Considering changing to patch from Avinza
Just some background info first: I have psoriatic arthritis that affects my ankles, knees, hips, elbows and a few other joints as well as thoaric back pain which is from an old fracture. I also have recently been diagnosed with thoracic outlet syndrome. All this at the lovely age of 30. Go me.
I am still working with the rheumatologist to find the perfect cocktail to get my arthritis under control. Currently I am taking methotrexate and naproxen for it. My primary care physician handles my pain medication.
I have been on 60 mg Avinza for about 6 months (was on 30 mg before that). Anyway, two weeks ago I went into his office because I wasn't getting very good pain control with the 60 mg. His first inclination was to raise it to 90 mg. I accepted the rx but the more I've thought about it, the more I'd like to maybe switch meds instead of going to an ever increasing dose.
I shot and email off to him about it, and specifically the patch. He does use it frequently in his practice and said it does tend to have fewer side effects. I am having bad constipation despite use of Miralax and good diet with the Avinza.
I have an appointment with him next Friday to discuss switching meds. I know Shoreline has said Fentanyl is sort of like the drug of last results, since it is the most powerful, and that's what makes me hesitant about moving to it. But I do like that I don't have to take pills. Also, I think with the type of pain I have from the arthritis, the very steady state would help.
Since I have only been on the 90 mg of Avinza a few weeks, I was wondering if I could get away with just using the 25 mcg Fentanyl patch? What do you think? And maybe change from Norco (which I have now) for breakthrough to something a little stronger.
I'd appreciate any advice/insight. My goal is to use the least amount of pain medication as possible. I'm still hoping a med can be found to get my arthritis under control (maybe starting Enbrel soon, which should help) and then maybe one day I wouldn't need a long acting med, only an occasional SA.