How To Get The Most Out Of Your Exalgo

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Cherub Says:

I have been on every narcotic out there from the lowest to 100 mg Morphine four times a day, in combination with OxyContin and Oxycodone, Norco, Percocet, and the 2mg Xanax four times a day with it. I got put on Exalgo 32 twice a day with Norco, Lyrica, and some other drugs and it was not taking care of the pain good enough. To make this short, I would put my Exalgo under my tongue to soften it up and split the pill with a pill splitter, you'll see grey and white. The white part is the med, but then I would chew it up or grind it in a pill grinder and swallow it. Works 100 times better and faster.

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buddy Says:
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Thanks for the advice. I know it's not recommended to take it that way, but you were right. I got relief for the first time.

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msfyt Says:
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Since I started taking Exalgo (and yes, like the rest of us, I've been on everything else), I feel strangely "restless". I'm not tired at all at night but of course, I still have some pain. I know I'm on the correct dose but has anyone else felt this type of sensation? I amost wanted to say "stimulated" but yes, it does make me want to get up and do things. (Naturally, some of the things I must do cause pain regardless of what I take.). I guess I expected a little more's fatigue or sleepiness. I want to be able to sleep at night. Anyone? BY THE WAY, that's a good tip about putting it under your tongue and I hate to say it but I tried it too BECAUSE OF THE LACK OF SLEEPINESS AT NIGHT. I only did it twice because I'm afraid and don't know what I'm doing. Any comments on the "restlessness"?

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David Says:


According to the National Library of Medicine, 'trouble sleeping' is listed as a side effect of Hydromorphone (Exalgo). So this could be what's causing the lack of sleepiness/restlessness you're feeling.


It goes on to mention that you should talk with your doctor if you experience this... but I don't know what they would do other than prescribe something else on top of Exalgo to help counter that particular symptom.

Have you tried using any natural sleep aids, such as lavender essential oil or cannabis (indica)?

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msfyt Says:

@David: Yes, I tried Valerian (my cats seem to get a lot out of that, LOL) and also have Tizanidine (a muscle relaxant), and recently bought a Sleep Innovations mattress topper. I slept on the mattress topper for the first time last night and got quiet bit of peaceful sleep. Coincidentally, I had this same problem with Nucynta, to the point where I had to quit taking it. My doctor told me that a few people will have the OPPOSITE reaction to some opiates (I seem to have the most problems with the synthetics and semi-synthetics (but the alternative is to go back to the pure opiates and feel like a zombie/with all the mental "fogginess". I don't have that at all with Exalgo. I'll give a little more time for me to get used to it. I usually give everything three months. THANKS MUCH!

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Ginja Says:

Separating the grey part from the white part, grinding the white part down with a Dremel, adding some sodium bicarbonate, and insufflating the powder is how to get the most out of your Exalgo.

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David Says:

@msfyt (post #3),

Valerian root is a great option! I actually have a bottle sitting in my medicine cabinet right now. The smell is pretty intense if you ask me, but it does seem to work well for its intended purpose!

Also, if you have the option to try an indica-based strain of cannabis, that sounds like it may be beneficial as well. I don't smoke it, but rather ingest capsules containing the resin oil and it seems to knock me out at night with no problem, even if I'm experiencing insomnia! However when it comes to any edibles/capsules, I find that you do have to wait at least 30min for it to kick in.

As to the mental fogginess, ginseng and black tea are what I personally use for mental clarity and increased alertness, so those are two things I'd encourage you to look into if you ever have that "zombie feeling" again with the pure opiates.

Hope this helps!

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Kate Says:
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What are the differences between the brand name Exalgo (12 mg extended release) by Mallenkrodt and Mallenkrodt's generic formula of Exalgo? My doctor indicated generics, in general, can be "different" from brand name by as much as 30%. Since Mallenkrodt manufacturers both the brand name Exalgo and its generic, I am hoping they are the same. My insurance company wants to cut costs. Does anyone know what the differences are between the two? Thank you in advance!

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Tamara Says:
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I dont know if the original poster will ever see this or not cause it's been so long but I was wondering if anyone knew how long does the pain relief last when doing it this way?

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veiled pi Says:

get Elavil for sleep. Start with 25 mil, and then go up if that doesn't work. I am on 100 mil a night, and going down to 75 m. It works well, except it makes me groggy, although I was always groggy in the morning anyway. I'd rather be groggy for a little bit then not having enough sleep.

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Leslie Says:

Re: Kate (# 7)

No difference But it does take 4-6 days to get full titration,full saturation of the blood stream. Take it the same time everyday. Don't crush it, this is a 24hr. pill. You might need 32mg if you've been on opiates a long time. After Opana was taken of the market I seached for days for a like drug, I took 40mg. OPANA THIS works for me not sick, no pain and they achived a 24 hr. pill that actually works for 24 hrs.I take it in the AM so I sleep for a good 8-9 hrs. during the 24 hr. Period, my sleep meds are not affected either?

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Joan Says:
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How long did it last? I’ve been on 4 16mg Exalgo for 5 years and have built up such a tolerance to it! I’m not sure what else I could take! I suffer from Failed Back Surgery-nerve damage-artificial disc at L4 & L5-Spinal Stenosis-DD Disorder and a few other issues. Been disabled since 2009. Severe-chronic pain is what I’ve lived with since 2004 and I’m so tired of this PAIN! I’m sure there are many others out there that suffer too!

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Jasmine Says:
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Does it take time for the exalgo to build up before it starts to help? I was on 8 mg of exalgo and now switched to 16 mg. I started it today but haven't noticed it really helping yet. Does it take a few days?

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Tracy Says:
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What is the bioavailability of 16mg Exalgo ER? How much of this drug actually goes into your system?

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