It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Pain Management Message Board
Post New Thread   Closed Thread
LinkBack Thread Tools
Old 07-18-2011, 11:01 AM   #1
Junior Member
(female)
 
Join Date: May 2011
Location: South
Posts: 46
Lindy77 HB User
ATT: Fentanyl/Dilaudid/Oxy users... please help w/?'s!

This might be a dumb question, but I can’t find much info on the web regarding this. My PM Doctor switched me to the Fentanyl patch, .75, along with my Dilaudid 4mg. I was on Oxy 20mg 3x along with Dilaudid (same dose), and I was still in awful pain. So far, that awful debilitating pain has lessened. My question is will I experience any withdraw symptoms from the cross over?

Few more questions:

1) Does anyone “black out” from intense pain?

2) Does anyone find their patch isn’t giving them as much pain relief on the third day as it did previously?

3) Is anyone on Nortriptyline for the purpose of treating nerve pain?

Thank you,
Lindsey
__________________
.Lindy.

 
Old 07-18-2011, 06:46 PM   #2
Inactive
(female)
 
Join Date: Mar 2008
Posts: 5,070
katlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB User
Re: ATT: Fentanyl/Dilaudid/Oxy users... please help w/?'s!

Well you shouldn't have any w/d's the Fentanyl will replace the oxy in your system. The fentanyl should give you pretty good pain coverage, it's the strongest out patient narcotic, and dilaudid works on a different pain center, so they should compliment each other well.

When you put your patch on, make sure you place it somewhere above your breast line, this is the only way it works correctly....placement, body heat has a lot to do with how well it works.

Be careful of taking too hot of baths as this can make too much of the med release too soon.

Good luck and welcome to the PM boards!

kat

 
Sponsors Lightbulb
   
Old 07-19-2011, 10:06 AM   #3
Junior Member
(female)
 
Join Date: May 2011
Location: South
Posts: 46
Lindy77 HB User
Re: ATT: Fentanyl/Dilaudid/Oxy users... please help w/?'s!

Hi Kat
Thanks for your reply. I believe we’ve talked before, but I haven’t been back on here in a while. I appreciate the tip on hot showers/baths… I found that one out the hard way when I took too hot of a shower last night… not a good feeling! Won’t make that mistake again.

Right now I have it on my upper arm. I find it sticks there the best and most things I do don’t make it bend a lot.

Hope you’re doing well!
__________________
.Lindy.

 
Old 07-19-2011, 10:15 AM   #4
Inactive
(female)
 
Join Date: Mar 2008
Posts: 5,070
katlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB User
Re: ATT: Fentanyl/Dilaudid/Oxy users... please help w/?'s!

Lindy,

The hot bath thing is one of the reason's I stopped using it, when my knees flare up it seems like one of the main ways to get relief is to "boil" them in a very very hot bath. I take probably 2 baths a day on average...so it didn't work out for me.

They also make "patch" covers that you can get at the Pharmacy. They're like big clear bandaids that go over the patch to help it stay on. I always seem to have trouble getting mine to stick and stay put!

Hope it works out for you,

Kat

 
Old 07-19-2011, 10:23 AM   #5
Junior Member
(female)
 
Join Date: May 2011
Location: South
Posts: 46
Lindy77 HB User
Re: ATT: Fentanyl/Dilaudid/Oxy users... please help w/?'s!

I'll go hunting this afternoon. Thanks!!
__________________
.Lindy.

 
Old 07-26-2011, 11:21 AM   #6
Senior Member
(male)
 
Join Date: Jun 2003
Location: moncton n.b. canada
Posts: 129
ruko4 HB Userruko4 HB User
Re: ATT: Fentanyl/Dilaudid/Oxy users... please help w/?'s!

I was on the Fentanyl patches for a little while. I found that switching the patches every 2 days instead of every 3 days worked great. I along with many others find that on the 3rd day the patches are pretty much used up, Now I know that they are labelled to be used every 3 days but like many other pain meds including Oxycontin which is labeled by the drug company that owns it to last 12 hrs, which is twice a day dosing. Most doctors will start with what the guide lines indicate and if that does not work, they are able to change the frequentcy at which they are dosed at. Alot of people I talk to find that certain drugs including the Fentanyl patches are better dosed at changing the patch every 2 days intead of the 3. Now tinkering with the dose is different story all together, but if you do find that the patch is not working as good by the 3rd day talk to your doctor because it is quite common to dose like this. You will need to be prescribed more patches per month, so it will cost a little more, but it is definetely worth it and you should have no problem with your doctor prescribing it, because again it is very common especially with the Fentanyl patches.
__________________
shawn

 
Old 07-26-2011, 11:26 AM   #7
Inactive
(female)
 
Join Date: Mar 2008
Posts: 5,070
katlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB User
Re: ATT: Fentanyl/Dilaudid/Oxy users... please help w/?'s!

I also was on a 48 hr schedule when I was on the Fent patches. We started at 72 hrs., but the coverage wasn't good enough, it worked much better at 48 hour changes.

kat

 
Old 07-26-2011, 12:00 PM   #8
Junior Member
(female)
 
Join Date: May 2011
Location: South
Posts: 46
Lindy77 HB User
Re: ATT: Fentanyl/Dilaudid/Oxy users... please help w/?'s!

Thank you all, I appreciate your responses... they're helpful. I have been on the patch for about 2 weeks now, and I am finding that by the 3rd day (afternoonish) I am in more pain. I might bright it up with my Dr. the next visit; however, it's not debilitating pain by the 3rd day... and the Dilaudid seems to keep it under control until I change the patch. I'm going to keep a schedule though, should my pain symptoms change.

Thanks again. I have found this board and its members to be very helpful and supportive. I hope everyone is doing well today

~Lindy
__________________
.Lindy.

 
Old 07-27-2011, 07:42 AM   #9
Senior Member
(male)
 
Join Date: Jun 2003
Location: moncton n.b. canada
Posts: 129
ruko4 HB Userruko4 HB User
Re: ATT: Fentanyl/Dilaudid/Oxy users... please help w/?'s!

When I was using the Fentanyl patches by the 3rd day I wasn't in severe pain either, but it was definetely noticeable and it was almost as if I was starting to go into mild withdrawl. Now I guess talking to my doctor he said by the end of the 3rd day the drug has already peaked and the blood serum levels of Fentanyl are starting to go down. Think of it this way if you make a line chart dosed for the 3 days (72 hrs) the drug levels of Fentanyl in your blood should stay pretty constant, and by the end of the 72 hrs the drug starts to go down and that is when you put on another patch to prevent this from happening and keep the Fentanyl levels in your blood from going down.
He also said that some people metabolize the drug more quickley than others and it can depended on alot of other things as well especially with the Fentanyl patches.. ex. some people exercise and workout which brings up your body temperature which can make the patches release more of the drug which in turn uses up the drug more quickley, others play sports and are more active than others, going to the beach can effect the patch as well due to the heat releasing the drug more rapidly, hot baths, hot tubs, etc. Anyway some of these are preventable, but for people who like to workout and play sports its hard to have to change this.
Also you should not have to use your Dilaudid every day around the same time due to your patch wearing out. So if you find that this is happening around the same time every day then you should be definetelty changing your dosing schedule to possibly changing your patches every 2 days. As for the Dilaudid it sounds like you are prescribed this for breakthrough pain which should not be every day at the same time because your patch is wearing off.
For example If you were taking Oxycontin twice daily (every 12 hrs) and you found that it was wearing off at the end of each dose, like say you take your first dose at 8:00 a.m. at 12 hr dosing your next dose would be at 8:00 p.m.
if it starts to wear out say around 4:00 in the afternoon (which would be around the 8 hr range) and then again around 4:00 a.m. in the morning waking you out of bed (again around the 8 hr range) then most likely your best bet of coarse would be to start dosing the Oxycontin every 8 hrs (3 times daily, which is very common with Oxycontin) instead of having to use your breakthrough pain meds at the end of each dose. Breakthrough pain meds should be used when needed in this case, and not on a fixed schedule like your base med. which would currently be Fentanyl, because it is a long acting pain med. Dilaudid, Percocet, Vicodin,etc. are short acting pain meds used usually for acute pain and for breatkthrough pain for chronic pain patients. Hope this helps a bit.
__________________
shawn

 
Old 07-27-2011, 03:22 PM   #10
Junior Member
(female)
 
Join Date: May 2011
Location: South
Posts: 46
Lindy77 HB User
Re: ATT: Fentanyl/Dilaudid/Oxy users... please help w/?'s!

Thanks for your detailed response. Interesting on the Fentanyl. As for my Dilaudid, my PM doctor wrote it as take it 3 times a day. So, my case is a little different in that aspect. I'm just thankful that he's found a combo that doesn't have me in horrific pain.

Again, thanks for taking the time to write back to me explaining all of this. I've been on the patch before, but not for long and not at this dose (my last flare up wasn't as bad as this one)... plus I'm new to PM in general... so advice/support/help is appreciated

Hope you're having a good week.
__________________
.Lindy.

 
Old 07-27-2011, 03:37 PM   #11
Inactive
(female)
 
Join Date: Mar 2008
Posts: 5,070
katlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB Userkatlin09 HB User
Re: ATT: Fentanyl/Dilaudid/Oxy users... please help w/?'s!

They always write a certain instruction on your BT med bottle, because they can't just leave it blank or put take when needed. Just because it's written that way doesn't mean your supposed to take it all day everyday. If you're having to do that to keep your pain under control, then it sounds like your LA med might need to be increased in strength.

All of our bottles have similiar instructions, my percocet says take 2 every 4 to 6 hours. But that doesn't mean my dr. wants me to take that many everyday, she'd prefer that I took as little as possible and let the LA med do the work, as that's how this system of LA and BT meds is designed.

It sounds like you might need to talk to your doc to clear up this confusion, I would almost bet the farm that he doesn't want you taking it all day everyday, as opposed to just taking it when you have a very bad pain flair.

Kat

 
Old 07-27-2011, 03:47 PM   #12
Junior Member
(female)
 
Join Date: May 2011
Location: South
Posts: 46
Lindy77 HB User
Re: ATT: Fentanyl/Dilaudid/Oxy users... please help w/?'s!

Quote:
Originally Posted by katlin09 View Post
They always write a certain instruction on your BT med bottle, because they can't just leave it blank or put take when needed. Just because it's written that way doesn't mean your supposed to take it all day everyday. If you're having to do that to keep your pain under control, then it sounds like your LA med might need to be increased in strength.

All of our bottles have similiar instructions, my percocet says take 2 every 4 to 6 hours. But that doesn't mean my dr. wants me to take that many everyday, she'd prefer that I took as little as possible and let the LA med do the work, as that's how this system of LA and BT meds is designed.

It sounds like you might need to talk to your doc to clear up this confusion, I would almost bet the farm that he doesn't want you taking it all day everyday, as opposed to just taking it when you have a very bad pain flair.

Kat

Hey Kat ,

There is no confusion between my PM Doctor and me. I’ve told him everything (in MUCH more personal detail than I have here on the boards) and this is how he’s instructed me to take my medication currently. There is no confusion at all.

If I don’t need it, then I wouldn’t take it; however, that’s not the case currently. We’re trying to figure out where all this pain is coming from. I hope to eventually not need this medication at all. But as of now, this is what my doctor has instructed me to do.
__________________
.Lindy.

 
Closed Thread

Similar Threads
Thread Thread Starter Board Replies Last Post
what dose of fentanyl lozenges should i use if i'm on 100mcg of fentanyl patch cazzeem Pain Management 11 12-15-2009 02:08 PM
New to Board, New to PM and Long Lasting Pain Meds - Fentanyl New To CP Pain Management 64 06-19-2009 10:44 PM
What other BT med works with Fentanyl Patch? sandollar Pain Management 2 02-26-2008 05:35 PM
Fentanyl questions jennfaery Pain Management 19 02-14-2008 11:22 AM
fentanyl lozenges doddsgirl1 Pain Management 9 04-03-2007 04:14 PM




Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off




Join Our Newsletter

Stay healthy through tips curated by our health experts.

Whoops,

There was a problem adding your email Try again

Thank You

Your email has been added








TOP THANKED CONTRIBUTORS



gmak (153), tortoisegirl (153), Shoreline (148), BB07 (91), backhurtz (84), katlin09 (69), Ilovemycutedog (53), galalena (50), jonnstar (35), Isotope (34)

Site Wide Totals

teteri66 (1162), MSJayhawk (991), Apollo123 (890), Titchou (826), janewhite1 (823), Gabriel (757), ladybud (737), sammy64 (666), midwest1 (665), BlueSkies14 (610)



All times are GMT -7. The time now is 08:58 AM.



Site owned and operated by HealthBoards.com™
Terms of Use © 1998-2014 HealthBoards.com™ All rights reserved.
Do not copy or redistribute in any form!