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New to Pain management


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Old 09-26-2017, 07:23 AM   #1
naomi5378
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New to Pain management

Good morning! I am new to PM. I've been to one appointment and was prescribed 4 different meds to help with chronic pelvic pain. One of the medications was Nucynta 50mg. Wow! What a horrible experience I've had with this medication! I took 1 pill and was feeling so out of whack. I felt like was very drunk, agitated and a bit itchy. I took half a pill the next day and felt the exact same way again. I don't know how else to describe the drunk feeling...I've only been drunk 2x in my 39 years and those 2x turned me off to alcohol. I cannot take this stuff again. I called my PM clinic and told them I couldn't tolerate this medication and I was told by lady on phone I need to wait until my next appointment and then discuss with my doctor. Thats 2 weeks out. I had to wait 2 weeks just to get it filled to to pre-auth and miscommunication with pharmacy and PM. Is this normal? Or does it just depend on the clinic? Has anyone else taken Nucynta and had this side effect?

 
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Old 09-27-2017, 10:13 AM   #2
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Re: New to Pain management

Often times, there is a period of acclimation to a new medication, and unpleasant side effects diminish over time, as your body adjusts.
That being said, you should never cut a medication in half unless and until you clear doing so with your dr. There are many medications that are extended release, meaning they deliver certain amounts of meds over a set time frame, and halving them can cause all med to be released at once, leading to possible overdose.
It is possible you may need to get the nucynta changed at your next appointment. Be sure to bring the remaining medication with you and turn it in to them so there is no question about where it is.
Yes, many PM Dr's want patients to wait until their appointment to make med changes.

Last edited by backhurtz; 09-27-2017 at 10:14 AM.

 
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Old 09-27-2017, 10:34 AM   #3
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Re: New to Pain management

Thank you for responding. I called the pharmacy to make sure I could halve it and she said it was fine because it's not ER. The Nucynta is not a daily medicine for me to take. Only for severe pain. I just don't want to feel like that every time I take it. I couldn't function at all and I was lucky my hubby was home because I wouldn't have been able to do anything for our daughter or anything really. I'm hoping I can get switched to something I can tolerate better.

 
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Old 09-27-2017, 09:24 PM   #4
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Re: New to Pain management

Welcome! Sorry you are having to deal with this. However, it sounds like a step in the right direction as you are seeing a pain doc and they gave you multiple treatment options. I know that for me, finally seeing a pain doc / going to a pain clinic was the best decision I ever made for treating my chronic pain, as I made the most progress.

I too had a bad reaction to Nucynta. I took a very low dose for my tolerance, and I was incapacitated by dizziness and felt pretty horrible. Its a unique med. Everyone won't respond well to every med, so I'd recommend moving on. That type of side effect is unlikely to get better if you keep taking the med (and being able to get used to a med doesn't happen as much with an as needed med as a daily med).

It is quite common for pain clinics to not make any medication changes in between appointments. Keep in mind that they only get paid when a patient comes in for an appointment, and there is already a lot of overhead; unless a doctor's office is doing procedures and such, they really aren't making much money on office visits alone. An exception to having to wait until the next appointment would be for example if a patient was in withdrawal due to a daily opioid switch, and even then they would usually just fit them in the appointment schedule.

Many pain meds need a paper script (Schedule II), so you'd have to go into the office for a replacement script anyways. Also, its very easy for info to get misconstrued on the phone when dealing with multiple people (reception, medical assistant, doctor, etc), so it is often not a great idea to try to get stuff done over the phone, even if the doctor's office is willing.

I know it can be disappointing to have even more waiting, as I imagine you have been going through chronic pain for months or years already. I would recommend taking some notes on your side effects so that is fresh and you can be specific when discussing it with your doctor at the next appointment (and, as recommended, bring the pills into the appointment). Were any of the other meds helpful? Best wishes.
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Old 09-28-2017, 05:21 AM   #5
naomi5378
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Re: New to Pain management

Yeah, I wasn't expecting a med change until my next appointment. I'm also on 300mg gabapentin 3x a day and it makes me foggy brained. I just wanted to let him know what was going on in case i forget. I normally have to write myself notes so I remember to do stuff but now I need them even more. I think the dose is too high. And I don't feel much of a difference in pain while on it. But I'll do whatever he wants me to do. I just want some relief and my life back.

 
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Old 09-28-2017, 10:30 AM   #6
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Re: New to Pain management

Did your doctor slowly increase the dose of gabapentin?
Usually, they start a new patient at maybe 100 mg, two or three times a day, then after a week increase by similar doses, to give patients time to adjust to the med.
Quote:
Originally Posted by naomi5378 View Post
Yeah, I wasn't expecting a med change until my next appointment. I'm also on 300mg gabapentin 3x a day and it makes me foggy brained. I just wanted to let him know what was going on in case i forget. I normally have to write myself notes so I remember to do stuff but now I need them even more. I think the dose is too high. And I don't feel much of a difference in pain while on it. But I'll do whatever he wants me to do. I just want some relief and my life back.

 
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