Extended release oxycodone-long-term use?

Hello @shafer1990, Welcome to Connect. I can't imagine what your husband must be going through. I have never heard of oxycodone being used to treat PMR but I'm not a doctor. My PMR was in remission when I had my right knee replaced a few years ago. Prior to the knee replacement I was told I had a steroid injection for the knee pain it would delay my knee replacement surgery a few months because they don't want to do surgery if you are on any kind of steroids from what I remember.

I was given oxycodone after the knee replacement but chose not to take it. I took over the counter pain meds instead. Has your husband discussed his pain symptoms or possible drug interactions between the oxycodone and prednisone with his surgeon or care team?

Hi John,

Thank you for the quick reply. We went through several meeting with the doctor and the surgical team. They were aware of the prednisone my husband was taking and only had him stop the day of the surgery. Maybe there was a difference in the oral steroid vs. injection?

15mg of prednisone is the most he has taken and he hates even taking that dosage. The only other thing that has helped the pain of PMR has been Delta 8 gummies. Unfortunately, he can't take those and work. The gummies have enough TCH (hemp derived) to make him feel "high". The PMR pain is completely gone while on the gummy.

This has been a frustrating disease and our last visit to Vanderbilt a few weeks ago was disheartening. My husband is only 55 years old and a young 55!

Thanks again for your reply. I was just curious if others had taken any other course of action for pain relief.

PMR can be frustrating. I don't think anyone likes taking the prednisone but if you have PMR, it's the drug of choice and really gets rid of the pain. Both of my occurrences were started at 20 mg prednisone with the goal of tapering off slowly as the body allows. My rheumatologist had me keep a daily pain log along with the dosage of prednisone which helped me taper off. I generally did not taper to the next lower dose unless my aches and pains were tolerable. For me, that was on my scale of a 1 or 2. There were times when I had to bump up my dosage.

You might find the following discussions helpful:
-- PMR Dosages and Managing Symptoms: https://connect.mayoclinic.org/discussion/pmr-dosages/
-- Prednisone tapering and remission: https://connect.mayoclinic.org/discussion/prednisone-tapering-and-remission/

Just a thought...If his pain is PMR pain (vs. knee pain), he may be having a flare caused by the stress of the surgery. If so, standard recommendation is to up the prednisone by 5 mgs. until he's stabilized and then drop back down to where he last felt good.

Thank you. That is definitely what is happening.
Appreciate you reaching out.

My husband has his first total knee replacement next week. He is currently taking 2 mg prednisone daily for his PMR. This dose has been a gradual taper since his diagnosis in July of last year. Unfortunately, he is saying some of the original, debilitating shoulder pain is recurring at this dose. The orthopedic surgery team is accepting his current steroid dose, but we are concerned about progressive shoulder/neck pain as he tries to complete knee physical therapy. He did not like how oxycodone made him feel after his RALP, so doubtful this is an option. Has anyone increased their oral pred dosage post knee replacement? Time frame? I understand everyone is concerned about infection and immunosuppression. Of course we will get his surgeon’s recommendation, but appreciate anyone who has PMR and has had knee replacement surgery discussing their recovery.
Thanks for your help!

So sorry your husband is suffering. Long term narcotic use can be prescribed by a pain management Dr. I hope you both find relief ✌️

Hi. I am new to the world of PMR and it's horrible....In the 90's I was diagnosed with chronic fatigue, fibromyalgia, Sjogren's disease, osteo arthritis and basically managed my pain with hydrocodone and tramadol with no side effects, and plaquenil. These meds kept me working in a very crazy busy all consuming career. In 2015 I was diagnosed with RA. We doubled the placquenil and added 3 mg. of prednisone because I got infections when we tried methotrexate. Things settled...I started having problems with my knees and eventually had to go on disability. Last year I went through a big downsizing and sold a house and moved to DE from DC area. They've was hard on me physically.and I noticed a big increase in my symptoms. Because of the issues with pain meds as my pain increased the meds did not change. I have tried oxycodone but.it makes me loopy so I prefer hydocodone which has no side effects for me. I started to have a new type of pain.in new places and eventually.I could not use my hands. I went to my new rheumatologist thinking it was RA but she thought PMR. So I was.put on 20 mg. of pred. Then had to start reducing. When I got to ten.things went south, but the focus seems to be on reduction of the pred. I am struggling to learn about how to manage. The thing I realized is I am not.functioning very well with this. It's very different than my other conditions. I am waiting for labs to see.sed rate etc. I am on 12.5 pred but my pain is bad. So I will go back up. I would think med decisions would be made on pain...no? So on what can help with pain for me was 800 motrin. It's not amazing but it has helped a bit...3 x day. If your husband can't take oxygen he might try hydrocodone instead. That has been the best for my knees. Since I have been on it since the 90's and my PMR pain was so bad I can't say what it could do for PMR.
.but I believe trying things is good. So way too much info there but I wanted to tell you about the meds...and see if anyone has advice for me on the decisions.on b reducing the dose...when and why. For 30 years I managed these conditions in a way to function. This is different....I am a bit lost. Any advice or info is welcome! Thank you for reading.this. take care

Hello @njtodctode, Welcome to Connect. It does sound like your rheumatologist is right about it being PMR. I think one thing all of us have learned with our PMR struggle and tapering down on prednisone is that you definitely need to listen to your body. If the 20 mg prednisone pretty much eliminated your aches and pain within a few hours and keeps you pain free all day, that is pretty much how PMR is diagnosed. Tapering slowly is the name of the game with PMR.

There is another discussion you might find helpful:
-- PMR Dosages and Managing Symptoms: https://connect.mayoclinic.org/discussion/pmr-dosages/

When did your rheumatologist diagnose the PMR and start you on prednisone?

Thanks for the reply. I was diagnosed in May. The 20 worked after a few days. Stayed on 20 for 2 weeks then 15. Symptoms backtracked some. Then 10. I was told to try 12.5. Didn't do much. My pain doc suggested I try 20 again which I did. 2 weeks then 15. My labs showed some reduction in my inflammation level. But I have intense pain in my hips and back and shoulders. I can't do anything. Never had back pain before. I am now on 12.5 but I think I need to go back up. My.rheumotogist wants me to try an immune med too....I don't really want to. Methotrexate made me sick right away...so she said there are others but......not sure what to do. I hope I get my labs today that will give us a piece of info. So.