What do you do when pain medications become less effective?

Posted by penn @penn, Jan 24 1:42pm

For pain I take, Trazadone and Hydromorphone, does nothing. Does anyone have any suggestions? Thank You

Interested in more discussions like this? Go to the Chronic Pain Support Group.

Also, are you aware of the controversy now regarding Pharmacy Benefits Managers? They’re trying to set the prices of drugs and putting the little pharmacies out of business.

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@belgagrande

Besides being a member of this group, I am a retired pharmacist with a doctorate.
All medications whether they are brand name or generic have to meet strict standards of efficacy by the government. Some drugs come in different shapes and sizes yet they are the same. In fact, some manufacturers actually make the tablets that are sold as generic brands but are made by brand name companies.
As far as a pharmacist dispensing you a medication that is for veterinary use, that is not possible. Pharmacies do not stock veterinary medications. I would recommend taking the suspect tablets back to the pharmacy, show him and let him explain.

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I meant no offense I have poly cystic kidney disease and no doc, only what I felt taking a different pill I was not familiar with , I did call , was just different manufacturers but I opted to be given same medications bc in my case my eyesight isn't what it use to be and they were exactly similar to my calcium and potassium pills. I meant no offense to anyone ,

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@wvsue

Also, are you aware of the controversy now regarding Pharmacy Benefits Managers? They’re trying to set the prices of drugs and putting the little pharmacies out of business.

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I also try to keep my hometown pharmacy in business , bc we have lost so many jobs here in VA.

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I have Adhesive Arachnoiditis. It’s one of the most painful chronic diseases of all; higher than cancer pain and higher than CRPS. It’s progressive and I’ve had it 16 years so far. I started out taking oxycodone for 5 years, went onto Vicodin for a year , back to oxy, onto Dilaudid , off of that, back to oxycodone for 8 years, onto buprenorphine for a year (I don’t recommend bup) then back to oxycodone till present. This was all due to me becoming tolerant of one drug or another and because we moved overseas, then back to USA, then back overseas, now back to the US again - for good. Also each doctor had different ideas of what works best. Tomorrow I see my PM doctor because I‘ve become tolerant of oxycodone again and I believe he’s going to put me on methadone; that’s what my PA told me anyway. I’ll let you know if that’s going to work. Oh, I’m also on a fentanyl patch too.

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@gldburg92jeep

I read your discussion and wanted to chime in on the company's that make the pills. I noticed one day the pharmacy had given me a huge pill , I called they said it was a different brand name and I also noticed the huge pill did not work as well for my pain also I have poly cystic kidney disease and the large pills caused me kidney pain/ issues , was not as strong even though they were bigger does not mean better just different fillers and make up , I talked to my pharmacy that I would rather stay w 1 brand name and not the large pills. The next month after suffering that month as if I were taking a sugar pill they put me back on smaller pills and I noticed a real difference in affects of the medication so be aware of this also. I have on my record the brand name only and honestly do know it made a huge difference in my pain . Do not mean to stick my nose into anyone else's business but this was just my opinion.

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I have taken a couple different brand name drugs, then the generic after. There is a HUGE difference! I don’t know why this is even legal! I‘ve asked for name brand only but my insurance (Cigna) would only pay 20% of the insurance price. In 2024 & now in 2025, they won’t pay for my pain meds period! I had to pay for Good Rx to help me pay for them. It’s infuriating what insurance companies are doing to us! I can’t even get a much needed MRI.

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@belgagrande

Besides being a member of this group, I am a retired pharmacist with a doctorate.
All medications whether they are brand name or generic have to meet strict standards of efficacy by the government. Some drugs come in different shapes and sizes yet they are the same. In fact, some manufacturers actually make the tablets that are sold as generic brands but are made by brand name companies.
As far as a pharmacist dispensing you a medication that is for veterinary use, that is not possible. Pharmacies do not stock veterinary medications. I would recommend taking the suspect tablets back to the pharmacy, show him and let him explain.

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@belgagrande I did take those pills back to my pharmacist and he said some Pharmaceutical companies make generics without markings. Drugs.com is an American publication. I am in Canada. I guess what is accepted in Canada is not accepted in the States - and vice versa. Many people used ivermectin, which also is for veterinary use, to treat for Covid as well. 🤷🏼‍♀️

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@cynthiaw

I have taken a couple different brand name drugs, then the generic after. There is a HUGE difference! I don’t know why this is even legal! I‘ve asked for name brand only but my insurance (Cigna) would only pay 20% of the insurance price. In 2024 & now in 2025, they won’t pay for my pain meds period! I had to pay for Good Rx to help me pay for them. It’s infuriating what insurance companies are doing to us! I can’t even get a much needed MRI.

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@cynthiaw same here in Ontario, Canada too, but our insurance coverage is run by our provincial government.

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@gldburg92jeep

I also try to keep my hometown pharmacy in business , bc we have lost so many jobs here in VA.

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Contact your state senators and representatives. There is a bill that has been sent to Congress to address this issue. The problem is that too many of the members receive kickbacks from the pharmaceutical companies for their profit.

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@belgagrande

Besides being a member of this group, I am a retired pharmacist with a doctorate.
All medications whether they are brand name or generic have to meet strict standards of efficacy by the government. Some drugs come in different shapes and sizes yet they are the same. In fact, some manufacturers actually make the tablets that are sold as generic brands but are made by brand name companies.
As far as a pharmacist dispensing you a medication that is for veterinary use, that is not possible. Pharmacies do not stock veterinary medications. I would recommend taking the suspect tablets back to the pharmacy, show him and let him explain.

Jump to this post

Are you aware of PBMs (Pharmacy Benefit Managers)? They include Express Scripts, Optum Rx, CVS. As I mentioned to another member, they set pricing for drugs. There is a bill before Congress to address this issue.

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My dr had prescribed Fentanyl patches and then I was allowed 2-3 Vicodin for break-thru pain. I started on 12.5mcg of Fentanyl patch that i changed every 3 days and 3 years later my dosage was 75mcg patched every 2 days. My dr had to keep increasing the dosage. He explained to me that it's a vicious cycle. Pain, then take pain meds, then they become less effective so more pain, increase dosage, etc. I did finally go down on patch and then totally stopped. No pain meds since 2019. I learned healthy ways for me to deal with the pain. It's not for everyone but for me, it's the best option.

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