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    Old 03-04-2007, 11:58 PM   #1
    youngone00
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    Help converting Actiq?

    Hey every1. Just out of curiosity, I have searched google and the board, and cannot find the answer, can anybody convert Actiq for me. I'm wondering what a 200mcg pop would be equal to in Oxycodone or morphine. A while ago, before I was on anything except percocet, my doc gave me a scipt for 30 200mcg pops, in which I threw away due to it being over 400 bucks to fill. Anyways, he gave me these to take right before bed because I wasn't getting any sleep (due to the fact I was getting no releif at night). I'm not exactly looking to start this medication, its more out of curiousity I guess.

    Thanks

    Bryan

     
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    Old 03-06-2007, 04:44 PM   #2
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    Re: Help converting Actiq?

    Hey Brian, I am not sure if you can afford them now or not, but they are worth it. I have been on them for over a year and could not live without them. This is the only medication (besides methadone but allergic) that I have found that will help decrease my pain. At least I can move with it.....I am not sure about helping you sleep, because I am on a higher dose and they don't help me sleep, my doctor recently started me on valium for sleep because the ambien and ambien cr wasn't working at all.

    I go see my PM next week I will see if he knows the answer. Good Luck

    Last edited by HBMod07; 03-06-2007 at 06:18 PM.

     
    Old 03-06-2007, 10:26 PM   #3
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    Re: Help converting Actiq?

    Thanks for the reply, and asking your Doc.. Yes I can get it now, because I found out I have mail order benefits, where if I mail my scripts into Caremark Pharmacy Company, its totally free with no co pay. I called to make sure they would cover Actiq because of what I read on this board about some ins co's not covering it, and they said its totally covered, and I can even get brand name if I want to, for free . I'd send all my scripts in, but it takes two weeks to get them. Because of this, its better to just send the scripts in that my Doc will give me a 90 day supply of. Bumping back up to the top to see if anyone can help..

    Bryan

     
    Old 03-07-2007, 02:30 AM   #4
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    Re: Help converting Actiq?

    Just keeping up top.. Some1 has to know atleast more than I do!!!

    Bryan

     
    Old 03-07-2007, 08:25 AM   #5
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    Re: Help converting Actiq?

    This is really something you need to talk to your doctor about. Converting medication doseages on your own and possibly starting a med that was not prescribed recently are things that your PM doc would probably not want you to do. My contract with my PM doc is very specific and I would not want to see anyone unintentionally violate their contract and possibly lose their PM doc.

     
    Old 03-07-2007, 07:38 PM   #6
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    Re: Help converting Actiq?

    No noo, I appreciate your concern though, I really do. My PM doesn't have his patients sign a contract, but never the less the rules are definatly still the same, or atleast I can be sure he wouldn't want me filling an old sciript with out him knowing.. But no, I dont have that script anymore, I threw it away a long long time ago. The reason I'm asking about all of this, is my PM doesn't feel comfortable prescribing alot of narcotics, but Actiq is one he will prescribe. So before I ask for it (I actually dont think I'm going too, but who knows, either way Im very curious), I'm just looking to do a little resarch on it, but its hard to find anything that would give me an idea of how strong it is. I'm also under the impression that its a pretty strong med, so I'm wondering why he would rather prescribe that than something like oxy ir. I appreciate your reply and help. Sorry I wasn't more clear.

    Thanks again!

    Bryan

     
    Old 03-08-2007, 05:14 PM   #7
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    Re: Help converting Actiq?

    Brian, thats great that your PM is willing to prescribe Actiq. My new PM hates to prescribe it and the only reason he does for me is because I was on it when I started going to him. The first visit he cut my dose. He has even told me that his daughter takes it. but prescribes it only to very few patients.......oh well

    anyway, that is amazing that you can mail your prescriptions in and not have to pay anything. You must have amazing insurance coverage. Be glad. Keep us updated on what you do and what you find out.

    jenn

     
    Old 03-08-2007, 11:02 PM   #8
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    Re: Help converting Actiq?

    Thanks for the reply. About my ins coverage, I much rather just go and have a $10 co pay and get my meds right there on the spot. My mother and father's ins is $10 generic, $40 for brand. If there is no generic, and they therefore aren't choosing the brand, but have no choice, I think its only a $25 co pay (because I dropped off a script of Ambien CR for my mom last week,and that was how much the co pay was, so I"m not 100 percent sure). Its cool being able to send them in, but when it comes to thing I can only get a 30 day script for from my Dr, I alot of times just go to the pharmacy. With the Pharmacy I have to pay out of pocket, and than I'm reimbursed 80%. Since I have to pay out of pocket I call all around and make sure I get the best price. Its amazing how much price can differ from pharmacy to pharmacy, its almost unbeleivable. At Pathmark and Shoprite, its $2 per pill for percocet 10/325. So for 120 tablets I get, its $240.00. Now I usually go to Quik Check, and its only $1 each, so it costs be 120.00 for the whole thing. I used to go to Drug Fair, where its even less. Its only $87.00 for 120 tablest. I go to Quik Check now instead though, because they have endocet, and Drug Fair recently changed from Endo to Malinkrodt (Malincrap). Whats really really intersting is I went to Quik Check the other day. They told me the percocet would be 180.00. I told them it usually was 120, and the guy told me Russ (who is thew head pharmacist, the nicest Pharmacist Ive ever met, never ever looks at me any different) was on vacation, and that is a special price. Russ is the only one who can do it. So no problem, I had enough to wait for him. What I think Russ does is, if somebody is paying cash, he gives them a much better and much more affordable price, if they have ins and have a low co pay, he charged the ins co the full price.

    Bryan

    ps: Sorry if I went on and on.. I'm just up, wide awake, not feeling good and I"m bored..

    Hope all have a good night!!!

     
    Old 03-09-2007, 02:03 AM   #9
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    Re: Help converting Actiq?

    Hey Bryan I checked as best as I could for a costco by you but I am eastern dumb as I am from oregon. I found they do have costco warehouses(w/pharmacies) back there I just dont know how close. Because they order in such big bulk their prices are outrageously low and you dont even have to be a member to use the pharmacy, here in oregon some of the large chain phar. will do price matching but some of them refuse to price match costco because they are too low priced, sometimes the chain pharm. wont even tell people that they do price matching because they dont want to give up their profit to keep the customer. So thats how good they are for us customers. Also I think costco is also Sam's club but I am not sure.

    I also tried to look up that conversion for you since no one else would but couldnt find the actiq,YET I will keep trying and let ya know if I find anything.
    I also find it a big bore when you mention OUT OF CURIOSITY you'd like to know the conversion and ya get people telling you its a no no, talk to doc,contract etc... when you already said you had threw it away , your not on a contract and you were just CURIOUS. I think people are speed reading again and not paying attention to things you ALREADY SAID either in the current post or before in your story history. Just want you to know I wont ever do that to you because before I would criticize a person I would make sure I knew what the hell I was talking about first. You have a good whatever when you read this, it is 1am here now so I am going to drink some warm milk or hot choco and that should put me to sleep. Bye guy take care.
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    Old 03-09-2007, 05:42 AM   #10
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    Re: Help converting Actiq?

    Hey Young One, You might want to save something for the furure since there is absolutely nothing stronger than Fentanyl available on the market. The fact your young, is reason enough to hold off. The fact he wants to use it as home anesthesia for sleep is reason enough to avoid the stuff. A patch that delivers 100 micrograms an hour roughly equivelant to someone taking 300-400 mgs of morphine per day. Double that and squish the time frame down to about 3 hours instead of 24 hours and your loking at something in the neighborhood of 600-800 mgs of morphine in a single dose. Most docs won't prescribe Aqtiq untill it's the absolute last resort because it's only aproved for BT pain for malignant cancer.

    It shouldn't be used for a sleeping med, It has a huge Black box warming and if you become tolerant to Aqtiq in your 20's. There simply isn't anything stronger they can give you other than more AQtiq.

    Using it for sleep is the most absurd thing I have ever heard in my 14 years as a CP patient. I haven't slept through the night or more than 4 hours straight since the last 6 level fusion in 99. I wouldn't use the fastest and most potent opiate available as a sleep aid if I went another decade without a full night sleep. It's comforting knowing there is something stronger out there should iver develop cancer and need Hospice care.

    It's just absurd beyond description and there are too many other things to try that actually are sleep aids. Have you tried elevil, seraquill, klonopin, trazadone, ativan, ambien, sonata, Lunesta, or Zanafflex. Have you video taped yourself to see if you have RLS , have you done a sleep study, tried Xanax, Tamazapam, Oxazapam, or Halcion, There are at least a dozen other safer drugs that are aproved and used for sleep aside from than the most potent opiate available that was first used as an elaphant tranqualizer before it made it's way into the anesthesia arena years before being created in a version used for the most severe cancer pain in the terminally ill.

    When you become tolerant and lets say break your arm sometime in the next 20 years, there is absolotely nothing any ER doc will ever give you in a single dose that will compare, That means you will suffer from any other pain that would drive most people to the ER. You will run through the most potent opiate available in your twenties and have absolulty nothing else to try.

    You have also had a bad experience with 50ugh patches, what makes you think taking a dose 4 times stronger won't simply stop all respirtory activity. Do your parents know how to resesitate someone that's blue and cold and hasn't taken a breath in an hour? Do they keep Narcan around for when you OD using Elephant tranqs for sleeping meds. If you can't tolerate 50 ugh patches, you can't tolerate a 200 mic pop. It doesn't take a rocket scientist to figure that out.

    That's just my opinion, everyone has one, but that's the most absurd thing I have ever heard in the 16 years I have been a CP patient, Aqtiq as a sleep aid? Why not just give you a pressurized tank of gasious Affentanyl, you know the the stuff they killed a movie theater full of rusian folks about 4 years ago to subdue a hostage situation in moscow. Then you have home anesthesia and can just put on a mask and deliver your own. Hopefully there is an anesthesiologist family member that can check on you every 5 minutes to make sure you haven't turned blue.

    I'm 41, have a pump delivering high doses of dilaudid, at least 10 fold anything you have ever tried, and I would never ask for AQtiq or consider using it because I like knowing there is still something stronger out there should I somehow have an arm ripped off by a piece of farm equipment. Fentanyl is also a NMDA receptor agonist which means it binds to the receptor most PM docs try to block to reduce rapid tolerance and increase drug effectiveness on neuro pain. Using it for sleep is so far off label, why not just take a big dose of Thorziene, at least it's proven to be safer than Aqtiq.

    Of course people like Aqtiq as far as a pain med, because there is absolutely nothing stronger. When it's the last reort, or when you have tried everything else anyone can ever think of, you might consider using it when your tolerance aproaches being able to handle 4 times the dose that caused you problems already.

    THAT'S JUST MY OPINION. I HOPE YOU FAMILY HAS THE MINIMAL LIFE INSURANCE TO OFFSET THE BURIAL EXPENSES YOUR DOC IS GOING TO CREATE FOR YOUR FAMILY IF YOU GO THROUGH WITH THIS CRACK POT IDEA. THERE TRULY IS ABSOLOYELY NOTHING STRONGER OR EVEN COMPARABLE OTHER THAN A HIGHER DOSE OF FENT AVAILBALE OUTSIDE OF THE ANESTHESIA ARENA. KETAMINE WOULD BE SAFER WHICH ALSO FALLS INTO THE FAMILY OF DISASSOCIATIVE ANESTHETICS JUST LIKE PCP WHICH WAS FIRST USED BY VETS TO SEDATE HORSES.

    I have read you think you have this high tolerance due to a few years of pain med use. What's the most pain medication you have ever taken outside of a hospital. Have you tried 30 mg Roxicodone, Have you ever taken 600 mgs of LA morphine a single day day? Have you even come close to the same ballpark as the strength of Fentanyl without an adverse reaction. Taking a fast acting version 4 times stronger than what you already had a bad experience with makes no sense at all from a tolerance POV. Your doc is setting himself up to pay your surviving family a multi million dollar settlement for loss of life for using this med for such an outragous and rediculous off label purpose.

    How is a drug that doesn't last more than 3 hours going to sustain sleep when it isn't even a sleep aid. It's meant to lower your consiousness during surgery down to a safe level when your on a respirator and monitored by a anesthesiologist with 1o years of education that still pays the highest mal practic premiums than any other profesion. Simply because 1 n 10,000 simply won't wake up from general anesthesia for no specific reason while on a respirator.

    You won't get a chance to ever report you think it's a bit too strong because you won't survive the first dose and if you do, you would be heading down a road in your twenties where there is absolutely nothing stronger available. Fent is measured in micrograms because it;s hundreds of times stronger than morphine. Why not just give you 600 mgs of MSContin to take at bedtime,, at least it will last 8 hours and is safer than aqtiq and isn't known to cause hyperalgesia "increased pain". it's less dope and will last longer than Aqtiq. If you have never come close to taking 300 mgs of morphine in a single dose, you have no biz taking aqtiq.

    Honestly, I have read some crazy stuff in the last 10 years I have been on the net researching PM, But this is the most absurd thing I have ever seen a doc consider.

    Hava you ever learned Bio feedback, self hypsnosis, any relaxation technique that might possibly work before using a drug meant for dying and screaming cancer patients? It would truly suck to be on the most potent pain med available and have nothing else to try in your twenties. What are you going to use 10 years from now or are you hoping science will keep up with your tolerance. Nothing stronger than Fent has come out in the last 20 years, what makes you think it will in the next 20.

    There are so many reasons it's wrong and completely absurd but the biggest is the danger and the fact it's not meant to be used as sleep aid. The rebound effect when it wears off will wake you and nothing other than more fentanyl will bring your level of pain back down if you happen to wake in pain. Aside from Fent having the abililty to induce hyperalgesia, it's a wondeful Idea.

    Good luck and If I scared you, that was my intent.

    Good luck, Dave

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    Old 03-09-2007, 08:22 AM   #11
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    Re: Help converting Actiq?

    Hey Brian:
    I'm confused about the actiq, I thought your doc wanted to rx them for pain relief at bedtime in order for you to get a better nights sleep??? If I'm reading your post correctly, I am thinking your doc is the one who wants to rx the actiq because he isn't comfortable giving you anything stronger than what you have now?? In other words, he won't increase your percocet or OC, but, he'll give you the actiq instead.....

    If I'm understanding the doc wants to give you something that is much, much stronger than taking 600mg of MS Contin, but, doesn't feel comfortable increasing your oxy and right now your taking 70mg daily(I think?)

    I would seriously think about what shoreline was saying because it sounds like the actiq is way, way to strong for you and your tolerance. When you go back to your doc, you should print out the black box warning that Dave gave you and come right out and ask him what he is thinking by wanting to rx you actiq, but, not wanting to increase your oxy?

    I can definitely relate to your problem with your doc not wanting to rx enough meds to help in getting pain relief. I had a pm doc who wanted to give me the actiq also, even though I was on a pretty low dose of oxy too.
    I didn't accept the actiq because I read up on it and it seemed way too strong in comparison to what I was taking. After reading Dave's post, I'm so glad I didn't take it. I don't understand why some docs usethe patch and the actiq when it is so much stronger than any other opiate?

    This is very difficult because the longer your in pain, the more likely you'll try anything the doc throws at you to get some relief. This is your health though and you have to research meds/procedures and then decide if you want to try it. Don't let the doc push you into anything you don't want to do even if it means you'll get terminated as a patient. There are alot of docs out there, but, one mistake can leave you dead or worse.

    Sorry for the preaching....I just don't want to see anything happen to you. Please print out info on the actiq and sit down with your doc and ask him what he is thinking??

    Good luck

     
    Old 03-09-2007, 11:11 AM   #12
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    Re: Help converting Actiq?

    Hey Bryan, I am soooo glad Shorline finally addressed your antiq questions. He really knows his s***! and been through too much in his life to guide you incorrectly.
    I think the fact that you were even curious about the antiq proves your doc is damaging you with his ignorant, illogical comfort levels. I know you never wanted to go as high as the patch but it was your doc's comfort level, you would never have even considered antiq as a remote possibility, if it werent for your ignorant doctor leaving you with the choice of unbearable side effects OR excruciating pain. Have you called Dr. Rubinfeld's office to see if there have been any cancelations? Remember to do it. I also think it's a good idea to start now researching and preparing for that doc appointment when it comes so you are prepared and feel sure you give him all the treatments you do/done what meds worked/not worked and try and trust in him to not be like your current doc and just let him decide the next step, oh ya from my experience DONT EVER bad mouth one doc to the next even if your right I have politely done that and gotten treated badly, I guess sometimes docs stick up for each other like cops, just tell new doc all the stupid ideas old doc had with out saying they are stupid and the new doc will draw his own conclusions and you wont be blamed.
    So, I hope you feel informed enough now about the antiq. I myself wont take even the patch and I am 41 because I want there to be something left that is strong because I will only get worse with DDD and I know I will need something in my later years, you are only in your early twenty's I hope this new doc gets more adventuresome than the old, there are too many different combo's of treatments and meds to try without maxing you out giving you the highest rightoff the bat especially when that is not your choice. I am just praying you get to the new doc and he sees the errors the old doc committed and has new tricks up his sleave that will get you off the patch, give you a good combo and maybe some new non med treatments you have never heard of and gets your pain level down to ? a 4-5. Please reassure shoreline you wont be taking the antiq I think he is very concerned about that and he is right it is the WRONG med for you right now, remember to check for cancelations today for next week. Take care.
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