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Temegesic vs. Duragesic
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Temegesic vs. Duragesic

I have a simple question. I am on about 6 mgs. a day of Temegesic 2mg.s three times a day. I will be applying a 50ug/h patch of Duragesic soon. Do I need to wait the requisite 6 - 12 hours after last dose of Temegesic (Bup) before I apply the Duragagesic (fentanyl). In the past I had to do so when switching from vicodin to Temegesic. Or are the two compatablile?

Much Thanks.
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You don't have to wait.  The only thing that could happen is the Temgesic might keep the Duragesic from working while the blockade is still active as buprenorphine does create a good one.  It takes anywhere from 8 to 18 hours for the patch to kick in, depending on the person and metabolism.  The reason you waited to go on the Temgesic is because it is an agonist/antagonist and if you go on buprenorphine while on an opioid agonist, you most likely will go into withdrawal.  Fentanyl is an agonist.  No need to wait.  Actually, with the time it takes for the patch to come up to speed, it would be better to put it on right away.  Hopefully, the amount of time will be enough for the blockade to die down.
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I have read where the blockade can last up to 72 hours after discontinuation of buprenorphine.  This a link to that info:  http://opioids.com/buprenorphine/bupren.html
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How are you doing?  I found a website this morning that listed pysicians that prescribe bup. Now that I have finally found some available I am leary on makeing an app't. because of this blocking period. Supposedly you are to wait until all the meth is out of your system, if that is the case that could take weeks or months so what would be the sense of taking this med to ease withdrawals?  I am very confused.

Sharon
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They are telling you that?  I was told people had to be down to 30mg before jumping over.  I have also seen as high as 60mg before, but I wouldn't be the one to do that.  You are at a very low dose.  But, they do what they do at the place you talked to.  Have you contacted anyone else?
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No, they didn't tell me that, what I am saying is that other forum members have said that you have to go 2-3 days without meth in your system before transferring over because of the antagonist in bup..  And on the other hand I heard you can transfer over anytime after 3omg. I am confused on how and when this transition takes place.

Sharon
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Interesting,

I have the opposite problem! My order for bup came in and I am ON DURAGESIC. Can I start the bup now and just take the patches off or will that throw me into withdrawals? Or can I keep em both on (HIGH TOLERANCE I HAVE) I didn/t know people were on patches so much or had so much bup around. MR MICHAEL do you KNOW>

I like the bup better, can always get the 50 mg patches.
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I have a freind who has desparately been trying to find resources for bup cuz it seems to be the only thing to resolve thier severe pain.  Can u plz e-mail me that site you found with resources for it?  thx!
Suzie   at ***@****
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i read your post yesterday and wanted to check in on you.  how are you holding up?  please let us know how you are doing.  we are all here for you and support you.  you'll find understanding here and have people to talk with who have been through exactly what you are going through.  LOVE and PEACE to you!
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Hey everyone,
I was just wondering what is a fentynal patch? is it a narcotic? if so, is it a strong narcotic?
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Hey gal!   I need to ask you a personal question can u e-mail me plz?
See my addy above.
ty!
Suzie
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I am so sorry u are hurting so bad hon!  You are a strong woman and i know u can beat this.  But if you have severe pain wut can u take?  You need sumfin.  No one should have to suffer like that!  Can u have family member hold the pills for u and dole them out as prescribed? Many of us do that.  
Suzie hugs ya!
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Bup seems to be widely used in your country true?  Here in the states a lot of Docs have not even heard of it let alone the pharmacys have it stocked.  Hopefully it will be more widely available soon here!  Pam
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Thank you so much for that info... I think  I understand it better now!  Because I am already experiencing early withdrawals on 5-6 mgs it should be ok for me for the transition. Right?
I guess different physicians do it different ways. Some say you have to be off meth for 2-3 days.  If that was the case for me I think I will try to do it on my own. I am making an app't soon so I will speak to the doctor on this and see how they do their transition period.  Wish me luck and thanks again for taking the time to explain all of that.

Sharon
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Yes, fentanyl patches are a narcotic and  STRONG. They are synthetic heroin for all practicale perposes. They come in 25, 50 and 100 microgram doses. Ive been in the 100 microgram (thats ther level they give severe cancer patients) for about a year. Stopped 6 days ago.. Sucked a bit but I just hooked up on klonopin today (a benzo, levels me out) and Soma (a muscle relaxant that might help RLS). Much easier now. Im almost there, with Gods grace. Gotta work the next two days though; they might be rough. But Im commited! When I went to my dealer I declined the patches and stocked up on Klonopin and Soma..

Believe me if you can get a benzo or even somas to knock yourself out for a few days the worst will be over.. I did it backwards, or course. Waited 6 days before getting them.

When he asked me if i wanted to do a patch I declined.. HOORAY!!

I have no idea how strong fentanyle compares to oxycontin or percs or heroin. There is a web site that has equivilant doseges for the different substances.. Ill look for it and post it soon

DM
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You've got mail!  ;-)
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Fentanyl is 50 to 75 times stronger than morphine.  Heroin is about six times stronger than morphine.
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just wanted to say good evening to everybody.  hope everybody had a good day.  i want you all to know that i love you and care for each and every one of you.  you guys are the best, it's just so wonderful to visit here where folks understand and care. if ALL OF YOU were in an NA meeting or something similar, I'd be there everynight the doors were open!  love to all of you. My pain is at least a good 9 right now, and that pill bottle is calling my name.  but i decided to log on here and check in before...now i have a little more resolve.  again, love to each of you.
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It is certainly my understanding that if you have an opiate dependence then you really NEED to be in early withdrawal to transfer to BUP - otherwise there is a very real risk of what is called "Precipitated Withdrawal"; which as discussed above is to do with the opiate antagonist properties of BUP. Basically precipitated w/d is what happens when you put BUP into a body that is still "full" of opiates. BUP targets the opiate receptors in the brain - just as other opiates, however it "kicks off" the other opiates (this is it's agonist property in action), but due to it's antagonist properties (like naltrexone/narcane), it will only give partial opiod sensations - & as you can see, if this happens in a body that is not in w/d - it can/will bring on w/d.

Here in Australia, the recommended transfer dose from methadone is 30mg .......before I could transfer I had to wait 48hours from my last methadone dose (due to methadones' long acting properties). With shorter acting opiates, they suggest a wait of between 6-12 hours. Either way early w/d is essential in an addict to remove the chance of precipitated w/d (which is reported to be awful - no kidding!).



Sharon - the more I read on the BUP, the more convinced I am that it is WAY "easier" to get-off than methadone alone.
Due to your low dose, you wouldn't have to wait 48 hours to start BUP. As long as you are in early w/d & start on a low dose of BUP (to determine how your body react/responds to it) then you will be fine. You may even find that due to only being on 6mg of Methadone that you will get comfort from a small dose of BUP.
As you know I am on 8mg - one week today! You also know that it hasn't been the easiest week for me - but the internal war that waged within, has been won & the last few days (with the help of valium) have seen me feel almost back to normal again.

There are just SO MANY stories out there about how much "easier" the BUP is to come-off - & IMHO this has got to be a good thing! A friend of mine (locally) has been on the BUP for 4 weeks. He came off 30 mg Methadone. He found the transfer (to BUP) virtually painless (admittedly he doesn't have 3 children to keep him *busy* like I do).
He also is now on his descent (he stablised on 8mg). Anyhow he has done 2 days of 6mg, 2 days of 4mg & 2 days of 2mg & then he'll be OFF....he is on his 2nd day of 4mg, & so far despite already dropping his dose by HALF in 2 days) he is still fine (even sleeping - just the occaisonal "twinges"  - as he'd say). WOW!

Also remember Gem1Angel from here? she was on the BUP for a total of 3 months & the only w/d she had was lack of sleep & RLS! - again WOW!. I mean I know lack of sleep & RLS SUCK major big time - but after a fullblown opiate habit - to come off with minimal w/d such as she has described is AMAZING.

Sharon - like someone else posted - everyone IS different. I do also believe that there is NO magical drug & there has to be some "pay back" for the years I've been filling my body with this drug. However, scientifically (sp?) speaking alone - they have studied the BUP ALOT - & with it's antagonist/agonist properties it IS an amazing drug.

I am thinking of you & hoping for you very much that you find the best way through this for you (as I do for you all).

My warmth & care to EVERYONE, Liquid.
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I made the transition to Bup from meth with no waiting time in between.  In fact, I dosed that morning and started the bup in the late afternoon and had no problems.  I was at the dose you are right now supplementing with Lortab 7.5.  I stopped taking both and went directly onto the Bup.

The good thing about Bup is if I don't have pain, I don't have to take it and I don't have withdrawals.  I've been taking it now since late September.  Some days I can get by with only taking half of my dose if I'm not in much pain that day.

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Hey G,
  Thanks!!! I did a search on this yesterday & found a lot of info. I called my GI doc & told her about this & she said she'll test for it when she draws my blood monday before the scope. I also told my Aunt about it who had suffered from ulcers years ago & it turns out that she had this bacteria...& it's hereditary. I'm on Protonix right now which is supposed to be WAY better than Prilosec or Nexium so hopefully I'll just need some antibiotics. My doc also called in a script for Regulan to help with the nausea but no relief yet.

Thanks for the info Goldie...you probably just saved me a lot of time & pain.

FINISHED!!
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Hey bud, did your doctors mention how you can mend your stomach and other internals that were damaged? DId they mention anything over the counter, supplements, or food products that help.

I want to start some preventative stuff as I have taken Ibuprofren for years.

Rex
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I take ibuprofen too but not every day.  It is awesome stuff!
Hugs!
Suzie
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Dear Finished ..... I had to post here so you will see this. Your doctor may give you the brush off .... but you MUST insist on a bio for H-Pylori. It is the number one cause of stomach ulcers! H-Pylori is cured by taking antibiotics and prilosec for 2 weeks. Do a search on it. We have to be informed so we can guide the doctors (smile) .... all my best to you .... G
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I have been on duragesic 50ug - one patch for 3 days for about 2 weeks. I took the patch off yesterday about 6pm. I woke up this morning feeling like my back was a corkscrew. I am thinking about taking  21/2 - 3 .2mg bups today at lunch (18 hours after the duragesic). But I can't make sense from the above postings. Is methodone different from fentanyl? If so will I go into wds? If I go into wds, would placing a fentanyl patch stop the wds. I have no access to hydro ( and don't want it anymore), so I am trying to figure out what to do. Any advice or links would help. Also I will post my email if you want to talk off the board. Either way, Much thanks.

Jack
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That is .2.5 - mgs to .3mgs of bup I plan to take today. Sorry about above typing.
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I have been having a tought month, i overtook my methadone and now i'm out i got some ms-cotin from a family freind, i thught because it is also a narcotic i wouldn't have withdrawels but after taking my forst dose about 3 hours ago i feel horrible, goose bumps, sore everywhere, runny nose and eyes, and feel terrible, could i be in withdrawels. i wa taking up to 40mg of methadone per day, and the ms-cotin is 30mg pills three X's a day

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Good morning Rex,
  There is a strict diet I have to follow now that would probably be good to start. It's pretty simple. Just avoiding things like citrus fruit, soda, chocolate, anything red, nothing that has much acid content etc. would probably be a good start for you. As far as meds...I'm on a med called Protonix. This helps in the healing of the stomach lining. As I understand, so do Nexium & Prilosec. I think it'd be wise for you to just be careful of the IB or motrin. Also avoid asprin when ever possible. These both contribute to the irritation of the stomach lining. This really came on with NO warning. Just started vomitting blood one night. I've been reading up on the H-Pylori that Goldie had mentioned & reports are saying that this can be caused by LOW stomach acid content so I wouldn't recommend taking over the counter antacids unless heartburn sets in. You may want to check with your doc & explain my little "adventure" & your concerns. I think that with a small change in diet & the use of anti-inflammatories & motrin etc. only when really needed, you'll be O.K...but I'm no doctor. I'm too far gone to be doing any preventive measures right now so I may not be giving correct info here. Sorry about that but I'll be sure to ask my GI doc about this Monday & relay the info to you ASAP.

Take care buddy,

FINISHED!!
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Since all of you are sharing your expertise maybe you can answer a question for me. I am just finishing day #5 of cold turkey W/D from MS Contin(morphine). I seem to be doing OK thanks to a lot of great information and support that I have gotten from all of you. My question is regarding Ultrcet. I have been taking Darvocet and I also have access to Ultracet to help with the symptoms. How do they compare? The Darvocet seems to work OK. Is the Ultracet similar? Thanks and God Bless!
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Sounds like withdrawals to me!  How long were you taking the meth? And how long have you been without it?

Sharon
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I don't know if what I've been thru can help you or not Waking Up. I was taking 400 mg of MS Contin (100 mg x 4 a day) plus Vicodin ES 3 or 4 times a day for breakthru pain a few years ago.  Then the resident doc that had me on that amount left the clinic and they gave me a new one. He told me before I even had time to say hello to him, that he didn't like the dose I was on, even though it wasn't really helping get all the pain, and he was gonna cut it in half.  Needless to say it was time to move on.

I went to a Methadone clinic and found that 100 mg of Methadone plus 2 Vic ES a day could get rid of the majority of my pain.  I have Crohn's Disease and Fibroyalgia.  I'm the crazy lady you see in the parking lot doing donuts in her wheelchair like a kid. :)  My daughter is the 16 yr old who doesn't always pay attention and runs me into things. LOL. (Sorry, had to throw in some comic relief here.)

I wanted to try to drop my dose some on the Methadone to give me some play to go higher in the future if I needed to, so I was able to drop to 80 mg. a day along with the 2 Vic ES. Then my hubby took a drastic pay cut and we couldn't afford the clinic any longer. Our insurance company won't pay for Methadone clinics and I called every doctor in the insurance book and none of them would take me on as a patient and write me a script for the 'done.

My family doctor said he was willing to help me when I talked to him.  He's always been very understanding of the pain I have and knows I have never abused my meds, I do take as directed.  My problem was getting thru the withdrawal from the 80 mg. of Methadone by trying a taper using drugs the insurance would pay for.  We first had me on 50 mg. of Durgesic, didn't help, he told me to try 100 mg (2 patches) and that made me feel horrible, like I was gonna OD, on top of the withdrawal, so he wrote out another script for 75 mg. patches.  That amount along with Vic ES didn't even begin to touch the withdrawal pains I went thru. While it did help my Crohn's and Fibro pain, the withdrawal pains were another critter all by themselves.  After 2 weeks at the 75 mg. patch I dropped to 50 mg. for a week, then I got an allergic reaction to the patch (I have eczema too) and had to quit using it.

I had some old 80 mg. Oxy's at home and so I tried those again. They really didn't do anything and I was still in total hell from the withdrawals.  I then dropped to 60 mg. on the Oxy and finally at that point was so fed up with it all, I said screw it and stopped the Oxy and only took Vic ES (one pill) about 5 times a day. None of it really helped.  After two months of trying all those different meds, the withdrawals from the Methadone finally started to ease up. I ended up dropping from my normal 95 to 100 pounds to 78 pounds by the time it was over.  Last week I was able to start eating again and I'm now up to 86 pounds.

This all started on Nov. 11th.  Last week I knew I had to come to the realization that I am a Chronic pain patient and I need to take the meds to help me.  With the Methadone finally getting out of my system (I am still having some withdrawal symptoms, but nothing that I can't handle), I took 40 mg. of Oxy and it was enough to ease my pain and I do take a Vic ES or two on some days when the breakthru pain is really bad from the bowel obstructions I get constantly.  Doing the withdrawal and taper, I ended up getting off the Methadone and also got my tolerance down to a level I'm comfortable with.  I now have room in the future to take a higher dose as my tolerance goes up again.

In my mind, when I knew I had to stop the Methadone, I really wasn't sure if it was real pain I had anymore (yes, stupid I realize now) or if it was the drugs making the pain worse.  I'm very stubborn and didn't listen to my doc or my hubby who was a nurse for 13 years.  I just had to try and get off the harder drugs and see if the pain was real or not.  My pain they have never really been able to put a number to, I pass out from it. I could tell the difference between the withdrawal pain and the pain in my gut, muscles, and joints from the immuno diseases I have.  I got my question answered, but in a very painful and hellish way.  I will never again take Methadone, it's just way too hard to get off of.  I will take the other pain meds available these days and pray they keep working for me and I don't have to up the dose any time soon.

I have no idea what your tolerance is compared to mine.  I read your post and felt for you, so decided to write out what I have been thru the past 2 months of my life. Maybe some part of what I've been thru can help you at this point in your life or possibly someone else who reads this.

While I know Methadone is the best painkiller out there and also the best available way to get off a bad drug habit, anyone considering it should be aware of the cost of a clinic. Also be aware that all the doctors I talked to in the uptown Phoenix area where I live, I must have called over 100 doctors, wouldn't even consider giving it to me so the insurance would cover the cost. The clinic I went to gave you no breaks - no pay, no 'done.  If there is a chance that money should become an issue in the future as it did for me, I'd suggest not starting on it.  Nothing I tried could stop the withdrawal pains and suffering for me in the past 2 months.  I just had to ride it out, while trying to keep the other pain I live with daily under control.  I didn't do it very well.  It will be at least 3 to 4 more months they tell me, before all of the withdrawal symptoms are finally gone for good.

I will be praying you make it without too much pain until you can get more doses of your Methadone or decide to go from where you are now and continue the withdrawal you are starting into.  I wish I could offer more encouraging words, but my experience was not a good one.
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HERE IS AN AWESOME SITE THAT A GOOD FRIEND TOLD ME ABOUT.  IT IS A BUPRENORPHINE PRESCRIBING LOCATOR.  IT WILL GIVE YOU ALL THE DOCTORS IN YOUR AREA THAT ARE ALLOWED TO PRESCRIBE BUP.

http://www.buprenorphine.samhsa.gov/bwns_locator

Hope this helps some of you.
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Sorry for the delay in getting back to you.

There is a difference between meth and fentanyl.  

I would like to email you some info about bup and my experience.  You can email me at ***@****.
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Much thanks, you have mail.

I stayed on the Duragesic, too afraid of the possible wds.

Jack
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Good morning,

The SAMSHA site is where i found my doctor!  I was amazed of how many physicians there were.  There were more than 20 in my state and one right in my city just blocks away from my employment. I called him to make an app't. we will see what happens. I am still holding at 6mg. right now and if this app't. doesn't work out I think I will just slow down a little bit more. Instead of doing 1mg everyother week, maybe I will do 1mg a month. Because these last few millagrams are the hardest by far!!!

Sharon
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I just want to let you know that I am thinking of you - & I think you are a doing a terrific job!

I hope that all goes well with the BUP doctor. Please let us know. Either way I can tell you are determind & I know that you will get through this.

I dropped to 6mg BUP today - will stay on 6mg for 4-6 days & then I go to 4mg....& I'll keep going like that until I come off altogther (got 'til late Jan).

I few days back I mentioned a friend of mine who has also used the BUP to get off the methadone. He was also on 30mg meth when her transfered to the BUP. He stayed on 8mg BUP for close to 4 wks & then did a rapid descent - 2 days of 6mg, 2 days 4mg, 2 days 2mg & then nothing - today is his 2nd day of nothing & he is doing REALLY WELL. Minimal w/d (basically nothing bu the occasional "twinge" according to him)......WOW!!!!!! (he even slept!). Now that is amazing & gives me (& hopefully US ALL) some hope.

I HOPE  for everyone struggling to find a BUP prescriber, that you WILL find one & all will be well.

With warmth, Liquid.
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Glad to hear your bup. tapering is working well,and your friends tapering is encouraging to all of us that are just starting or trying to get on. I am a little bit nervous about getting on because I am not sure how the antagonist in the med is going affect me. I am just hoping that it does not put me into major withdrawals.  My withdrawals right now are not too bad because I have been holding for a few weeks. You start to get used to the dose after a few weeks. I am also wondering what the expense is going to be, the doctor didn't mention it yet, and I am afraid to ask. I hope that my insurance will cover it, and if not I hope that I can.  I wanted you to know that your comments and advice have been very helpful to me and I appreciate them more than you'll ever know.

Sharon
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WARMTH TO YOU LIQUID!!!!
Love your handle....

Percs
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I have never had temegesic, but I do have the duragesic patch for my chronic pain. I have gone 5 days without changing it and the hell pain set in. I don't think I could stop the patch for something else right now. I know it controls my pain that I have from 3 different devils, fibromyalgia, post polio and multiple sclerosis. Yes, MS does emit pain in spite of what some folks think and my MS lesions are on the nerves that cause the pain thus the need for pain control.
The one time I was out of the duragesic made me afraid to be with out it again. I'm not good with pain as my husband can tell you, and nothing helps it like the duragesic.
Also, with the duragesic, you don't have to take pills every 6 hours, you stick it and forget it. So to speak. :o)
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