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Opioid cross tolerence?
by Joe, Jan 25, 2001 12:00AM
Dr.Steve,
I was wondering if tolerence to opioid pain meds translates to tolerence to other pain meds specificially fentyl. The reason for my question, I'm having a medical out patient procedure done next week and I will be given I.V fentyl as an anestetic. But since I am tolerant to my (presrcibed)oxycodone pain meds, I didn't know if the doctor should be giving me a higher dose of fentyl to handle the pain of the procedure or is this a mute point when it comes to fentyl?
I was wondering if tolerence to opioid pain meds translates to tolerence to other pain meds specificially fentyl. The reason for my question, I'm having a medical out patient procedure done next week and I will be given I.V fentyl as an anestetic. But since I am tolerant to my (presrcibed)oxycodone pain meds, I didn't know if the doctor should be giving me a higher dose of fentyl to handle the pain of the procedure or is this a mute point when it comes to fentyl?
Yes, it can make a difference since they are both opiods. Even though fentanyl is a morphine derivative and oxycodone is a codeine derivative, my experience shows that fact will not change anything. Depending on how high of a dose of oxycodone you are on however, you may not have a high enough tolerence to warrant an increase in the fentanyl dose.
I would make sure that the physician ordering the fentanyl (whether it be an anesthesiologist, radiologist, etc.) knows the amount of oxycodone you take by telling that person YOURSELF. Don't rely on the information being relayed to them via the form you fill out when you check-in or the nurse who swares they will tell them - do it yourself. Voice your concern about pain BEFORE and DURING (if you will be conscious) the procedure.
If you have any more questions, please ask.
Good luck!
Jim
However, as long as your use is supervised, I imagine you will come through fine. Since your drug of choice was codiene, your doc will probably try to avoid codeine. MY guess is, he'll give you Ultram, which is not opioid in structure but affects the brain in the same way. If he offers Ultram take it. It's slow acting, that is, it takes about an hour before it takes effect and works better after your second dose. But it's a very potent pain reliever and may be considered less likely to "awaken the monster" of addiction in you.
Beware of any bold promises by your doctor if all he gives you is an antiimflamatory like Voltarin or daypro. they might be good for arthritus pain, but post-surgical pain? I doubt if that would give you much relief. But you might mention the Ultram. A lot of doctors feel more comfortable prescribing it because it is not a scheduled narcotic, even though it provides pain relief the same way that an opiate does.
I will check back though. Hope you are doing well now, JOHN B.