Levorphanol ER

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HCandKROD
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Sir Ebril

Yes, from time to time they do run short. Roxane is the only manufacturer of this drug and my doctor tells me there is a resurgence of popularity in the drug........therefore shortage. To tell you the truth the Levo shortages I have encountered over the last 20 years pale in comparison to Oxycodone IR 30 mg shortages. Also, in times when they run low Roxane at least has the courtesy to tell the doctors. My doctor then writes a compounding order and here in Boca Raton,FL we have a strictly compounding pharmacy that has them ready within 2 hours #280 capsules. They charge my insurance company whatever but I pay my regular co-pay of $20. The compounds are stronger IMHO. Good luck and have a great Monday!!!!             Greg

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saeon
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Compounding cost

HCandKROD:

Would you by any chance be able to check your pharmacy receipts to see what the cost to your insurer is (e.g. the total bill, not just your co-pay)? I'm on Disability and therefore have no coverage for compounded medications, but Levorphanol is so promising that I'm thinking I will give it a try if the cost is reasonable enough.

Since the cost of compounding is often primarily a per-capsule thing, I was thinking of getting the whole day's dose made up as a single capsule (say, 1X 24mg capsule instead of 12X 2mg caps) and then I'll open the capsule and dissolve in water to split up the day's doses. With any luck, the cost of just 30 capsules will be modest.

 

Any insight you can share into the cost I might be looking at would be a huge help!

HCandKROD
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I will look for compounding records

my house is in disarray right now due to selling some businesses and I have paperwork everywhere. I know at Walgreens for #240 2mg tablets my co pay is $20.00 and the insert says I saved $188.39. You mention in your post 24mgs in a day. I don't know how opioid tolerant you are but Globalrph.com has 24 mgs Levorphanol chronic dosing(using zero cross tolerance) as equivalent to 480 mgs of Oxycodone. Acute dosing has 24 mg equal to 120 mg Oxycodone. I have been on Levo for many years and I'm rx'ed 16mgs a day but I rarely take more than 12 or 14 mg a day. Maybe you were just using 24mg as a number. Levo to me is a wonderful medication that isn't utilized enough. Good luck and when I find a compounding sheet I'll post the price. Have a great day!!!!  Greg

gailwj
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What Insurance Do You Have?

Hi Greg -

Our insurance refuses to cover Levorphanol.  (6 mg/3x daily)  May I ask who you are insured with?

Thank-you!

GWJ

maht26
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Levorphanol tolerance-need addvice

If someone can help me with this I would really be greatfull. I have been taking levo for years,then it wasn't availabe,Roxane was very good about giving updates,I tried other things but NOTHING worked on my chronic pain like Levo did,did the methadone...terrible...did hydrocodone,had break through pain before the 8 hrs was up...and the pain doc said it was because my body was so used to the longer acting opiads..he made me feel like I was an addict...I know the difference between dose tolerant and addiction...he wanted me to eventually be able to take "tylanol"said my own body would evnetualy be able to produce its onw natural pain killers again...AGAIN?? I wasn't doing this in the first place and that is why I was put on pain meds! I don't think he knows the type of pain some people with Interstitial Cysitis have. I have terrible searing pain that makes my life a living ???$*. Well I am trying to go of off my meds now...it is ???$*....I am thinking about having a neuro spinal stimutlator implant. It is suppse to block the pain receptors in the brain that tell me my bladder is on fire...but I am very scared about this whole procedure. When Levo came back on the market I went back on it...and it was working at first,now I am having break through pain! OMG! ...so I guess my body has become dose tolerant? I am slowely backing down and like I said it is ???$*....my pain levels shoot through the roof...I can't even leave my house...but I am worried that I may be addicted...??...I am so confused..please advise thank you!

 

maht26
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Levo tolerance-need addvice....

Sorry for all the typo's!

celticgreenman
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Dependency vs addiction

maht26,

Sorry for all of your troubles. Welcome to Pharmer.

You state that you understand what tolerance is, but then ask about being addicted.

Dependency, tolerance, addiction, and abuse are used in describing reaction to opioid medications. They are not interchangeable.

When you take opioids for a long enouhg period of time and in high enough doses, you will become dependent upon them. This is a physiological response by the body, where your internal opioid set point has been reset by the use of exogenous opioids, and which is manifested by having withdrawal symptoms when the medicine is abruptly stopped. It has nothing to do with addiction.

Tolerance is when the current amount of opioids that are taken, no longer covers your pain. Again, this is a physiological response.

Abuse is the misuse of opioids medications. This can be taking the substance without a prescription, increasing your dose on your own, using someone else's medicines, etc. It is just using a substance incorrectly.

Addiction is a behavioural problem, where the use of opioids is associated with deterimental effects, and one continues to take the substance knowing that it will cause more problems. These problems can be health related, financial problems, family problems, etc. It is a maladaptive behaviour.

Again, dependency and addiction are not the same.

.
If you are having problems with the treatment plan that your pain management physician has outlined, then you may have to see a different physician. If you and the physician just cannot see eye to eye, and you feel that you are not being treated adequately, then you will have to change physicians. But, this is not to say that the next physician will agree with what you think is the best method. That is just one of those things that goes along with pain management.

Good luck. Hope you find a solution to your pain management problem.

cgm