent

thing with Kadian started because I asked my neurologist if I could increase the

Soma from 4 to 6 per day, which he a long while ago said was ok even, and I have

been taking now for a couple months until my appointment [again because I

thought it was ok, I just wanted a prescription for all 6 so I didn't run out

early].

Another big plus is that both those medicines are generic and cost a TON less

then Kadian or Oxycontin or the other brand ones. And as written about here, I

have tried them & haven't had much luck. But with the Norco/Soma together, they

DO help a lot. Without them, I am stuck basically in bed all day & still curling

up in pain. I've also gone through every other muscle relaxer that he knows of &

none work very well if at all, and the few that help somewhat are very sedating.

So I am really stressing about this, as I can't get an appt. with him until the

end of next month. It's these kinds of things that make me feel so guilty and

like a true 'street addict'. I'm posting this here because I was really really

hoping that someone might know if there is truly something 'wrong' with this

combo, or if there is some reason that I should not be taking it?

I have never pressed my doctor for any special requests & have always tried

every medicine he wanted to try. I've been switching through different

medications now for probably well over 3-4 plus years, trying to find the best

solution to my problem. But I feel now that there is some outside pressure with

this specific combo that could possibly be swaying his willingness to prescribe

what works. I feel so guilty that THIS combination does help relieve the pain

more than

others, as it looks like it is abused maybe more then some other medicines.

I just don't know if there is a real reason that he is trying so hard to take me

off of these 2 meds, or if it's more of a 'covering his own behind' thing. he

was the one that helped me find these 2 meds in the first place, and they work

wonders for me so far.

Once again I rambled on & on. sorry for being off topic also. I literally think

my mind is stressed beyond what it can handle at this point & could use any &

all suggestions regarding taking Norco [hydrocodone] & Soma [carisoprodol]

together. Heck in my mind, it surely seems like this should be less 'addicting'

or 'abuse able' then Oxycontin, Methadone or Fentanyl or the other things he

would prescribe much easier.

Thanks again every one, I don't know if this message is even readable, very

sorry for my typing & craziness.

[Guest guest]

Hello all,

I want to first say thank you all so much for the long and very helpful replies

that so many of you posted

for me. I know that takes a lot, lot, lot of time to do and I thank you

personally from the very bottom of

my heart.

I've said this before but wanted to say again that I know I don't know anyone

here on a personal level

very well. But I can't over state how much every one here, no matter if it's a

reply to my own endless and

confusing questions, or your own experiences, or replies to other member's

questions...this group is like

a second home to me. I feel so cheesy saying this but the endless and

unconditional support you all

provide to myself, and to each other is something that I've never been lucky

enough to experience.

Ok ok, I will end my cheesiness here. But things for me over the past few months

have been well,

horrible. I'm not asking for pity or any thing of that sort. I just say it

because when I come here, and

when my hands are able to type and my brain can sort out more then a sentence,

this group feels like a

family to me. I know, cheesy. Because I have never met any one of you in person.

But I'm betting that at

least some others here feel the same way, or maybe I am just weird. LOL

Any way I went to my neurologist finally, early appointment. And she did give me

a prescription for 6

Soma per day, but no refills I now notice on the bottle. Maybe she just wants to

watch it for the first

month or so. Also though, she is still definitely not very fond at all about

taking more than 4 soma,

generic name 'Carisoprodol' for those in other countries. I had to really put my

foot down and say how

much they really help versus every other thing I've tried so far; which is a

LOT.

But she wrote it and I got it filled for now at least. So at least I can catch

up on all of the stuff I couldn't

do for weeks now being out so early. I also still take the 6 Norco per day.

I posted before also about taking Kadian, and got so much great feedback. So

like I keep saying, thank

you all! However the 60mg of Kadian I took, I tried to hold out for nearly 3

days and was in absolute,

horrible, and the most painful pain I can remember. So either it was just too

low or not the right thing, I

don't know.

But my neuro also still wants to go and try it again. Except this time she says

to keep taking the Norco

and I believe even soma; as before with the Kadian, I had stopped all of those

on my pharmacists advice

and being that my doctor was on vacation.

So maybe it won't be so bad this time. Also a giant bonus this time, which she

should have given me

before and she thought she did, guess she messed up is, she prescribed an

anti-nausea medicine called

'Phenergan' 25mg.

I have never had any anti-nausea medicine before, so if anyone knows anything

about this medication

and could tell me if it is a good one or if there is a reason I might not want

to take it (This is for when I

try the Kadian again), any suggestions would be really appreciated.

Ok I will stop here, as I ran on and on once again. Hope every one is good.

Thank you again!

[Guest guest]

--- " S " wrote:

>she prescribed an anti-nausea medicine called

> 'Phenergan' 25mg.

> I have never had any anti-nausea medicine before, so if anyone

knows anything about this medication

> and could tell me if it is a good one or if there is a reason I

might not want to take it (This is for when I

> try the Kadian again),

Hi again -

If the Phenergan is only for using for a few days, right when you

start taking the Kadian, to get you through any initial nausea, then

it should be okay. However, you should NOT be on any anti-emitic

(anti-nausea) med continuously for any length of time.

If you don't get over the nausea from a new med within a couple of

weeks, then you probably shouldn't be taking that med. That side

effect should pass quickly, then you could stop taking the

Phenergan. If the nausea doesn't go away once you've been on the

Kadian for a while, then you need to try another opiate entirely.

Also, I remember you said that morphine didn't give you nausea, so

I'm not sure why you would need it now. But if it makes you feel

better to have it " just in case, " then fill the script but just don't

use it unless you actually experience nausea.

Be aware that anti-emitics are VERY strong medications, derived from

anti-psychotics. They are safe enough for short-term use, but they

should not be used long-term. I'm speaking from experience here. I

was put on another anti-nausea med long-term because of severe

gastroparesis, and it caused more problems than the original illness.

I now cannot take any anti-nausea meds ever again.

I don't want to scare you. My reaction was very rare. It could make

the difference for you getting through the first couple of weeks on

an opiate if you find nausea is a problem right at first, so it's

worth trying. Just be intelligent and use it only as needed and get

off it as soon as possible.

Cheryl in AZ

Moderator

[Guest guest]

" S "

I dont know if you have ever tried Emetrol, but it is an excellent over the

counter that ive always used and recommended and have had 100% success with. Its

the only one I even know of.

Healing, Hope, and Peace

Tim