Rags,

Just based on my own experience my thoughts about Oxy tolerance is that the people who seem to have tolerance issues - needing higher and higher doses to get the same relief - well everyone I have ever met or talked to who had/have that issue take their oxycontin every 12 hours.

In the literature the drug company gives to the doctors it says something like "if the dose is wearing off before 12 hours then raise the dose"... well my doctor decided that made no sense. If a person is getting perfect pain relief for 9 hours and then it goes down the tubes, then why give a higher dose instead of decreasing the time between doses?

This is just based on my own experience, but patients on 12 hour dosing schedules have a lot more tolerance issues that those who are on an 8 or 6 hour schedule.

When I needed the 4th pill added I knew it was an increase in pain instead of tolerance because of an actual physical change. It wasn't just a pain increase that I was having, it was a pain increase in one body area due to a specific problem - so it was clear that it was an increase in pain and not tolerance.... but without a clear physical change it is hard to tell the difference, and when my doc and I can't tell we switch me to a different med for a while and then it becomes more clear about whether it is med tolerance or pain increase.


I would have stayed on the patch if it didn't cause the rash... BUT, I am glad it caused the rash because I get much better relief with far fewer side effects from oxycontin. I got good pain relief from the patch, and if for some reason oxycontin was no longer available then I would choose the patch over morphine products, but for me OC works the best. Don't know why, don't care why, I just know it works and works well so I'm happy

I was on the fentanyl patch for about three years, switching back and forth between 50 mcg and 75 several times. 50 wasn't enough and the side-effects from 75 were too much. I agree that the Duragesic worked better than the generic brands, but to me the difference wasn't all that dramatic.

I went off the patch in February because I just couldn't stand it any more. For three years I'd felt like I was just existing in some strange different world by myself. I tried methadone, but got hardly any pain relief from it, and it made me feel sick a lot, so I stopped taking it after only a month.

Now I try to get by on nothing but Dilaudid, which I was taking all along for B/T pain anyway. My doc is willing to try whatever I want, but for as long as I can I'm going to try to live without it. Most people have problems with drug tolerance, but for me the effect seems to be the exact opposite. The longer I take a drug, the more intolerant of it my body becomes, at least when it comes to the side-effects. Besides, no matter what I've tried, the relief I got from pain has always been marginal at best. I guess for some of us, effective pain relief is just a dream.

I'm so glad I found you all. I happened to check back on the Spiney Land site and saw this posted in one of the posts.

I have been on the patch for 2 years and am glad to see someone else finds a difference between the different brands. I started out with the brands and then they sent the generics and I felt as if I had the flu. Everyone assured me that they were made in the exact place. My internist suggests it is the adhesive. No matter, there IS a difference. I got the brands again by mistake and felt so much better so I'm fighting the insurance company now for the brand names.

After changing back and forth two or three times it is like night and day.
Keep us posted. I finally feel that I wasn't delusional.
Maggie
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I was on original Braintalk from day one of the older forums and am addicted to Braintalk . Registered March, l997.

Greetings to All,
I wanted to post my findings about the generic Sandoz brand of the fentanyl patch. After suffering all month waiting to get my monthly script, so I could get the Duragesic brand once again, I finally got the Janseen/Duragesic brand name again. There definitely IS a difference with these generics patches, it is NOT in my head, and the posters here seem to agree with me.
I did a little experiment with the Sandoz brand, which is closer to the Duragesic in looks, and how it works, transfer mechanism, etc. I cannot believe that these are exactly the same product, and here is my proof.
I weighed a Sandoz patch after peeling of the protective layer, and it weighed 1.4 grams. Then I weighed it again after it was on 2 full days, and it now weighed 1.3 grams. I though, OK, I better do some more weighing to be sure, and every patch weighed 1.4 when new, and 1.3 after 2 days.
Then after getting the Duragesic, I again weighed it after peeling off the protective film, and it also weighed 1.4 grams, BUT, after having it on for 24 hours,(I timed it), it weighed only .9 grams after taking it off!
I will retry this again in 2 days to see if the results are the same.
This tells me what I already thought was the case, the Duragesic brand transfers much more of the gel to my system than the Sandoz did.
I don't know if it is something to do with the glue, or the transfer layer in the patch, but after 2 days, the Duragesic is all but empty, while the Sandoz still had most of its gel left, it looks like most all the gel was still in the reservoir.
So, only .1 gram of the gel was getting into my system with the Sandoz/generic brand, and .5 grams was getting through with the Duragesic.
This is a HUGE difference in my opinion, and probably accounts for the poor performance of the generics.
I would like know how they can say these things are the same, when they obviously are not. I didn't even bother testing the Mylan brand, as they hardly provided any relief at all for me, so I refuse to buy them after suffering with them for a whole month, feeling like I was in withdrawal all the time.
The pharmisist was very surprised when I asked to go back on the brand name, she said that she has never heard of any complaints about the generic patches, but I haven't told her about my weigh in test yet.

Thanks to Liz, Maggie, and Idealist for answering my post, I do appreciate your input!
My wish to all is, less pain, and more life!
Peace
Rags

I've been back on the generics for two months until I can get insurance cleared up. I am having a lot more pain but did finally quit having the withdrawal symptoms. That makes me wonder if maybe a higher dosage than the brand would work.
Bets on that going over good with the Doctor?
Maggie

Hi Maggie,
Looks like your body has finally got used to the lower dose you get with
the generic, I'm glad at least the withdrawal symptoms have passed for you, sorry that your pain isn't being handled as well as it could be.
I actually felt like I was on a 50ugram duragesic when using the 75 generic.
That's about the amount of relief I was getting, if that.
You have a good thought there, maybe your doc will allow you to get a higher dose, since the generics don't work as well, and that will fix the insurance situation too. I'm glad you posted this, as it makes me feel like I'm not the only one going through this. Mostly my doctors, and pharmacy people say it must be in my head, when I know it is NOT. Thanks for the reality check!
I hope you get the proper dosage or brand thing taken care of so you can get the relief you need. There is nothing worse than having to be on these meds, and then they don't work as advertised!
I am interested in hearing about your experience with the pain relief you
had with the pump. I have been asking my doc about it, but he says, "your nowhere near that stage yet" I have heard good and bad, and a lot of talk about some plaque buildup of some sort at the catheter that can cause nerve damage if left unattended. If you would rather PM me than dicuss it on the forum, that would be appreciated also.
Thanks for your post
Peace
Rags

Took sleep med. - 3 weeks ago. It was liquid chloral hydrate(3 tsp.) It triggered off burning pain in mputh ,toungue - got worse and spread to upper and lower stomach. Hospitalized to try IV morphine and other drugs - but couldn't get an IV line. I have severe allodynia and a very sensitive nervous system. They think drug triggered off pain in nerve endings. Now it spread to my teeth. Taking 75 mg.Fenatnyl Sandoz. Also, aciphex, . The pain in my teet is so severe - I can't brush them and can't use any toothpaste - even sensodyne.
Maybe I should ask for the non generic Fentanyl patch????????????
Got about 20 injections in my mouth, face, etc. to try to calm down the nerves. No help so far.
Stomach pain flares when I eat or drink.
Sydney

I had the pump in for nearly five years when the battery started running down. My experience with it was O.K. as far as the lumbar pain was concerned but I had other pain issues such as migraines, cervical pain, and it didn't help with that at all. We don't have a pain doctor locally and I was having to drive 2 hours to even see him. He didn't believe in breakthrough meds so I had to endure the other pain.

The other problem was having to go for refills and dosage adjustments. This was paid for by medicare but I had to pay the co-pay which was around $300.00 a month. The reason it was so high was because he wouldn't do the refill anywhere but in the hospital and they charged an arm and a leg.

As you can see, there are a lot of factors involving the pump that may not effect anyone else. Due to problems related to the doctor, I had four different ones during this time.
Check out all of those factors and possibly, you may have better experience than me.
Maggie

With all due respect there are several things to consider when "testing" the weight and so forth. Each individuals genetic makeup ,body temperture,placement of patch,meds,diet,exercise etc can make it almost impossible to measure how much a patch weighs or more importantly how much fentanyl is being introduced over a specific time.
The fact is that if you average it out it delivers 25,50,75 or in my case 100mch an hour over a 72 hr period, I will have to research this more though and get back with you. sincerely DTRB

I have read this thread with much interest...I started the generic fentanyl patch a month ago, and didn't have good results. Today, because of this conversation, I asked for the Duragesic..It is larger (nearly twice the size) for the same 25 patch. Also..the generic was a strip of plastic with adhesive...no "gel" that is how it came out of the sealed packets. Much to my surprise, the duragesic looks almost like a pouch...with gel visible inside! did i get a bad batch of the generic? or are they that much different? i would really like help on this, as my generics cost me about $90 and they are all the same.
Thanks!
Dave