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Old 02-19-2011, 03:44 PM   #1
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Norco vs .25 mcg Fentanyl

Hi folks! First and foremost I should say hello as I'm a newbie! I hope all are well here, and I hope I can answer questions as well as ask, since I've had my injury since 1990 and I've gone through quite a bit to get where I am. (34 surgeries and yes, even medical history was written about my particular case)

I've always been afraid of pain medicine addiction so I've been hesitant to move up from Norco to any other "harder" pill like oxycontin, etc... plus I'm allergic to Morphine and Dilaudid.

Well, after 21 years my doc finally convinced me to try a Fentanyl patch (.25 mcg) rather than taking up to 10 or so Norcos a day) I absolutely hated Vicodin either regular or ES because it made me REALLY crabby and really jumpy and I startled easily and chewed out anybody nearby who startled me. (great, what a joy to be near, huh?) My doc wanted to do a spinal implant of one of those nerve impulse machines that makes my brain think my body isn't in pain when it really is, but I figured Murphy's Law would let my 35th and final surgery finally be the one to paralyze me and I said NO WAY on that one!!!

Anyhow, I was afraid of Fentanyl because I didn't realize how I would react to it and I didn't know if I'd be able to function on a normal level on a daily basis, because I do have a job and I do have to be able to manage daily as I'm also a mom.

Well, I put my patch on my shoulder last night around 6'ish and for the first time in my life since my accident in 1990, I woke up this morning with only moderate pain in my leg and didn't feel the need to choke down pain meds in order to walk. I was amazed, and still am!

My doc said he wanted me to try the Fentanyl and I'm going for a check-up with him exactly one week after I tried the first patch.

My main concern is that I want to know if the pain med dose will be constant. What are the side effects? Will it constipate me like Norco does? Also, will it maintain the same pain management control years down the line or will I have to keep upping it?

I'm really petrified of addiction and actually agreeing to try this patch was a big move for me due to that fear. Was it the right decision? Is the chance for addiction less than it is with Norco? Can anybody give me their story or input or advice or whatever info they have based on similar situations?

Thank you so much in advance, since I really am clueless about this particular medicine and how it works. I appreciate any info you have to offer.

Traci

 
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Old 02-19-2011, 05:51 PM   #2
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Re: Norco vs .25 mcg Fentanyl

You might find it less constipating than Norco, because the drug bipasses the gut, and because it has less specificity to the opioid receptors in the gut than hydrocodone, but it can still cause constipation. When taking regular narcotics, a high fibre diet and a daily dose of Sennokot S is a good idea (the correct dose is that which gives you a comfortable, soft but formed bowel action every day, for some it might be 2 pills, for others it might be 6 or 8)

Addiction is usualy less of an issue with the patch than with norco, because the dose is relatively out of your control.... you either have a patch on or you dont, with pills like norco, which you take throughout the day, there is always the temptation to take another 2 pills to get you through till the ned of your work day, or another 2 pills to get you off to sleep at night - its easy to adjust the dose on your own initiative.

You will become dependant on fentanyl (just as you were almost certainly dependant on hydrocodone/Norco) but that only becomes an issue if your pain goes away and you need to stop the drug..... instead of stopping cold, you need to taper the drug down over 1-2 weeks.

It seems like the patch is just what you need, it could give you your life back from a continual cycle of pain-pills-pain-more pills, if it works, stick with it
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Old 02-19-2011, 06:23 PM   #3
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Re: Norco vs .25 mcg Fentanyl

Thank you John! It seems like I've been on the darned pills for so long that the patch was what made me so afraid. But now that I have it on, it seems to be doing it's job and I only have to deal with "breakthrough" pain (new term I've learned since joining this site) in between patches and when I overdo things a tad, (which is constant, because I HATE being not able to be "normal") I must admit, I'm ECSTATIC to hear that I might be able to have normal or closer to normal BM's (who knew they'd be such a joy?) but I'm hoping that this isn't one of those temporary fixes that just last only so long, then goes all defunct and stops working at all.

I'll um, keep everybody posted, and btw, I do adore my PM doc, and I'm in So Cal if anybody needs to know who he is... he is quite attentive. Plus, he does realize when you're truly in pain, versus just trying to get high (which I guess a ton of people try to do) but hey... with this many surgeries under your belt, it's not imaginary!

 
Old 02-19-2011, 09:59 PM   #4
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Re: Norco vs .25 mcg Fentanyl

And I thought I had a lot of surgeries, 22 in the past 11 years, but you take the cake. Drug dependency when you are on daily narcotics, of any support, is pretty much a given, there's not really a way to avoid it. Having said that, " There is a big difference between addicition and dependance." As long as you are using your meds the way you're prescribed them, then you are not an addict. Constipation will still be there, it is after all a narcotic. As for the consistency of pain control, the patch is designed to delivery a certain amount of medication over the period that you wear it, unlike short acting meds that spike and then go down. Fentanyl is the strongest narcotic pain med. It's great that you're getting relief from it...most people have to do a few different trials and jump through various hoops to find the med that works.

One thing you said did alert me...you said, "between patches." You should never be between patches. When you take your patch off, say after 3 days, you should immediately put a new one on, there should be no gap in patches, hence no gap in coverage. Are you going without a patch for periods of time? As for the pain control years down the road question. Once again the patch is a narcotic pain med, just like pills. Your body will eventually get used to it and the dose will probably have to be tweaked, but that is completely normal...it should be a while before that happens.

Congrats on the feeling better, take care.

Kat

 
Old 02-19-2011, 10:35 PM   #5
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Re: Norco vs .25 mcg Fentanyl

Re your tummy and BM's, it would be an excelent idea if you got into the habit of taking a dose of Metamucil or Citrucel in the morning, and a dose of Senna at bedtime (buy generic senna, not Sennokot, it is far cheaper and it is identical)

Just vecause you take a narcotic, there is no reason you shouldnt have normal, comfortable bowel movements
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Old 02-19-2011, 10:38 PM   #6
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Re: Norco vs .25 mcg Fentanyl

Actually here in the States Miralax is very popular and works well. It's a newer Bowel maintenance med. Do you have it in Australia?

 
Old 02-20-2011, 04:21 PM   #7
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Re: Norco vs .25 mcg Fentanyl

Thanks Katlin! I guess for the "in between patches part" I meant that I'm due to take my patch off tonight and put another one on, but doesn't it take up to 12 hours to start taking effect? That's where I was going with that. Is that considered a gap? or just a timed delay? I have no idea!

And Johnstar, I will be heading up to my local Henry's and get generic Senna tomorrow! Do you have a preferred (less disgusting) way of taking it? Like in a cup of tea, or juice or such?

Thank you both so much!

Traci

 
Old 02-20-2011, 04:29 PM   #8
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Re: Norco vs .25 mcg Fentanyl

Nit under that brandname, but i am pretty sure that Movicol which we have here is the same active ingredient.

I guess in different countries, different protocols get addopted, the recomendation to use regular doses of Sennokot came from "Theraputic Guidelines - Analgesics" published by The Pharmacutical Society of Australia, regarded as the gold standard textbook in this country. At the end of the day, whichever laxetive the patient chooses doesnt realy matter, as long as s/he is getting a comfortable bowel movement every day

You can buy generic senna in tablets (the same as Sennokot), much less nasty than taking it as a tea! Ask the pharmacist, they should be able to help you find them on the shelf.
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Last edited by jonnstar; 02-20-2011 at 04:32 PM.

 
Old 02-20-2011, 04:30 PM   #9
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Re: Norco vs .25 mcg Fentanyl

Quote:
Originally Posted by hbp82 View Post
Thanks Katlin! I guess for the "in between patches part" I meant that I'm due to take my patch off tonight and put another one on, but doesn't it take up to 12 hours to start taking effect? That's where I was going with that. Is that considered a gap? or just a timed delay? I have no idea!

And Johnstar, I will be heading up to my local Henry's and get generic Senna tomorrow! Do you have a preferred (less disgusting) way of taking it? Like in a cup of tea, or juice or such?

Thank you both so much!

Traci


It does take 12 hours for a new patch to start taking effect, however, the old patch leaves a bolus of fentanyl in the skin, which keeps working for atleast 12 hours after you remove it, so you shouldnt go through any periods without pain cover.
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Old 02-20-2011, 07:42 PM   #10
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Re: Norco vs .25 mcg Fentanyl

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Originally Posted by hbp82 View Post
Thank you John! It seems like I've been on the darned pills for so long that the patch was what made me so afraid. But now that I have it on, it seems to be doing it's job and I only have to deal with "breakthrough" pain (new term I've learned since joining this site) in between patches and when I overdo things a tad, (which is constant, because I HATE being not able to be "normal") I must admit, I'm ECSTATIC to hear that I might be able to have normal or closer to normal BM's (who knew they'd be such a joy?) but I'm hoping that this isn't one of those temporary fixes that just last only so long, then goes all defunct and stops working at all.

I'll um, keep everybody posted, and btw, I do adore my PM doc, and I'm in So Cal if anybody needs to know who he is... he is quite attentive. Plus, he does realize when you're truly in pain, versus just trying to get high (which I guess a ton of people try to do) but hey... with this many surgeries under your belt, it's not imaginary!
When it comes to constipation, the Duragesic is GUILTY, guilty, guilty.....it WILL plug you up BAD. You will definitely need to take a laxative if you are taking the patch because if you do not you will probably experience a cerebral hemorrhage trying to have a bowel movement, or at the very least it sure FEELS like you are, LOL. Try taking Metamucil or Benefiber also as these will help with your fiber intake. The patch actually works quite well and comes in 25, 50, 75, and 100 mcg strengths. So good luck!

 
Old 02-20-2011, 09:10 PM   #11
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Re: Norco vs .25 mcg Fentanyl

Tracy,

What jonnstar said is very accurate, once you've had your patch on and your blood plasma levels have gotten to where they need to be you have a continuous stream of medication in your system, there is no drop when you change patches, as long as you put another one on as soon as you take the old one off. One other suggestion I might offer, to avoid skin irritation move your patch around, it needs to always be above your breast line, but try not to put it in the same spot over and over again.

Take care,

Kat

 
Old 02-21-2011, 01:04 AM   #12
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Re: Norco vs .25 mcg Fentanyl

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Originally Posted by katlin09 View Post
Tracy,

What jonnstar said is very accurate, once you've had your patch on and your blood plasma levels have gotten to where they need to be you have a continuous stream of medication in your system, there is no drop when you change patches, as long as you put another one on as soon as you take the old one off. One other suggestion I might offer, to avoid skin irritation move your patch around, it needs to always be above your breast line, but try not to put it in the same spot over and over again.

Take care,

Kat
No kidding. I'm glad you mentioned that because I was going to put it on my butt next time so I guess I'll go for the other shoulder instead! Thanks!

 
Old 02-21-2011, 05:41 AM   #13
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Re: Norco vs .25 mcg Fentanyl

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Originally Posted by katlin09 View Post
Actually here in the States Miralax is very popular and works well. It's a newer Bowel maintenance med. Do you have it in Australia?
I live in the states, not Australia, just FYI.....:-)

 
Old 02-21-2011, 03:42 PM   #14
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Re: Norco vs .25 mcg Fentanyl

yeah definitely don't think the butt patch would work too well....the idea is to keep it away from any undue moisture so that it stays on better it also needs to be above a certain BPL in your body so the absorbtion is handled properly by your system. Your doc should have explained all of this to you.

 
Old 02-23-2011, 01:36 AM   #15
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Re: Norco vs .25 mcg Fentanyl

I personally didnt like the 25MCG patch, didnt help as much as I thought it would....i just got more relief from oral medication which is weird but my body just digested it differentely. also patch dosent last the full 3 days either in my opinion

 
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