Syd566 asked
How long should I wait to take hydrocodone 10mg for breakthrough pain, after taking a 15mg OP (extended release). The OP is not enough instant relief for me, I barley feel like I have taken anything I'm used to taking 10/15 mg of hydro every 4 hours. I have taken instant release oxy 15mg.
Answer
While it isn't often recommended to take two different opioid medications together (e.g. hydrocodone and oxycodone), it is considered an option to use a long acting opioid (e.g. OxyContin) with an immediate release opioid for breakthrough pain only.
Using Hydrocodone With OxyContin
Oxycodone and hydrocodone are classified as opioid medications and have the same mechanism of action. Opioids work by binding to opioid receptors in the body, which include:
- Mu receptor
- Delta receptor
- Kappa receptor
Generally, it isn't recommended to take two different opioid medications as they have the same mechanism of action and the risk of side effects and adverse reactions greatly increases as doses are elevated. Potential side effects include:
- Excess sedation
- Pinpoint pupils
- Sweating
- Dysphoria
- Respiratory depression
If two fast acting (i.e. immediate release) opioid medications are to be used in the same day, they should be separated by at least 4 to 6 hours to avoid side effects. However, there are cases where immediate release opioid medications are used in conjunction with extended release (i.e. long acting) opioid medications.
OxyContin is an extended release form of oxycodone. It comes in the following strengths:
- 10 mg
- 15 mg
- 20 mg
- 30 mg
- 40 mg
- 60 mg
- 80 mg
The oxycodone from OxyContin tablets is slowly released from the tablet. Per the package insert:
For individuals taking an extended opioid such as Oxycontin, an immediate release product is sometimes added on for symptoms of breakthrough pain."The activity of OxyContin Tablets is primarily due to the parent drug oxycodone. OxyContin Tablets are designed to provide controlled delivery of oxycodone over 12 hours."
For example, an individual may be prescribed Oxycontin to be taken every 12 hours consistently and hydrocodone to be taken every 4 to 6 hours as needed for breakthrough pain symptoms.
If you are on an extended release opioid, it is important not to take your immediate release (i.e. breakthrough pain medication) all the time. It should only be taken as needed.
Your doctor will adjust your doses of your opioid medications if you require both an extended release and an immediate release product to reduce the risk of side effects.
