Fent Update

[Hydro-Joe]

Today, I went back to my doctor. I told him the 50mcg/h Fentanyl patches were not really helping me at all.

He was more than happy to prescribe 100mcg/h Fentanyl patches [1 patch every 48 hours] plus 120-10/350mg Endocet tablets [oxycodone, i.e., Percocet] for "break-through" pain.

He also told me the good thing about Fentanyl patches is that he can continue to increase the dosage until I get pain-relief if the 100mcg/h patches + oxycodone combination does not work.

I'm really glad my personal doctor [a general practitioner] does all he can to make my life easier by assisting in the relief of my pain. I have not been asked to submit to any testing. I have also not been asked to see any other doctors, including pain-management specialist. I don't know of many doctors willing to accept a patient's statements for "face-value." I've read many peoples horror stories about doctors who just do not understand their needs...or doctors who give their patients a hard time about narcotics. My doctor has never had an issue with prescribing narcotics.

Has anyone ever used the Fent + Oxy combination to any degree of success?

Thanks for listening!

Hydro-Joe

[AWOL]

hehehe, I thought this was badly drawn girl for a min there. I was quite confused. Looks like you got to that avatar a while back though :p

[PRIZEFIGHTERINFERNO]

hehehe, I thought this was badly drawn girl for a min there. I was quite confused. Looks like you got to that avatar a while back though :p

yeah seriously i had to give dude some rep just for being here so long. Glad you have a REAL doctor. peace

[bronyraur]

It's AWESOME that you have a doc that will PROPERLY treat your pain. You are very fortunate.

I personally haven't be on the fent + oxy combo, however I have heard of people getting good relief from the 2 drugs together when the doses are at the right level.

Good luck.

[sweetbaby]

hi, i'm new here and have spent many enjoyable evenings since i found this site so thank you to everyone for your willingness to help a newby!
I have been on a combo fent/oxy for 3+ years for chronic pain & of course being an addict I have to mess with the dosages etc.;)

Each month I get 10-75mcg fent( brand name so w/ the jell ) & 360-5mg oxycodone for break through. when using them as prescribed they work very well unless i'm having a really bad month. My problem is i'm trying to find a way to extend the fent patches beyond 2 weeks (i've been eating the jell) and a way to extend the oxy past 3 weeks, i taper down before that so wd's won't be worse then they already are so i usually end up having a very bad 5-7 days. I've been looking into iv use as i have access to needles. does any one have any new info on ways to extend their opiates?
so hydo-joe yes the combo can work very well and i'm so happy you have a great doc i'm lucky i have one too though it took several years and several a-hole docs to get there, but it was all worth it. good luck!

[OxyContinuously]

What's up, Joe.


To answer your quest., I think that should be an excellent combo for pain. Especially since you at least have the ten mg percocets. From a pain standpoint, Fent is excellent for the chronic nature of the pain, and oxycodone happens to be very good for those moments of breakthrough pain. I would have to say that you got a very good combo.


Not to mention that you seem to have a doc that actually understands what pain is---which is very refreshing. Fent is a good med, like your doc said in the sense that there is no real "ceiling" to its effects. It can be increased *cautiously* cause Fent does play games w respiration more so than morphine in higher doses, but you can inc. slowly until appropriate analgesia is reached. They also have Fent lollipops called Actiq, which are bucally absorbed and are immediate in effects; I have heard that these work well also. Good luck man


Oxy

[Hydro-Joe]

As of today [Friday], I have yet to use the 100mcg/h Fentanyl patches. I've been using the Percocet, but I may have to go to work and I don't know what effects I'll get [if any] from the patches. I don't want to go to work and fall out or anything. Has anyone had any success with a nerve block? Does anyone have an opinion? I've been seriously considering such...Guess I need to research nerve blocks on Google. Hydro-Joe

[RoadHead]

hey joe--if you have been using the 50mcg patches without problems, the 100's shouldn't be much of a problem. you can cut them in half if you think they will be a problem, or change it every 3 days instead of every 2 days.

as far as the nerve blocks go some people have bad results from them while others have great luck with them. i am one that has pretty good luck with them as long as they hit the right spot. i usually get two blocks a month done, thru the throat area and into the spine. as long as they hit the right spot it works great, if not then it just hurts more for a couple days.

i'm not sure where your dr is talking about doing a block on you but like always, hope for the best but expect the worst. they will give you something for anxiety if you want or need it so don't get too worked up over it. just tell yourself it will be fine and that the rx's you are getting are worth it. makes it a lot easier on yourself mentally that way.

good luck

[Curio]

hey joe--if you have been using the 50mcg patches without problems, the 100's shouldn't be much of a problem. you can cut them in half if you think they will be a problem, or change it every 3 days instead of every 2 days.
as far as the nerve blocks go some people have bad results from them while others have great luck with them. i am one that has pretty good luck with them as long as they hit the right spot. i usually get two blocks a month done, thru the throat area and into the spine. as long as they hit the right spot it works great, if not then it just hurts more for a couple days.
i'm not sure where your dr is talking about doing a block on you but like always, hope for the best but expect the worst. they will give you something for anxiety if you want or need it so don't get too worked up over it. just tell yourself it will be fine and that the rx's you are getting are worth it. makes it a lot easier on yourself mentally that way.
good luck

^^ I have two BIG SAFETY concerns here ^^


1) 100mcg is DOUBLE what he was taking before, so I think his caution is good!! Think about someone doing TWO of their normal hits of heroin all in one syringe and not testing the effects??? I give him kudos for waiting until he is safely at home where he can try the dose increase without worries about OTJ safety factors...

2) I DO NOT think it's a good idea to cut the patch in half either....the proper time-release distribution of the drug is partially attributable to the the size of the material and the contact with that skin surface area which is covered....I don't know if I'm explaining it correctly, but to cut the matrix will potentially cause a release and absorption of the medication too quickly; emptying the gel reservoir within HOURS instead of DAYS could seriously put a person into an overdose/death..

I'll send a pm to Candy asking if she can let us know what is best ~ but I was on the patch myself for several months, and I KNOW the brand Duragesic gel patches I was using said specifically not to cut or cover the patch, etc..

People having probs with adhesive were to get ahold of them for a special cover to go over the top, not to apply their own tape and non-approved materials for patient safety reasons. Same reason as not cutting the patch, because covering it can also cause the skin to absorb the fentanyl faster.

Just thought I'd throw that out there in the name of harm reduction!

Disclaimer:
I am not a doctor or nurse... Firefighter/Paramedic 5yrs prehospital emergency service

[Ginger Snap]

If you cut the paatch in half it is useless. You could OD depending on tolerance, but even if not it just wastes the patch. If you read the literature with the med that is the BIGGEST NO-NO.

I am a RN, if that helps

Ginger Snap

[HistoryofMadness]

If you cut the paatch in half it is useless. You could OD depending on tolerance, but even if not it just wastes the patch. If you read the literature with the med that is the BIGGEST NO-NO.

I am a RN, if that helps

Ginger Snap

the first opie i had after kicking my habit was late year before last, and a friend came over with a fent patch. we cut the shit open and squeezed that gel in our mouths... i was so fucked up it was crazy... but i didn't come close to OD, hell i was bouncing all over my living room.

i had zero tolerance. and now that i think about it we popped a soma and a couple of xanax too... hmmm probably not smart.

i should add they weren't very strong patches. but still.

[Curio]

If you cut the paatch in half it is useless. You could OD depending on tolerance, but even if not it just wastes the patch. If you read the literature with the med that is the BIGGEST NO-NO.

I am a RN, if that helps

Ginger Snap

wow, it's so cool to have another nurse here....
we've gotten so used to calling out Candy's name when stuff comes up
I forgot that we now have another RN mod!

my apologies!!

:)

[Hydro-Joe]

The patches that I am prescribed are the Sandoz brand with the gel. I think that if the patch was cut the gel would be exposed. Does anyone know what to use for the nausea associated with the Fent patch? I'm allergic to the anti-emetic class of drugs, i.e., promethazine/compazine/phenergan. Hydro-Joe

[Curio]

The patches that I am prescribed are the Sandoz brand with the gel. I think that if the patch was cut the gel would be exposed. Does anyone know what to use for the nausea associated with the Fent patch? I'm allergic to the anti-emetic class of drugs, i.e., promethazine/compazine/phenergan. Hydro-Joe


wow, that sucks Joe...I don't know for sure but the other drug I have personally been given in combo with pain meds sometimes is Atarax/hydroxyzine but it is actually an antihistamine and helps both to tone down any excessive histamine issues like itching and also can be a potentiator...but if you're nauseous from the patch it is simply because of the strength I would think so I would worry that it would be unsafe in the event it potentiated the fent too much; going beyond nausea control and into respiratory probs...

Talk to your doc for sure; obviously you are also just getting used to the new dose so it may simply take some time to adjust...

Take care!

[Hydro-Joe]

I want to say thanks to all [medical professionals and non-medical professionals] for all the information and input in regards to my situation.

After I received the 100mcg/g Fentanyl patches, I was too chicken shit to use them. When I ran out of the 50mcg/h patches, I started using the Percocet [too excess of course] in an attempt to relieve some of my pain.

After tossing and turning all night from being in pain, I decided I was going to have to do something. I got up the next day and slapped one of those 100mcg/h patches on. After about 8 hours, I started to get nauseated [and a little worried] so I took the patch off. My thinking is that maybe I took too much Percocet prior to using the patch [I may just have answered my own questions in regards to nausea...Okay, I AM an IDIOT].

I've had another patch on for about twelve hours now and no nausea. I have used one 10mg Percocet until the relief [if any] kicks in. I guess I should try to reduce my usage of Percocet while I am using the patch. :)

I was off of the patch for about 2-3 days prior to using the new patch, so maybe I was having wd symptoms, even though I was using the Percocet?

Should I start to see increased pain relief after 24 hours of continuous use of the patch, and should I indeed let the patch start to work, and then use Percocet as needed [not before the patch starts to work]?

Thanks!

Hydro-Joe

[Porgie]

Hydro-Joe, we are in similar situations. I get 12 100mcg patches per month. My insurance will only pay for 10 per month. I can pay for the extra 2 but I don't...they are expensive! He will also give me 30 5mg oxycodone if I remember to ask. They are for break threw pain or help until the patch kicks in.

Mine are also the Sandoz brand. I can only wear them. Anything other than just wearing them makes me ill...very..very ill. A heating pad helps. I sometimes let the patch lifespan overlap which means I may have on more than one patch at a time. After 3 days I put a new one on but leave the old one on. This may not be all that safe.

I can also take the patch on and off. I may need to use medical tape to get it to stick the second time. I've also found that sometimes it is the weight of the tape that is what causeing the patch to come off.

I am a Suboxone patient as well. Both doctors know of each other. I tell my family doctor, who gives me the patches, that I'm on Suboxone but he really doesn't understand it all that well. The Suboxone doctor is from India so I barely understand him. He knows I have chronic pain issues.

[OxyContinuously]

Glad to hear that you're feeling better and that the 100mikes are doin it.

later


Oxy

[candy]

I know we all want to get the most out of our meds, but Fentanyl patches can be dangerous when cut or applied with tape over them or used with a heating pad. They are designed to deliver a certain amount of medication per hour and misuse could lead to overdose.

If you are looking for extra pain relief, it is best to look at faster acting opiates for breakthrough pain and most docs will give them.
Opiates are addictive and when used for pain control it can be easy to take 1 more just to relief the pain, but his can lead to running out of meds before you can refill.

I know not every doc is understanding and or willing to increase the dosages of meds, but be honest and let him/her know that the meds just are not holding you through in between. Hopefully your doc will raise the breakthrough meds, but use the patches as prescribed. With Chronic pain sufferers, docs do understand that over time their will be a need for an increase in dosage. You have to be patient and find a doc willing to work with you.

No, I don't advise cutting the patches or applying 2 at a time. Use them as prescribed or you will get to a point where nothing will work!