I only know of Metronic’s for the pump, refills about every 3 months. It takes my pain down for sleeping and enjoying short walks. I try everything I can to stay active with an average pain of a 5. The new bugle and tear keeps it the pain to 8 by the evening. I also take 1800 mg’s per day 1200 30 minutes before bed. The procedure was a walk in the park compared to any of my back surgeries.