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Old 11-05-2005, 01:27 PM   #1
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ladyalaska HB User
starting l/t meds need input!

Hi everyone, i am new here but not new to p/m. i have my p/m appt on mon 11/7 and i am needing to talk to my doc about starting a long term med, again. about 3 months ago i stopped taking the avinza, it caused too much stomach upset and i wasn't getting any relief from it. doc agreed to let me just use perc 10/325 4xdaily with the agreement that if it stopped working i would let her know and we would try different long term med. my options are the patch or methadone. i tried the patch in the very beginning of my p/m (with a different p/m doc)and it was too much, but now that i have been doing this for 2 plus years i should be ok with it. the challenge for me is that i don't know anything about either, except what i have read and what my pharmacist tells me. i need to hear from people who have taken either or both. i take sonata for sleep and read in the warning section of the patch that you aren't suppose to take that while on the patch---any words from anyone on that? i cannot stop taking the sonata, insomnia too bad. i have read posts that the patch can make you "energized", that doesn't bother me, what i need to know is does it make you "stupid"? or are you able to stay clear headed? the Oxycontin 10 3xdaily with perc 10/325 4xdaily made me very agressive and i lived in a continual fog. Please help!

 
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Old 11-05-2005, 04:41 PM   #2
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Re: starting l/t meds need input!

Hi Lady,

I'm on Duragesic 125mcg (100mcg patch + 25mcg patch). I also take Actiq for breakthrough pain. If you don't know already, Actiq is the same medicine (Fentanyl) that is in Duragesic, but in a lollipop form where the medicine is absorbed through the lining of your mouth. The only problem I have with the patches is mild skin irritation. It doesn't make me feel foggy like other meds have. It just takes the pain away. Thank God!! The only "complaint" I have (it really isn't a complaint) is that I have to wear 2 different patches because the highest strength made is 100mcg.

There are 4 strengths...25mcg, 50mcg, 75mcg, & 100mcg.They will probably start you on the 25mcg patch. ( Actually, I think there is a new lower strength 12.5mcg. I believe someone mentioned it came out a little while ago.) From what I understand, everybody starts on the lowest dose. Be prepared in the beginning for increased pain while your dose is being titrated. Make sure you have plenty of breakthrough meds for the initial phase. My pm doc made sure of that! I hoped this has helped. Good luck!!

Last edited by friendly_one; 11-05-2005 at 04:53 PM.

 
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Old 11-05-2005, 04:56 PM   #3
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Re: starting l/t meds need input!

thank you! i have to admit that i had never heard of a "lollipop" until today! is there a reason you had more pain when you started the patch? yes there is a 12.5 according to my script website, i'm not sure that it is offered here in Anchorage, AK as my pharm didn't mention it. have you ever tried the methadone? thank you so much for your input, i am looking forward to hearing from everyone with their thoughts and suggestions! Dawn

 
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Old 11-05-2005, 10:48 PM   #4
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Re: starting l/t meds need input!

I'm a big methadone fan, after being on it for a few years now. (Previous meds = hydrocodone, oxycodone, oxycontin... I know there's a couple more, but it's been a while - don't remember the names. Before I switched to methadone I was on 20mg of oxycontin 3x/day, but needed more - it seemed my tolerance with that med grew very quickly, which I did not like. I had heard people saying methadone worked well for them, but I was thinking "That's the drug for heroine addicts!" (Didn't know at the time that it's also quickly becoming one of the best and most Rx'd meds for chronic pain). Finally (when oxycontin was just not cutting it!) asked my pain doc about it, and he thought it would be a good idea to try. Started with 10mg 3x/day (2 years ago), now on 20mg 3x/day, plus soma, amitryptaline, hydrocodone for BT, celebrex. When I first started the methadone it made me VERY, VERY tired/sleepy - so much that I almost gave up in the first week. I literally fell asleep mid-sentence when reading to my kids - more than once! (We homeschool, and I do a lot of read-alouds, so that was NOT going to work for me!) After the first couple weeks, that improved quite a bit (though it still does make me sleepier/more tired than oxycontin ever did). What made me willing to stick with it, though, was the difference in pain relief - like night and day! The methadone works MUCH better for me than the oxycontin ever did - and is MUCH, MUCH cheaper! (If I remember right, the oxycontin was costing us around $60-something per month - AFTER insurance - the methadone costs $11/month - TOTAL! A couple years ago I decided the tiredness was something I didn't want anymore, so asked my doc to switch me back to oxycontin again (guess I forgot how good the methadone works in comparison!), which he did. Within 3 days I was on the phone with my PM doc's nurse, in tears, begging to go back to the methadone because the oxycontin felt like it was doing NOTHING in comparison. Lesson learned - I won't do that again! A bit of tiredness is much better than level 8-9 pain anyday!

I say give the methadone a try - it does work very, very well for some people. You can always try the more expensive meds if you're not satisfied with the methadone - but if the cheaper one works great, no need to spend big bucks on something else.

Good luck!
JD

 
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Old 11-06-2005, 12:47 AM   #5
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Re: starting l/t meds need input!

wow! thank you for such a wonderful answer! you covered all the areas i was looking for in an answer, heck even my husband was impressed with what you said! the tired part is what i am concerned about, but like you said in comparison to the pain level being a little sleepy isn't so bad............ i will keep everyone posted! thank you! Dawn

 
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