Does anyone use Oxycodone for RLS?
Does anyone use Oxycodone for RLS?
It's been years since I've been online; in fact, I had to re-register. I hope some of you old timers are still around. I still have severe RLS. I live in Oakland, CA, am 49 years old, am a high school teacher, and have tried everything. Problem: Requip makes me feel horrible; I've lessened the dose by augmenting it with percocet. That works wonders since I have other pain issues, but it's hard to keep getting. Does anyone else use this, and what are your experiences? Best health wishes to all RLS sufferers out there.
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ViewsAskew
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Sorry you had to re-register, Oaklander. I hope it wasn't an error on our end.
Lots of people use opioids for RLS. Percocet is an option, but few of us find it effective enough (and there are other issues with it. Most of us who use opioids try for the ones that have few, if any, additives - aspirin or other pain relievers - as those are hard on the liver.
Throughout this section - the pharma one - you'll probably find hundreds of posts affirming what you know: opioids work. Ahd, you'll also find hundreds of posts affirming what else you know: doctors are skeptical and it's hard to convince them.
Lots of people use opioids for RLS. Percocet is an option, but few of us find it effective enough (and there are other issues with it. Most of us who use opioids try for the ones that have few, if any, additives - aspirin or other pain relievers - as those are hard on the liver.
Throughout this section - the pharma one - you'll probably find hundreds of posts affirming what you know: opioids work. Ahd, you'll also find hundreds of posts affirming what else you know: doctors are skeptical and it's hard to convince them.
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.
Hi,
As has been mentioned, many of us use opiates for our RLS. Typically among this site, we will have already tried medications like Requip and Mirapex at some point, unsuccessfully, and made the jump to opiates as per the Mayo Clinic Algorithm for diagnosing and treating RLS.
The opiate in Percocet is Oxycodone, which works for some people but not for others. Oxycodone can be prescribed by itself without additives, usually in 5mg pills. There is also a time released version called Oxycontin, which is the same, only it releases the medication I believe, over a 12 hour period.
I usually don't reccomend it to people because it can be extremely addictive, and even more so than the manufacturer admitted when they brought it to the market.
People are really all over the scale in terms of what they take. Tylenol #3 w/codeine, Vicodin (hydrocodone), Oxycodone/Contin, Morphine, and a few of us here are taking Methadone. I am one of them, and am also a recovering addict, but I think its a great medication in my case.
You'll probably find a lot of doctors recoil in fear when asked for opiates to treat even the most severe cases of RLS, because most are ignorant of the condition and scared of the FDA; its unfortunate. I definitely wouldn't tell someone the first time you see them, that you are routinely substituting Percocet for some of your medication or you will most likely be written off as a drug seeker almost immediately, and maybe even threatened to have the cops called on you.. (I think we had one person here for a short while who was actually arrested for "drug seeking").
If you do see a doctor, I'd just casually drop the bomb as something like you had some leftover painkillers from a root canal (or if you have had teeth pulled recently, use that) and indicate that you thought it helped a lot better than your current medication.
Anyway this is all just general talking, I'm not trying to give you advice on obtaining painkillers or telling you what to do, etc. Most of us just know how difficult it is to find a doctor who believes us and will prescribe the meds we need.
As has been mentioned, many of us use opiates for our RLS. Typically among this site, we will have already tried medications like Requip and Mirapex at some point, unsuccessfully, and made the jump to opiates as per the Mayo Clinic Algorithm for diagnosing and treating RLS.
The opiate in Percocet is Oxycodone, which works for some people but not for others. Oxycodone can be prescribed by itself without additives, usually in 5mg pills. There is also a time released version called Oxycontin, which is the same, only it releases the medication I believe, over a 12 hour period.
I usually don't reccomend it to people because it can be extremely addictive, and even more so than the manufacturer admitted when they brought it to the market.
People are really all over the scale in terms of what they take. Tylenol #3 w/codeine, Vicodin (hydrocodone), Oxycodone/Contin, Morphine, and a few of us here are taking Methadone. I am one of them, and am also a recovering addict, but I think its a great medication in my case.
You'll probably find a lot of doctors recoil in fear when asked for opiates to treat even the most severe cases of RLS, because most are ignorant of the condition and scared of the FDA; its unfortunate. I definitely wouldn't tell someone the first time you see them, that you are routinely substituting Percocet for some of your medication or you will most likely be written off as a drug seeker almost immediately, and maybe even threatened to have the cops called on you.. (I think we had one person here for a short while who was actually arrested for "drug seeking").
If you do see a doctor, I'd just casually drop the bomb as something like you had some leftover painkillers from a root canal (or if you have had teeth pulled recently, use that) and indicate that you thought it helped a lot better than your current medication.
Anyway this is all just general talking, I'm not trying to give you advice on obtaining painkillers or telling you what to do, etc. Most of us just know how difficult it is to find a doctor who believes us and will prescribe the meds we need.
More Q's, re: Percocet
Thanks ViewsAskew & Zach. Thank you both so much for your insight into the percocet deal. I've been on it for months now, doctor prescribed, for reactive arthritis (brought on by God-knows-what) that I have inexplicably, and have found that percocet works wonders for RLS, and my case is severe. The biggest bummer for me, about percocet, is that every single Rx I get through my doctor (and she's the best doctor in the world; absolutely the most understanding, giving, helping, etc.) is a "0" refill, so I go through this endlessly, asking for me. I am made to feel like an addict. It has started me wondering, "am I a drug addict?" when, in fact, percocet is the only thing that has helped me. Requip's side effects are horrible for me. Percocet doesn't have any.
I do have another Q about percocet/oxycodone for anyone reading.... Zach, you touched on this: Is oxycodone better than percocet because of the liver danger thing? Since I use percocet for arthritis as well, I wonder what would work.
My doc is with Kaiser in California, and just last month they put in new regulations making it harder to get percocet.
Do people finally resort to buying it online from Canada? Do they go to jail for that? Is it worth the risk?
I do have another Q about percocet/oxycodone for anyone reading.... Zach, you touched on this: Is oxycodone better than percocet because of the liver danger thing? Since I use percocet for arthritis as well, I wonder what would work.
My doc is with Kaiser in California, and just last month they put in new regulations making it harder to get percocet.
Do people finally resort to buying it online from Canada? Do they go to jail for that? Is it worth the risk?
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ViewsAskew
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Oaklander, any opioid without aspirin or acetaminophen is definitely "better" in this case - you are completely right. Your liver doesn't need that stuff and it's not helping the RLS in any way. I'll quote from then RLS book by Hening, et. al. "Although these additives help reduce pain, they have no therapeutic effect on RLS. Therefor, the can only cause adverse effects without adding any positive benefits and should be avoided when possible. If possible, opioid analgesics should be chosen in their pure form without any unhelpful (for RLS) additives)"
The Mayo Clinic Algorithm for treating RLS clearly states that opioids work and should NOT be withheld for RLS patients IF the other classes either do not work or cause side effects that can't be dealt with.
Edited to say: propoxyphene is considered a 'low' potency opioid, but it still Schedule II (which limits refills - there is a new law allowing physicians some latitude, but state law may take precedent). Other low potency ones are codeine and pentazocine. Next up are medium, such as hydrocodone, tramadol, and extended release tramadol. High are things like oxycodonem oxymorphone, hydromorphone.
I think, if it were me, I'd ask about the tramadol. It works well for many with RLS, but hasn't the addiction risk as other opioids (it's not quite considered one), but like all drugs, has some potential problems. Zach will share his experience. But, if you don't take something else (like Zach does) that might interfere and cause problems with the tramadol, it's a good option. And, the docs are more comfortable with it (often).
The Mayo Clinic Algorithm for treating RLS clearly states that opioids work and should NOT be withheld for RLS patients IF the other classes either do not work or cause side effects that can't be dealt with.
Edited to say: propoxyphene is considered a 'low' potency opioid, but it still Schedule II (which limits refills - there is a new law allowing physicians some latitude, but state law may take precedent). Other low potency ones are codeine and pentazocine. Next up are medium, such as hydrocodone, tramadol, and extended release tramadol. High are things like oxycodonem oxymorphone, hydromorphone.
I think, if it were me, I'd ask about the tramadol. It works well for many with RLS, but hasn't the addiction risk as other opioids (it's not quite considered one), but like all drugs, has some potential problems. Zach will share his experience. But, if you don't take something else (like Zach does) that might interfere and cause problems with the tramadol, it's a good option. And, the docs are more comfortable with it (often).
Last edited by ViewsAskew on Sun Nov 16, 2008 6:52 pm, edited 1 time in total.
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.
Ann, Percocet is not propoxyphene. Percocet is a brand name for the Oxycodone/Acetaminophen combination. So, no.. Percocet is VERY potent and we all know I've had plenty of experience with that :p
I don't have a link, but the first thing you should do is get yourself a copy of the Mayo algorithm, print it out and show it to your doctor. MAKE them go over it with you and at least acknowledge that they are reading the same thing you've been saying.
As I said before, I really can't reccomend Oxycodone, unless nothing else is gonna work or you can't get anything else except for that. But that is my personal perspective. Personally I can say Oxycodone doesn't put much of a mental dent in me, I could load up on the stuff but it just isn't the same.
I think every individual has a certain natural affinity to certain types and subtypes of medications. For example, nothing I have taken thus far in my life can compare with the sheer joyful experience of taking Hydrocodone. Other meds, and even the methadone have one of or a couple of the same effects to a lesser degree, but for whatever reason something in Hydrocodone totally breaks my will for self control just from even THINKING about the stuff and the good times I used to have.
Oxycodone does that to some people, cocaine does it to others, etc etc. We're all different.
If you can get tramadol it is a great place to start. It is non-schedules and regarded as a non-narcotic psuedo opiate, with opiate-like effects; it does bind to some opiod receptors. But all you need to receive it by the truckload is a prescription from your doctor.
It can cause seizures however. If you are taking most anti-depressants and some other meds I don't have a list for, basically anything that can potentially block its metabolism in the liver because it makes your liver busy processing the other drug. Tramadol will build up and you'll likely have a seizure before you actually O.D (if that's even possible on tramadol).
I had a seizure, about two years ago. I was on Fluvoxamine (Luvox) at the time, and I made an informed decision to take the risk. Also any medication that can lower your seizure threshold obviously doesn't play well. Although I had no memory of the event, I had the bruising and injury to my back and shoulder muscles to remind me. I finally recovered from those after about two months. I still have problems reaching one of my arms behind my back, because it will start to hurt.
Its a pretty decent medication all in all, and if you don't fall into any of the risk categories, a perfectly acceptable solution.
I don't have a link, but the first thing you should do is get yourself a copy of the Mayo algorithm, print it out and show it to your doctor. MAKE them go over it with you and at least acknowledge that they are reading the same thing you've been saying.
As I said before, I really can't reccomend Oxycodone, unless nothing else is gonna work or you can't get anything else except for that. But that is my personal perspective. Personally I can say Oxycodone doesn't put much of a mental dent in me, I could load up on the stuff but it just isn't the same.
I think every individual has a certain natural affinity to certain types and subtypes of medications. For example, nothing I have taken thus far in my life can compare with the sheer joyful experience of taking Hydrocodone. Other meds, and even the methadone have one of or a couple of the same effects to a lesser degree, but for whatever reason something in Hydrocodone totally breaks my will for self control just from even THINKING about the stuff and the good times I used to have.
Oxycodone does that to some people, cocaine does it to others, etc etc. We're all different.
If you can get tramadol it is a great place to start. It is non-schedules and regarded as a non-narcotic psuedo opiate, with opiate-like effects; it does bind to some opiod receptors. But all you need to receive it by the truckload is a prescription from your doctor.
It can cause seizures however. If you are taking most anti-depressants and some other meds I don't have a list for, basically anything that can potentially block its metabolism in the liver because it makes your liver busy processing the other drug. Tramadol will build up and you'll likely have a seizure before you actually O.D (if that's even possible on tramadol).
I had a seizure, about two years ago. I was on Fluvoxamine (Luvox) at the time, and I made an informed decision to take the risk. Also any medication that can lower your seizure threshold obviously doesn't play well. Although I had no memory of the event, I had the bruising and injury to my back and shoulder muscles to remind me. I finally recovered from those after about two months. I still have problems reaching one of my arms behind my back, because it will start to hurt.
Its a pretty decent medication all in all, and if you don't fall into any of the risk categories, a perfectly acceptable solution.
You two are great; thank you so much
Thank you both for this amazing information (ViewsAskew and Zach). I do have a copy of the Mayo Clinic algorithm, and just printed out your two replies. You're helping me tremendously. I'm on my way to the hospital minor injury clinic in hopes of a refill; otherwise today will be brutal in the extreme. Will write again if I have more questions. Til then, thank you both.
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ViewsAskew
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Thanks for catching Zach - guess that's my cue not to write when I've had no sleep. The post is edited for accuracy.
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.
Oak-- if taking percocet helps your symptoms and you are already taking it for something else (pain)-- my recommendation would be to continue taking it. It sounds like you're killing 2 birds with one stone-- which is nice on the pocketbook and less pills to take. Taking the oxycodone without the tylenol is better in the long run--- but when taking oxycodone for arthritic pain, I have found that many patients respond better to the combination product (percocet). So you'll have to do a trial and error to see how that works for you.
Regarding the refill issue you mentioned... this is a federal law and not by your doctor's choice. Oxycodone is a "schedule II" narcotic and therefore cannot have refills--- ever. I have a system where I email my doctor for another prescription and his nurse brings it to the pharmacy across the hall from his office and the pharmacy automatically mails it to me. I encourage you to chat with your doctor and his/her nurse to find a way for you to get your drug with the least amount of hassle. I have found that the nurse is the best resource for getting this done!
Regarding the refill issue you mentioned... this is a federal law and not by your doctor's choice. Oxycodone is a "schedule II" narcotic and therefore cannot have refills--- ever. I have a system where I email my doctor for another prescription and his nurse brings it to the pharmacy across the hall from his office and the pharmacy automatically mails it to me. I encourage you to chat with your doctor and his/her nurse to find a way for you to get your drug with the least amount of hassle. I have found that the nurse is the best resource for getting this done!
Josh
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ViewsAskew
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Josh, this may or may not be related...there was a ruling last year regarding Schedule II, but I can't remember if it was just methadone...it may have been. My pharmacist and doctor didn't even know it (I read it here). It's sort of convoluted, but it allowed me to get three months at a time. My pharmacist called the Illinois office of whoever is in charge of pharmacies and they didn't know about it! It took about a week for everyone to research the ruling and agree it was safe to follow.
Now, if I can just find it somewhere...
Now, if I can just find it somewhere...
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.
Hi Ann! I think while federal law may change to be more lenient-- state boards of pharmacy are allowed leeway to be more strict with federal rulings. For example-- while the federal law states you need 5 separate items to be on a prescription label-- here in MN, the state board of pharmacy has increased this to 7 items. So I think state boards of pharmacy can actually favor a more stringent interpretation of the law. Statute 152.11 here in MN disallows any refill of a schedule II narcotic- and this has not changed despite the federal Controlled Substances Act change.
I found this on Wikipedia which nicely summarizes the federal changes:
Schedule II narotics--These drugs are only available by prescription, and distribution is carefully controlled and monitored by the DEA. Oral prescriptions are allowed, except that the prescription is limited to 30 days worth of doses, although exceptions are made for cancer patients, burn victims, etc. and oral prescriptions for schedule II drugs must be confirmed in writing within 3 days. No refills are allowed. The Drug Enforcement Administration (DEA) is finalizing a Notice of Proposed Rulemaking published on September 6, 2006 (71 FR 52724). In that document, DEA proposed to amend its regulations to allow practitioners to provide individual patients with multiple prescriptions, to be filled sequentially, for the same schedule II controlled substance, with such multiple prescriptions having the combined effect of allowing a patient to receive over time up to a 90- day supply of that controlled substance. This went in to effect December 19, 2007
I found this on Wikipedia which nicely summarizes the federal changes:
Schedule II narotics--These drugs are only available by prescription, and distribution is carefully controlled and monitored by the DEA. Oral prescriptions are allowed, except that the prescription is limited to 30 days worth of doses, although exceptions are made for cancer patients, burn victims, etc. and oral prescriptions for schedule II drugs must be confirmed in writing within 3 days. No refills are allowed. The Drug Enforcement Administration (DEA) is finalizing a Notice of Proposed Rulemaking published on September 6, 2006 (71 FR 52724). In that document, DEA proposed to amend its regulations to allow practitioners to provide individual patients with multiple prescriptions, to be filled sequentially, for the same schedule II controlled substance, with such multiple prescriptions having the combined effect of allowing a patient to receive over time up to a 90- day supply of that controlled substance. This went in to effect December 19, 2007
Josh
My doctor and I have done this. He provided me with two prescriptions my last visit, and I filled the other one earlier this month after my previous one ran out. He seems to be on the ball about the ruling, as we've talked about it from time to time.
Wonder where Oak is... hope he got what he needed, or didn't get locked up or some weird stuff...lol
ok that's mean.. Hope everything worked out for him though
Wonder where Oak is... hope he got what he needed, or didn't get locked up or some weird stuff...lol
ok that's mean.. Hope everything worked out for him though
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eastbayrls
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Oaklander,
I too am in the East Bay and go to Kaiser.
I tried mirapex and all that other garbage and it didnt work.
He had me try Vicodin and it worked out great for me. However, he was worried about my liver, so he has me on Codine now.
It seems to work fine, but I sometimes I need to take more then I would like to feel better.
I go to the neurologist in Union City and he is very good. Plus he's an A's fan!!!
I too am in the East Bay and go to Kaiser.
I tried mirapex and all that other garbage and it didnt work.
He had me try Vicodin and it worked out great for me. However, he was worried about my liver, so he has me on Codine now.
It seems to work fine, but I sometimes I need to take more then I would like to feel better.
I go to the neurologist in Union City and he is very good. Plus he's an A's fan!!!