Replacement for Fentanyl patches....
 

Hey all,

I have been on the Fentanyl patch for about 2 years now. Started out at 75mcg./hr. and switched to 50 about a year ago. I have adjusted my life to this patch. Adjusted, meaning found a way to put up with it. My main problem with the patch is that you can't really "enjoy" a shower with it on. In fact any activity where you break a sweat or get an elevated body temp, the patch's med release is affected. Basically, I can't work out with the patch. I am about 50 lbs overweight and want to get rid of the fat. Exercise is warranted. However, the patch just won't work well with a "workout." Granted, with my back injuries my workout won't be anything like it used to be, but I need to start getting serious.

A historical note.....I was placed on the patch because our insurance changed and the new company did not supply my then drug, Oxycontin. So, the Fentanyl patch was my only suitable choice given to me. So.....my main purpose in this thread is to see if folks have gotten off the patch and found a replacement that isn't trans-dermal based. Ya know, I just had a thought. We have moved out to the east coast and again changed insurance company. I hate to say it....(mainly because of it's reputation) but is oxy do-able with a more active lifestyle? I also take Norco, Tramadol, and Flexeril. But have found I have needed a more "potent" main drug to take up the main pain, and the others to assist as needed. And as all of us...I would eventually like to drop some of these. But, for now....not so much. Any help or suggestions would be greatly appreciated!!
Paul

Paul
 

I have PN, as well as spine pain/fusion. My Pain Specialist has tried different meds, including the patch. The best relief (still have quite a bit pain) I get is from the Oxycontin and Oxycodone (percocet) for breakthru pain. I had gradually increased and for more than a year have remained on the Oxycontin 60MG's every 6 hours for 240 mgs daily and 7.5 mg./325 Oxycodone (percocet). The one thing that is so important is the fact that this does not affect my mind and thinking as some meds may do. You mentioned you change insurance companies; the new insurance may allow Oxycontin.

My doctor had to write the prescription in a way the insurance would accept. That is....they only allow the meds twice a day, every 12 hours. So my doctor prescribes qty of( 4) 60 mgs. of Oxycontin to be taken 120 mg's every 12 hours. Writing the scrip this way, the insurance accepted. He said it was up to me if I wanted to take one every 6 hrs. or 2 every 12 hours. I find every 6 hours work best for me.

I had to work with the insurance customer help in order to find out how the prescription needed to be written, the allowance of 2 x's a day, every 12 hours is what most insurance will pay. They will also allow up to 4 Oxycontin's and only 2 different doseages. i.e., can't be 30's, 40's, 20's. This make 3 different doseages. Finding the way the insurance would accept the prescription is most important; otherwise....denial. Just need to work with them in order to accomodate what they will accept. It all came out with doing it their way, plus I am being covered. I hope I am not complicating my response.

(Gerry)

Right now, I am on Morphine Sulfate and Hydrocodone for breakthrough. My Part D provider will not cover Oxy. I was on Fentanyl and it quit working.....at any dose. I have to rotate the meds about once a year as they quit working. When they quit, they quit at any dose and it is time to change meds.

Hi Paul,

Yes it is doable. Having been on opioids as long as you have, there are a couple phenomena that may be helpful to know about, ask your doctor, and/or look into yourself.

When some people rotate opioids, especially after a lengthy period, they may find that a lower "equivalent dose" will provide the same analgesia as their previous medication.

Long term intractable pain, as well as opioid therapy, may deplete/suppress adrenal hormones, which can result in reduced analgesia - patients feel like their medication isn't working (as well) anymore. Testing for this is just a blood test, and these hormones can be replaced/supplemented, which can reduce the perception of pain, help the medications work better (requiring less), and improve overall feeling of well-being. See:
http://neurotalk.psychcentral.com/thread156416.html

Also, as you mention weight loss, there is also a diet specifically for chronic pain patients. I've been on it for over a year now, and it's the only diet I've tried (out of many) that has helped me lose and maintain with reduced activity due to intractable pain. You can find the diet here:
http://pain-topics.org/pdf/IntractablePainSurvival.pdf
(Page 34, but the whole free book is excellent and indispensable)

HTH,

Doc

methadone pills
 

I had back surgery and it made my back pain a lot worse than before. i am scared to go to my next surgery. I am on fentanyl 100mcg. Prior to this i was on methadone pills for pain and with that i did not need any other pain meds. The pain clinic i went to was closed. I recommend asking your doctor about methadone pills for pain. When I was on the meth pills i was able to work and do almost anything compared to the patch. Where i live the only doctors who prescribe methadone are not for pain but for people who are addicted to opiates. any doctor can prescribe it if they get a license but mine wont because of all the drug addicts who will want her as a doctor because in this town there are no methadone doctors and she doesn't want all the grief. Anyways I recommend anyone who has chronic pain should try this medication. It worked for me. It takes care of the pain without messing you up to much. I was able to work full time and still enjoy my off time. I hope this works for you. I know what its like to have chronic pain. My life isn't the same since I started the patch. I cant work anymore. Its been 2 years now. I'm 26 years old and feel like I'm 90. Good Luck!!!!!

I would call the insurance company you are currently with and ask if its on their formulary to have oxy or MS contin. I like MS much better than oxy. Oxy really messes with my constipation and other things, and MS was so much milder on my day while dealing with my pain on a much higher level. You may need a medical letter of necc from your Md provided to the insurance company, and thats shouldn't be an issue if you explain your situation. Most are happy to get you off the fet patch and onto a pill. Make sure you get accommodation for break thru pain. In the last 3 years most insurance companies have been spanked quite severely about providing adequate pain relief for patients, where as in days gone by they got away with many things that were shameful.

Please speak to the nurse at your MD office and tell her your plan. She can be a valueable ally in your fight to get over to a better way of life.

Good luck! I am so proud of you!

Fentanyl replacement
 

I recently switched from fentanyl patches to a new? Drug named Exalgo. Its a long acting hydromorphone pill. Longer than OxyContin but not as long as the fentanyl patches. One dose lasts 24 hours. Being a new drug you may have problems with insurance coverage but it doesn't have the stigma that OxyContin does. This is my first time on hydromorphone and we have not fount the correct dose yet so I can't reall say how it's working, additionally, I seem to be have some pretty severe anxiety issues that are new since I started it. I had a lot of the same issues with the fentanyl patches.

covers
 

there are covers for fent they are askina derm the kind they put over your iv first shave arm really good and big take shower and scrub the hell out of the area when its patch day then put fent on then the derm over it as long as you do it right and get the derm over the patch and flat not screwed with wrinkles and crap i take at least two showers before derm starts to peal a little and is not safe for any more showers but you have to dry derm really good after the shower it will start to peel as long as its a small peel take another shower its commen sense to know when not to risk a shower with it the number is 1-800-796-9526 and you will need the very hard to read info on the bottom of the fent box lot number etc then once you get a pack it has a form so you dont have to call unless form is missing good luck

Fentynal patch
 

Hi there,

I've been using this patch for years and occasionally have the same problem so my pharmacist gave me a small roll of Hypafix and it does the trick without any problems. Good luck with the excercise I'd love to be able fo it.



I've also just read some other posts on this drug and it can be a dangerous one so don't mess with it. It can take 24hrs to get into your system, try to change it at the same time every 72hrs and I would always feel very tired when I first used it. Coming down although for me was a God send, that's tough too but do it under Dr's supervision. Like I said this drug is not to be messed with and don't even think of using it like they do on the street. You may suffer from chronic pain but you don't have to be a text book junkie too.

Sorry for the lecture but it needed to be said

Sophie :)