Meds?
 

I see my PCP again this week, I have the option of eather going up on my fent patch to 50 mcg, or going up on my oxycodone, probley to 40 mg. Which one would you choose? Im afraid that the fent wont last long like I need it to, where as the oxycodone I take every 4hrs. Im exhausted and having to push my body past the limits, so I know thats why my pain is way worse then normal, however this is going to continue on like this, im going to be exhausted and im going to keep pushing my body past the limits, nothing i can do about it. So i need my meds raised im just not sure which one. Which one would you choose?

I would suggest switching to a time released opiate. After you're on it for a month you can add in a very low dose of breakthrough opiate. I frankly don't understand why any doc familiar with RSD doesn't start with time released? You can take much smaller quantities this way and effectively control your pain.

You can try fenatyl but I personally hated it. It made me feel highly intoxicated. There have also been many that have OD'd on them...

Im already on the fent patch, and it does work best for me, and im oxycodone. So my choices are going up on the fent patch to 50mcg, which is a time released med. So i often wonder if another time released med would help with the fent patch? The pain is just so bad and i need to get a little bit of relief. Actually my dr that gives my meds is my PCP but she understands chronic pain and thats why i go to her and shes been great at trying to manage my meds and trying anything i want.

Whoops, your post was clear! Generally, it's better to increase the time released version. You may also want to try a combo med like Nucynta (both in ER or IR forms). I doubt they will prescribe Fentanyl and another straight ER med. Your pharmacist likely wouldn't fill it. It's sounds like you need more than just an increase of IR.

Tos8

For what my view is worth, I think you should first increase the fentanyl dose. 50mcg/hr is a pretty low dose and should be your main slow release opiod painkiller so it would be very odd to first try to increase the amount of the other drug you are taking. As you will know it can take 6 days for the increased fentanyl dose to be effective so as always, patience is key.

The issue im having with my meds is $$$. I cant work, so my parents have to pay for my scripts which are 500$ all together and will now go up even more. Im still waiting to get aproved for ssi and disability. Until then I have to be so careful with what meds i go on and my going up on my doses because of the cost. I havent found a opiat pain med yet thats actually afordable. But they do know I need to go up on atleast one of my 2 meds for my pain. The fent patch defently seems the better option, i had the better relief with it when i first started it, and hopefully i can get that again. And we have tried non opiat meds like gabapentin and a couple others, but it interfeared with my epilepsy meds and I had to stop them. So its hard when im in alot of pain but have to watch what I do with meds because of the cost.

Few years ago i was in similar situation. Waiting on disability w no insurance. My dr and i tried just about every combo out there. Now that i have insurance, I presently take Opana extended release along with oxycodone instant release......when i didnt have it i took Oxycontin extended release with Oxy instant. Same med, just controlled and instant release forms. Worked better than anything else i had tried. Maybe give that a try? Fentanyl can really be bad news!!!!

I was on that combo befor I switched to the fent. I couldnt go any higher then 10mg on the oxycontin ER because it was 200$ to go up to 20mg. So thats why I had to switch to the fent patch and that was cheaper. Yeah the oxycontin ER and oxycodone IR worked great, but I had to go up on the dose because it was such a small dose and i managed for about 1 1/2yr on it that way and i then couldnt stand it anymore and once I was on the fent patch i couldnt believe how much pain I was actually in after I got relief.

Kadian's patent expired about 6 months ago, and is now sold as a generic--Morphine Sulphate Extended Release. You might want to price it out.