Advice for breakthrough pain medication.

[cameronlanni]

Thanks a lot for the help thus far. I do want clarify one thing, though, and that is that although I have taken OxyContin before as a LA med and now Percocet as a BT med, OxyCodone in general has never seemed to work well for me - so the liquid formula probably wouldn't either. I had forgotten about the Fentanyl lollypops though, maybe I will look into that. Has anyone here had good luck with these? Thanks again.

[Director]

The Fentanyl Pops seem to be quite helpful. There have been a lot of people on the board that use them for BT pain. They are very expensive (some insurance companies don't cover them unless you have cancer), but come in a variety of doses. I think they come in 200 to 1,600 mics. These are usually the end of the line and for patients who have tried everything else.

I am on Methadone now and don't use BT medication. When I did, I had good luck with the Roxicodone, which comes in 5, 15, and 30 mg. I know you said you tried it, but were you on a high enough dose to be effective? That could help if you went to the 30 mg or higher dose.

[forginon]

The fentanyl lollipops work well, but tolerance builds very, very fast. The problem you face then is 'what will you use then when you develop tolerance to the lollipops?' This is one reason they are considered 'end of the line,' as Director wrote.

I think Director had a very good point when writing about oxycodone dose, which is why I recommended the concentrated oxy liquid. At 20mg per milimeter dosages are easy to adjust. Being allowed 1-2ml every 6 hours, that's up to 40mg at a time. Have you ever tried that high of a BT med dose? Get an Rx for 3ml and you get 60mg.

Of course, it's up to you and your PM doc. I just recommend saving last resort for after having tried everything else, including higher doses of the more conventional opioids.

Best of luck!

steve

[Executor]

I use the lollipops...they come in 200mcg, 400mcg, 600mcg, 800mcg, and 1600mcg. They work almost INSTANTLY and Director is correct in that they are expensive. However, there are generics now and the price is coming down. They are the perfect compliment to the patch in that it's the same active ingredient, assuming you respond well to it.

There is also a new drug made by the same company called "fentora." Same concept as the pops except that it comes in a lozenge. It's place next to the gum (like the pop) but dissolves faster. Cephelon came out with this right when there patent expired with the pops (Actiq). Nothing but a strategy to keep the price up. I like the pops best (Actiq) because you can titrate the med...meaning, once you achieve enough pain relief, you can take the pop out... I actually save mine for future use. Conversely, with a pill or liquid med, you have to take a predetermined amount.

I also take "Oxyfast" which is liquid Oxycodone 20mg per dropper. Also sold under the brand name "Roxicodone" and there a plenty of very cheap generics. Comes in a 30cc bottle, or 30 one dropper doses. Each dropper has four lines on it....5, 10, 15,& 20mg. Each line represents the equal of one percocet. Thus, one dropper equals 4 percs. One bottle equals 120 percs, but liquid of course. Works within 5-10 minutes.

Any type of pill takes 30-45 minutes to hit your system.

Hope this helps.

[JoJo921]

I would suggest oxycodone, it comes in 5, 10, 15, & 30 mg SA tabs and is quite effective for me....However my wife uses the lollipops and she swears by them