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Old 02-27-2008, 10:40 AM   #1
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fentora 200 mg equals how much in oxycodone?

fentora 200 mg equals how much in oxycodone?

 
Old 02-27-2008, 01:11 PM   #2
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Re: fentora 200 mg equals how much in oxycodone?

Dear caress,

Fentora is a newly-formed medication containing fentanyl. It does NOT contain any oxycodone!! It is measured in micrograms (mcg's) instead of milligrams (mg's). Look it up on the internet for better product information than my description!

This is a potent pain/opioid medication that is practically the same as Actiq (oral transmucosal fentanyl citrate)--except that it doesn't have a lollipop stick inserted. So, let's be careful about its use.

Sincerely,
Jon (Conductor)

P.S. Realizing that I am--IN NO WAY--a professional (!)--my guesstimate is that Fentora 200 mg is roughly equal to 100 mg to 200 mg of oxycodone. However, perhaps some of the other members would be better-suited to help calculate this question.

 
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Old 02-27-2008, 01:16 PM   #3
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Re: fentora 200 mg equals how much in oxycodone?

I looked up Fentora and it says that it is only appropriate for treatment of cancer related pain. I suppose pain management doctors could use it for non-cancer pain but I highly doubt this. The information I read says they make it in tablet up to 800mcg. I would definitely tell your doctor that it is not working as well and he may raise your dosage.

Brian

 
Old 02-27-2008, 07:15 PM   #4
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Re: fentora 200 mg equals how much in oxycodone?

Fentora is fentanyl and is dosed in Mcg so comparing it is difficult. No fentanyl based med is dispensed in Mg, so I'm sure you mean Mcg. 200Mg of fent would equal 2000Mcg.

Back to our question: 10Mg of Oxy is = 25Mcg of fentanyl. Those on 10Mg of Oxycontin are given the 25mcg fentanyl patch. Therefore, as a very general comparison, 200Mcg would be = 40 Mg of Oxy. Those on 200Mcq Actiq (fentanyl) are typically given between 40-50 Mg of Oxy IR.

Fentora is made and marketed by Cephalon....The same maker of Actiq. Actiq's patent expired last year, thus, opening up the fentanyl lollipops to generics. Fentora is Cephalon's market replacement as a way to maintain the healthy profit price margins they enjoyed via Actiq. Fentora is a 100% fentanyl lozenge while Actiq is a 100% fenanyl lollipop.

Cephalon has recently applied to the FDA for expanding it's label to back pain and other forms of pain (from cancer pain). The reasoning is much more sales potential. Unfortunately, Fentora is off to a less than desirable start as there have been several deaths. Fentora disolves (5-10 minutes) much quicker than Actiq (30 minutes), thus, hits your blood stream much quicker. You really can't titrate the lozenge as once it dissolves, it's mushy and pretty much gone....No real in between. Actiq can be sucked on and then taken out of the mouth once a certain amt of pain relief is achieved.

Hope this helps. Good luck.

Last edited by HBMod07; 02-29-2008 at 10:23 AM. Reason: Directing members to search engines is not permitted

 
Old 02-27-2008, 07:28 PM   #5
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Re: fentora 200 mg equals how much in oxycodone?

Quote:
Originally Posted by Executor View Post
Back to our question: 10Mg of Oxy is = 25Mcg of fentanyl. Those on 10Mg of Oxycontin are given the 25mcg fentanyl patch. Therefore, as a very general comparison, 200Mcg would be = 40 Mg of Oxy. Those on 200Mcq Actiq (fentanyl) are typically given between 40-50 Mg of Oxy IR.
I hate to question you there but from what I had read and understood I thought that 25mcg fentanyl = 40mg oxy since it says in the information leaflet for the patch that 25mcg fentanyl ~ 30-67mg oxycodone I believe that 200mcg fentanyl would be equal to 320mg oxycodone. Can you tell me if I am incorrect?

Brian

 
Old 02-27-2008, 07:46 PM   #6
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Re: fentora 200 mg equals how much in oxycodone?

Not 100% sure....Whatever the info says is what I'd go with. I just know that at my PM clinic when they switch people from OC to the patch or vice versa, it's 10 OC x 2 = 25mcg patch.

 
Old 02-28-2008, 07:42 AM   #7
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Re: fentora 200 mg equals how much in oxycodone?

This is the same person who asked about the ratio. To continue my questioning, I am asking for help from professionals in HMOs. by background-I have failed back surgery syndrome, with often severe chronic pain in back and nerve pain with both legs/feet. My Dr's have me on 40mg oxycondin BID with up to 8 five mg oxys for break through pain. I am trying to keep from developing a need for an even higher dosage by taking "vacations" from the oxycodin with vicodin and Valium. The Dr who prescribed it now he's been told he can't any more, even though he is supposed to be the specialist in charge of my case. (Kaiser). Recently, one different Dr prescribed the Celephon "lollipop" and it was the first time I have been pain free in 4 years. I found that I got relieve within a few minutes, without even finishing the lozenge. Then, a busybody pharmacist decided there was a chance of abuse.

Naturally, my HMO PC provider changed his mind and wouldn't refill the script.
Doesn't it make sense to give a patient who is opiate dependent, a 57 year old professional woman with a family and responsibilities, a drug that helps her? I don't want to get high, I want to be able to engage in life. I exercise, eat right, and have never had an addiction problem ( except to books and good smelling bath oils!) I did not need any of the 5 mg. oxys all day after the one dosage of oral fentanyl200Mcg.
What can I do to convince them this is a reasonable pain management decision?

 
Old 02-28-2008, 02:37 PM   #8
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Re: fentora 200 mg equals how much in oxycodone?

Quote:
Originally Posted by caress View Post
What can I do to convince them this is a reasonable pain management decision?
First of all is this a PCP or a pain management doctor? Many times it is difficult or nearly impossible to get a PCP doctor to keep prescibing opiate type medication. It sounds like you really need to be on a LA (long acting) type medication instead of the SA (short acting) medication like the hydrocodone and oxycodone. You said that you got relief from the Fentora tablet whose active ingredient is fentanyl. Since you got relief from that then it would be logical to go on the fentanyl patch which you should get pretty good pain relief from. Ask the doctor if he would be willing to presribe a LA med like the fentanyl patch (Duragesic brand name) since you got relief from the fentanyl tablet. If he is not willing to do that then you will need to get a referral to a PM (pain management) doctor. Hopefully he will know of PM docs that do presribe opiate/opiod medications instead of those that just do procedures. Good luck and keep us posted on your progress.

Brian

P.S. From your current medication you are probably taking the equivalent of the 50mcg fentanyl patch

 
Old 02-28-2008, 07:24 PM   #9
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Re: fentora 200 mg equals how much in oxycodone?

Just curious.....What was the pharmacist's problem? How did he/she get involved in your care? This is so wrong!

I'm certainly not going to argue against the abuse potential of the Actiq lollipop, but for pete's sake, the 40mg of Oxy you're taking is in the exact same category!

Just a flat out guess, but the Actiq pops are horrendously expensive, so I'm wondering if this HMO thing is managing cost instead of your care. You may want to check into it....That's why I ask about the pharmacist you referred to.

Good luck and please keep us posted.

 
Old 03-03-2008, 09:22 AM   #10
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Re: fentora 200 mg equals how much in oxycodone?

Continuing with the question of the ratio of oxycodin to fentanyl lozenge on a stick, I have gotten conflicting answers. What I am hoping to do is get a definitive answer I can take to my HMO primary care physician with the goal of switching from 5 mg oxys ( up to 8 a day) to the lollipop as a breakthrough pain management. If works so much better,but is it because it is higher in strength, or just a different type of opiate that my brain isn't used to. Caress

 
Old 03-03-2008, 10:20 AM   #11
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Re: fentora 200 mg equals how much in oxycodone?

I have really never seen the lollipops how do they work out??? seem like they may be working out for you better fr right now..... Today my pain sucks... I am now verry stressed maybe I should check out the lollipops and see if they will be good for me...
Thanks for the info.
kim

 
Old 03-03-2008, 04:57 PM   #12
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Re: fentora 200 mg equals how much in oxycodone?

Quote:
Originally Posted by caress View Post
get a definitive answer I can take to my HMO primary care physician with the goal of switching from 5 mg oxys ( up to 8 a day) to the lollipop as a breakthrough pain management.
I really do not think you should go on the fentanyl lollipop because it will increase your tolerance to narcotic medications very, very quickly. Also keep in mind that they only last for a short period of time for the pain. The real goal should be to get the pain level down to a reasonable level for most of the day which would mean an appropriate amount of a LA medication and not a BT medications, especially not one of the strongest BT meds available. Please try the fentanyl patches before suggesting the lollipop. It keeps the level of fentanyl in your body at a constant dose which is what you need. You might need to even go up to 100mcg or higher dose of the patch but that is no where near the 200-800mcg dose in each of those lollipop. Please think about what you are suggesting. Sure I would love to try the lollipops but I know what would happen and it is exactly what I have told you. I don't want to have the tolerace to narcotics that is ridicuously high. Just please think about going on the patch first.

Brian

 
Old 03-03-2008, 07:22 PM   #13
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Re: fentora 200 mg equals how much in oxycodone?

Brian is right about the patch keeping fentanyl in your body around the clock. If you want the exact recommended conversion, look at the drug's (Duragesic is the brand name) patient/Dr. literature, they have a conversion chart of daily average morphine/morphine equivalent to the fentanyl patch. It can found on-line....It comes in the box with the patches. A pharmacist can give it to you as well. For example, those on 10mg of OC 3x day are converted to the 25mcg fent patch. Since it's 25mcg per hour, thats 600mcg per day. The fent lollipops come in 200mcg, 400mcg, 600mcg, 800mcg and so on. So, you could make your conversion that way.

The lollipop is very quick in your body, and therefore, very quick out. Works in less than 5 minutes, but is gone within 2 hours, sometimes less. They have a blood plasma graph (Actiq is the brand name) in their patient/Dr. literature (that comes in the box) that documents this concept. It can be found on line as well. It shows a very quick and sharp peak, and then the bottom drops out. Works great for BT pain, but isn't appropriate as a only med. You should be taking some type of LA med (which will keep your blood plasma levels elevated and constant) and then something short term for BT. Without something LA, your "ups and downs" will be miserable.

Also, beware that the lollipops are EXTREMELY expensive and most insurance plans only pay for them if you have Cancer....Unless you've got great insurance.

Good luck and hope this helps.

Ex

Last edited by Executor; 03-03-2008 at 07:40 PM. Reason: spelling

 
Old 03-03-2008, 10:29 PM   #14
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reply to Brian from Caress

Thanks for the concern, Brian. I am on a LT medication- 40-80 mg oxycodone time release taken BID- they are supposed to last 12 hrs, but I experience breakthrough pain about 6 hours or so later, or earlier if I do something to aggravate my back, like too much exercise or work that is too much. I have a degenerative disc at L5-S1 with almost no disc material- so its bone on bone, plus "failed back surgery syndrome" which includes a damaged nerve to the left foot resulting in numbness, pain, and occasional zings like being stung by a wasp or electrocution. So, the plan I have been on for the three years since the surgery has been to take my TR med early in the morning a couple hours before getting up, then take the 5mg oxy as needed up to 8 a day. I take another 40 mg in the late afternoon, which gets me through making dinner and taking care of my family. When I was prescribed the fentanyl 200, I was pain free for the first time in years, and one sucker kept me feeling great for several hours. Then, my P C Provider decided not to give them to me, based on a misunderstanding with the oxycodone. Now I have a different Doc and want to get them to let me have some for times I just am in serve pain and can hardly walk.
I think I ended up with less narcotic in my body. I did not have any side effects, and it worked! So it is obvious why I want them as a choice, at least, for pain management. Of course, my HMO is afraid of abuse, but, my goal is to be healed, not a drug addict. Since they botched my operation, you would think they would want me to at least have a better quality of life! I have been a pilates instructor and personal trainer for 10 years before my injury.
Aloha, Caress

Last edited by caress; 03-03-2008 at 10:32 PM.

 
Old 03-04-2008, 03:36 PM   #15
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Re: reply to Brian from Caress

Quote:
Originally Posted by caress View Post
When I was prescribed the fentanyl 200, I was pain free for the first time in years, and one sucker kept me feeling great for several hours. want to get them to let me have some for times I just am in serve pain and can hardly walk.
my goal is to be healed, not a drug addict.
Caress,
I feel for you, I really do but you need to understand what is going to happen if you do start using the fentanyl lozenges (which I doubt you will even be able to get again). I want to say that there are times when I am in severe pain and I don't think any "safe" amount of narcotic would get me pain free in those times. I wish that I could have the losenges in those times as well, but I know that it might increase my tolerance to the fentanyl or other narcotic in general very quickly. Just think where are you going to be in 20 years if you start using these losenges and your tolerance becomes astronomical and you have to beg a doctor to try to prescribe enough of a narcotic to even make a dent in your pain. I am really trying to "save" you from reaching that point and then saying "crap, I wish that I would have listened to the people that were warning me this would happen". I am not saying this because I don't want you to have relief, but I want you to have effective PM for many, many years. Let us know what you decide and what your doctor and insurance company does.

Brian

Last edited by brianpain33; 03-04-2008 at 03:37 PM.

 
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