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    Old 08-28-2016, 04:24 PM   #1
    PainIsMiserable
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    Nucynta ER

    At my last follow up with my pain management Dr, I informed him opana ER was not doing anything and wanted to try another. He said we could try fentanyl patches or a newer one called Nucynta ER. Looking for anyone that's tried both fentanyl and Nucynta ER to get your feedback. We went with fentanyl because I told him I've read alot of people have success with it. It seems to be working. But still want opinions on Nucynta ER.

     
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    Old 08-28-2016, 04:58 PM   #2
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    Re: Nucynta ER

    I tried the regular short acting Nucynta and it didn't agree with me; I got dizzy on even a small dosage. Nucynta is a really unique pain med, a different mechanism of action than all the others. Everyone is different and some folks do well on it and some don't, same as any med. You may want to check if your insurance covers it before your next follow up, as its still brand-only, and its a real pain to get to the pharmacy and find out a med isn't covered, then try to get a different script from the doctor between appointments. I think because its newish and brand only, you don't see as many folks posting about it online. The studies showed it was as effective as Oxycodone, but less addictive and lower gastro side effects. It has a max dose which eliminates it being an option for some folks, but you said you are on 25 mcg/hr Fentanyl patches, so you'd be under that. Best wishes.
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    Old 08-30-2016, 07:03 PM   #3
    tiggertoo2174
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    Re: Nucynta ER

    I tried Nucynta and it was one of the worst experiences I have had. I went thru full blown withdrawl going on to it AND it did absolutely NOTHING for my pain, I would have been better off drinking a glass of water. I toughed it out for two months to be sure as I had just started with this PM clinic, finally I told the Nurse PRN that it wasn't working. Going off it wasn't easy either, but not as bad as going on as at least my pain was finally being handled. I guess it works for some, but not for me.

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    Old 08-31-2016, 12:00 AM   #4
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    Re: Nucynta ER

    I had tried Nucynta when it first came out. It was suppose to stop the pain signals to the brain I think. I could be mixing it up with another pain med. It didn't help me at all. I was on the Fentanyl patch at the time. So I take 20mg of Oxycodone every 4 hours and 75 mcg Fentanyl patch every 3 days. I feel like the patch isn't working and then the third days comes and I feel extra pain. So it helps. Dr. wanted to increase it but trying to hold on.




    Quote:
    Originally Posted by PainIsMiserable View Post
    At my last follow up with my pain management Dr, I informed him opana ER was not doing anything and wanted to try another. He said we could try fentanyl patches or a newer one called Nucynta ER. Looking for anyone that's tried both fentanyl and Nucynta ER to get your feedback. We went with fentanyl because I told him I've read alot of people have success with it. It seems to be working. But still want opinions on Nucynta ER.

     
    Old 08-31-2016, 05:11 AM   #5
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    Re: Nucynta ER

    Quote:
    Originally Posted by hessie28 View Post
    I feel like the patch isn't working and then the third days comes and I feel extra pain. So it helps. Dr. wanted to increase it but trying to hold on.
    hessie28: I'd ask your doctor about the possibility of changing your patches every 2 instead of 3 days. Quite a few folks don't have them last 3 days, and even the prescribing information recommends switching to a 2 day change schedule if there is breakthrough pain on day 3. These patches were designed to be used on hospice patients and such, so for many ambulatory patients they just don't last as long. You might want to double check with your insurance, but most now cover 15 patches / 30 days. If the majority of your breakthrough pain is on that 3rd day, it seems to make much more sense to change them more often than to increase your dose. I'd emphasize your pain levels on day 1 vs. day 2 vs. day 3 to your doctor.

    Also, you can emphasize your use of Oxycodone for breakthrough pain on day 1 vs. day 2 vs. day 3. You don't want to be taking breakthrough meds on a schedule, as then when you really need it, it won't work as well. Does your doctor really give you enough for every 4 hours (6 doses / day), or just you can take them as needed that often but you get less doses? Its more typical to get a dose or two a day, with the goal that the long acting med manages the pain (a common reasonable goal is 50% relief) the majority of the time. Best wishes.
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    Old 09-09-2016, 01:10 AM   #6
    Kyle524
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    Re: Nucynta ER

    The problem with Dr.'s being quick to give out Fent patches is that's it, the crown at the top. Fentanyl is the strongest narcotic medication there is. Its 100 times stronger than Morphine. So if you get it, and then build a tolerance to it and it starts to not work....you've got no where to go. Oxycontin, Morphine, Kadian, Nucynta....none of these will be strong enough to handle your pain.

    People also need to remember that if your being treated by a non Pain Management Dr., in most States, the highest dose of narcotic they can give you is a 100mg Morphine equivalent. So if your over that dose, you'll be getting cut back. Pain Management Docs will be cutting back to, patients that are on huge amounts of Narcotics, now that the CDC has released it's Findings and the FDA released there's, the new laws won't allow for these large doses of narcotics. I have a friend on another Board who was on 380mg of Morphine a day, and they cut her dose down to a quarter of that in 2 visits.

    If you have a choice to try a lesser narcotic you might want to take it and see if it will work for you, its better than getting dependent on a high dose high level narcotic like Fentanyl and then having to wean down in a couple months.

     
    Old 10-22-2016, 03:45 PM   #7
    TranscendZen
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    Re: Nucynta ER

    Quote:
    Originally Posted by Kyle524 View Post
    The problem with Dr.'s being quick to give out Fent patches is that's it, the crown at the top. Fentanyl is the strongest narcotic medication there is. Its 100 times stronger than Morphine. So if you get it, and then build a tolerance to it and it starts to not work....you've got no where to go. Oxycontin, Morphine, Kadian, Nucynta....none of these will be strong enough to handle your pain.

    People also need to remember that if your being treated by a non Pain Management Dr., in most States, the highest dose of narcotic they can give you is a 100mg Morphine equivalent. So if your over that dose, you'll be getting cut back. Pain Management Docs will be cutting back to, patients that are on huge amounts of Narcotics, now that the CDC has released it's Findings and the FDA released there's, the new laws won't allow for these large doses of narcotics. I have a friend on another Board who was on 380mg of Morphine a day, and they cut her dose down to a quarter of that in 2 visits.

    If you have a choice to try a lesser narcotic you might want to take it and see if it will work for you, its better than getting dependent on a high dose high level narcotic like Fentanyl and then having to wean down in a couple months.
    I do not know where you got this information, but most of it is inaccurate.

    First and foremost, the CDC is not a regulating authority in terms of what doctors can prescribe, nor do they have ANY bearing on doctors' modalities of treatment. The CDC has none of the authority the DEA has, and the DEA offers doctors quite a lot of "wiggle-room," particularly those who have a specialty requiring constant and repetitive prescription issuances of scheduled medications.

    Fentanyl is definitely strong, but it's not the strongest. Fentanyl is a class of specific structurally formulated opioids created from the derivative of 4-anilinopiperdine.

    Also, transdermal Fentanyl patches do not give a patient a peak tolerance where lower pain medications will not work for pain. Molecular biology plays a critical role - as in how the opioids bind to the receptors, how they bind to certain enzymes, how rapidly and effectively they cross the blood-brain barrier, etc. Because of this, no two pain medications are identical in either pain relief, effects or tolerance.

     
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