Posted by Elizabeth on March 22, 2002, at 18:33:00
In reply to Re: chronic pain - More Bup?, posted by cisco on March 21, 2002, at 15:11:49
> Hey Liz Beth:
I'm neither a "Liz" nor a "Beth," much less both! :-)
> Have U tried increasing the Buppy Morphine?
Does "buppy" rhyme with "puppy?"
Seriously -- there's supposed to be a ceiling effect with buprenorphine (as it is a partial agonist), but nobody seems to know where the ceiling is in humans. But using opioids for chronic pain can be tricky. I'd prefer not to go down that road; I think that my pain could be managed with muscle relaxants (Soma, benzos).
My mdoc has me taking a NSAID (diclofenac, brand name Voltaren) thrice daily, as opposed to just "as-needed." He says that it may work better if used regularly, so I thought it'd be worth a try. I ran out of Xanax because I was using it for the muscle tension. I should have asked him (my mdoc, that is) for a new script when I saw him, but it didn't occur to me, and now I'm just out and I can't reach my pdoc (my next appt with her isn't until 4/16).
> Disregarding cost for a moment, Can palliation be achieved with a substantial (2x, 4x or more) dose increase? You are currently taking 300ug, 3x times a day? That is a fairly low dose, IMHO.
It's a reasonable amount; 0.3 mg of buprenorphine is supposed to be equivalent to 10 mg morphine (the equivalent PO dose would be about 30 mg, I think). The maximum recommended amount of buprenorphine to be given in any single dose is 0.6 mg, and it's recommended that this dose only be used occasionally, not regularly. (Addicts need much higher doses for maintenance, of course, but that's a very different situation.)
-elizabeth
poster:Elizabeth
thread:97162
URL: http://www.dr-bob.org/babble/20020322/msgs/99516.html