Monday, October 20, 2014

Friday, March 06, 2009 Patricia, Community Member, asks

Q: Is there any extended release medication that I can take for my severe, chronic spinal pain?

I have had severe, chronic spinal/leg pain since 2004. I've had L4-L5-S1 fused and a Stimulator implanted which works similarly to a Tens unit. Even still, I've been on Hydrocodone APAP 10-325 varying from 2-5 pills a day. The last three days I've taken Oxycodone 20 mg ER tablets and have not felt any relief. I added a Vicodin tablet to my 3rd tablet for breakthru pain, and only felt relief for about an hour. Relief meaning the pain was tolerable. I get very itchy when taking morphine and most codeine combinations and up to this point, Vicodin has been my only option. Gabapentin did not seem to work at all either. Is there ANYTHING out there that I can take for pain with extended release or am I needing to look at surgery which has not been very successful in my opinion. I have degenerative spondylosis (genetic) and my thoracic spine as well as my neck is very painful as well. Life stinks for me and I'm only 55 years old.

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Answers (8)
Karen Lee Richards, Health Guide
3/10/09 1:52am

I'm sorry to hear you're having so much pain.  The oxycodone you said you are taking is extended release.  You might talk with your doctor about increasing the dosage if it's not helping.  There are also extended-release versions of other opioids, such as morphine and oxymorphone that you could ask about.  Then there's the fentanyl patch that is worn for several days and releases the opioid medication steadily over that period of time.  So there are several possible options.  Ultimately your doctor will have to decide which option would be best for you.  Good luck to you.

chippi, Community Member
4/14/09 4:25pm

Hi Patricia, I'm sorry to hear your in so much pain for so long. I've recently had back surgery for a ruptured disc that produced lower back pain and debilitating leg pain and numbness. I thought I would lose my mind some days from the pain, believe me I know how depressing and discouraging it can be. Thank goodness the surgery was a success and the pain is gone. I felt as though life really stinks too living with that pain 24/7 for only a couple months, I can't imagine enduring it as long a you have. My heart goes out to you, I know how difficult it is and how much it strips all the enjoyment out of life. Karen gave a good reply. Just keep in contact with your doctor and keep talking until he/she finds what works for you. Good luck 

Nan from the Dunes, Community Member
8/ 8/09 12:28am

I too have a stimulator.  Five months after the stimulator implant doc did pump trial, and it helped.  This along with10/325 make 5-6 hours a day tollerable.  Try discussing a trial for a pump.  It is also advantageous to the life of your liver without the amount of stuff being pumped thru it daily.  I was 49 when I had these wonderful devices placed in me, Thank God for good pain docs.

Spooky, Community Member
10/25/09 1:22am

I have used hydrocodone APAP (that's vicoden, BTW) and oxycodone 20mgER (that's Oxycontin).  Neither came close to the releif I get from Fentanyl transdermal system.  They can add fentanyl absorbed through the oral mucosa for breakthrough--that works blazingly fast but doesn't last long.  Amazing pain relief, in seconds, but it doesn't last long. Many people don't need breakthrough meds to last long, especially if they're on the correct dose of 24/7 med.  I don't need it to work that fast but need it to work a little longer, so I use oxycodone 10mg (NOT ER!) for breakthrough.  Even for breakthrough, most pharmacists will tell you, hydrocodone just isn't a very good med. 


Ask your pain doc about fentanyl, especially the patch for long-term pain relief but buccal or lollys for breakthrough as well.  Fentanyl is 80X more potent than morphine (Hydrocodone is about 1/3 to 1/2 as potent as morphine) so it's certainly a good chance it may help.  It has saved my quality of life.

marksmith107, Community Member
11/11/09 6:37pm
Hi,My PM dr started me on the fentanyl a few months back,I have had 3 failed cerical fusions and have been taking hydrocodone 10/500 for some time and it really got to where it was doing no good.The fentanyl has really made my pain so much more bearable.I change my patch every 48 hrs.I'm new here and its nice to be here with people that understand chronic pain.Thanks Reply
dana2bs, Community Member
12/ 7/09 5:35pm

I used to use the patch but because of the amount of sweating, it would be absorbed too quickly. I also changed it every other day rather than every 3rd day as usually directed. I am now taking OPANA ER 20mg am. and pm.. It seems to be working more consistantly than the patch and I seem to be more clear headed. I too have my Narco-hydrocodone 10-325 for break through and muscle relaxers as well. I was frustrated because of the cost of the patches because once you are on Medicare and hit the "black hold" or as they put it the dounut hole, the patch is extremly expensive. Opana is as well but a couple hundred dollars less a month. Good luck and I hope you find some relief!

loni52, Community Member
6/ 1/10 12:33pm

Hi, I am loni52, I too am on opana 30 mg twice a pain management doctor put me on a 5 mg quick release dose of opana for my break thru pain. As for the donut hold in medicare I have joined AARP as my supplement for the part b and part d coverage that medicare does not cover. My monthy payment to AARP allows me to be covered 100% for anything and everything that medicare does not cover. If you would like, you may contact me at I am NOT a person promoting this insurance company. Just a lady who has lived in chronic pain for over 34 years.....and have checked out every supplemental coverage to medicare.

God Luck...Loni52

GJ, Community Member
1/21/10 6:41am

I am sorry to hear about your condition. There are many ER meds out there such as MS Contin/Kadian/Avinza all morphine, then theres the Duragesic fentanyl patches that contain enough medicine to last every 72 hours, there is Opana ER which oxymorphone, a metabolite of oxycodone which is much stronger by nature but has a low bioavaibility so dosing will have to be titrated carefully. I personally am on 30mg x 4 a day with two breakthrough medications 5 times a day but I have been on everything possible prescribeable for the past 10 years so my tolerance is through the roof. Another reason you might have not felt anything from the OC 20mg is because even though it is stronger than the Hydrocodone its an extended release vs an immediate release. Goodluck, just talk to your doctor and hopefully things will work out. I have learned the only way to survive is one day at a time.

john, Community Member
1/10/11 12:12pm

I have severe de-gen osteo along with rheum. my joints back, knee, hip, are finally shot. Worked constr. for 11 yrs. after diag. had bills, kids, you know deal.Does an extended release (generic) exist that my coverage won't killme on or is it just oxycontin for er

Christinesmcr, Community Member
10/29/11 6:37am

I am on the Duragisic Fentanyl Patches (100 micro-grams every 3 days) and it has changed my life! I do still have to take oral pain meds for breakthrough pain but the patch is the only thing that has allowed me to live a somewhat 'normal' life while having to deal with all of my severe neck problems & surgeries!

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By Patricia, Community Member— Last Modified: 11/15/12, First Published: 03/06/09