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Celeste NP
Celeste NP, Nurse Practitioner
Category: Health
Satisfied Customers: 1002
Experience:  Family Practice with emphasis in Women's Health, Forensics, Urgent Care, for 14 years.
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2 herniated discs, spinal stynosis,and severe muscle spasms

Customer Question

I have chronic pain syndrome, 2 herniated discs, spinal stynosis,and severe muscle spasms. My pain specialist has me on MS Cotin 100mg 2x daily and opana 5mg 1 to 2 tablets every 4 to 6 hrs. The opana is not covered under my RX insurance. This is my question: my pharmaist suggested methadone 10mg instead of the opana, is this a good choice of substitute, I am in pain every day of my life ranging from a 5 to 10 on a bad day. I am also allergic to tylenol.
Submitted: 6 years ago.
Category: Health
Expert:  Celeste NP replied 6 years ago.
Hello,

Methadone is a good choice and is widely used for chronic pain. It is usually tolerated very well also.
Celeste NP and 2 other Health Specialists are ready to help you
Customer: replied 6 years ago.
How do I go about asking my Dr. to change to this medication.
Expert:  Celeste NP replied 6 years ago.
I have patients all the time requesting to try different medications. I would just be up front and explain that the insurance does not cover this and your pharmacist suggested methadone. If he does chronic pain management he will be familiar with this. Also this med is easy to adjust as well.
Celeste NP and 2 other Health Specialists are ready to help you
Customer: replied 6 years ago.
How do I go about asking my Dr. to switch to this medication and is the dose strong enough to supplement the opana?
Customer: replied 6 years ago.
He also suggested an increase to 120mg of MS Cotin to compensate for the reduction in pain control by the methadone or should I ask for a stronger dose of the methadone
Expert:  Celeste NP replied 6 years ago.
As far as the dose of 10mg that is what he may start out with but you may take it a few times a day. That will have to be up to him to decide. But that is what I meant that it is easily titrated to take care of your pain. Only your provider will be able to decide what dose will be good to start since he has your records and history.

Again, I would just make an appointment and tell him your insurance does not cover it and then ask to try methadone as an alternative. We are very used to insurances not paying for certain medications.

Personally, I would leave your dose of the MS Contin the same and adjust the methadone to meet your level of pain control needed.
Customer: replied 6 years ago.
He also has me on 10mg of valium for the severe muscle spasms do you know of any other relaxant that would work just as well
Expert:  Celeste NP replied 6 years ago.
Valium is really one of the best for that. i am sure you probably have tried others like Skelexin that is used for long term.