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    Old 03-31-2007, 03:05 PM   #1
    doddsgirl1
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    fentanyl lozenges

    Still no luck with the fentanyl patch staying on so I am going to ask to try the logeners. Has anyone tried these and if so can you tell me a bit about it? Like does it work as well, better or worse, does it taste bad or last as long? Any advice is good. TIA
    KJ

     
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    Old 04-01-2007, 01:48 PM   #2
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    Re: fentanyl lozenges

    Hi KG, Is there some reaon you can't try any other drug aside from the most potent drug available that's only aproved for malignant cancer? Of course they work for pain, because there is nothing stonger. Is there some reaon you can't work yolu way up the ladder with oxycodone instant release, morphine instant, dilaudid or oxymorphone. When you start with the most potent and expensive drug available, there really is absolutely nowhere to go except increrase that drug. You were worried about the strength of a 25 patch so you want to try the instant release lozanges. It just doesn't make sense unless your allergic to every other form of opiate.

    JMO Dave

    Last edited by Shoreline; 04-01-2007 at 01:50 PM.

     
    Old 04-02-2007, 06:31 AM   #3
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    Re: fentanyl lozenges

    I have been on pain medication for about a year now. The patches work great for me I just can't keep them on. I have tried a lot of different medications and this is the strongest one yet. I have know idea why my Dr. put me on the patch. I am not the Dr. just the paitent. All I was doing was asking a question. Also I thought that the lozanges were the same dose as the patch just put in you system different.

    Last edited by doddsgirl1; 04-02-2007 at 06:33 AM.

     
    Old 04-02-2007, 07:27 AM   #4
    cpapp31
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    Smile Re: fentanyl lozenges

    Hi Kelly!

    I am on the Duragesic 75mcg every two days, with Dilaudid for breakthrough pain. The Actiq or Fentora are a oral form of Fentenyl, used ONLY for breakthrough pain. The patches last up to 3 days, whereas the oral forms only last for a very short time, like maybe 3 hours. The other thing is they are usually only Rx'd for cancer pain and most insurance companies will noy pay for them because they are VERY expensive. I know some people who use them for breakthrough pain and it cost about $3000.00 to $4000.00 per month!! Eeek! You can see why the insurance companies don't want to pay for these. Anyway, I hope this helps.

    Take care,
    Cpapp31

     
    Old 04-02-2007, 08:26 AM   #5
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    Re: fentanyl lozenges

    Hi KJ, Fentora/ Aqtiq or any transmucosal fentanyl has a 3-5 minute half life, it's truly meant for extreme BT pain and only aproved for malignant cancer. Duragesic works despite the short half life because the dose is delivered continuously. Duragesic is approved for nonmalignant pain but fentora isn't used as the sole opiate for CP except in the most extreme cases to stop a migraine and avoid a trip to the ER.

    You need to maintain some level of some opiate in your system or the clue it's time to take another will be the onset of withdrawal. They take about 15 minutes to disolve and then you swallow the remaining bits with a glass of water, then the 3-5 minute half life starts.

    Your asking to replace a long acting med with a med that at best lasts 30 minutes before needing to be redosed. That's why it's a bad idea.

    I'm sorry if I Upset you but wouldn't you prefer to hear why it's a bad idea here than getting a huge lecture from your doc about letting him make the medical decsions and how rediculous the request is? I've seen patients discharged after going through every LA med available in a year and insisting only short acting meds will manage their chronic pain.

    Like you said, you don't know why he used prescribed the patch, All I'm doing is telling you the difference between the patch that delivers a steady dose for days and why he won't prescribe Fentanyl pops or lozenges with a half life of 3-5 minutes as your sole method of pain management.

    The idea behind managing CP is using a long acting med to prevent pain from going through the roof because it's easier to keep pain in check than it is to bring a high level down. If pain gets out of control despite the LA med, then BT meds can be used used. To use a med that only last 30 minutes at best means you have to redose every 1/2 hour.

    Ideally he will find a LA med you can tolerate and perhaps use a short acting med on occaision for break through pain. Not a med you need to redose every hour around the clock to prevent withdrawal.

    Good luck, Dave

     
    Old 04-02-2007, 10:50 AM   #6
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    Re: fentanyl lozenges

    Thank you. I did not know that they were used for BT pain. I was just thinking that since I had a patch they were the same thing and would act the same way. But that is why I asked. Not upset. I am just having a really bad day because I have to depend on pain meds to live my life abd be able to take care of my babies the way I do. I just want my body back and my old life. I am not a drugie but I sure do feel like one. I know my body is dependant and I hate it. Dr. can't seem to find out why I am in pain and it sometimes makes me wonder if I really am in pain even when I know I truley am. Sorry so long just really sad at the moment and can't stop crying. I live a June Clever life and I depend on meds to get me through. What a mix.

     
    Old 04-02-2007, 09:32 PM   #7
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    Re: fentanyl lozenges

    Dear doddsgirl1,

    It sounds like things haven't been going very well for you lately--in many ways. All of us here truly understand the emotional difficulties involved in dealing with Chronic Pain--no matter what the source is.

    My past Pain Management doctor explained the reasoning and differences between the Fentanyl Patches and the Fentanyl Lozenges as follows: The patches are the Long-Acting (LA) form of Fentanyl. These patches give the body a constant release of fentanyl. IF WE NEED AN ADDITIONAL BOOST OF PAIN MEDICINE WHILE ON THE FENTANYL PATCHES...the Actiq (which thankfully comes in generic from the Barr company) can quickly boost the amount of fentanyl in the system. According to this doctor, the idea of using additional fentanyl (albeit short-acting as Dave [Shoreline] pointed out) is often a better alternative than introducing a different type of opiate into the system--particularly if the pain is mainly an increased intensity of the patient's regular pain.

    ON THE OTHER HAND (IN MY OPINION), I have found that a different type of opiate can be more effective if the additional pain is coming from a different source.

    This is why I use Generic (Sandoz--NOT MYLAN!!) Fentanyl Patches (75 mcg, 15 per month, which I change every two days), Generic (Barr) Actiq (800 mcg, 60 per month), and Generic (Roxane) Dilaudid (8 mg, 100 every 3 weeks). I have been very fortunate that these dosages and amounts have not changed much in nearly 10 years! My pain levels generally run around a 5. I am thankful for the relief I receive--especially when I remember what my pain problems used to be back in the early 1990's. DON'T MISUNDERSTAND ME...There are times when I have some bad months, but I generally can function.

    MY DIAGNOSIS? I have Lupus and the Lupus Anti-Coagulant, which took 6 or 7 years to figure out!!

    Just to keep on the subject (sorry...), fentanyl is one of our most potent opiates--if not THE STRONGEST. So, we should be careful about its usage.

    Doddsgirl1, please keep us updated on your situation. We want to help you through your difficulties. As Dave (Shoreline) pointed out, it is probably better for YOU if WE point out some of these possible problems before a doctor thinks you are a drug-seeker or something!

    TRYING TO KEEP YOUR PATCHES ON?? I use Johnson & Johnson Adhesive Tape. The cloth type has the blue-colored dispenser, while the paper type has the green-colored dispenser. For me, they both work well!

    Take care, friend!

    Sincerely,
    Jon (Conductor)

     
    Old 04-03-2007, 06:30 AM   #8
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    Re: fentanyl lozenges

    Hi KJ!!!!

    Very well said Conductor! I tried to explain the difference to Kelly but, you were way more informative, Thank you.

    Kelly, I really hope things work out for you. I know how frustrating it can be before you find a med that works well for you. I have been in pain management for over 9 years. If you have any other questions, please let me know, I try to help when I can. I am lucky I guess because the patch works great (when they stay on) with the Dilaudid for breakthrough!

    Take care and I wish you much relief,
    Cpapp31

     
    Old 04-03-2007, 02:13 PM   #9
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    Re: fentanyl lozenges

    Doddsgirl~

    I am in the same boat as you. I am married, mother of 3, and also on the patch (75). I also get IR meds for breakthrough pain.
    I am 45, but have been a CP'er for the last 16+ yrs. Although I had been in several car accidents as a teen, it really began being on bedrest for most of my pregnancy and then bringing home my babies.
    I have had back surgery and more injections that I care to think about. Now that my kids are in their teens, at least physically, it has made life a bit easier...i
    I seldom tell people that I am on opiates or a CP'er...I did in the past, and then became the subject of gossip for others around the pool and play yard. No one could "understand' WHY I had to take those dangerous drugs!!
    I understand how you feel, and often wonder how life would have been, but now I am just grateful to have found a great Dr. (have many stories of not-so-great ones , so I really try to focus on the good...what else can you do? lol
    Anyway, if you ever need someone to talk to, that understands, please feel free to PM at anytime.
    Dani

     
    Old 04-03-2007, 04:14 PM   #10
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    Re: fentanyl lozenges

    Quote:
    Originally Posted by doddsgirl1 View Post
    I am just having a really bad day because I have to depend on pain meds to live my life abd be able to take care of my babies the way I do. I just want my body back and my old life. I am not a drugie but I sure do feel like one. I know my body is dependant and I hate it. Dr. can't seem to find out why I am in pain and it sometimes makes me wonder if I really am in pain even when I know I truley am. Sorry so long just really sad at the moment and can't stop crying. I live a June Clever life and I depend on meds to get me through. What a mix.
    I can totally relate to what you're going through! I am in my fifth year of pm and still have NO DIAGNOSIS! No one has ever heard of having pain in your lung after pnuemonia! But, that's what I have. Things were fine until this last visit with my pm when he decided my dosages were to high.....and now I am at his mercy.

    I'm sure most of us on this board have had those same thoughts...'I feel like a druggy' etc. And we all miss our old lives. Hang in there and keep us posted.
    It is a good to run things by the message board if you're not sure....Everyone has good advice and a different perspective on things.

    Take care~Mush
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    undiagnosed lung and back pain after pneumonia in '03, tmj, migraines,(two failed surgeries for) Kienbock's disease

     
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