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Old 14-03-2012, 14:51
velvetstp2772 velvetstp2772 is offline
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comparable medications to opana ER 40mg

Hello,
My doctor has just prescribed Opana ER 40mg X 60 for my back pain. when I went to the pharmacy the cost after my insurance was still over 600.00 because there is no generic for this dose. my question is is there a comparable medication that isn't going to murder my wallet every month? any help would be greatly appreciated! thanks!
  #2  
Old 15-03-2012, 07:24
mistman mistman is offline
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Re: comparable medications to opana ER 40mg

Exalgo is a once daily formulation of hydromorphone. You would need the strongest strength for it to be comparable.. Reason I'm bringing it up is that there is a copay assist card available that you use with your insurance.

Last edited by Shampoo; 11-07-2012 at 15:14.
  #3  
Old 04-04-2012, 18:58
Drummer16 Drummer16 is offline
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Re: comparable medications to opana ER 40mg

Quote:
Originally Posted by mistman View Post
Exalgo is a once daily formulation of hydromorphone. You would need the strongest strength for it to be comparable.. Reason I'm bringing it up is that there is a copay assist card available that you use with your insurance.

http://www.exalgo.com/patient/exalgo-co-pay-card.aspx
To answer this question, we first must know if you are taking the Opana the directed way, or a non-directed way, such as insufflation.

Exalgo only comes in a max of 16mg strength. If you are snorting 2 40's a day, that is like getting 35mg of oxymorphone in your system when adjusting for BA. 16mg of Exalgo either eaten or insufflated is somewhere around 40-50 BA. That would mean you would get about 8mg of hydromorphone for the entire day in your system. Since oxymorphone is like 7 times stronger than morphine and hydromorphone is 5 times stronger, you would be getting about 245mg morphine equivalent with oxymorphone and 40 mg of morphine equivalent with hydromorphone, assuming you take it once a day as directed. You will be feeling quite sick in that scenario.

Now let's assume you are taking it as directed. If you are eating 2 40's a day, that is like getting 8mg of oxymorphone in your system when adjusting for BA. Eating one 16mg exalgo would still be about 8mg of hydromorphone in your system. You would be getting about 56mg morphine equivalent with oxymorphone and 40 mg of morphine equivalent with hydromorphone, assuming you take it once a day as directed. Now adjusting for incomplete cross tolerance, you should not be feeling much of any withdrawals in this situation. You will probably not feel the energy of oxymorphone and will feel more sedated because hydro is more like a morphine like feeling.

Anyways, you can see that ROA makes a huge difference. I have been asking numerous times about the first scenario, and I haven't gotten any feedback yet. I want to switch from Opana using it instranasally to something that would be equivalent with any ROA besides IM/IV. From my research, nothing exists unless maybe I get a 1.6 mg fentanyl lollipop lol.

Post Quality Evaluations:
Well broken down information that's easy to understand thanks to the well expressed comparisons.
  #4  
Old 04-04-2012, 21:31
mistman mistman is offline
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Re: comparable medications to opana ER 40mg

I was speaking to the OP about oral administration. I should have clarified that.

I don't think anything intranasally can touch oxymorphone.

Last edited by mistman; 04-04-2012 at 21:33. Reason: added info

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