Fentanyl Patch/Oxycodone error...?

I'm not sure if I am in the right place for this or not?

I have Chronic pain and my pain doctor started me on the Fentanyl patch about a month ago along with the Percocet I already take together. Only I'm just usinng it as a supposed to type of thing.

See, I had no Idea what I have gotten into. The pain doc told me only much as it is like Morophine and all. Told me read instructions and stuff.

So I am taking Fentynal 25/mcg per hour for 72 hours using the patch. Then take Oxycodone 10/325mg (2) three times a day. At the start of the month I was is less pain and doing ok only still in pain.

So I had got 10 patches for 30 days my appointment is in 4 days. When I first got them I never used any before so I messed the first one up cause I couldn't get it stuck on right so the pharmacy called the doctor and said to put a Tagederm dressing over the patch. So the one was worth 3 days, I figure.

Now today, I for last 3 days only have put my last patch on, and since I messed up on the Oxycodone tablets again... Not bad I dont think cause I have the appointment in 4 days and counted my Oxycodone beginning of the week and was short so last 4 days or so I will only have enogh oxycodone tablets to make do for like 2 1/2 tablets a day instead of usual six or so.

What I dont get is the pain doc said that dr wanted to cut my oxycodone next month down to eventually go to down to 40 mg's a day only I don't get what is this all about. So the oxycodone thing being short makes me end up going detox in way.

Told the dr that so that why put me on the Fentanyl patch with the 6 oxycodone 10/325mg a day, the same middle of this month the pain is bad with the patch and I over take the pills over time to keep the pain gone only I cant understand how this New to me taking patch I should still be in pain with the aprox 6 a day Oxycodone.

So Changed the patch about 4 hours ago decided to leave the old one on too and make up for the not enough oxycodone next 3 1/2 days. Only after hour or so Got a Major headache and sick to my stomach and a bit ago took and flushed the old one.

So I am to go in 4 days now I dont have enough patch to only as they claim 72 hours and that leaves over extra 24 hours to wear it with it to last another day than 3 days? I know it helps me only about 3/4 of the way through the 72 hours or whatever, I start getting all crazy mad and bitchy and pissed off and barely make it 72.

So now I wonder to call on the day before this last patch today runs out or to do what? I got so many meds to keep track of like 21 different pills, capsules, powders to mix with my soda now a patch and a patch cover and it is driving me mad crazy insane trying to keep track of them all.

So what would be good pain patch or more of fentynal patch something? I use the oxycodone and the fentynal patch for pain of neuropathy and neurological spinal stenosis pain. Is it to late to get off this patch and something like morophine or is the fentynal stronger. I dont know about this patch thing only it is messing me up then pissing me off at the end. Any one can have advice? Thanks

 

fentanyl is as strong as its gonna get. maybe you could get a higher doese patch like maybe 50 or 75mcg an hour. pain sucks so talk 2 ur doc and try an get somethin figured out.

 

Thanks-
Doing ok now. Hope. Figure I will have to talk to pain dr about increase. I guess 50mcg would be the best and for the doc to see the pain without it for one day. Thanks again-

 

RX, I PMed you. Cross tolerance between different opiates is rarely complete. (Which means that you can still have some "withdrawal" for one drug when you are takng an other. Something I have recently learned about Hydro and Oxy, they are NOT the same.) I PMed you with more info.

I hope you are alright.

You have to talk to your doc about the tolerance, he has to understand that differnet people have different tolerances. And that due to pain breakthrough, stress, the fact that, even though you are on the Patch, your tolerance will continue to increase, and other things, the same exact dosage of a drug may not work one day and work on an other. You need to be able to titrate your own dosage. (one of the reasons I have always strongly said NO to a patch.)

Check your PMs.

 

It looks like your doctor mistakenly assumes that the Patch will "Cure" you of Increasing Tolerance. As you and I (and every chronic pain patient and good doctor knows) it does not. YOU need to let him know your pain, as well as your tolerance is too much for the dosage you are getting.

Doctors need to understand pain and get it though their heads that "the lowest dosage possible" is rarely good for people in pain. My doc always would rather I have a little extra in the house than to go into major breakthrough, or God Forbid, withdrawal.

TALK to your doctor, even if you have to call him. Some people don't last a full72 hours on the Patch, you may be one of them. Or maybe you need a larger dose.

Blessings and pain free day,
Maggie

 

Fentanyl patches are excellent. Mg for Mg, nothing is more potent than fentanyl. If you are accustomed to 60 mg of oxycodone each day, the 25 mcg/hour is not strong enough. An equianalgesic dose of fentanyl would be 60 mcg/hour (The patch is available in 25, 50, 75, and 100). Like Maggie said, though, the dose of fentanyl would need to be decreases intitially, due to incomplete cross tolerance, and then titrated up.

The doctor shouldn't have let you go a whole month in between appointments, in my opinion, during this titration.

Have you tried Cymbalta (duloxetine)? It is an antidepressant, but it works great for neuropathy. Neurontin (gabapentin) also works great for neuropathy, but is often very sedating. If you haven't tried Cymbalta, I would recommend you ask about it.

 

Thanks Maggie Sugar and Photo-

I made it to the appointment and discussed alot of this with the FNP who was going to reduce my Generic Percocet 10/325mg (oxycodone) form 2-tablets tid, down to 1-tablet four x day, only told her of the need for the 60mg a day along with the Fent Patch, She agreed that I would be best to stay on the 60mg a day and try another month for the patch to be full effect.

I realize now what Maggie was saying about the Fent patch--I have no control over going off it now since I started using it. I did not know at the beginning of agreeing to the patch of the serious nature of it or not having it. I realized when I went to get the meds filled, that this month that they gave me a different mfgr. of the Duragesic generic Fent. Patch. I think last month I was using one system by (Sandoz) this month they gave me a patch system mfgr. by (MYLAN) and it is much smaller than the Sandoz and no visible 'gel' inside of it? I think that this form or T-patch thing made by the "Mylan" mfgr. company is working better than the other one even thought same dose.

Pharmacy said the other type is on backorder? So I asked if I could keep getting this Mylan kind on the Medicaid and they didn't say for sure only I am hoping so.

I do also take the Generic form of Valium and have been for about 12-years now and take 40mg a day and I think it helps with the pain and spasm, only think I am taking the max dose of Valium being 40mg a day that they can prescribe? Also for the side effects of the Risperdal I take ARTANE® or the generic form of it 5mg 3xday it is supposed to help also.

I had bad reaction I think to Neurontin, back when it first came out on the market--I did not have the pain back then only was being prescribed the med from my Psychiatrist for the Bipolar condition. For almost a year of the Neurontin I was urinary incont. during sleep. It was awful. I was in my late twentys and had to wear depends diapers to bed. So I think the Neurontin was the cause of it. Once dc'd I did not have to take DDAVP at bedtime anymore and no more Urinary Incont at sleep. So think I will leave that one alone.

I think that some of the problems are all the 20+ prescription pills, casules, patch, powers for solution, topicals and all that try and work against one another. I also need to remember to eat with alot of them and well I am rambling Sorry..I just hope this is a better month. Think I will leave several days worth of my Oxycodone with my mom to 'hold on' to for me so I am sure not to run short this month again.

Peace RX-