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  • METHADONE for PM?

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    Old 02-05-2014, 08:05 AM   #31
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    Re: METHADONE for PM?

    Let me add calamine lotion to the suggestions already presented. Make sure to get the clear kind, unless you want to paint yourself pink. :-) Along with oatmeal baths and benedryl, this has helped me tame the itch that comes when I start a new opioid.

    Hopefully, this too shall pass!

     
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    Old 02-05-2014, 10:01 PM   #32
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    Re: METHADONE for PM?

    Will the excessive itching subside? I am literally CLAWING the flesh off my back and my chest. I have an enormously high threshold for pain and suffering, but ITCHING drives me NUTS.

    I can survive anything if I know it's only temporary and that pain relief is SOON to follow (I say with guarded conviction).

    Last edited by WhistleDixie; 02-06-2014 at 09:55 AM.

     
    Old 02-06-2014, 08:41 AM   #33
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    Re: METHADONE for PM?

    For me, the itching stopped in less than a month, but, as with most drugs, reactions and side effects are highly individual. Perhaps an antihistamine that's longer lasting and less sedating than benadryl, something like generic versions of claritin or zyrtec, would help.

    FWIW, to keep from ripping my skin apart, I wore gloves when I went to sleep - super cheap, thin, white cotton ones. Most drugstores have them wherever they keep skin care accessories.

    Sorry you are having such difficulty with the medicine.

     
    Old 02-06-2014, 07:25 PM   #34
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    Re: METHADONE for PM?

    Sorry you are still suffering! Its anyone's guess. I think many folks who would get extreme itching wouldn't wait to see if it stops, and would just be switched to something else, so there might not be a good consensus. I definitely have heard of it stopping, or being an off & on thing.

    What have you tried so far for it? A combo of an oral antihistamine and topical treatments should help some. You could even see your primary care doctor to see if there is something they could prescribe short term. I've never got itching from opiates, but have for other things, such as eczema on the tops & sides of my hands, which drives me nuts as hands always brush up against something, which it just as bad as scratching it (which makes it worse).

    Putting on a topical treatment and covering it with guaze and tape in the worst areas could help too. I find the topical stuff works better with a barrier, plus you have the physical barrier against the scratching. Massaging the area or using heat or ice against the urge to scratch may also be helpful.

    If you can somehow find a way to not scratch, it will itch less, but easier said than done I know. When you are that itchy you really can't think about anything else! I put itching right up there with nausea as far as intolerable.

    Pain relief with this or any medication is no guarantee, but since you've responded to other opiate pain meds, it is highly likely that with an appropriate dose and dosing schedule, you would achieve it. There are always those folks that don't respond to a medication at the doses tried though. I don't mean to be a downer, but I'm a realist, and don't want to lead you on. So is your next appointment awhile off still? Best wishes.
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    Old 02-06-2014, 07:59 PM   #35
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    Re: METHADONE for PM?

    Thanks for all of your thoughts. I AM still ITCHING. I can control my need to scratch while I'm awake, but I literally "rip my flesh" while I'm sleeping. The sedation is not leveling off, either, and I began the Methadone a week ago today. ALL I CAN DO IS SLEEP. This is not acceptable for me to function and to perform the requirements of not only my career, but also family obligations. I am the only 1 of 6 that my 87 year old mom can count on to visit often, to shop for and provide her clothing and personal needs...and just basically oversee her healthcare. Even though she lives in a nursing facility, you would be surprised at how essential it is for me to advocate on her behalf.

    I only took half of the 5 mg this morning, because the PM doctor told me to do so if the dosage was too sedating. I experienced pain throughout the day, with the same level of "coma" while watching TV tonight. I was told that I should know if the med is successful for me by 5 day's usage. Right now I can't see continuing this med for the full 30 days. What should I do?

    P-L-E-A-S-E H-E-L-P!!!!

     
    Old 02-06-2014, 08:19 PM   #36
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    Re: METHADONE for PM?

    Dixie, If i lay around any narcotic will make me sleepy so i have to move around but in order to do this i must have pain relief. Of course going to the dr for a med change is always possible but then the question of rx cost comes up but if you have taken antihistamines, worn very covering pjs, cut nails & tried topical OTC creams, oatmeal baths etc i think calling the dr is your only alternative.

     
    Old 02-06-2014, 10:04 PM   #37
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    Re: METHADONE for PM?

    Oh, g...I DO NOT now, nor have I ever "laid around", whether taking narcotics or not. I thrive on multi-tasking, problem solving, meeting deadlines. I remain active, no matter my pain level...because I've HAD TO in order to survive.

    However, I too need pain relief, which has yet to show itself. By the end of the day I HAVE to SIT or stretch out to get any semblance of relief in my spine, hips and knees. I can't sit for 5 minutes without "nodding" into a deep sleep. My husband is convinced that aliens have entered my body because HE KNOWS that I don't sleep soundly in bed, much less sitting in my chair.

    I specifically told the PM doctor on the day we met, that I did not want to start a pain medication that had "depressive" or "sedative" properties. He said "If it does, break pill in half". I tried that today with no success. I am trying to remain positive. If I were a quitter, I'd have quit LONG AGO.

    My life requires that I be clear and present at all times. I cannot possibly be the "exception" to every rule of pain management. There's something that's going to work for me...something I can afford. I have to stay positive=)

    I wish for all a restful evening with less pain=)

     
    Old 02-07-2014, 06:25 AM   #38
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    Re: METHADONE for PM?

    Hi dixie, I didnt mean lay around like being lazy i meant like having to lay down before you fall down, like "nodding off" & thought without pain relief you were having to stay still. I didnt mean to offend. If i had no significant pain relief even if i overcame the sleepiness, pain would still make me immobile & then adding in the itching & if trying everything to make it better & its not then i would have to just go ahead & call the pm dr not necessarily to quit the medicine but for physician advice &/or possible prescriptions to offset side effects. And of course if the dr thinks its time for a change there are many other narcotic pain meds to try, & most long acting dont cause drowsiness! So please dont worry it will work out! It took a year or two to find the right combo of meds that worked for me. You will find the right meds too!

    Last edited by gmak; 02-07-2014 at 07:18 PM.

     
    Old 02-07-2014, 08:14 AM   #39
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    Re: METHADONE for PM?

    WhistleDixie - Your frustration is understandable. Drug side effects can be difficult to tolerate. Perhaps it's time to call your PM and discuss the situation.

    Speaking only for me, I've had side effects of varying degrees with most of the pain meds I've tried, but my PM has always advised me to try and stick with a particular medication for at least a month. And in truth, most side effects have resolved over that time. Obviously if the situation was completely intolerable, the advice would be different! And for some folks, side effects never go away.

    If I understand correctly, you haven't used any narcotics, aside from Norco, in a while, so it seems logical you might be hit hard by the methadone. Not that this makes the side effects easier to deal with! I certainly wouldn't want anyone to stay in a potentially dangerous state, but it is possible that if you can give the methadone a little longer, you may see better results.

    As for being the exception to pain management - I know it can feel that way, but many on this board, myself included, have had to try a variety of medications before finding the one that works. It's a frustrating process for sure.

    Last edited by PhilliesFan20; 02-07-2014 at 08:19 AM. Reason: typos

     
    Old 02-07-2014, 06:25 PM   #40
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    Re: METHADONE for PM?

    Agreed its probably time to call the doctor. At least let them know what is going on, but hopefully, get an earlier appointment and/or some suggestions. Sorry you are still struggling. The drowsiness often improves in time, but often continues to some extent. Also agreed this is the most likely pain med to be sedating. But, you didn't exactly give your doctor too many options when you requested a long acting med which was affordable to pay cash.

    To give yourself a better chance of success, if possible, I would follow your doctor's suggestion for several days in a row and take half the pill twice a day...it will take at least a few days for the medication level to drop significantly. I personally think 5 days is too short of a trial with this or any long acting med. However, early signs point to you likely having difficulty getting success with this medication, as it appears you will need a significantly higher dose, and that will be difficult to tolerate.

    I too easily nod off anytime I am not active with the Methadone. I easily nod off when reading, in meetings, watching tv, etc. Yet I still have bad insomnia lol. I have ended up on Ritalin, because between the Methadone and my other conditions which cause drowsiness & fatigue, I couldn't function. I'm hoping once we work on my sleep disorders I could at least cut down on it. Its usually just weekday mornings though.

    Have you got a price quote on the Fentanyl patches yet? You should at least know what you are working with to see if you could make it work somehow. Also, please avoid driving if you are nodding off so badly. That is the main reason they started me on Ritalin actually...I was nodding off while driving.

    If you ended up without other options and Methadone was good for your pain but too sedating, its possible that would be an option, although its not desirable to have to start medications just for side effects, so its a last resort sort of thing. However, Ritalin isn't cheap, even generic, although its dose dependent (I actually have to pay cash since my insurance will only cover it for ADD and its about $60/month for my relatively low dose). And I think its about the cheapest medication in that class.

    I too have had difficulty tolerating medications for pain, non-narcotic and narcotic. Its rare to find something that works on the first try. Its a tough decision as to when to throw in the towel. Best wishes.
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    Old 02-07-2014, 06:42 PM   #41
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    Re: METHADONE for PM?

    Hi,

    I don't know if you are continuing to try the med or not, but if you are still itdhing zyrtec is good for itching and much less sedating than benadryl, you could also try allegra, all are otc.

    Good luck,

    Tigg

     
    Old 02-07-2014, 10:06 PM   #42
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    Re: METHADONE for PM?

    Thanks to all of you=) As of tonight, I'm continuing the Methadone, but with a Benadryl at night, when itching seems at its worst. I'm going to give it a few more days.

    As for my "limiting my doctor" as to what he can prescribe based on cost...This certainly is not a place I would ever have chosen to be, I assure you. I, like most other pain patients, want the best meds available that will lessen my day to day pain. I prefer Morphine...but can't get a straight answer of cost (even if there IS a generic?)

     
    Old 02-08-2014, 04:34 AM   #43
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    Re: METHADONE for PM?

    Its very confusing but i will attempt to pass on what i just had to learn about generic morphine. As i understand via my pharmacist & people helping me on healthboards all morphine is morphine sulfate & the immediate release morphine sulfate that comes in generic equivalent is MSIR, then there is a generic extended released morphine tablet that releases over 8 hours ,MSER. And also generic Morphine ER extended released capsules that can be prescribed every 24 hours or every 12 hours. However i was prescribed these to replace long acting brand name morphine that lasts 24 hours called avinza . On the bottle it says Generic Morphine ER but the capsules on the inside say kadian on them which is another brand name extended released morphine but they were sold to me as morphine ER a generic at a generic price. Also there is MS contin a name brand extended release morphine that last 8-12 hours. So i am a little confused which morphine ER is considered generic except MSER is definitely a generic as well as MSIR, short acting immediate release morphine sulphate tablets. I asked pharmacist which is generic & didnt understand very well about the capsules. Of course like you i wouldve liked to stay taking the avinza that definitely last 24 hours but it is not covered on my insurance. I know this is as clear as mud right? Lol im sorry!

    Last edited by gmak; 02-08-2014 at 11:07 AM.

     
    Old 02-08-2014, 10:34 AM   #44
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    Re: METHADONE for PM?

    I know you don't choose to have limitations on prescription cost...I was just stating a fact that your doctor doesn't have many options, so I wouldn't be upset at them for prescribing something that had a strong potential to be sedating, as it was really the only option for a long acting med which was affordable for a cash patient.

    Your pharmacy will have the best answer on cost, as it varies greatly by pharmacy and region. There are three long acting formulations of morphine (MS Contin, Kadian, and Avinza), and two of those have generics (MS Contin and Kadian). MS Contin is a pill that is typically prescribed every 8 or 12 hours. Kadian and Avinza are capsules that are typically prescribed every 12 or 24 hours (Kadian) or every 24 hours (Avinza).

    To get a prices quote on MS Contin (the cheapest long acting option), I would have them price out a few different doses assuming three doses a day. You should also get the Fentanyl patch quotes (a few doses using either 10 or 15 patches a month). Why do you now say you prefer morphine? Have you tried it before? How did it work with your absorption issues?

    Gmak is very likely receiving brand name Kadian at the generic cost by the manufacturer of the brand name (no reason to make another run of capsules without the brand name printed). Actually though, I believe that the generic Kadian costs almost as much as the brand name. Best wishes.
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    Old 02-08-2014, 03:54 PM   #45
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    Re: METHADONE for PM?

    I dont know anything about pricing. But the itching i think will be a side effect of any narcotic. I had bad itching with just percocet. And people need time with any medication, not just methadone. I hope it works out whatever you decide to do. This is powerful stuff and if we want relief, there is a price to pay, and not just in currency.

     
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