Best Generic Dilaudid

Opiates available on prescription: (all IR PO-oral):
Eqivalent of 30mg oxycodone is 10-22mg hydromorphone, 80mg morphine sulphate (best brandname Sevredol one each 50-20-10mg, dipipanone (Diconal) 30mg, dextromoramide (Palfium) 30mg, heroin hydrochloride oral 25mg (but like morphine bioavailability only c.50%).
Hydromorphone instant release in UK available only as Palladone (SR is heavily favoured) caps 1.3/2.6mg. I take FIVE capsules (13mg). I have tried US hydromorph by Mallinckrodt (by far best value) & Abbott (which mmy body seems to uptake a little better). Many of my American friends opine that Mallinckrodt use excipients which slow down uptake of the API but my friend is always asking me to get US friends to get scripted hydrocodone/apap 10/325mg as she finds it helps her back more than the cheaper (and in my opinion better) DF118 Forte IR 40mg with no apap. She insists of the four brands I have procuted for her, Mallinckrodt M367 is best closely followed by Watson 853. I think Mallinckrodt products are fine esp their 30mg oxycodone.

Answer to question posted - best definitely 5 x Palladone 2.6mg, next best Abbott 8 & 4mg tablet form. Capsules act much faster and are stronger. Best taken intranasally - hydromorphone is the only drug I know whose bioavailability is more than 10% higher when insufflated than swallowed.

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Hi are you based in the united kingdom im guessing you are because 2 of the brands you mentioned are pritty much exclusive to the UK. I knoticed you mentioned dextromoramide aka palfium, are you saying you have had and been prescribed this drug recently because this drug was discontinued 10 years ago in UK its no longer in the BNF . If you have had palfium idd like to know how you got your script filled as the pharmacy would have a lot of trouble obtaining it. Also if you could obtain palfium a 30mg dose of palfium in one go would be at least twice the strength of a 30mg oxycodone tablet maybe even 2.5-3 times stronger. Palfium is also stronger than Diconal but im unsure of by how much. Some of the medical proffesion also claim that diconal is only the same strength as morphine and that its down to its cyclizine content that enhances its strength. I have had diconal on a number of occasions its harder to get them prescribed to you than sevredol and can say its deffinatly at least 2x stonger than sevredol tablets as im prescribed sevredol. .

Palfium was around 3-4 times stronger than oral morphine but was more compareable to pethidine in terms of the drugs half life dosing every 2.5-3 hours was required if patient was not on a timed release version of morphine like mst continus/morphgesic or oxycodone/oxygesic as well. Also oral oxycodone instant release tablets are not 2.5 times stronger than morphine instant release, A more correct conversion would be 30mg of oxycodone to 40-55mg of sevredol. Whoever told you that palfium is still available in uk im 90% sure there incorrect. It is still available as white 5mg tablets in the netherlands but not the 10mg peach coloured palfium you used to get here. Palladone instant release is available here like you have stated in 1.3 and 2.6mg and diconal is still available normally only as generic dipipanone with cyclizine tablets now.Hope this clears up a few things about dextromoramide aka palfium.

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Hey Minoguesque, I was intrigued by your statement about oral bioavailability of opiates. Diamorphine tablets 10mg have around 30% b/a orally. Tablets or the powder for reconstitution taken intranasally is up to near 80%. The two most stunning are hydromorphone, PO <35%, IN approx 87%. Most incredible of all is OX. MORPHONE (Opana, O-morphon) which has oral b/a of only 10% but intranasally an incredible 90%! That drug is available only in the US and Bangladesh although several Chinese API manufacturers can provide the pure hydrochloride salt and I am reliably informed by a friend on a chronic pain forum that when insufflated, oxymorphone, of which in the US she rates only Endo Opana IR as a quality tablet and if a generic is needed due to financial constraint, the ever-reliable Mallinckrodt make the best generic, if an ER formulation is required, Global Pharma's generic is far better than the supposed abuse proofed Endo ER, which few patients rate at all.

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