I'm taking Opana ER 10mg substitute

[joepriley]

I'm taking Opana ER 10 mg and it's not on the list of approved drugs for my new RX plan. Fentanyl patches weren't effective. What's a good substitute? oxymorphone is not listed but hydromorphone is.

[Tuckamore]

Hi Joe,

Welcome to our Pain Management Forum. I'm glad you posted but am sorry to hear about the issues with your insurance. As always Remar has offered a good suggestion.

You didn't say if Opana is effective in relieving your pain. Does it do well for you?

Hydromorphone is better known to most ppl as Dilaudid. It is very effective controlling pain for most ppl. However our systems are all different as to how we metabolize drugs, including opiates. What may be effective for me might not be effective for you. It use to be a crap shoot or trial and error. Today many PMP are utilizing a DNA cheek swab that reveals which opiates we metabolize well and which ones we don't. It's called Pharmacogenetic Testing (PGT).
As you might guess this is not without controversy.  You can learn a bit more on this older thread in our Forum: http://www.medhelp.org/posts/Pain-Management/My-Dr-gave-me-a-mouth-swab-test/show/1801289

Hydrocodone (Vicodin) works better for me than Oxycodone (Percocet). That makes no sense to most ppl or even physicians that do not consider the metabolism of opiates in an individuals systems.  

In short, it's not prudent to suggest a specific opiate for you. It all depends on your metabolism of drugs. There are many ppl that find Fentanyl Patches very effective, I'm not one of them.

I agree with Remar.  Take your approved drug list to your prescribing physician and discuss it with him/her. Together you can begin a trial of opiates to find an effective one that is covered by your insurance. It may also be possible that the (Opana) manufacturer has coupons or a "card" that would reduce the cost for you. I know that is true with the OxyContin manufacturer.

I wish you the best - and hope you'll share with us the outcome. We'll look forward to hearing from you again soon.

Best of Luck,
~Tuck

[remar]

I'm sorry your insurance won't pay for some medications, but glad to hear you do have insurance.
I recommend getting a complete list of pain medications from your insurance company that they will cover and go over that list with your Dr. The two of you can decide what you should try next. There are several medications to choose from. You may have to try a couple on the list to find one that works best for you. Some people take a combination of a long acting and also a short acting med for breakthrough pain.