They'll ban them and attempt to pry them from my cold dead hands. fark off FDA - Mexico ain't too far away.

Hammurderer: numb3r5ev3n: Vicodin never did a damn thing for me painwise anyway.

Vicodin didn't seem to do anything for me period. I was prescribed it after getting a very bad cut on my leg and it didn't seem to do anything more than extra strength Tylenol. No buzz, just a mild blunting of the pain.

Same here. I was given it for migraines, and nothing happened at all except I was a little fuzzy headed. That's it. I went back to ibuprofen.

Thats great now people who suffer from stomach ulcers and gastric problems will have nothing to take. Everything else causes more problems that it solves.

I get a lot of my drugs off the Walmart price list. So my guess is that no new drug is needed to make Big Pharma a ton of money. Now prescriptions will go from $4 per month to $8 per month (two scripts.)

For the chronic pain sufferers, if your doctor is truly overseeing your pain management they will have your hydrocodone prepared by a compounding pharmacy with less acetaminophen. Mine has 80 mg per dose.

Hammurderer: numb3r5ev3n: Vicodin never did a damn thing for me painwise anyway.

Vicodin didn't seem to do anything for me period. I was prescribed it after getting a very bad cut on my leg and it didn't seem to do anything more than extra strength Tylenol. No buzz, just a mild blunting of the pain.

It barely does anything for me, either. It's better than nothing, but it's far from a "cure" for my pain. Percocet works a lot better, but it makes me unbearably itchy.

I wish I could still take NSAIDs. Advil worked great for me, but now I have colitis and it'll eat holes in my intestines.

sparkeyjames: Thats great now people who suffer from stomach ulcers and gastric problems will have nothing to take. Everything else causes more problems that it solves.



/hot like it's lit

Alacritous: I'll bet that shortly before or shortly after this ban takes effect that a product will come on the market conveniently that does the same thing as the banned combinations... Any money on which company it'll be that brings it?

Monsanto

There are already other combinations of both drugs(vicoprofen and percodan).

Darvocet and Tylenol #3 are probably just as prescribed and suffers the same hepatotoxic dangers.

Oxycontin has a higher street value and tends to rope in the masses.

The FDA is just a political whore spreading it's legs for the highest campaign contributor

As someone who worked for a pharma company I'm getting a kick...

Typical knee-jerk reaction. Before I was laid off we were in the middle of clinical trial for a new anti-radiation drug. The FDA consultant practically lived in my office. Any one of our test subjects got the sniffles and the study was shut down for a week while the consultant poured over the data. A 15 patient phase 1 trial ballooned to 100 patients in a matter of weeks. Not that I have a problem with the FDA you know, looking out for the best interests of the people. But come on guys, shutting down a whole study because one guy has a runny nose?

mruttan: Hooray for my Dilaudid!

THIS...Dilaudid (hydromorphone) works better than oxycontin or hydrocodone for me any old time.

If you NEED the acetaminophen with your hydrocodone (vicodin), just buy a $5 bottle of 200 acetaminophen and take two tabs with the generic version of hydrocodone that you can get for $8 for a month's supply (60) at Walmart.

Voila, homemade Vicodin!

This REALLY isn't a big deal.

sparkeyjames: Thats great now people who suffer from stomach ulcers and gastric problems will have nothing to take. Everything else causes more problems that it solves.

I manage chronic abdominal pain with ibuprofin and heat therapy. I kinda fear prescription drugs and don't wish to start with them.

Still, where will these patients turn now for respite? If these are such dangerous drugs, why where they approved without considerable trial and due diligence?

I think money. No one gives a shiat about the patient anymore. Not the FDA, not the drug companies and certainly not the criminal farks we call HMOs.

If you can kick the dependency, you'll be better off. Sadly, I haven't the foggiest notion what a good alternative would be.

Well, there is grass, but smoking that chit makes you some kind of Satan worshiper or something along those lines.

I barely got a damn thing out of vicodin when I had my wisdom teeth, but then again I barely get anything out of most meds :\

Ask your doctor if are right for you.

Crackers Are a Family Food: Hammurderer: numb3r5ev3n: Vicodin never did a damn thing for me painwise anyway.

Vicodin didn't seem to do anything for me period. I was prescribed it after getting a very bad cut on my leg and it didn't seem to do anything more than extra strength Tylenol. No buzz, just a mild blunting of the pain.

It barely does anything for me, either. It's better than nothing, but it's far from a "cure" for my pain. Percocet works a lot better, but it makes me unbearably itchy.

I wish I could still take NSAIDs. Advil worked great for me, but now I have colitis and it'll eat holes in my intestines.

D: Well, I understand that. Advil wrecks my stomach if I take it too much, but it's the only thing that works for me, and I try to space it out as far as I can.

Rush Limbaugh seen headed for the Mexican border, looking worried.

skinned: Ask your doctor if are right for you.

Did those bullets just give me the finger?

KickahaOta: I can't believe that the FDA is taking this horrible and unjustified action. It makes perfect sense to take a painkiller (oxycodone or hydrocodone) that can be expected to require increasing doses over time to remain effective, and combine it with another painkiller (acetaminophen) that inflicts horrible liver damage when used at high doses. The people behind this ban obviously just want to see people suffer.

+1

/Methinks your post is lost on many others

Gyrfalcon: Rush Limbaugh seen headed for the Mexican border, looking worried.

Not a chance in hell he'd make it in time.

Weaver95: Alacritous: I'll bet that shortly before or shortly after this ban takes effect that a product will come on the market conveniently that does the same thing as the banned combinations... Any money on which company it'll be that brings it?

As bad as that would be, if the FDA doesn't come up with a replacement for vicodin then I wish that everyone involved in removing that medication from the marketplace has 8 months of kidney stones.

I'll bet they find a way to reverse the ban after that.

Calm down their chief. They aren't taking the drug off the market. They are taking the combination of acetaminophen and *codone off the market. You will still be able to get *codone, and combine it with another anti-inflamatory drug, maybe even acetaminophen.

The issue is that the drugs, for some reason are combined, so the doctors can't just perscribe *codone and cut down on the liver killing portion.

I'm seeing a lot of misinformation in this thread. Let me explain.

1. Vicodin/Percocet are not on patent. The reason that I like to prescribe oxycodone with acetaminophen is that it works better. You get more pain relief than with the oxycodone alone. If you are taking a few percocet a day, then you will have better pain relief, less drowsiness, less itchiness, etc. than a person with just oxycodone alone.

2. Yes, you can get the same benefit from taking the two drugs separately. But I know patients. Most will just take the oxycodone because it has a stronger effect, and will think the acetaminophen isn't helping, so they won't take it very regularly. And so they don't get the full benefit.

3. The advisory panel isn't 100% full of crap (only 95%). Acetaminophen can be dangerous in high doses. If you need high doses of narcotics, I'm certainly not going to be prescribing percocet - I'm going to separate out the two drugs.

4. But the advisory panel is overly cautious. Physicians who are prescribing percocet and vicodin have a decent understanding of the dangers of acetaminophen. This is the proper job of the doctors, not of the government agencies.

/anesthesiologist

FloydA: Did those bullets just give me the finger?

And I was worried no one would pick up on it - such a fool I was :)

Riffington: 4. But the advisory panel is overly cautious. Physicians who are prescribing percocet and vicodin have a decent understanding of the dangers of acetaminophen. This is the proper job of the doctors, not of the government agencies.


Agreed, but many, many people buy the drugs on the street, not from the pharmacy, and certainly not prescribed by their MD / DO. Addicts often overuse Lortab, Percocet, Darvocet, etc... they will increase dosage due to needing more of the opiate, and not know the danger of the added acetaminophen.

/ophthalmologist
/thankfully don't have to deal with the stuff very often

Riffington: I'm seeing a lot of misinformation in this thread. Let me explain.

1. Vicodin/Percocet are not on patent. The reason that I like to prescribe oxycodone with acetaminophen is that it works better. You get more pain relief than with the oxycodone alone. If you are taking a few percocet a day, then you will have better pain relief, less drowsiness, less itchiness, etc. than a person with just oxycodone alone.

2. Yes, you can get the same benefit from taking the two drugs separately. But I know patients. Most will just take the oxycodone because it has a stronger effect, and will think the acetaminophen isn't helping, so they won't take it very regularly. And so they don't get the full benefit.

3. The advisory panel isn't 100% full of crap (only 95%). Acetaminophen can be dangerous in high doses. If you need high doses of narcotics, I'm certainly not going to be prescribing percocet - I'm going to separate out the two drugs.

4. But the advisory panel is overly cautious. Physicians who are prescribing percocet and vicodin have a decent understanding of the dangers of acetaminophen. This is the proper job of the doctors, not of the government agencies.

/anesthesiologist

Very much appreciated, doc. Couple of questions, if you're keen.

Do you not think that prolonged use of these drugs -- or the combination of these drugs -- can, over time, increase the dangers of serious damage to the liver?

Also, when it comes to chronic pain, do you think there are other natural alternatives that may produce acceptable results?

I'm not speaking of the wild-eyed pain that cancer patients endure. I'm speaking of people with back worries, female problems, bowel disorder, etc.

Is there something else worth looking at?

Proud2B_American: I'm thinking those aren't really intended for long term use anyway...I much prefer
Put it on for 3 days at a time...then replace....

This! This! 1000x this!

I love those more than any other pain killer.

/degenerative bone disease 5 years running limping

Shrew2u:
/tramadol ftw - far better for pain relief than vicodin

That stuff never touched any pain I had, they gave it to me when I hurt my foot. Vicodin helped a bit, but not in the small doses they prescribed, and since it was apap, I was very hesitant to take a higher dosage, just for the selfish reason of being able to walk to the bathroom.

I never take tylenol, but it is about impossible to find a lot of common drugs without it. I'd rather find a cough/cold medicine without it and pop a few ibuprofen.

As a fark user, I prefer to damage my liver in only very specific ways. Tonight it is Captain Morgan, not tylenol.

Barakku: I barely got a damn thing out of vicodin when I had my wisdom teeth, but then again I barely get anything out of most meds :\

I had oxycodone for an oral surgery, and I didn't know how much it helped until day 3 when I ran out.

The feds push doctors to prescribe the combination with tylenol they think it is harder for people to abuse due to the liver toxicity of the tylenol. So they ban the tylenol combination. Cue feds harassing the crap out of any doctor prescribing the same med without tylenol after they ban tylenol. This sounds like the end result may be no more hydrocodone. I don't take it but it is next on the list if what I do take ever stops working so I am a bit concerned. The fark heads at the FDA need to live for a few months in chronic pain with no medication before they start banning pain drugs.

I am so sick of being treated like a criminal because some idiot takes pain meds for entertainment.

I'm lucky. I have both GI and liver problems, so neither ibuprofen nor acetaminophen are really good choices for me. I had to have major abdominal surgery at the beginning of this year, and when I first got out of the hospital they put me on Vicodin, then Percocet, then Darvocet (knowing I had severe liver damage, mind you, because they are the ones who saw it during my colostomy). Most recently, my GP switched me to 5mg oxycodone tabs.

Why didn't the surgeon put me on that to begin with? I have a wild theory, that doctors are hesitant to prescribe the straight-up oxycodone because of its popularity for recreational use/abuse. The same thing goes for 'nerve pills'. There's nothing like going to the ER with a legitimate health crisis (diverticulitis with perforation) and waiting for hours in agony while the staff deals with people asking, "Can't you just give me some Xanax/Ativan/Vicodin/Percocet/wtf-ever?", when those people wouldn't even be there if they could just go to their corner store and buy a bag of weed.

PS: The GP also prescribed gabapentin, generic for Neurontin; it's mainly used as an anti-convulsant for epilepsy, but for some reason is also prescribed for chronic nerve pain, like with shingles. So far it does seem to reduce my need for other pain meds.

The whole article is misleading on many levels.

All of these patent pain-killers have one thing in common: They are not as effective as opium based analgesics.

In general, they cause more side-effects, they have a higher tendency to cause addiction, and they can become positively deadly when mixed with other drugs; alcohol and barbituates for example, can be fatal even at very low doses.

Opium-based pain killers share none of these drawbacks, but they are indeed habit-forming, not usually as much so as the newer pain-killers.

Unfortunately they are not patentable, so there are no big profits in prescribing them; it pays better to administer a medication which is much more dangerous, but much more profitable.

Bohemian: The feds push doctors to prescribe the combination with tylenol they think it is harder for people to abuse due to the liver toxicity of the tylenol. So they ban the tylenol combination. Cue feds harassing the crap out of any doctor prescribing the same med without tylenol after they ban tylenol. This sounds like the end result may be no more hydrocodone. I don't take it but it is next on the list if what I do take ever stops working so I am a bit concerned. The fark heads at the FDA need to live for a few months in chronic pain with no medication before they start banning pain drugs.

I am so sick of being treated like a criminal because some idiot takes pain meds for entertainment.

Yeah, I think there is a little bit of tin-foil going on here. As Riffington pointed out, the combo drugs are popular because they work well... unfortunately the acetaminophen portion is dangerous at high dosages.

For that matter, ibuprofen and acetaminophen work well in combination too... they aren't addictive, hence little abuse. Of course, GI and liver side effects are common if taken too much.

If they follow through on this, they'll just be creating a new 'Meth'-style homemade drug.

/Unintended Consequences are the Liberal's Kryptonite.

So people will taken Vicuprofen and Lorcet (hydro/ibuprofen) instead of Vicodin and Lortab. Personally, I prefer Advil to Tylenol anyway.

Percocet will be replaced by OxyIR (just oxycodone instant release) or Combunox (oxy/Ibu). I don't know why percodan (oxy/aspirin) became unpopular, so I don't know if it'll make a comeback.

FTR, oxycodone and hydrocodone are combined with the acetaminophen because there is a clinically-proven "booster" effect.

SingletonFactory: probably to attempt to minimize abuse.

more to make abuse much more dangerous than to prevent it.

In other news, they are considering pulling NyQuil from the market. Assholes.

Opiates are Bad Drugs. There are no good Bad Drugs. All Bad Drugs are Bad. It doesn't matter if some responsible people use Bad Drugs because they need them for real chronic pain; because there are some stupid idiots who abuse Bad Drugs, all Bad Drugs have to be criminalized, taken off-market, or made hard to get. Because they are Bad Drugs, and we can't be seen as promoting Bad Drugs in any way.

Bad Drugs get people addicted, and addicts are Bad People. Bad Drugs make Bad People, so they are Bad. Bad! Bad! Bad!

olddinosaur: Unfortunately they are not patentable, so there are no big profits in prescribing them; it pays better to administer a medication which is much more dangerous, but much more profitable.

Profits for who? Do you think Lortab, Percocet, etc make money for the prescribing physician? They are both available generic, dirt cheap. Not too sure what you're getting at here.

Acetaminophen makes me vomit, so I taught myself the coffee-filter treatment when I got my wisdom teeth out. I'm pretty sure that, if the US weren't on par with third-world countries in terms of elementary education, I'd probably be a rocket scientist.

alywa: olddinosaur: Unfortunately they are not patentable, so there are no big profits in prescribing them; it pays better to administer a medication which is much more dangerous, but much more profitable.

Profits for who? Do you think Lortab, Percocet, etc make money for the prescribing physician? They are both available generic, dirt cheap. Not too sure what you're getting at here.

Not all doctors follow the pattern, but the drug companies tend to push their newest, and thus patented and higher cost margin, drugs to doctors, usually with an extensive list they've come up with why they are better than the old drug they were harping the year before, which suddenly isn't as good once it has gone off patent.

Enough doctors fall into the trap, and enough patients want the newest and "best", that the drugs with no generic equivalent get prescribed at a high level.

Riffington: 2. Yes, you can get the same benefit from taking the two drugs separately. But I know patients. Most will just take the oxycodone because it has a stronger effect, and will think the acetaminophen isn't helping, so they won't take it very regularly. And so they don't get the full benefit.

that is why this policy change is a good thing. the current state of affairs puts idiots who don't follow directions (taking other APAP containing drugs at the same time) in physical danger. the new policy will mean idiots who don't follow directions just give themselves less effective pain therapy.

"alywa:" I have studied the situation for many years, and find that any medication which is new, must be profitable, or it will be driven off the market.

Examples would be vitamins, intravenous Vitamin C for cancer, hydrazine sulfate, dimethyl sulfoxide, aspirin, colloidal minerals and especially hemp, a medication with which mahy Farkers are familiar.

All of these medications are effective if used properly; few cause any serious side-effects even if grossly misused, but all can be administered for pennies a dose---and none can be patented, hence there is no profit.

The pharmaceutical industry and the medical industry walk hand in hand, in the direction of the money.

phenn:
Do you not think that prolonged use of these drugs -- or the combination of these drugs -- can, over time, increase the dangers of serious damage to the liver?

Also, when it comes to chronic pain, do you think there are other natural alternatives that may produce acceptable results?

Moderate doses of acetaminophen are safe over prolonged periods, unless there's something else going on. High doses are not, and people using a large number of pills should really not be getting acetaminophen put in them.

There are a number of alternatives (natural and manufactured) to opioids for chronic pain. Far too many to describe in one thread, but it could range from massage to gabapentin to steroid injections to breathing techniques. Opioids and acetaminophen are powerful and valuable tools. They shouldn't be the only things a physician offers for pain, but they should certainly remain available.

Regarding abuse: I assure you all that the toxicity of acetaminophen is purely a negative effect. We do not put silent and dangerous things (like tylenol) in our drugs to avoid abuse: they don't prevent abuse very well, and we aren't trying to murder people. The fact that vicodin is sold to abusers is certainly an argument against putting tylenol in it... just not a good enough argument considering the benefits to patients who use it appropriately.

evilgreg: So people will taken Vicuprofen and Lorcet (hydro/ibuprofen) instead of Vicodin and Lortab. Personally, I prefer Advil to Tylenol anyway.

Percocet will be replaced by OxyIR (just oxycodone instant release) or Combunox (oxy/Ibu). I don't know why percodan (oxy/aspirin) became unpopular, so I don't know if it'll make a comeback.

FTR, oxycodone and hydrocodone are combined with the acetaminophen because there is a clinically-proven "booster" effect.

This is what I will have to do. I currently take Norco because I am in constant pain. It lets me go outside, play with my kid and have a somewhat normal life. Every month I get my blood levels checked and take my medicine like I should. Now this happens because a few dumb-asses cant follow directions.

Percocet and Vicodin just plain don't work nearly as well as marijuana for pain relief.

/motorcycle accident
//not just talking out of my ass

Riffington: I'm seeing a lot of misinformation in this thread. Let me explain.

1. Vicodin/Percocet are not on patent. The reason that I like to prescribe oxycodone with acetaminophen is that it works better. You get more pain relief than with the oxycodone alone. If you are taking a few percocet a day, then you will have better pain relief, less drowsiness, less itchiness, etc. than a person with just oxycodone alone.
/anesthesiologist

I didn't know that was a major side effect. I always thought it was just that I was allergic to something in the mix. I'm still taking benadryl with my percoset tonight though. I've got bad enough allergies tonight without the mad itchies.

It was a whole lot worse on non-generic percodan, which I was on several years ago.

/Once broke out in hives because I was allergic to my allergy medicine

LavenderWolf: Percocet and Vicodin just plain don't work nearly as well as marijuana for pain relief.

/motorcycle accident
//not just talking out of my ass

That is why I chew Lotus leaves.

I would prefer not to look like a drug seeker when asking for drugs without acetaminophen in them. I got enough probing questions last time I was in the ER on day 8 of a migraine.

I prefer to get as many of my drugs separate and just take what I need at that time, which has become enough of a pain in the arse with pseudoephedrine, and having to get a two weeks supply at a time from the pharmacist.

phenn:
Also, when it comes to chronic pain, do you think there are other natural alternatives that may produce acceptable results?

I'm not speaking of the wild-eyed pain that cancer patients endure. I'm speaking of people with back worries, female problems, bowel disorder, etc.

Is there something else worth looking at?

"Natural"??? Given that opium is a plant derivative, how much more "natural" do you want it to be?????

Aspirin is derived from salicylic acid--which is derived from a tree bark; arsenic is a heavy metal. Good god I'm so sick of people wanting "natural" alternatives to "drugs" when most drugs are, in fact, totally natural.

For your female problems, cramps and what not, why not try Kagel exercises, more water, less chocolate, and asking your OB/GYN about hormone therapy? (Hormones: body chemicals: natural) Or have her see if you have ovarian cysts that need removing. SHeesh.

Gyrfalcon: Opiates are Bad Drugs. There are no good Bad Drugs. All Bad Drugs are Bad. It doesn't matter if some responsible people use Bad Drugs because they need them for real chronic pain; because there are some stupid idiots who abuse Bad Drugs, all Bad Drugs have to be criminalized, taken off-market, or made hard to get. Because they are Bad Drugs, and we can't be seen as promoting Bad Drugs in any way.

Bad Drugs get people addicted, and addicts are Bad People. Bad Drugs make Bad People, so they are Bad. Bad! Bad! Bad!

Wow. That's bad.

Lehk: Riffington: 2. Yes, you can get the same benefit from taking the two drugs separately. But I know patients. Most will just take the oxycodone because it has a stronger effect, and will think the acetaminophen isn't helping, so they won't take it very regularly. And so they don't get the full benefit.

that is why this policy change is a good thing. the current state of affairs puts idiots who don't follow directions (taking other APAP containing drugs at the same time) in physical danger. the new policy will mean idiots who don't follow directions just give themselves less effective pain therapy.

That would make almost perfect sense if patients could be placed into a convenient dichotomy of "smart people who take medications properly" and "idiots who use drugs in crazy ways". However, patient compliance is a lot more complicated than this. There are a huge number of people who will avoid taking medicine if you tell them not to, but will also skip medicines sometimes (more often if they don't see much benefit). I say almost, because if they take too much oxycodone (more likely without the acetaminophen to help), they can hurt/kill themselves that way too.

It's important to know your patients. The FDA can't know them for you.