10 to 15 mg of hydrocodone or oxycodone
2 to 4 mg of hydromorphone
30 to 60 mg of codeine
15 to 30 mg of morphine

These starting doses are equal to each other. As you can see it takes more codeine than hydrocodone to have the same effect. So it looks like he gave you a little more when he changed you to the tylenol #4.

Hey dawg, I made some corrections to the numbers on codiene, It was supposed to be 400 mgs a day is the max dose, not 40.But very few pure opiates have ceilings when you factor tolewrance into the picture. Other than codeine and demerol, there is no real ceilng on morpihine, Oxycodone, fentanyl or methadone. The side effects usually prevent increasing a dose before a problem like respirtory suppreson is reached.
Codeine and demi can cause seizures after prolonged use and that's why they aren't widely used in treating CP. Canada does have Codeine Contin, but the limt in dosing is clearly spelled out.

Codeine is roughly 1/10th the strength of morphine, less euphoric than hydro or morphine because it produces little Kappa receptor activity and at best your getting something half the strength of the 10 mg norco, and that's being really generous. It sounds more like you on a taper. Is this post op pain or chronic?

There was a thread last week or two weeks ago about CP in young people. You might want t bring it back to life. It seems we have lots of young folks being told the same line.

If you stop for years you tolerance will reset and you could have surgery and the norco will work fine for post op pain. There are some docs that believe n medication holidays, meaning discontinue the norco for a month or two and use T4's and then when he switches you back to Norco in 2 months it will work better. Unfortuantely that only works for a couple months before your right back to the same level of tolerance. IMO. I'm not sure the two improved months when it's reintruduced is worth the 2 bad months when you went without or with squat. But every PM doc has their own POV and physlophy about using opiates, BT meds, dosing, his own comfort level and understanding of tolerance, dependnece and the value of opiates.

Good luck, Dave

[QUOTE]10 to 15 mg of hydrocodone or oxycodone
30 to 60 mg of codeine


These starting doses are equal to each other. As you can see it takes more codeine than hydrocodone to have the same effect. So it looks like he gave you a little more when he changed you to the tylenol #4.

If you go by what the chart says 15 mg. hydrocodone is equal to 60 mgs. codeine and you were getting 10 mgs. hydrocodone and now getting 60 mgs. codeine, then it appears to be slightly higher. The other changed was 325 mgs. acetimenophen decreasing to 300 mgs. so that making the tylenol #4 less potent. My mistake, sorry. I was just looking at the opiate number.

I haven't read anything on paxil in a long time. It might be a factor to consider. Docs are pretty good about looking at all of your meds and knowing about reactions, but once it was overlooked that I was taking tagament which had an impact of one of my pain meds.

Sorry bout that mistake,
Carol :confused:

Pdawg: I think what you really need to do is somehow convince your doc to prescribe a Schedule II for you. There are a lot of them and you really don't have to worry about prescribing them at your age. There's no ceiling (as Shore pointed out) to them, so there's always plenty of room to go up, if need be.

I would suggest, at the very least, he try you on Oxycodone. Maybe Percoset or just plain Oxy. That would be the next logical step in pain relief.