Discussions that mention morphine

Pain Management board


Lou:
I think it is definitely time for a different LA(long acting) medication for you siince the Oxycontin is not agreeing with you. Here are the list of LA meds that you could possibly take:

morphine based - MS Contin, Kadian, Avinza

oxymorphone - Opana

Methadone

fentanyl based - fentanyl patch (Sandoz(generic), Mylan(generic), Watson(generic), or Duragesic(brand) - I take the Sandoz brand and have success with it. Many people do not have good luck with the Mylan brand and steer clear of it. However, everyone reacts differently so make up your own mind concerning it

I would suggest not taking Percocet either, although you may have find a differnt BT med as well but there are BT meds containing the same active ingredients as the LA verisons (ie. morphine, oxymorphone, fentanyl). You may want to seriously try either Methadone or fentanyl patch, just my suggesting. Good luck and let us know what you do ok?

brian
[QUOTE=sandollar;3540850]

1= 10mg Percocet= 1-25mg Fentanyl Patch

So you can figure with this, how much Fentanyl it would take to equal the amount of Oxy your used too, and decide if you REALLY WANT TO GO THAT HIGH!




I must respectfully disagree. I think what you meant to say was those patients on 10mg are given the 25mcg patch as a conversion. This does not mean, however, that it is equal. The 25 patch is far more potent....Equal to at least 90mg of Oxy per day.

According to Janssen, Docs should use their conversion table when converting patients from other narcotics to the patch. However, everything must be converted to morphine first, since it is the basis for the conversion. In this table, it lists the 25 patch being equal to a range of 60-134mg of morphine. Since Oxycodone is 1.5 X potent than morphine, you divide the range by 1.5, or come up with 40-90mg of Oxycodone. 40-90mg of Oxy is roughly equal to 60-134 of morphine. So, this means that any patient who is taking between 40-90mg of Oxy per day, should be converted to the 25 patch.

As you're probably thinking, this is pretty big range! Yes, indeed. Janssen makes specific mention that they are very conservative in their conversion due to the potency of fentanyl. Conversion to any med is always trial and error.

If Lou is taking 10mg 2X day, he will probably find the 25 patch very strong, and some getting used to....Maybe too strong....But, that's for his Doc to decide. However, it seems as if he is reacting negatively to Oxycodone in general, so this case is especially complicated.

Good luck, and let me know if I can be of any further help.

Ex
[QUOTE=gregar;3540950]Hmm.. I was on the 50mcg patch and my doctor told me 110-120mg of oxycontin daily would be close to the same as the 50mcg patch. You have to realize the patch releases its dose every hour. And for me 120mg of oxycontin (30mg x4 a day) isn't working as well as the 50mcg fentanyl patch.

The 50 patch conversion lists those patients on between 135-224 of morphine per day. Thus, it's roughly equal to 90-150mg of Oxycontin. So, your Doc has picked a number right in the middle, which seems prudent.

Ex
[QUOTE=Executor;3540969]The 50 patch conversion lists those patients on between 135-224 of morphine per day. Thus, it's roughly equal to 90-150mg of Oxycontin. So, your Doc has picked a number right in the middle, which seems prudent.

Ex

Yep! I was just pointing out that one 10mg of pec doesn't equil one 25mcg of fentanyl patch. When my doctor started me out 60mg a day of oxycontin it was to test to see if maybe a lower dose of a new med would do the same as the 50mcg I was on. It didn't and so we settled on 120mg a day. So I still have room to raise the dose. :)
So true Brian.....My only issue was when a poster said that (1) 10mg of OC = (1) 25mcg patch....This is waaaay incorrect, as you know.

If we think about the range Janssen lists (30-67mg) of OC (to a patch), that's one heck of a range! Also, I'm sure you noticed on the sheet how the ranges get even wider for the higher dosage patches. For example, for the 50 patch, they list a range of 67-112 of Oxy and 135-224 of morphine. WOW. Hard to believe that conceptually, two patients....One on say 70mg of OC per day and the other on 100-110mg per day, are recommended to start with the same patch.

I've also seen in their literature where each 12 patch is equivalent to 45mg of morphine or 30mg Oxy (45/1.5 since Oxy is 1.5 x potent). This contradicts the previous chart (table C in their prescribing info)....I'm guessing they're using the same info (table C) they've always used before they came out with the 12. This is why the 12 is so potent, despite not appearing so.

The take away is that one really has to know what they're doing when getting involved with the patch!

Ex
I will try to help. Fentanyl is right at 100 X's more potent than morphine. 100 micrograms mcg is the equivalent to 10 mg of Morphine and 75 mg of pethidine (meperidine) in analgesic formular. The thing with Oxycontin is that everybody no matter who is going to build a tolerence to it and it's that way with most durgs. Opana has oxycodone and morphine in it. I would ask the doctor about the patch. Pain management doctors know usually who there problem patience's are and there certain ones they don't trust and know they abuse medicine. To me the patch has worked well I have felt better throught the day probably because I haven't been waking up early with those opiate dreams having to get up and take a pill but the patch has helped all the way around and also as far as helping the pain it has been the best antidepressant medicine I've ever taken even though it's not for that it's helped me in that way. Good Luck