One Daily Morphine Sulphate (Avinza) Relieves Chronic Pain Better

Discussion in 'Fibromyalgia Main Forum' started by JLH, Jun 4, 2006.

  1. JLH

    JLH New Member

    Once Daily Morphine Sulphate (Avinza) Relieves Chronic Pain Better than Twice Daily Oxycodone (OxyContin)

    Presented at AAPM
    SAN DIEGO, C.A. -- March 1, 2006


    Opioid naïve patients with chronic low back pain may get better relief from once daily morphine sulfate (Avinza) than twice daily oxycodone (OxyContin), according to a study presented here at the annual meeting of the American Academy of Pain Management (AAPM).

    Morphine treated patients also had significantly lower daily morphine-equivalent doses compared to those in the oxycodone group.

    "You don't need to give as much opioid [with morphine sulfate]], and it's always better to give less opioid," said co-author Richard Ghalie, MD, Vice President of Medical Affairs, Ligand Pharmaceuticals, San Diego, California, United States, in a presentation on February 23rd.

    In the open-label study, opioid-naïve patients with moderate to severe chronic low back pain were randomized to receive oxycodone or morphine sulfate. The 266 patients who completed the dose titration phase went on to the 8 week evaluation phase.

    Of these, 174 entered the optional 4 month extension phase. Demographics in the extension phase were statistically different in the morphine and oxycodone groups: 68% versus 84% were Caucasian, 9 versus 7 years average duration of back pain, 23% versus 11% non-mechanical cause of back pain, and 43% versus 28% with nerve involvement, respectively.

    The average morphine dose was 86 mg; the average daily oxycodone dose was 79.5 mg. Using the American Pain Society's conversion factor, patients in the oxycodone group received significantly more opioid daily (119 mg vs. 86 mg).

    Brief pain inventory scores reported at monthly office visits were similar between treatment groups, Dr. Ghalie said.

    Absolute changes in pain scores from baseline were about 1 point lower on a 10 point scale at the second, third and fourth monthly visits for patients in the morphine group, but this difference was significant only at the second and third visits. Dr. Ghalie said this finding narrowly missed significance at month 4 because the number of patients was getting smaller.

    Sleep scores on the Pittsburg Sleep Quality Index were consistently lower for the morphine group, while the relative change from baseline on the same index was significantly better at month 1, according to Dr. Ghalie.

    Patients in the two groups reported similar incidence and severity of adverse effects.

    Dr. Ghalie said both drugs clearly work well, but one reason for differences in outcomes between the groups is that about a third of patients typically need three times daily dosing for oxycodone rather than the twice daily dosing indicated on the label.



    SOURCE: American Academy of Pain Management (AAPM).
  2. Mikie

    Mikie Moderator

    Even at my worst, I was only taking 15 mgs. of Morphine once every 24 hrs. The 25 mgs. of slow release Morphine (Kadian) knocked me out for about 30 hrs.

    Everyone is different and so many of us with these illnesses are very sensitive to meds. I'm not sure that studies done on people who do not have our illnesses necessarily apply to us. Seems to me that each of us has had to fine whatever treatment regimen fits us best.

    Thank you for posting this. A lot of docs are loathe to prescribe Morphine because for so many years, it was about all we had for people with terminal illnesses. That old image is stuck in many people's minds, including docs. Morphine is an old tried and true drug and I'm glad that my doc prescribed it. It certainly helped me before the Guai was able to relieve my FMS pain.

    Love, Mikie
  3. NyroFan

    NyroFan New Member

    jlh:

    I had morphine only once and it did give me relief until the flare up passed. I was in such bad shape it was all the doctor could do. I agree: good drug when used properly.

    nyrofan
  4. JLH

    JLH New Member

    I hope I get a little of this morphine after my knee surgery on June 22nd!!

    Maybe it will help all my other pains, too!


    Janet
  5. rosemarie

    rosemarie Member

    Who knows maybe I am just strange as the Avinzia did not last even close to 1 day. I was lucky for it to work 6 hours with out being in pain again. But then I was told that MSContin was to last 12 hours to and it does not last that long either. So it muct be me that the meds just don't work on.

    I don't know why these meds don't last as long as they are coaimed to last. I wish they did, it would be really nice to take 1 pill a day and that was all but not me I am just strange and it done not work for me.

    I am now on MSContin and MSIR and they have helped the most now and i like the dosage i am on as it is working now for me. And I aam thankfull for my apin dodctor who presribed it for me.

    I hope that the pharmacical s keep up with finding new pain meds that will last longer and stay wwwroking longer too. IT would be greaat to have a med that would last all day long and I would jump for joy is the new meds would really last as long as they claim to work. I really wish that they did.
    Love Rosemarie
  6. lilac123

    lilac123 New Member

    Good Morning Every "Body"

    I have been on Avinza for way over a year now. I started on the smaller dose and gradually he worked me up to 120mg. I take it once a day and I don't notice any ill side effects and actually don't notice anything different.

    But.....if I miss a dose or forget, I have the worst pain in my lower back and elsewhere. I have tried taking it every other day to cut back on the cost as it is expensive. Not a good idea for me. It really does help me and I can't imagine being without it.

    I take hydrocodone and flexeril for breakthrough pain. I too wonder about how long it last though. I have read it is dangerous to take it too often. Only every 24 hours.

    Hope this helps someone!
    Lil