double up on patches?

[U4Euhhhhh...]

I am on the patch and I get rx'd 15 patches(100s) a month. Also the baby dillies i was rx'd weren't helping with breakthru, so my doc switched me back to roxis for breakthru(kinda). Yes i am rx'd 240 roxi30s and 15 gel100 patches as well as 120 somas (with refills) per month. And I am still in pain too frequently. I am going to see a new pm doc on monday. I am thinking about requesting a different opi for breakthru and possibly a additional patch every two days. For example... 15 of the 100 patches and 15 of the 50 patches so that I would be wearing one if each for a total of 150 mcg per hour for 48 hrs. And also want/need the 1600 actiq pops for breakthru. So heres the Qs:
1) Is anyone here on two patches every 2-3 days? Or know of someone who is on 125+mcg/h...?
2) What would it cost for the 1600 actiq pops...they come in packs of 30, correct?
3) Does anyone here know if the generic actiq pops are available yet? i think they're called "fasliq"
Does anyone here know if the the sugarfree actic pops are available yet? called Actiq-SF
4) What would it cost for the 800 fentoras? 800 is the strongest, rite?

Much thanks to those who reply with useful info. I love you guys(/girls)...

[roxi*stardust]

Originally Posted by U4Euhhhhh...

<snip>
1) Is anyone here on two patches every 2-3 days? Or know of someone who is on 125+mcg/h...?
2) What would it cost for the 1600 actiq pops...they come in packs of 30, correct?
3) Does anyone here know if the generic actiq pops are available yet? i think they're called "fasliq"
Does anyone here know if the the sugarfree actic pops are available yet? called Actiq-SF
4) What would it cost for the 800 fentoras? 800 is the strongest, rite?

Much thanks to those who reply with useful info. I love you guys(/girls)...

1.) Actiq is indicated for the treatment of cancer pain. It is not reccommended for any other pain so more than likely you are not going to get an MD to script it to you, especially since the FDA put out guidelines for it. Secondly, if you do get an MD to RX it most insurance companies won't cover it unless your DX is cancer. You want to pay cash for it. Price from pharmacychecker.com: For 60 or the 1600mcg; $4399.76. Yeah that's four thousand dollars. http://www.pharmacychecker.com/Prici...engthId=115763
I could not a find a price for Fentora.
Actiq contains sugar. In the package insert it warns Diabetic patients that it contains 2 grams of sugar. Here is the full prescribing info.
http://www.actiq.com/pdf/actiq_packa...ert_4_5_07.pdf

I found reference to a generic but was not able to find any products or an NDC number for a product.
Sorry to rain on your parade.

Edit: Forgot about yur first question. Yes MDs do write for patches like you are talking about. Either (1) 100mg and (1) 50mcg or any combination of them. It is pretty common in nursing homes and hospitals and I have even seen it at the retail level.

[samsong]

I can only help on number 1, and yes, there are people who are scripted patches like that so that they are wearing two different strengths (the 100 plus something else), so it is not uncommon, but I wouldn't say it is all that frequent either. The problem maybe bringing it up with your doc though, like you can't say someone on O'Phile told me about it, so maybe you just ask it as a question, playing dumb, "I wish they made these patches stronger, becuase though the 100 seems to work to a good extent, it would be nice if they made 125mic or 150mic" and see how he handles that. Or jokingly say, "I wish I could wear two of these, ha, ha, ha"

The problem with asking for something a little bit out of the norm is that he may switch you off the patch all together and maybe put you on a high dose of Opana ER, which is extremely expesnive without insurance. Fine line with many docs as to getting an increase and your plan backfiring on you--has happened a few times with me and I always just wish I had never said anything, but if you have a good relationship with this guy, worst thing he may do is just increase your BTs instead of doubling you up on the patches.

[U4Euhhhhh...]

thanks roxi... I know that the actiq pops are for cancer pain, but I know a former patient of my new pm doc and he rx'ed the 800s and 1200s for (non-cancer) pain. That is the reason i was going to suggest. I do not have cancer yet, but from what I have seen this doc must not care what kind of serious pain i am in. And I have heard of patients on 2+ patches at a time, but never met any.

[20Dollarholla]

I know a girl in the late stages of cancer who has to wear 3 100mcg patches, and she is still in extreme pain. It is common for doctors to double up on patches.

The actiq for breakthrough pain is a miracle drug, and some pm docs will perscribe it to non cancer patients. My Mother had a rare nerve disorder (trigeminal neuralgia) and she was perscribed 240-270 ( 8-9 suckers a day) of the 1600mcg Actiq pops a month for breakthrough as well as MS-Contin then Oxycontin. Like Roxi said the suckers are extremely expensive although I thought it was $4,000 for her whole script not just 60. It is news to me that there is a generic brand of Actiq, I had been wondering when the patent on them was up.

[jerets]

Wow... I can't imagine going to see a new pain management doctor when you have one scripting you so much already. I know we all have our own tolerance and pain, but I feel lucky to be getting 10 50 patches per month. I've tried several times to get b/t meds and end up with nothing. I would be thrilled to get 12/15 patches per month. Be careful and good luck.

[havok]

OMFG, you are getting 240 roxis and 15 100mcg patches and you want to go see a new doctor? You have hit the fucking jackpot. I would give my left leg to be scripted with that for the rest of my life. What kind of pain are you in exactly? You better be a terminally ill cancer patient or something.

Personally I think the roxis would be the best opiate you can get for breakthrough pain, and also the cheapest. The Actiq pops aren't that good in my opinion. They barely give me a buzz. I would much rather have oxycodone or dilaudid than the Actiqs.

Hell while you are at it, why not just ask for straight fentanyl amps and IV that shit. I'm sure your doctor won't mind giving you that.

[Princess]

Wow, that's a lot of meds. I personally wouldn't change docs!

As far as actiq for only cancer patients, not anymore. It was approved for other types of chronic pain as well. I don't have cancer....my doc was gonna give me those for break thru pain on top of the patches but my insurance wouldn't cover it. He was going to look into a patient assistance program for those since I'm on the one for Duragesic already...

I think I recently read something about it on the internet too about a study done for actiq in non-cancer patients, but I could be wrong.

[reddragon3668]

I didn't take what the OP said as they were doubling up on doctors. I took it to mean that perhaps their old doctor is unavailable or something. At least, I hope that is the case.

The pops would be great. I am hesitant, though, to recommend it to someone without terminal cancer pain. One thing that freaks me out is if I exhaust all my options regards pain control, what the hell am I going to do if I end up with cancer late in life. I'll have to be hooked up to a frickin' tanker truck full of fentanyl or something... scares the shit outta of me. As a result, I've been trying to keep my pain manageable, but not over do it. I could take twice the medicine I do now.. often do..LOL But, I am trying to keep it as low as possible. I am 40 years old (almost) and there are allot of potential painful conditions out there that I've never met. Hope I don't. But, i don't want to be untreatable if I ever do. So, the morale, go as slow as you can.

Take care and I hope it works out for ya!

[HMMM...]

whooaaa.... that is a whole lot of opies right there.
Is this common in a lot of pain patients?
That even with such high doses it still is not efficient enough to take care of the pain?
Does tolerance affect the level where pain is alleviated?

[reddragon3668]

I wouldn't say its uncommon. But, yeah, that is a boat load of medicine. The OP didn't say what kind of pain they were medicating, so its hard to say.

Yes, tolerance is an issue. Some people here can take 150mg of Oxy and be right. I can take 300mg and just get a little energy. Methadone screwed my tolerance.

I just noticed that you asked if tolerance affects the efficacy of the medicine. I would say yes. Others would argue against it.

[Princess]

Does tolerance affect meds...OMG yes. That's a major problem for me. And methadone but mainly Fent really screwed mine up.

I don't know what the medical condition is for who is taking all these meds...but I have had cancer (in remission now) and have serious back issues that are here for life. I do worry about if I get in an accident or something....but in everyday life I can't live with my pain without *help*.

In regards to Actiq, my doc had said something before about that being his choice for me for break-thru because he'd rather keep me on Fentanyl all around. Maybe so other meds would help if I ever needed them? I don't know, just throwing that out there.

There are chronic pain conditions that are comparable to cancer pain, so I wouldn't say to save the Fent for terminal patients only.

Originally Posted by reddragon3668

I wouldn't say its uncommon. But, yeah, that is a boat load of medicine. The OP didn't say what kind of pain they were medicating, so its hard to say.

Yes, tolerance is an issue. Some people here can take 150mg of Oxy and be right. I can take 300mg and just get a little energy. Methadone screwed my tolerance.

I just noticed that you asked if tolerance affects the efficacy of the medicine. I would say yes. Others would argue against it.

[reddragon3668]

Your right, Mom. there are allot of painful conditions out there that are not necessarily terminal. In some ways, it makes it worse, cause your not sure if its ever going to end. So, when it comes down to it, you do what you got to do to live comfortable now. But, its does scare me, just for the scenario you suggested; a horrible car accident or something like that. It would take a boat load of medicine to control the pain in some of us.

I want there to be some options left, ya know? I am almost forty, and I plan on living a long time... so, what will I be on 20 years from now? Its just one of those rhetorical questions that's hard to find a satisfactory answer to.

Originally Posted by PTO Mom

Does tolerance affect meds...OMG yes. That's a major problem for me. And methadone but mainly Fent really screwed mine up.

I don't know what the medical condition is for who is taking all these meds...but I have had cancer (in remission now) and have serious back issues that are here for life. I do worry about if I get in an accident or something....but in everyday life I can't live with my pain without *help*.

In regards to Actiq, my doc had said something before about that being his choice for me for break-thru because he'd rather keep me on Fentanyl all around. Maybe so other meds would help if I ever needed them? I don't know, just throwing that out there.

There are chronic pain conditions that are comparable to cancer pain, so I wouldn't say to save the Fent for terminal patients only.

[Princess]

Couldn't agree more, Red. It scares the shit out of me. I'm only 34 & a single mom. It sucks, big time. I do have surgery (kidney) coming up too....wondering how the hell that's gonna go.

No ortho surgeon wants to start surgery on my back yet, starting the chain reaction in my spine. One disk now, another next year and so on. Not to mention the arthritis in my spine & scoliosis, etc. I'm screwed. Royally.

Originally Posted by reddragon3668

Your right, Mom. there are allot of painful conditions out there that are not necessarily terminal. In some ways, it makes it worse, cause your not sure if its ever going to end. So, when it comes down to it, you do what you got to do to live comfortable now. But, its does scare me, just for the scenario you suggested; a horrible car accident or something like that. It would take a boat load of medicine to control the pain in some of us.

I want there to be some options left, ya know? I am almost forty, and I plan on living a long time... so, what will I be on 20 years from now? Its just one of those rhetorical questions that's hard to find a satisfactory answer to.

[reddragon3668]

I really hope your kidney surgery goes well. Since I had my back surgery in 2000, I've not had any major surgeries. I have no doubt that I can be medicated well enough to control my pain if I did. Problems is whether or not the doctor will be willing to dose me enough. I am sure your doctor knows your tolerance to these drugs hopefully they will treat you accordingly.

Your doctor's wisdom regarding the back surgery is good. I now have a bulging disc above my surgery site. Since I was fused on two levels, it was an inevitability. That is where some of my pain is coming from. And, its bound to get worse with time.

I am not inclined to ever let them cut on me again. If I have any choice at all, I have underwent my first and last major surgery. It is not a pleasant experience, as I'm sure you can relate.

Take care, and once again, I hope your surgery goes well!

Originally Posted by PTO Mom

Couldn't agree more, Red. It scares the shit out of me. I'm only 34 & a single mom. It sucks, big time. I do have surgery (kidney) coming up too....wondering how the hell that's gonna go.

No ortho surgeon wants to start surgery on my back yet, starting the chain reaction in my spine. One disk now, another next year and so on. Not to mention the arthritis in my spine & scoliosis, etc. I'm screwed. Royally.