Opiates, How much is too much?
Opiates, How much is too much?
I,m going to my doctor in a couple of weeks. He has me on Requip 1mg at night, Neurotin 600 mg 3x a day and Lortab 2x a day. We seem to have fixed the "restless" part of my leg symptoms, but the pain is there all the time. The Lortab is 7.5 and some days it takes 4 to make it. And then some days 3 will do. I think this pain is RLS related and left over from the Sinemet I was taking. I don't think I'm hooked on the Lortab. It just feels soooo good when I'm not hurting. I am going to ask my dr to up my dose. I'm just not real sure he's going to understand. I have been to a sleep clinic (hense the Sinemet) and had a nerve conduction study (I'm diabetic). The nerve conduction study did show slight nerve damage, but the pain symptons don't match up with that. Anybody out there know dosages for opiates?
There really is no set dosage, at least from my experience. I have been as high as 40mg a day, but early on I often broke that rule anyway. I can say the highest amount I've ever taken was when I was given 10mg pills and went up to around 100mg at one point. But I started speaking up and said I don't really like being able to have that much and have been back on 5/500 ever since, with a usual accepted limit of 4 (20mg) a day. I tend to go up in down in my use and my supply and preference dictate. All I can say is don't escalate your dosage unnecessarily (and I'm not saying you are). I almost never go through withdrawl no matter how many of the 5's I put anyway in a given period, but when I was taken off the 10's it was a pain in the ****. I got nasty pain that I had to take Ibuprofen for, and got the hot and cold flashes as well. So I vowed never to go through that again.
I should point out I do not take hydrocodone (lortab/vicodin etc) for pain related symptoms, but it has shown to be the most effective treatment period (I get 90 - 95% tolerable relief from codeine, but it gives me stomach cramps). I've been on the usual merry go round of meds too. Requip, Senimet (which I failed and suffered for horribly), tried straight sleeping meds but they stop working after a time. Now I'm trying to set up a routine with my Hydro and Oxazepam, and I took a voluntary qty cut as well.
That's been my experience. Literature has suggested up to as much as 40mg as an acceptable range. But if you're still having problems you may want to ask about either a trial of Oxycodone, or it's time released version Oxycontin.
I should point out I do not take hydrocodone (lortab/vicodin etc) for pain related symptoms, but it has shown to be the most effective treatment period (I get 90 - 95% tolerable relief from codeine, but it gives me stomach cramps). I've been on the usual merry go round of meds too. Requip, Senimet (which I failed and suffered for horribly), tried straight sleeping meds but they stop working after a time. Now I'm trying to set up a routine with my Hydro and Oxazepam, and I took a voluntary qty cut as well.
That's been my experience. Literature has suggested up to as much as 40mg as an acceptable range. But if you're still having problems you may want to ask about either a trial of Oxycodone, or it's time released version Oxycontin.
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ViewsAskew
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I think Dr B has suggeted dosages in him book on RLS. PRobably a great think to have when you go to the doc.
You might also get more mileage from a higher-potency opioid that lasts longer. That allows us to take it less frequently, which may help with any problems with addition or tolerance.
I just looked at the book. . .he says the "correct dose for opioid drugs is the lowest dose that relieves symptoms."
hydrocodone: 2.5 to 10 mg every 4-6 hours
He lists the potency for treating RLS as medium.
Opioids with a "high" potency for treating RLS include:
fentanyl, hydromorphone, levorphanol, methadone, morhpine, morphine controlled release, oxycodone, and oxycodone sustained release.
You might also get more mileage from a higher-potency opioid that lasts longer. That allows us to take it less frequently, which may help with any problems with addition or tolerance.
I just looked at the book. . .he says the "correct dose for opioid drugs is the lowest dose that relieves symptoms."
hydrocodone: 2.5 to 10 mg every 4-6 hours
He lists the potency for treating RLS as medium.
Opioids with a "high" potency for treating RLS include:
fentanyl, hydromorphone, levorphanol, methadone, morhpine, morphine controlled release, oxycodone, and oxycodone sustained release.
Ann - Take what you need, leave the rest
Managing Your RLS
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.
Managing Your RLS
Opinions presented by Discussion Board Moderators are personal in nature and do not, in any way, represent the opinion of the RLS Foundation, and are not medical advice.