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Advice for taper oxy er plus dilaudid- which first-when start buprenorhine
  1. #1
    smilingdave is offline New Member
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    Default Advice for taper oxy er plus dilaudid- which first-when start buprenorhine

    Hi,

    Two years dilaudid 8mg 4 per day for severe hip pain, increasing to 2 per day OxyContin 20 ER plus 3 4mg Dilaudid 6 times per day. Finally was able to have the surgery, and now tapering to get done with this!
    i
    My doc is recommending I taper off dilaudid first then oxy er. I need a slow taper or get very sick. I'm worried that since oxy only comes in 5mg increments that dropping 5 at a time will be too much when I reach that point. What's the advantage of tapering ir first then er? Why not just switch to ir and keep dropping in smaller increments? I am now down to the 2 oxy 20 er and 6 4mg Dilaudid daily.. I'm a teacher so cannot be sick all the time.

    I'd greatly appreciate any advice for approaching my situation. My doc seems willing to help.but sometimes I don't like his advise,

    Thank you kindly for any support.

  2. #2
    froggy_069 is offline Member
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    Hi Dave, welcome to the forum!

    It's awesome that you are looking to taper down off the pills. You said you get sick when you taper too fast so you know all too well just how much of a hold those things can have on you. I wish I had a solid answer for which to taper first, the ir or er and what the advantage would be. If you are worried about dropping 5mg at time when that time comes, perhaps you can stay at your current dose and cut your pills in such a way that you are able to drop even 1mg at a time if you cut them right. Once you have tapered down a full 5mg you can drop to next lower dose and repeat the process? Just a thought.

    Have you expressed these same concerns to your Dr? Maybe he can come up with another plan that will work the way you need it to even if it involves switching to a different med of a different strength.

    Keep posting and let us know how you are making out. Other members will drop by sooner or later and we're all here to help in any way we can.

  3. #3
    smilingdave is offline New Member
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    Thank you. I cannot cut the er oxy because it is tamper proof otherwise that would solve it! I will be talking to my doc soon again and will be discussing this all with him. I read the it has shorter and more intense we while er is longer and less so, just mulling that over. I am wondering if something like clonidine might help me accelerate my taper so we? And then at what level could I stop meds and go onto suboxone? Like have people gone from say 2 20 oxy right into suboxone or is that too high? Or is it just Best to go tapering down to nothing or very little then use suboxone? I’m guessing the downside is only wanting to be on suboxone for 7 to 14 days to avoid suboxone s own we?

  4. #4
    Randy35 is offline Platinum Member
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    Quote Originally Posted by smilingdave View Post
    Thank you. I cannot cut the er oxy because it is tamper proof otherwise that would solve it! I will be talking to my doc soon again and will be discussing this all with him. I read the it has shorter and more intense we while er is longer and less so, just mulling that over. I am wondering if something like clonidine might help me accelerate my taper so we? And then at what level could I stop meds and go onto suboxone? Like have people gone from say 2 20 oxy right into suboxone or is that too high? Or is it just Best to go tapering down to nothing or very little then use suboxone? I’m guessing the downside is only wanting to be on suboxone for 7 to 14 days to avoid suboxone s own we?


    Hello Dave!

    I would ask your doc tor if he would switch you from the ER Oxy to maybe say Vicodin? That way you can taper off the Vicodin much easier because you'll be able to cut the pills into smaller amounts. If he/she will agree to do that you could lower your dose by 1/2 of a pill every 4-7 days so any potential wd's will be limited.

    Clonidine is a blood pressure med that is quite often used for opiate wd's. And it is very effective, but you must be careful because after all it will lower your blood pressure so that will need to be monitored.

    As for the Suboxone. You can go right to the Suboxone from basically any amount of Oxy or other opiates. Only exception would be if you were taking Methadone, but I've known some that have switched to Suboxone from Methadone at very high doses. But I caution you that Suboxone should be the very LAST choice you make.

    If you can taper your other meds down to very low doses you won't need to consider Suboxone. It's always advised to taper off current opiates or even try cold turkey before ever considering using subs. Suboxone is a powerful opiate. It's best used in a plan like the one we have here on the forum that thousands have used successfully, including myself. Our sub plan takes about 6-8 weeks from induction to the final jump give or take a couple weeks.

    The short, or fast Suboxone tapers rarely produce success. The relapse rate is very high for those that want to get on and off the subs quickly. Not saying it can't be done, just not recommended. Our plan has you inducting on the lowest effective dose (usually 3-4mg daily), remaining on that dose about a week, then starting the taper process of lowering your dose by 25% every 4-7 days until you're down to tat least .25mg per day. Follow that plan and you'll have a very positive Suboxone experience I promise.

    But PLEASE don't use the subs if you don't have to. Think it over very carefully. If you can do this without the subs you'll be way ahead of the game. However IF you want to give Suboxone a shot then I would be more than happy to see you all the way through it as will many others here. We're here to help and support no matter what you decide.

    Randy

  5. #5
    smilingdave is offline New Member
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    Thanks Randy,

    It seems you feel strongly against the suboxone. I will work towards getting as low as possible and consider the final step without suboxone. I have to say it would be nice not to introduce another drug (sub) when I get so close to the end!

    At my recent visit to my doc, he said he decided he wants me off the Dialudid, and move to oxycodone er all by itself. I had expressed that the Dilaudid taper was going ok, and that if I kept it slow it was tolerable, but i was not feeling particularly zippy every day. When I said that he indicated that the dilaudid was just making me feel sick now because of its fast release and my steadlily taking less of it. He said I was in a constant cycle of feeling bad due to that. He told me he wants me to take 2 80mg oxycodone a day instead of 2 20 mg oxycodone a day along with 10-12 dilaudid a day. I was kind of freaked out by the idea that it take 160 mg of oxycodone to replace 40 mg of oxycodone and 40 -48 mg of dilaudid. Is this right? He said it might even be a little low so I could take some dilaudid as needed to even things out. That just seems like a boatload!

    Can anyone comment on that?

    Thanks!

  6. #6
    Randy35 is offline Platinum Member
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    Quote Originally Posted by smilingdave View Post
    Thanks Randy,

    It seems you feel strongly against the suboxone. I will work towards getting as low as possible and consider the final step without suboxone. I have to say it would be nice not to introduce another drug (sub) when I get so close to the end!

    At my recent visit to my doc, he said he decided he wants me off the Dialudid, and move to oxycodone er all by itself. I had expressed that the Dilaudid taper was going ok, and that if I kept it slow it was tolerable, but i was not feeling particularly zippy every day. When I said that he indicated that the dilaudid was just making me feel sick now because of its fast release and my steadlily taking less of it. He said I was in a constant cycle of feeling bad due to that. He told me he wants me to take 2 80mg oxycodone a day instead of 2 20 mg oxycodone a day along with 10-12 dilaudid a day. I was kind of freaked out by the idea that it take 160 mg of oxycodone to replace 40 mg of oxycodone and 40 -48 mg of dilaudid. Is this right? He said it might even be a little low so I could take some dilaudid as needed to even things out. That just seems like a boatload!

    Can anyone comment on that?

    Thanks!

    Hi Dave -

    Tell you what I would do. I would run as far away from that doctor as I could get and never go back to see him again. While it's true that when tapering full agonist opiates such as Oxy and Dilaudid you're in wd's the entire time you're lowering the dose, telling you to take 2 of the 80mg Oxy's along with 10 - 12 Dilaudid daily is absolutely nuts in my opinion!!! What is he thinking? Answer - He's not. Theres no way on earth I would ever do that. First he says he wants you off the Dilaudid, but suggests you take 10 - 12 of them daily? And you are telling him you want OFF the drugs but instead you should take MORE of everything? Find a different doctor my friend.

    Just continue lowering your dose as best you can. Slow and steady is the way to go to avoid harsh symptoms.

    Randy
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  7. #7
    Catrina is offline Diamond Member
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    Hi Dave,

    Just catching up with your thread here. I'm on board with Randy as usual. What in the good H*ll is this doctor thinking? You're been working your taper so well and he's suggesting that you increase your dose? This makes absolutely no sense to me. I'm familiar with both the oxy and the dilaudid and I think that your doctor's advice is stupidly misguided.

    I also agree with Randy that so long as your doctor(s) allow you to take your taper slowly and you are able to stick to a good plan, your best bet would be to get your daily dose way, way down and just make the jump. If at some point you are having just too much trouble getting low then perhaps subs can and should be considered but for those on lower doses of ordinary opiates subs would be overkill. This is your decision so for now if tapering is working for you, then keep at it. I suppose if you choose to stay with your current doctor, it's going to mean that other than providing you with your scripts, you're going to be on your own to figure out how to get your dose down Go slow to minimize any symptoms with a reduction and at some point it might make things a bit easier to take smaller doses more frequently rather than big doses a few times a day, begin to lower one or more of those doses, and then begin to eliminate one of those small doses. It really doesn't matter so long as you are diligent about reducing the total you are taking per day on a regular basis. In any event, increasing what you're taking at all, let alone by the huge amount your doctor has suggested is pure insanity. I'd work on reducing and eliminating any of the extended release meds first because it will be easier to control things with the fast acting opiates. Your plan, your pace so long as it's in the right direction which is DOWN.

    Best wishes. I could never taper. Ever So I'm in awe of people like you who can. Keep posting to let us know how you're doing. Trust me when I say that there are others who will be helped by following your taper and to know that it is possible.

    Peace,

    Cat

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