My experience with the new crush resistant Opana ER

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Inreksalsa
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Hello fellow Pharmers, i am a CP patient with a history of back problems, in addition to neck and shoulder pain. After many years of being on 10/325 hydrocodone 8x daily, sometimes accompanied with darvocet 2x daily-discontinued due to ineffectiveness), along with muscle relaxers, primarily zanaflex and flexeril, I asked my doctor to switch me to an extended relief medication, primarily due to concern for my liver and consistent difficulty adequately managing my pain.

I am lucky to have an excellent doctor who actually takes the time to listen to me when I describe my pain issues and level of success in adequately managing my pain so that I may live a life that does not revolve around constantly focusing on my pain. In July 2011, he switched my meds to 2 10mg Opana ER, with 4 10/325 hydrocodone for BT pain, and 5mg Valium daily as needed for muscle spasms. This helped manage my pain better, although I found the Opana ER definitely did not provide adequate pain relief for 12 hours as indicated. But with the hydrocodone, I was still managing better pain management than with the hydrocodone alone (which provided pain relief for only 2-3 hours).

However, when the newly formulated Opana ER came out, I once again found myself in a situation where my pain management was inadequate, and that dreadful cycle of watching the clock for when I could take more pain meds. I told my doctor the situation I was facing in April 2012, and he increased the Opana ER to 20mg 2x daily, leaving the 10/325mg hydrocodone and 5 mg Valium where they were. I honestly thought this was adequately bring my pain levels back to a manageable level. To my surprise, while there was some improvement, I was still in more pain than I was from when I was taking the pre-reformulated 10mg Opana ER.

My next appointment was with his assistant (who cannot change medication levels) and she mentioned that the reps from Endo had informed the office that with the new Opana ER formulation, quicker onset of pain relief would be attained by drinking a full glass of water with the dose. In fact, this did help the onset time frame of pain relief; however, overall my pain relief was still inadequate IMHO.

I made an appointment with my doctor this month to address
my concerns (after going through two months of being in pretty bad pain most of the time). I asked if it would be possible to increase the Opana ER to 30mg and the Valium to 10mg (half pill in the am, half in the pm) or to try a different ER med. Exalgo was the only other long acting med he mentioned that may be an alternative.

In the end, he decided to try the 30mg Opana ER and 10mg Valium. Thankfully, within two days, my pain levels are back down to a decent level, and I'm able to go about my life without pain being constantly what im focusing on.

I guess the purpose of my post is that for anyone taking Opana ER, and dealing with the seemingly less effective reformulated version, for me, to achieve the relief I used to receive taking 10mg Opana ER, now requires 30mg of the new "improved" Opana ER. If you previously were able to attain adequate pain relief with Opana ER, then found yourself in a world of hurt with the new crush resistant version, my experience is you can still receive adequate relief with the new Opana ER, it just may take a higher dosage to receive the level of pain relief you were getting with the original formulation.

Best of luck to all suffering, and as a community, let's all resolve to do our part to keep the government out of the health care decisions between doctors and patients.

BrokenDownNurse
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Hi Inreksalsa

Welcome to Pharmer! I'm pretty new here too. I also had problems with the new Opana ER. I believe that in their rush to provide abuse resistant pills they simply didn't do enough testing before releasing this new formulation. I was on Opana ER 10mg bid like you and it was working fine. The new formulation was like taking nothing. I am NOT a pill chewer, as I'm a nurse and I know how easy it is to overdose. My husband saw the new formulation and said it looked and felt like plastic, which it kind of does. That's one medication that used to be effective for pain relief and has now failed, IMHO. When I complained to my PM PA that the Opana ER isn't working anymore she changed me to Nucynta ER 50mg bid. I'm very unhappy with it. I'm reluctant to increase the dose due to the horrible side effects I've read about. I am so happy that your doctor was willing to experiment with you to find a new combination that works. My PM PA is too conservative in attempting to manage my pain. Anyway, I totally agree with you about the "new and improved" Opana ER and I know you'll find 99% here agree with us!
BDN
(the other 1% are the Pharmaceutical Reps that might be planted here LOL)

Inreksalsa
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Thanks BDN

My doctor also tried the Nucynta with me (first 75mg then 100mg) and like yourself, it provided no pain relief for me.
Interestingly, when my doctor changed my Opana ER to the 30mg he asked if my problems had started after they changed the formulation, and I told him yes they had. He wasn't surprised, so im guessing he's hearing it from multiple patients. Of course, he says the Endo reps swear it's no different and just as effective lol!!

BrokenDownNurse
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I need to try 30mg then

I need to spend yet another $45 to go in and talk to my PA about retrying Opana ER but at a higher dose. Since I'm in the process of switching I have a little more courage. Isn't that sad? Just keepin it real. :-/

quincy
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Good to know . . .

That valium / diazepam helps with the new Opana formulation. If you plug Opana into the pharmer search engine you will find at least 2 50 reply topics cussing that stuff out. I'll just bet your doc has been getting feedback but his patients don't provide his clinic with catered lunches either. You should see what the reps bring into my Cancer Care Center, WOW, now that's some good eating. I wish they'd bring some for us patients too, lol . . . Q

Inreksalsa
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New Opana ER and Valium

I know for me taking 5mg Valium 2-3hrs after the Opana ER seems to help the Opana ER work better and last longer. Enough that I may not need to take my BT meds til 8 hours after the Opana ER instead of 5 hours.