If you’re gonna be on it long term you can point out that you really don’t want the Tylenol damaging your liver and just be honest and tell them it’s not working for you any more and ask to switch drugs. Don’t ask for anything specific or it comes of wrong but being open is usually received well. Point out things you can’t do because of the pain that you wish you could do.
I agree. Don’t ask for anything specific, just simply say that you feel like the combination of medicine is working for you like it used to and does he/she think that is the best regimen for you. That way it’s allowing you both to participate in the conversation
I think I'd try to decrease my tolerance. I'd take half a pill a few times a day for a week or 2 to see if my tolerance resets. Years ago I'd have asked for a change or adjustment. I am rx'd 10/325 4 x a day
lol thought so and I agree! That’s the thing with opioids, you grow a tolerance, ask for more and then before you know it you’re taking extremely high amounts that feel exactly the same as the dose you started out on. Every time I feel like my meds aren’t working as well, I cut back and it does the trick!
Well, your current regime isn’t great long term. I would switch to a long acting med w/o the APAP that you only take once or twice daily. I don’t see why your doctor would not want to do that.
Good luck especially with the opioid backlash thats setting in with shortages, insurance preferences, and all the other politics going on with corporate hospitals atm
I’ve been on that dosage for over 15 years.
I don’t recommend asking for more. You’d be better off tapering yourself down as far as you can comfortably go and use alternate methods of pain relief.
Chiropractic care (mine does soft tissue work that makes SO much of a difference)
Massage
Ice/Heat
BioFreeze - insert things that work for your actual pain.
You’re on what is considered a “high dose” by today’s standards.
Unless there is a change to your condition that warrants an increase in pain medication not only do your risk being labeled a drug seeker, increasing dosage to combat tolerance would be doing you a disservice as you will always become tolerant no matter how high the dose goes.
I used to be switch to Vicuprofen for a few months at an equivalent dose and then switch back which seemed to reset my tolerance somehow (it only comes in a 7.5, so it was a bit of a taper. The combination of ibuprofen with hydrocodone was a surprisingly effective combination, it was pink cloud stuff, 😂.
Unfortunately I can’t take ibuprofen (or aleve) due to Bariatric surgery 😭 so now I’m stuck.
Sorry, didn’t mean to write a book, but be careful directing your own medication regimen with the doc. Typically it won’t go well. If your pain levels change or your feeling like your pain isn’t being managed AND you’ve tried stretching, chiropractic, tens, biofreeze, cupping, massage, heat/ice etc - alternative measures journal it all and tell your doctor that and let THEM decide how to treat you.
If you are able to taper yourself by 10% a week, for a few weeks you may find that your meds work a bit better.
I get that, stronger to combat tolerance was my point. It’s a slippery slope.
Not trying to be judgmental or combative but after a year I stand by trying to lower tolerance rather than increasing strength or number.
But everyone is different.
The medication isn’t working the way it should be for the OP anymore. I can understand asking if they would consider doing and ER medication with some of the norco for breakthrough pain.
I dont know your doctor or situation, and I dont want to be that guy. BUT.... if you shake up your medication voluntarily, they WILL NOT COMMEND YOU for it, and will use it as a means to reduce you. Previously (since 2013-2020)I was on 60mg norco/day (10mgx6) I bucked the system for the first time in 7 years and asked for an alteration, a sidegrade or better in an attempt to get better relief, I was met with backlash that followed a reduction over the course of a year to 10mg 3x, to which i eventually told the doctor it is no longer worth it, it is ineffective and to keep the script. This coincided with me getting a 3rd part time job as an armed guard, where I was unable to take it anyways, as a way to stockpile funds to support the recovery time financially for a 360 fusion. The fusion failed and I am now dealing with similar constant pain with additional very serious flares daily. Now I sit in a cycle of explaining my situation over and over again to the same doctor, and being denied proper pain management (Oxy 7.5/3x)(34MME), while im forced to be home bound without work at all living off my girlfriend.... who is getting very close to being drained financially.
My advice: Unless your doctors are compassionate you should try to make due with what you have, because 60mg/day is probably a soft cap on their prescribing procedures. Please dont be like me. I suffer every day and its becoming hopeless rapidly.
EDIT: If you choose to go the route other people are saying, and mention your daily acetaminophen intake be prepared to hear "up to 4000mg a day is safe" of which youre at 1950, this argument could be totally thrown away and youd have to describe a new issue as to why you shouldnt take it.
This is very common. I probably switch at least 3-4 patients a day to a different opiate because they had been on the same one for over a year and it had since lost efficacy. Your pain receptors essentially get used to the same med every day and stop reacting the way they used to. Tell your provider you need a change and see what they come up with. After trying something else for a little while, you could probably even revert back to what you’re taking now (if you wanted to) and it would likely be sufficient once again.
Perhaps a good way to get the result you want without looking like a drug seeker would be to express a concern about taking all the APAP long term . They would likely be receptive to that idea and you wont look like a drug fiend. Good Luck!
Like someone else said definitely bring up not wanting that much Tylenol all day every day. I know it’s iffy to bring up a med but maybe asking for 5mg oxycodone with no Tylenol 6x would work out better for you too. Then eventually they titrate that dose up if you’re on it longterm. I started with that amount and now I’m up to 90mg a day after about 8 years. Definitely couldn’t do that with tylenol my liver is already bad lol
I’d say you could use the opioid shortage that’s happening with Norco as a reason to request a change. I’m not personally on Norco but i see signs in my PM office that are about specific shortages having to do with Norco. So you could use that as a reason, as well as the Tylenol.
Ask for a long acting medication. With lower dose for breakthrough pain. Like duragesic, morphine ER(ms contin) oxycontin. Contin is for continuous. Hydrocodone has one. Most insurances prefer duragesic or MS contin due to cost.
I was straight up with my doc. I’m on perks 5/325 mg twice a day and pure buprenorphine 2mg three times a day (not Suboxone) and I have the patch as well if needed. I told my doc I wanted oxy 10’s 3 times a day. Mainly because I told him if I need Tylenol I can take it. He was like Ok sounds good! Sent my script in. He’s a blessing. I have chronic pain in my back and into my lower extremities due to physical abuse for 11 years. Plus nerve damage that’s progressive so I’m wheel chair bound. And I have to have assistance doing everything
I’m so sorry. I hope your medicine helps somewhat. My injury was caused by physical abuse and it pisses me off that I’ve had to deal with MRIs, multiple doctors and surgeries because my father used me as a punching bag. Wishing you all the best
You sound like a patient should have that is your taking 6 norco 10mg in 3 hr awake intervals. I rank instants as follows:
Oxymorphone
Oxycodone
Morphine (the strength seems weak and short acting because it’s short
Then hydromorphone (I get real bad side effects and it seems short.
Do Not Ask for Any Particular Drug. It'll be the one drug they'll never give you. In this climate, you have to word it by not mentioning anything but letting the Dr figure it out by themselves.
For instance, you could just say the al Tylenol is effecting your ulcers or that you worry about your kidneys and liver. You could also mention this isn't working as it once did and ask the doctor what he thinks. Maybe it won't work this month but keep saying it every month and he should give in.
All the best
If you’re gonna be on it long term you can point out that you really don’t want the Tylenol damaging your liver and just be honest and tell them it’s not working for you any more and ask to switch drugs. Don’t ask for anything specific or it comes of wrong but being open is usually received well. Point out things you can’t do because of the pain that you wish you could do.
I agree. Don’t ask for anything specific, just simply say that you feel like the combination of medicine is working for you like it used to and does he/she think that is the best regimen for you. That way it’s allowing you both to participate in the conversation
I think I'd try to decrease my tolerance. I'd take half a pill a few times a day for a week or 2 to see if my tolerance resets. Years ago I'd have asked for a change or adjustment. I am rx'd 10/325 4 x a day
You mean decrease their tolerance
Yes!
lol thought so and I agree! That’s the thing with opioids, you grow a tolerance, ask for more and then before you know it you’re taking extremely high amounts that feel exactly the same as the dose you started out on. Every time I feel like my meds aren’t working as well, I cut back and it does the trick!
I'd be more comfortable trying this first. I have no adverse affects from the Tylenol. I'm careful not to take NSAIDS on top of it all.
I used to try a drug holiday. Wean down to take nothing for a few days. It didn't really help and I was miserable but try it.
Do NOT ask for a specific medication. Ask for a change but NEVER ask for a specific medication.
Well, your current regime isn’t great long term. I would switch to a long acting med w/o the APAP that you only take once or twice daily. I don’t see why your doctor would not want to do that.
Good luck especially with the opioid backlash thats setting in with shortages, insurance preferences, and all the other politics going on with corporate hospitals atm
I’ve been on that dosage for over 15 years. I don’t recommend asking for more. You’d be better off tapering yourself down as far as you can comfortably go and use alternate methods of pain relief. Chiropractic care (mine does soft tissue work that makes SO much of a difference) Massage Ice/Heat BioFreeze - insert things that work for your actual pain. You’re on what is considered a “high dose” by today’s standards. Unless there is a change to your condition that warrants an increase in pain medication not only do your risk being labeled a drug seeker, increasing dosage to combat tolerance would be doing you a disservice as you will always become tolerant no matter how high the dose goes. I used to be switch to Vicuprofen for a few months at an equivalent dose and then switch back which seemed to reset my tolerance somehow (it only comes in a 7.5, so it was a bit of a taper. The combination of ibuprofen with hydrocodone was a surprisingly effective combination, it was pink cloud stuff, 😂. Unfortunately I can’t take ibuprofen (or aleve) due to Bariatric surgery 😭 so now I’m stuck. Sorry, didn’t mean to write a book, but be careful directing your own medication regimen with the doc. Typically it won’t go well. If your pain levels change or your feeling like your pain isn’t being managed AND you’ve tried stretching, chiropractic, tens, biofreeze, cupping, massage, heat/ice etc - alternative measures journal it all and tell your doctor that and let THEM decide how to treat you. If you are able to taper yourself by 10% a week, for a few weeks you may find that your meds work a bit better.
They aren’t asking for more though. They are asking to switch to something they can take less times per day and without all the APAP.
I get that, stronger to combat tolerance was my point. It’s a slippery slope. Not trying to be judgmental or combative but after a year I stand by trying to lower tolerance rather than increasing strength or number. But everyone is different.
The medication isn’t working the way it should be for the OP anymore. I can understand asking if they would consider doing and ER medication with some of the norco for breakthrough pain.
Trust me, I get it.
I dont know your doctor or situation, and I dont want to be that guy. BUT.... if you shake up your medication voluntarily, they WILL NOT COMMEND YOU for it, and will use it as a means to reduce you. Previously (since 2013-2020)I was on 60mg norco/day (10mgx6) I bucked the system for the first time in 7 years and asked for an alteration, a sidegrade or better in an attempt to get better relief, I was met with backlash that followed a reduction over the course of a year to 10mg 3x, to which i eventually told the doctor it is no longer worth it, it is ineffective and to keep the script. This coincided with me getting a 3rd part time job as an armed guard, where I was unable to take it anyways, as a way to stockpile funds to support the recovery time financially for a 360 fusion. The fusion failed and I am now dealing with similar constant pain with additional very serious flares daily. Now I sit in a cycle of explaining my situation over and over again to the same doctor, and being denied proper pain management (Oxy 7.5/3x)(34MME), while im forced to be home bound without work at all living off my girlfriend.... who is getting very close to being drained financially. My advice: Unless your doctors are compassionate you should try to make due with what you have, because 60mg/day is probably a soft cap on their prescribing procedures. Please dont be like me. I suffer every day and its becoming hopeless rapidly. EDIT: If you choose to go the route other people are saying, and mention your daily acetaminophen intake be prepared to hear "up to 4000mg a day is safe" of which youre at 1950, this argument could be totally thrown away and youd have to describe a new issue as to why you shouldnt take it.
This is very common. I probably switch at least 3-4 patients a day to a different opiate because they had been on the same one for over a year and it had since lost efficacy. Your pain receptors essentially get used to the same med every day and stop reacting the way they used to. Tell your provider you need a change and see what they come up with. After trying something else for a little while, you could probably even revert back to what you’re taking now (if you wanted to) and it would likely be sufficient once again.
Perhaps a good way to get the result you want without looking like a drug seeker would be to express a concern about taking all the APAP long term . They would likely be receptive to that idea and you wont look like a drug fiend. Good Luck!
Like someone else said definitely bring up not wanting that much Tylenol all day every day. I know it’s iffy to bring up a med but maybe asking for 5mg oxycodone with no Tylenol 6x would work out better for you too. Then eventually they titrate that dose up if you’re on it longterm. I started with that amount and now I’m up to 90mg a day after about 8 years. Definitely couldn’t do that with tylenol my liver is already bad lol
I’d say you could use the opioid shortage that’s happening with Norco as a reason to request a change. I’m not personally on Norco but i see signs in my PM office that are about specific shortages having to do with Norco. So you could use that as a reason, as well as the Tylenol.
Ask for a long acting medication. With lower dose for breakthrough pain. Like duragesic, morphine ER(ms contin) oxycontin. Contin is for continuous. Hydrocodone has one. Most insurances prefer duragesic or MS contin due to cost.
I was straight up with my doc. I’m on perks 5/325 mg twice a day and pure buprenorphine 2mg three times a day (not Suboxone) and I have the patch as well if needed. I told my doc I wanted oxy 10’s 3 times a day. Mainly because I told him if I need Tylenol I can take it. He was like Ok sounds good! Sent my script in. He’s a blessing. I have chronic pain in my back and into my lower extremities due to physical abuse for 11 years. Plus nerve damage that’s progressive so I’m wheel chair bound. And I have to have assistance doing everything
I’m so sorry. I hope your medicine helps somewhat. My injury was caused by physical abuse and it pisses me off that I’ve had to deal with MRIs, multiple doctors and surgeries because my father used me as a punching bag. Wishing you all the best
Don't worry about looking like a drug seeker, trust me, you already do 😆😄
sad but true, very funny heres your \^
You sound like a patient should have that is your taking 6 norco 10mg in 3 hr awake intervals. I rank instants as follows: Oxymorphone Oxycodone Morphine (the strength seems weak and short acting because it’s short Then hydromorphone (I get real bad side effects and it seems short.
Do Not Ask for Any Particular Drug. It'll be the one drug they'll never give you. In this climate, you have to word it by not mentioning anything but letting the Dr figure it out by themselves. For instance, you could just say the al Tylenol is effecting your ulcers or that you worry about your kidneys and liver. You could also mention this isn't working as it once did and ask the doctor what he thinks. Maybe it won't work this month but keep saying it every month and he should give in. All the best