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differences between oxymorphone and hydromorphone?

On Health & Drugs & Medications » Pain Diseases

8,384 words with 7 Comments; publish: Tue, 18 Dec 2007 01:47:00 GMT; (90046.88, « »)

while i know that hydromorphone is the actual ingredient in dilaudid,i am curious about what the actual differences between the oxy M and hydro M are?does anyone know?shore??i am thinking of changing my oxycontin to something new since my c spine issues have become BIG issues over the past few months.i am wondering about what may be more effective for me.i know that new med Opana is oxymorphone,soooo as you can tell,i am just wondering about what IS the difference between the two meds.any help would be more than appreciated.i am pretty much maxed out on the oxycontin and am sure my pain clinic would not want to up my current dose,and quite frankly,i wouldn't want to actually go there either.i am currently at 80-80-40 of the OC.i usually sleep well at night with that lower dose only because i have to take my 5mg valium when i sleep to help keep the energy buliding in my legs from the constant motor signals that just never seem to stop.but i do not want to go past the 80mg dose anyway.i was offered one increase to the 100 during my midday dose before my knee surgery only because this was my worst pain time,but turned it down cuz it really just seemed like way too much,so we temporarily added it to my night dose and once things were better after the knee surgery lowered at least some of my pain,i dropped that added 20mgs and went back down to only the 40 again.

my c spine is litterally falling apart right now and will be going for a new (number 17)MRI just to see whats going on in there now.i think i may have had another bleed from the remaining part of the cavernoma inside my cord as my symptoms of the old ones are back again.scarey.i just need to find better pain control,mostly for the c spine crap as that has always respnded the best to narcotics.this is the area where i know when my OC has kicked in in the morning as the level there starts to become much less intense and more tolerable.i am glad it responds to something,unlike my neuro crap.any help would be much appreciated with regard to the two "morphs'.thanks for listening to the ramblings.Marcia

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    • I can tell you that by looking at my chart that hydromorphone is 5 times stronger than morphine and Oxymorphone is 7 times stronger than morphine.Whatever you switch to it should be a long acting as short acting opiates aren't much good for chronic pain and you end up taking to much tylenol.Good luck...Dave:)
      #1; Tue, 18 Dec 2007 09:00:00 GMT
    • Hey Guys, Those conversion charts were made when there wasn't a oral version of oxymorphone on the market, so you half to acount for decreased potency due to delivery route. Numorphan "oxymorphone" was available as an injectable or supository, The latter makes the med about 6 times more potent than an equal dose of oral and IV makes it 10 times stronger.

      Oxymorphione and hydromorphione are in the same synthetic family that oxycodone, hydrocodne and hydromorphone/ Dilaudid fall into. They don't make a hydromorph or oxymorph product with any tylenol and the new opana prescribing instructions has it listed twice as strong as OxyContin or 3 times stronger than MSContin. Which still leaves hydromorph stronger per mg when taken orallly but Oxymorphone stronger when used IV. This is why it took so long to get an oral version on the market. Poor bioavailability of oxymorphone when consumed orally.

      Oxymorphone is less effective orally with only 10% bioavailablity when delivered orally. So the oral conversion is very different than the IV conversion. IV oxymorphone is 10 times stronger than IV morphine mg to mg. However , orally it's only 3 times stronger than oral morphine due to poor bioavailabilty, acording to the full prescribing instructions. Basically it's not as effective orally as IV so you can't use the 10:1 guide That's used when converting IV meds from one to another. OxyMorphone looses much of it's potency when taken orally.

      The manufacturer reccomends a 3:1 conversion from oral morphine to Opana "oral oxymorphone"

      Also, it's just as dangerous to mix Opana with alcohol as it was to mix the long acting dilaudid with alcohol, Concurent use of alcohol can result in a 270% higher serum level of oxymorphone. Don't drink with this stuff or it won't be on the market long either.

      Good luck, Dave :wave:

      #2; Tue, 18 Dec 2007 09:00:00 GMT
    • Thanks for clearing that up Dave(Shoreline)....Dave:)
      #3; Tue, 18 Dec 2007 09:01:00 GMT
    • thanks for the very important info guys,i knew i could count on you.i don't drink alcohol at ll anymore so that wouldn't be a problem.i know tho even when palladone was on the market,it was said that even as little as the amount of alcohol in cold meds like nyquil could cause a persons death.now thats just plain scarey.i wonder if this would hold true for opana as well?

      i just really really need a new plan here.thanks again,Marcia

      #4; Tue, 18 Dec 2007 09:03:00 GMT
    • Hey Marcia, I would thuink it's worth a try, Although they are both in thehe keto synthetic family, there are some slight differences in the way every med works. Although there may be a precise conversion as far as pain relief from one drug in the family, like Hydrocodone to oxycodone, there are other factors aside from anelgesia, On parer the conversion from oxy to Opana may be 40-40-20, Opana being twice as stron as Oxy, it may work much more effectively. Oxycodone and hydromorphone are in the same family and I definitely oprefer oxy to hydromorph, It has a longer half life which means longer duration and causes me to feel less spacey when I use it for BT. That's comparing short acting versions. Opana is suposed to be a true 12 hour med with a different release technology.

      The full prescribing info is now available on line but IT's truly one of those have to try to know for sure. The doc may not be comfortable starting at 40 mgs per dose so youhave to pretty much expect a little titration. I've tried so many I try not to stress, because you know there is light at the end of tunnel. I would love to hear what you think of it if you get achance to try.

      As far as mgs of OxyC or any drug, That's reallly just a number. It's all about function and lthe least amount of impairment. Impairment can mean many different thuings, If it impairs your motivation to keep doing what your doing, or make needed changes that's a hefty price for extra pain relief.

      Have you tried nemanda yet? We are fighting with the insurance company again about my wifes Botox so my wife filled her Nemada last week and it's made a diference. She had stopped using it after the last 2 consecutive Botox injections and occiptial blocks over 6 months for her C-spine and head aches. She does swear by it, and if it works the way it's supposed to on alzheimers patients, It might even help with memory. Between the Nemanda and the botox, she was able to decrease her dose drom 75mgs of MSC 3 times a day to 30 mgs 3 times a day. It does work for some people.

      She also started exercisng and dieting too back on Valentines day and she's lost 30 lbs and feels better than ever. As absurd as excercise sounds when you hurt, If your going to hurt anyway, why not reap the benefit.

      Hang in there, Dave

      #5; Tue, 18 Dec 2007 09:04:00 GMT
    • I'm on 40mg twice a day of Opana ER and 4 times as needed daily of 5mg Opana IR. It was a rough 4 days of change from MSContin and MSIR. After that it hasn't been so bad. I still have stomach cramps, but nothing else. It's a good drug if you ask me. I have had relief most every time I needed it.

      There is no Eurphoric rush that so many people seem to get addicted to when taking narcotics. Which I like. I was on 330 oxycontin at one point in my life and that stuff will give you an addictive feeling and I haq a really hard time getting off that ****.

      Anyway, for you guys out there whop want to try Opana. Give it some time to work...a week. It might work for you it might not, but at least it's another option for those of us who have tried everything and rotation is all we have left (if your not a fan of continuing to up your dose every couple of months).


      #6; Tue, 18 Dec 2007 09:04:00 GMT
    • I was also on at one time 330mg's of OxyContin a day. I am currently taking

      one haundred and twenty milligrams of opana i also take eight milligram dilaudid for break through pain i find them both pretty much equal

      #7; Tue, 18 Dec 2007 09:06:00 GMT