• tcavner1 tcavner1
    October 14, 2011
    Which drug is stronger in a pump, Dilaudid or Fentanyl?
    tcavner1 tcavner1
    October 14, 2011

    Hi! Newbie here, so I will apologize for mistakes now. I have a pain pump implanted after years of different therapies, none of which gave me relief. First it was only morphine. Then it was morphine, clonidine and ribivacaine. I didn't know my levels of morphine were being lowered each time. Then they changed the morphine to dilaudid which started out low, took out the clonidine, and raised the ribivacaine and gave me 6 boluses. Every refill now, they lower the dilaudid a little more and raise the ribivacaine. My big questions are, can fentanyl be used in a pump? Is it stronger than dilaudid? And can you take orals with a pump? Any information would be greatly appreciated!

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FROM OUR EXPERTS

  • Cort
    Health Guide
    October 16, 2011
    Cort
    Health Guide
    October 16, 2011

    Yes, Fentanyl can be used in a pain pump and it is stronger than hydromorphone. It sounds, though, as if they are trying to wean you off of opioids (both morphine and dilaudid are opioids) which is not a bad idea given all the side effects - while ramping up ropivacaine, if I have the drug correct. 

    • Patti Rooke
      October 17, 2011
      Patti Rooke
      October 17, 2011

      actually one really isnt any stronger then the other as they are 2 different types of drugs. Fentenyl is a sedative and hydromorphone or dilaudid is a opiate and are designed to do 2 different things.

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    • Karen Lee Richards
      October 17, 2011
      Karen Lee Richards
      Health Guide
      October 17, 2011

      Fentanyl is most definitely an opioid.  In fact, it is a very powerful opioid.  It may have some sedating effects for some people, but it's main purpose is as a pain reliever.  See:  Fentanyl

       

      tcavner1 – When it comes to questions about pain pumps, a good place to ask  is on our forum.  That's where everyone gathers to discuss anything to do with intrathecal pain pumps.  There is an excellent ongoing thread entitled “Willing to share experience with intrathecal morphine pump implant.”  It's a pretty long thread, but it's a very active group, so rest assured your post will be read and answered.  Just click on the link above, then go to the last page and post your question. 

      (Note:  If you've never been to the forum before, you'll have to register separately from your registration here on ChronicPainConnection.  You can, however, use the same e-mail address and password if you'd like to make it easier to remember.)

       

      Karen Lee Richards

      ChronicPainConnection Expert

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    • tcavner1
      October 18, 2011
      tcavner1
      October 18, 2011

      Well it seems a little oxymoronic to give me the orals first, 100mg 3 times a day, suggest the pump at a later date, then implant it. Treat me with morphine and ramp me a little, then suggest dilaudid and leave me with less than 2 mcs total including my boluses. My pain still sits at 7 and I can't walk to the other end of my house...

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    • tcavner1
      October 18, 2011
      tcavner1
      October 18, 2011

      I am SO sorry for the meltdown. I am just so discouraged with it all and I hurt so bad! I just can't seem to find the answers that might help. I don't know, maybe I'm asking the questions wrong. All I know is I can't walk with my son to Trick-or-Treat, and it makes me sad...

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    • Patsy
      January 12, 2014
      Patsy
      January 12, 2014

      I am just getting fentanyl into the pump now after being on dilaudid for 10 years, hope it does the job

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FROM OUR COMMUNITY

  • nancyrae January 24, 2014
    nancyrae
    January 24, 2014

    My mother had fentanyl in her pain pump for 6 years. Her back surgery had failed and after taking morphine drs gave her the pump with fentanyl she had to replace the first pump lasted 4 years battery went dead. At 73 years old she started having side effects from fentanyl. Everytime she stood up her blood pressure would drop. Drs told her they had to take her off it and she had become so depended on it and knew the with drawl off would probably kill her. So she took her own life overdoses with morphine which was still prescript to her for break thur pain. Please anyone reading this understand this medicines is so strong they give it to people who are dying. Its not meant for those who still have to live. Quality of life but is it worth it ?? The drug will take control and give you a premature death date from side effects or trying to with drawl off it.. 

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  • Christof60 December 07, 2013
    Christof60
    December 07, 2013
    Fentanyl IS a synthetic opioid Ms. Patty... ER/Trauma nurse for 16 yrs and we kind of know our medications. Taken straight from the source- "is a potent, synthetic opioid analgesic with a rapid onset and short duration of action". Now addressing your "advice" to the person to use Morphine in their pump. Did they tell you WHY you got the granuloma???? Read up on long-term intrathecal Morphine and that is one of the not-so-rare complications of it. That is why I was taken off Morphine after a year and placed on Dilaudid. I am now on Fentanyl and have been for a year. It has reduced many of the horrible side effects of Morphine and Dilaudid (morphine was the worst) such as nausea, anorexia, and especially constipation. I receive 255mcg/24 hr if I use my boluser. The only negative thing I can say about the intrathecal pump is that if it ever cannot be filled, for whatever reason (natural disaster, collapse of economy, etc.) I'd likely be dead in a week. Withdrawals are supposed to be more deadly than from those we saw who drank heavily daily and suddenly stopped. I hope I never find out. But for so many who like "the buzz" that pain pills give, the pump will not make them happy. Since it doesn't enter the bloodstream, the only effect I notice is numbing of lower extremities but BIG reduction in my pain. I'll never go back to Morphine in my pump for exactly the problem you now have, a large granuloma that is far too frequently seen in patients who get long term intrathecal morphine... READ MORE
  • Ben w/RA October 17, 2011
    Ben w/RA
    October 17, 2011

    FENTANYL is a very powerful pain med belive me I'm on it and by no means a sedative , now thats my opinion based on what I feel.

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    • firestorm20034
      October 20, 2011
      firestorm20034
      October 20, 2011

      I totally agree with you.  Fentanyl IS a VERY strong pain med.  I know this because my surgeon gave it to me after surgery when none of the other pain medications were working.  I was in so much pain I couldn't sit up and he came in and said they were changing over to Fentanyl which was the strongest pain med. available and much, much stronger than the medication they were giving me introveniously.  They also gave me a sleeping pill at night and I don't think they would have done this if it were a sedative.  I guess any pain medication can be looked at as a sedative per se' if Fentanyl is because most can have a drowsy effect on some people.  I also have it in my pump.  I have had Dilaudid and Morphine in the past also.  In fact I just had my Dilaudid replaced with Fentanyl because I felt like my body had gotten use to the Dilaudid and it wasn't working as well as it had been.  I tried Morphine when I first got my pump and it caused my feet and legs to swell so badly that they had to replace it with a different medication.  I also know of people who swear by the Fentanyl Patch to control their pain and wouldn't think of using anything else.  I take Oxycotin 60 mg twice a day for pain and have Percodan for my break-thru  when it's really bad and take Norco 500/10-350 when the pain is bearable instead of the Percodan.  I have severe back pain and have had several surgeries in the past and have been seeing a pain management doctor for the past 5 yrs.  I was referred to him by one of the top back surgeon's in the Houston area which I had been seeing for 5-10 years previous to that so I am no stranger to this either.  I do think anyone who has a pain pump should know what's in it.  If you don't then ask questions, ask for the print out, ask more questions, why? why? why? and if you don't get the answers you are looking for then by all means find another doctor.  There are too many out there to put yourself in incapable hands. 

       Hopefully we will all have better days ahead!!! Smile

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    • denise
      February 12, 2014
      denise
      February 12, 2014

      I myself have a pump since 2008 and have morphine and buvicaine in it. I'm ready for a change everytime I try to get it increased I get sick. Talked to the dr and he suggest putting a med in it to help the medicine work better or change it completely to dilaudid.I'm nervous about it what do u think.

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    • Ima
      Ima
      February 26, 2014
      Ima
      Ima
      February 26, 2014

      You are absolutely CORRECT!!  It's not just how YOU feel but it is a FACT that it is given for pain management.  I have been in pain management for 15 years and 4 years ago, my pain management doctor prescribed the fentanyl patch.  I would be an unbearable pain without it.   It was also given for pain in an IV to someone I know who was in a very bad motorcycle accident (he died later).

       

      Good luck to you and may you be pain free.   :-)

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  • Patti Rooke October 17, 2011
    Patti Rooke
    October 17, 2011

    fentenyl is a sedative and morphine is for pain and a major or the major narcotic. Dilaudid is a dirivitive of morphine or in that family and the same family as herion. Fentenyl works in a pump for pain as it masks it more than opiates do. It matters also how much medication  is in there and what kind of pump you have and so on.And if your dr lowered your morphine without telling you....Get a new dr.!! I knew every aspect of my pump refills along with a paper that gave my levels and the pump size info and all that in case of emergency and you should always be getting a log of what was in the pump as well as what was new in the pump and your oral scripts and pump info should all be on the leflet your dr should give you each time you go for a refill. Its a life saving paper if you ever have to go to the hopital and you take it with you otherwise if the ER or any part of the hospital talks to your dr. they can relay the info to your dr. and he/she should be able to talk better with the er dr or who ever as they would then have your info. Pain drs can not remember all thier pump patient concetration levels and that paper will tell him/herall they need to know to be able to treat you for pain or what ever you are there for. if u arent getting that, seriouosly get a new dr. And you can take orals with a pump but only one narcotic. I took methadone with mine, some take oxycodone with thiers. You will have to try ssome to see what works for you and talk with your dr about being more involved in your management.

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    • tcavner1
      October 18, 2011
      tcavner1
      October 18, 2011

      I have been on the fentanyl patch but that was way back when. Like you, I've suffered so many years I have just about reached the end. I have a 5 year old son that keeps me going is the only reason I hang around. I'm raising him from my bed or my chair. Mostly my bed though. It's not fair to him. My husband could just remarry. But I'm still hanging in there desperate to find some advice. I used to have morphine in my pump. Been about 2 years ago. I wonder if I could go back to it now and take orals? I have to be able to tell my doc what I want or he will put me right back on this dilaudid turn it down and give me no info. I don't even have this card I'm supposed to have. I'm going to raise Cain about all this when I go in to next appt, which I believe is next Monday! Thanks for the advice!

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    • Jeffer
      December 03, 2013
      Jeffer
      December 03, 2013

      I have fentanyl in my pain pump and believe me it is a pain reliever. I tried 3 other drugs before going back to fentanyl. I am not or ever will be cured buit it does take the edge off the pain.

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    • Ima
      Ima
      February 26, 2014
      Ima
      Ima
      February 26, 2014

      Fentanyl IS an opiate and it is also given to manage pain.  My pain management clinic started me on the fentanyl patch 4 years ago.  It is 80 times more potent than morphine.  Fentanyl is also used in an IV as well as sometimes administered during epidural steroid procedures.  Anyone who says opiates are not given for pain should probably do further research or ask their pain management doctors.  Dilaudid is also an opiate that is prescribed for pain.  I know this for a fact because when I went to the emergency room, morphine would not ease my pain because it was not strong enough so they gave me dilaudid injections.  Also... yes, heroin is also an opiate but let's hope that nobody is resorting to that for a pain management solution.

       

      Good luck to everyone trying to find a solution to living with their pain.  

       

       

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  • Patti Rooke October 17, 2011
    Patti Rooke
    October 17, 2011

    fentenyl is not a pain drug and it is used as a sedative and my pain dr uses it on me prior to diprovan which puts me to sleep before proceedures he does on my spine. I also am answering fenteny taken oral your question on diladid in your pain pump. I looked at fentenyl in my pump too but kept the morphine and (claunadine which is used to regulate blood pressure) as it ultimately worked best for me. I no longer have a pump as it was removed as I had an alergc reaction to the morphine sulfate and it grew a granuloma down my spinal cord that was  5 vertabrea long. My pump was removed and since then have taken only oral meds. I have taken oral fentenyl in lolipop form and they did not work on my pain alone but somewhat with methadone. they are way expensive and my insurance wouldnt cover them for my condition. The lolipops seem to be mainly for cancer patients and are only covered for them. My spinal problems which are many is also terminal so I dont understand why it doesnt fit in my catagory but what ever. I now take oral meds only which consist of oxycodone and methadone, one for long term pain  (methadone) and one for breakthru (oxycodone) plus lyrica and robaxin. Some of the time I get  decent relief but most of the time I live in hell. Get a second opinion about what to put in that pump. Try to stay away from fentenyl and go with morphine if u can as it worked very well for me for 4 and a half yrs. The only reason again I  lost my pump was because of the tumor had to be removed and because it clogged the cath line and the yhigh risk of infection the whole apparatus had to go and I was pissed when I awoke from 13 hrs worth of surgery to find my pain pump gone. I can help you thru alot of this as I am a 49 yr old woman that has been in pain mgmt for 18 yrs with same doctor and diagnosed since I was 11 yrs old. Yes...been dealing with this all my life. So believe me when I tell you that I have been thru it all. Pain meds will work diferent on everybody so I can only share with you about me however I know hundreds of pain patients and have spoken in great detail with most if not all and I have quite a bit of knowledge on this subject.

     

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