Need Advice On Pain Med Change - Pain Management Message Board

leebrown61 · 12-06-2007, 02:01 PM

Hi everyone,

I have posted here before and I appreciate all of the support. I currently take vicodin 7.5 mg twice a day and dilaudid 4 mg twice a day for lower back pain and arthritis in my hip and knee. The pain is caused by herniated discs, Osteoarthritis,ect... I also take amitriptyline 10mg before bed. (spelling??).
My previous family prac doc retired and I see a new doctor. He is very nice and compassionate. We spoke today about switching my short acting pain meds for long acting meds. We will decide when I see him in early February. He mentioned either MS Contin, Fentanyl patch, or methodone. I don't like the idea of methodone because of the stigma attached. I know that it used for pain but people are sometime ignorant. In your experience which do you think might be best, MS Contin or the patch. I think that his idea of long acting pain relief is smart and I will do whatever the doc thinks is best. It is kind of scary to switch.

Thank you and I hope everyone has a happy holiday season.

brianpain33 · 12-06-2007, 02:56 PM

It really all depends on how your body reacts to the medications. I am on the patch right now and it was working pretty well until this last month. I hope to increase it tomorrow with doctors approval. Just be aware of the conversion if you do switch to the patch. I believe the 25mcg patch (usually the one they start you out on) is equivalent to around 60-70mg/day of hydrocodone. I would recommend switching to the patch though. You can go on a search engine and type in fentanyl conversion chart and get some information on which dose might be appropriate. If you do go on the patch I would definitely stay away from the MYLAN (generic) brand and would stick with either the Brand Name DURAGESIC or SANDOZ (generic). I believe that getting on the longer acting drugs are very helpful. For one, they keep the dose in your system at a steady level so you are not getting that up and down feeling from pills. Two, you can greatly decrease the amount of pills that you need to take. Three, you can stop clock watching waiting for your next dose of hydrocone. Four, I feel that you are less likely to develop addiction tendencies when you cut down or get off the hydrocodone. Just my opinion.

Brian

Boxerluver · 12-06-2007, 03:17 PM

Lee, I'm glad to see your doc wants you on a long-acting, it is such a better way to manage pain. I'm not really sure one is better than another, it just depends on how it works for you. I too am on the patch and it has been a life-saver for me. I was taking hydro, before then got started on the 25mcg patch, but it didn't work at all so he upped me to the 50mcg, then I changed it every 48 hours and I was on that for quite awhile then was upped to the 75mcg which is what I am on now.

I agree with Brian about the Mylan, it doesn't work as well. Also some docs will have you change the patch every 48 hours instead of every 72. Many people find that that third day on the patch was torture. You'll just have to see how you respond to the meds.

Take care
Melissa

leebrown61 · 12-07-2007, 05:57 AM

Thanks for the feedback. I am leaning towards the patch. I am going to do some research, as suggested.
I have read that the third day can be difficult so I am hoping that the doc will prescribe for every two days. If not, I will try it every three and let him know if it does not work well on the third day. I am looking forward to 24 hour relief. I hate the ups and downs of the pills.
I will wait until after the holidays to start since I will be traveling during the holidays and don't want to start anything new.
Thank you all again for the support and feedback.
Happy Happy Holidays (I love the holidays)
Lee

jasgirl · 12-08-2007, 01:29 AM

Hey There
Ummm I have been in your position b4 and have been on everything except methodone (which I hear is a great pain mangement med for some ppl) but all of them have there pros and cons obviously but the patch for me was a pain in the butt to be honest.depending on how many ur to have on but u end up running out of spots to put them,with marks left on your arm from the sticky stuff (that doesn't stick very well at all) so I used medical tape and I ended up looking like a freak, plus its hard to shower cuz u have to try and keep the patch dry and I used to use SOS pads to take off the sticky stuff left on my arm,so it was soooo much hassle and work that I rather not of dealt with. Mscontin or oxycontin are pill form and much easier to take and I found better/easier than the short acting meds and better pain relief especially in the begining u will notice longer acting is much more helpful to the pain and alot esier.But my opinion on the patch is its too much to deal with.But each person is differnt right?!? I truly hope u find what works for u and what keeps the pain manegable