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Pain Management Message Board


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I saw my doctor today and ask to start on a long-acting drug. Up until now I have only had Vicodin and Tramadol, both of which only last a few hours. My doctor prescribed Kadian (30mg). I told her I didn't think my insurance would cover it, so she also gave me a prescription for MS contin just in case. Well, my insurance does not cover Kadian, but I decided to spring for it anyway. My doc gave me a coupon for $50 off the drug each month for 12 months. The total cost to me was just under $100. I decided to pay it because I have lived with unmanaged pain for too long, and wanted to at least see if it worked.

My question is this: How does MS contin compare to Kadian? It would save me $100 a month, but I am worried that it will not work as well. My doctor said it might not last as long, but is essentially the same drug. I really don't know much about morphine at all, so I don't know what to expect. Any help you can provide would be appreciated.
Hello.....Sorry to hear about your problem. I take Avinza, which is also LA morphine....24 hr though. My Doc has discussed possibly trying the other two as well.

I think all are about the same, if you take them 2 x day. I started out on Avinza 1 x, but had to move to 2 x, and it's worked fairly well since. I think the main issue with morphine, is to ensure you get the coverage every 12 hours. But LA morphine is LA morphine....Just a matter of whether it lasts as long as they claim. Kadian may in fact work a little longer than MsContin, but I'm not sure. They do have a patent on their time release mechanism and claim coverage lasts 12-24 hours. The originally debuted it as a 24 hr med, but recently changed it to 12-24. Somewhere in the middle is probably appropriate. With that beign said, I'm not sure it's worth the big price difference. I would try MsContin and see for yourself and then decide from there. Normally, when one goes through a regimen change, follow-up appts every 10-14 days is appropriate. If it were me, I would ask my Doc if I could try both given the huge price difference...Maybe two weeks on one, then the other.

The main thing you need to know about LA morphine is that the pain fighting mechanism is great....You also don't get euphoria and some of the traditional side effects that you get with say Oxycontin or Fent. I don't think it's nearly as drowsy as some others either. The main disadvantage is that it has poor bioavailability....Around 30% when taken orally. Thus, the dosage required is usually much higher than comparable meds.

For example, you need about twice the qty of morphine as Oxycodone....So, if you take 40mg of Oxycontin 2 x per day, then you need around 80mg of Morphine 2 x day. Kadian comes in strength of 10, 20, 30, 50, 60, 80, 100, 200. Conversely, Ms Contin comes in strengths of 15, 30, 60, 100, 200. I bring this up because your dosage requirement may decide which you will ultimately need to use.

Lastly, please keep in mind our discussion previously on brands vs generics....Remember the thread "brands vs generics- major findings".....Generics can be up to 20% less potent. So, comparing Kadian (doesn't have a generic) to a MS Contin generic, may be comparing apples to oranges.....Just wanted to remind you.

Hope this helps, and please let me know if I can help further.

Regards,

Ex
As Ex points out, brand versus generic can make a noticeable difference.

I've been on MS Contin for over a year now, and started with the Ethex generic. It worked OK, until one time they had to substitute with the Endo generic, because of a supply problem with the Ethex tabs.

I was blown away at how much more potent the Endo generic was. It actually felt like I was given a dose increase. I never want to return to the Ethex generic. And I've never even tried the brand tabs.

So be careful with generics.

Another point Ex makes is the duration of the LA meds. the MS Contin is indicated for 12 hour relief, and for me that fails miserably. I am given the med 3 times per day now and it's fine.

Best of Luck!

steve





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