Thursday, June 20, 2013

Monday, October 27, 2008 hurting36 asks

Q: Could someone please help with a very important pain med? PLEASE! Fentanyl vs. ?

I'm currently on Fentanyl 50mcg, wont stay on, so I received the cover patches from the manufacturer. Still seems only controls the pain for 2 days tops! My pain Dr. & I are still looking for a good combination. I was wondering if anyone suggests extended oral meds, the patch seems to help some, but it is a constant battle to keep it on. So I rely greatly on breakthrough meds, especially the day, to day and a half not working. Sounded good when first started, but after 2 months, it just seems to add to my frustration. I take 10/325 perc. for breakthrough, along with Lyrica due to left leg pain, and also have had bladder issues. If anyone has any suggestions please help! I see my pain Dr. on the 7th of Nov. Thanks!

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Answers (7)
10/30/08 12:04am

Sometimes those darn patches just do not stay on. The fentanyl patches work well if they do stay on because they work 24/7 for your 24/7 pain. Extended relief medications provide a "safety net" of pain relief that allow you to play with your children or go to work without the inconvience of taking pills all the time. If one does not work for you, other options are available.

 

Which ones work best? Ultram ER (extended release tramadol) is very good (best if taken twice a day instead of the recommend once per day). Avinza is a once per day morphine product. Kadian is a twice per day morphine product. Both, work well as directed. Opana ER is oxymorphone extended release and is taken twice per day. It is too new for me to have an opinion about it. OxyContin brings several opinions to mind, none of them favorable. Methadone can work, but the dose is highly variable. New medications are coming soon. So stay tuned.

Dr. Christina Lasich, MD

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10/28/08 1:22pm

There are two extended release meds that I know of. They are MScontin which is morphine and Oxycontin which is oxycodone. I take Oxycontin and Oxycodone for breakthru pain. They both help, but I am never totally painfree. Good luck

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10/30/08 11:42am

Hi there! I was on Fentanyl patches (2 200mcg patches) for years. I also had problems with them popping off and adhering to my skin. I've got a couple of great suggestions that really work!! Firstly, if you can substitute the Fentanyl patches with the generic ones, they are completely flat. They have no reservoir that makes the patches blister-like. They seem to stick 1000 times better by being flat. Also, there is a product called Hypafix that I used to put over the patches. It is a cloth type tape that comes in various widths. I used to make sure that I had at least 2 inches beyond the perimeter of the patch size itself. This stuff sticks like a madman!! Showers don't effect it at all, and you could sit in a boiling hot tub for days, and it still wouldn't come loose. And since it's a cloth like material, it shapes itself to any form. If you can't find it in the bandage isle of a drugstore, ask the pharmacist to order it for you. Believe me, it will not let you down!! Since I had used the patches for so many years, I have tried every type of adhesive to keep the darn things on!! Including the worthless ones from the manufacturer!! The Hypafix tape works like a dream. It's made by BSN Medical. A pharmacist can order it for you!! Good luck!! Stacey 

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11/ 3/08 3:11pm

I had the same problem with the patches.  They seemed to help but didn't last as long as they claimed and I couldn't keep them on to save my life on top of getting a itchy rash from them.  You have to just keep trying different meds that will do a better job.  If the patch works for you for a couple of days maybe a short acting med along with the patch might be more helpful.  The key is whether or not you doctor is willing to try different things with you.  If they aren't; find another doctor.  There is plenty of oral long acting meds that may suit you just as well.  They key is finding the right combo.  But because of the unfortuanate stimga out there about chronic pain and " addiction" is rampant and doctors are afraid to treat their patients the way they should.  You HAVE to keep trying.  You will not be pain free; and if you have that idea you are being unrealistic.  That is the problem you have to accept as part of chronic pain and if you can accept there is no such thing anymore as pain free the better you will be for it. The only way to be free of pain is to be in a complete coma and that doesn't do you any good. The long acting meds that I have been on are Avinza, MS Contin, Fentanyl patches, oxycontin, along with Ultram, Percocet, Vicodin, Darvocet, and numerous muscle relaxers.  Some combos work better than others.  But everyone is different and that is why you have to be tolerant and willing to try different things and allow enough time to see if it helps.  Don't give up because one combo doesn't work,  You might have to put up with more pain than you would like until you and your doctor can find the right combo.  Even some anti-depressants have been known to help with chronic pain.  Because if you are depressed, no amount of pain meds are going to make you feel better.  I have dealt with chronic pain for over 10 years and I seem to keep adding to my diagnosis' as to what is wrong with me,  Though it can be very difficult to dealt with you have to keep going.  You have the RIGHT to adequate pain control and the right to live as normal as possible.  Hope this helped a little and good luck.  Educating yourself is key.

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11/ 4/08 3:57pm

I am on Fentanyl 100umg. I change them every 2 days vs 3days because as you say they don't provide enough pain control on the third day. I have been on this medication for 6+ years. I do take break through medicine as needed. When the pathces don't stick the bioclusive seems to help very well. Best of lucl - Chris M.

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10/13/11 7:15pm

I have been on the fentnyl patches for over 12 years. I currantly am perscribed 2/patches every (2) days. and also perscribed two (2) 15 mg tablets of Oxy IR (3) times a day for breakthru pain. This combination was initialy started with one 5mg Oxy IR's. Together they work great in addressing all of my issues for chronic pain. some times i only use on of the 15's instead of the two as perscribed depending on what pain levels i need to correct. My main concern with the levels I am on is no one seems to know about the facts of "dry Mouth or better known as cotton moputh in which the flourides are disolved an dryed up. and all but two of my teeth have since just fallen out, and not from any decays. Yet Medicare wont cover the tooth losses or surgery I need to eliviate this on-going problem, to correct it either. I am also allergic to the zylocaine and Novacaine used to numb the gums for surgery procedures to be done.I just can't afford the costs either being on S.S.Disability income.

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10/13/11 7:22pm

continueing with my answers- I too had a problem with the stickers staying on an Duragesic will send you overlay patch free of charge by just asking an telling them how mant patches you apply an how often !!!!!! regards,wpaulywog The generics wont supply overlays at a freebees. they will chages you extra for their misstakes. THE BEST OVERLAYS are made by 3M, an one of such is listed as follows- Tegaderm Film- it's 4in X 4 3/4 in. stock # 9506W or NIRIC-8333-9506-05 ........regards, wpaulywog

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10/13/11 8:32pm

I have a severe RA problem and have taken fantynal patch starting with 50mg than 75mg and ended up with 100mg which helped the most and almost did away for the need of norco for break thru pain. But like you I had problems keeping it on especially after taking a shower. What I ended up doing was putting a waterproof band aid patch "perfect fit" which allowed me to take showers with no problem, any brand will suffice. Now here lies the problem if you do this you sapposibly take a risk of transfering med into your system in a larger dose quicker and more precisely. Although I did not have any problems my Pharmicist cautioned me. I also made my Doctor aware of the use of a waterproof patch and he thought that was a very good idea and in his opinion safe; also thanked me. But please contact your Doctor before you try this. I currently take oxycotin 60mg 1-2 morning, 1-2 afternoon or evening with norco for break thru, with 50mg lyrica morning and 75mg evening (Lyrica added 4 weeks ago "Samples" on a trial bases and to get back with my doctor if effective). This combination to me has worked the best and seems to give me improved continous pain relief. My ability to have a window of pain relief, energy overall a sense of well being basicall enough to where I can go to my son's ballgames. Which at one time impossible. I hope this helps and I completely know of the pain factor its overwhelming at times but hang in there.

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10/13/11 9:49pm

Thank you both, I did try the cover patches from Mylan, but I shortly after posting had meds changed to Oxycontin, and oxycodone for break thru. This has seemed to be best combo for me, been on them for a year and a half or more, I guess I should have updated, but thanks again.

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10/14/11 1:07pm

Great I hope that med continues to help you. I'm due for a round with my RA DR. soon; will post if anything out there helps with condtion.Stay in peace my friend.

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12/ 7/11 10:17pm

Hi,

 

My doctor just switched me from the fentanyl patch to oxycontin and oxycodone for breakthrough pain as well.  I was wondering if you went through any of the fentanyl withdrawal symptoms, and also if you tapered down the fentanyl patches or just went straight to the oxycontin.  Thanks for your time!

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12/ 7/11 11:49pm

I had no problem, and the oxycodone for breakthrough, I am still on, same dosage for almost 2 yrs., does its job. As for the switch, had to wait I think 17 hrs. to take first Oxycontin, but was fine after that, but it does different things to different people, but haven't heard many having problems with the switch. Hope it goes well, good luck!

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By hurting36— Last Modified: 06/20/12, First Published: 10/27/08