Re: Anyone have experience with Butrans or Nucynta?
Quote:
Originally Posted by katlin09
Have you considered adjusted dosing for the patch. Just like some folks (moi) have to change a Fent patch at 48 hours instead of 72. Ask him if you can do 5 day doses instead of 7 day.
Why exactly are you wanting to switch from Norco as your breakthru, is it not working, don't want the APAP, what?
Kat
Will PM's allow a 5 day switch of a transdermal patch? I assumed they would consider it an attempt at violating the contract by asking permission to dose more frequently. If a PM will allow replacement of the patch every 5 days then that would be ideal to solve that problem, I just assumed that wasn't an option.
As for the Norco, 3 10/325 Norco provide modest relief from BT pain, where MSIR and Dilauded provide complete BT coverage. If I have BT pain, I want the BT pain to be as tightly controlled by the BT meds as possible, not leave significant lingering pain even after taking BT meds. And yes I don't want the APAP. Ive been on Norco 12 tabs a day for so long, and part of that time it was 5/500 tabs where I would be taking 1000 mg APAP per 10 mg hydrocodone dose. Plus, it is almost as expensive as MS Contin and Butrans at 120 tabs a month, and I really need to go with the most economical options I can. That said Norco is better than nothing, but it would be nice to only pay $20 a month for BT meds as opposed to $60-$110.
If he will allow me to rotate the patch every 5 days instead of 7, then MSIR for BT (which he has already put on the table) would only add $20 a month to my Rx fees. Still, the BuTrans will be > $100 especially if I am filling it more often than 28 days (due to rotating them every 5 days rather than 7).
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Re: Anyone have experience with Butrans or Nucynta?
Re: Butrans patch lasting 5 days- is this something you personally experienced? or something you have read about? I am on Butrans 10 and don't find that is the case at all. Regarding getting them wet- I was worried about that also but 4 months later I can tell you I have never had one come off due to showering.
Re: Anyone have experience with Butrans or Nucynta?
Quote:
Originally Posted by hanginin
Re: Butrans patch lasting 5 days- is this something you personally experienced? or something you have read about? I am on Butrans 10 and don't find that is the case at all. Regarding getting them wet- I was worried about that also but 4 months later I can tell you I have never had one come off due to showering.
I've both read about it and also personally experienced it through a third party. A family member was apparently on Duragesic for a long while, then switched over to BuTrans when it came out due to the less frequent dosing and the fact the Duragesic was a little strong in terms of side effects. I only found out about this in the last day or two, as the family member is not close to me, but is a direct relative of my grandparents (speaking of, everyone in my family seems to live incredibly long - my grandparents are in their 80's and their parents lived to their 90's - 100's). Today in fact I suggested my grandfather, who takes Hydro/APAP 7.5/500 4-5 times a day for chronic pain and is still not sufficiently medicated, inquire about a BuTrans patch because he suffers a lot but is scared of oral pain meds. I will know for sure from my direct experience by this weekend how it turns out. If it lasts 7 days - fantastic, but the prescribing instructions even state that the first 2-3 days the peak plasma concentration is about 235 pg/ml (picograms/ml) then it slowly tapers down to about 140 pg/ml by day 5 and then by day 6-7 about only 90 pg/ml. SO that would indicate at day 5 it is only administering 60% of the initial dose, tapering down to less than 38% on day 6-7.
Here is a link to a graphic plot of Cmax/Cmin over multiple doses through time and an inferred AUC (area under curve) upon extrapolation of data.
Re: Anyone have experience with Butrans or Nucynta?
I personally experienced the 1 yr I was on the Butrans Patch 10's that they NEVER lasted the 7 days the company claimed they would, although they worked great for my pain when 1st applied, the effect diminished around day 4 and but day 5 there was very little pain stopping effect. My BT meds were used mostly at that time
Re: Anyone have experience with Butrans or Nucynta?
I am more familier with the Suboxone ( same ingredient ) but it is a sublingual film taken twice a day . i started taking this medication when my month supply of pain meds were stolen FROM THE PHARMACY the day they were filled. Long story there. Anyway at first the Sub film were limited to special group of Doctors with special lisence. My PM actually prescribed me these to aleviate WD's as I had been on a pretty high dosoge of a LA med AND Ocycodone for BT pain. I LOVED IT. I didn't have the sluggish dopey feeling I get sometimes when my meds are first taken, but it didn't give me the best pain control
Re: Anyone have experience with Butrans or Nucynta?
If the patch isn't lasting as long as it is supposed to, definitely tell your doctor. See what they say to that. That way you aren't asking to be switching it more often. Some people do absorb meds faster, and often there is documentation that a good number of folks need to dose something more often than the prescribing info. Worst they can say is no, and then you need to decide whether to put up with it or ask to try a different med. Best wishes.
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Kate
constant head pain, fibro, and other fun!
chronic pain established in 2006
