I suffer from degenerative osteoarthritis secondary to Marfan syndrome, and there have been times when it has been difficult to obtain adequate pain control medications from physicians in the US, who (for the most part) are shockingly ignorant about the role that opioid medications can and should play in the long-term management of moderate to severe pain.

Marfan syndrome is a connective tissue disorder — it is an inherited condition caused by a faulty gene (FBN1) on the 15th chromosome. This gene codes for a glycoprotein named fibrillin-1. In patients with Marfan syndrome, this gene codes for a defective version of fibrillin. The consequence is that my connective tissue is insufficiently elastic, leading to very serious anatomical and physiological abnormalities impacting numerous organ systems.

I worked as an Information Technology consultant for many years, which led to my traveling all over the US during those years. Many doctors refused to provide me with adequate pain relief, out of concern that I would become “addicted” to medications from the opioid class of drugs. Other doctors — more enlightened doctors who knew what they were doing and who know how to treat people for chronic pain — were more reasonable.

During those periods when I found it impossible to obtain adequate pain relief within the US, I obtained prescriptions from doctors in other jurisdictions, and was thus able to obtain adequate pain relief. Azur contains 30 mg codeine phosphate per dosage unit; codeine is one of the weaker opioids. Although it is weaker than dihydrocodeine and hydrocodone, and although it is much weaker than oxycodone, oxymorphone, and hydromorphone (Dilaudid), I [personally have found codeine to be an effective analgesic for the control of mild to moderate pain. Caffeine renders it suitable for the treatment of headaches, and paracetamol (acetaminophen) is a non-opioid analgesic that, when combined with codeine, is very effective. The analgesic power of these three ingredients combined is greater than the sum of the analgesic powers of the three ingredient (this is called synergy).

Azur is a medication that I have taken on many previous occasions, and that I find to be highly effective. It also contains less paracetamol (acetaminophen) than Tylenol with Codeine #3 (350 mg as opposed to 500 mg per tablet), which permits me to take a greater number of Azur tablets every 24 hours than Tylenol with Codeine #3 tablets every 24 hours.

This is an excellent drug for the long-term management of mild to moderate pain. For more severe pain, I take other medications from the opioid class (such as hydrocodone with acetaminophen (Norco, Vicodin, Lortab, etc.). Please note that I am not a doctor and that these comments reflect my experience as a patient.

SINCERELY

PHIL

Yeah, Phil, I am also not a doctor and may say only about my own experience that resembles your one as for Azur. I have found a real relief in this drug and going to take it so far as I have not found any another medication that could substitute it.