Advice for breakthrough pain medication.

[cameronlanni]

Hi all. I have chronic back pain and am currently using Fentanyl patches for my ongoing pain. I am trying to find a breakthrough pain medicine that works well for me. Vicodin and Norco worked well for me for a long time, but after a couple of years they started becoming ineffective. I am currently on 10/325 Percocet, and it doesn't seem to be helping much. I've also tried and failed with: Darvocet, Tylenol #3, and Lortab. Probably a few more, also, but can't think of at the moment. Any recommendations as to what I should try that may work better for my breakthrough pain?

Thanks in advance,
Cameron

[brianpain33]

You could possibly try something stronger like Dilaudid (hydromorphone) or Opana (oxymorphone). They are both used for breakthrough pain although not as regularlly. I don't know if MS Contin would work but it might be worth a try before resorting to the Dilaudid or Opana. I am sure others will be by to comment as well

Brian

[cameronlanni]

MSContin is a time release mediaction and I've been on it before. It didn't work for me at all. I thought Dilaudid and Opana were also LA. I guess I was mistaken? What are the major BT pain meds. What about Demerol?

[forginon]

Dilaudid (hydromorphone) is a short acting opioid and is used as a BT med for some. Opana comes in both long and short acting tablets, so it too can be used for BT pain.

Others are oxycodone (single entity as opposed to Percocet with the tylenol), fentanyl lollipops and buccal tablets, morphine IR, etc. Demerol would not be Rx'd as it can cause a build-up of nasty metabolites. MS Contin, which I use, is a LA med, not suitable as a BT med.

Since oxycodone has worked for you in the past, you might consider the concentrated liquid formulation. This is what I use for BT pain. It comes in 30ml bottles, and the formulation is 20mg oxy for every 1ml. So, it's pretty potent, but using a dropper you can get as little as 5mg at a time. My doc prescribes 1-2ml every 6 hours, which is 20-40mg every 6 hours. Works great!

steve

[lizzybrog80]

I'm watching this thread, too, b/c I'm at a point where my breakthroughs aren't working well either. I am now on Fentanyl (after switching from Avinza). Prior to the LA meds, I was on Percocet. 1 pill never worked; 2 worked for a long time, then 3, then 4, you know how it goes, until I was taking too much & PM put me on LA drugs. He continued to give me Percocet for BT pain, but they just don't work well, even 6 at a time. Then he switched me to Roxicodone, which is the same thing without the Tylenol! So I need to talk to him about switching to something that WORKS!!! Best of luck to you!