Changing pain medications

[joerock]

I've been taking the Duragesic 75mcg. hr pain patch for 3 years now, one patch every 48 hours instead of 72 because they only provide me with 48 hours of good pain relief, along with Percocet 10/325 for breakthrough pain for some serious spinal issues.  herniated disc, disc fragment impressing upon and displacing the S-1 Nerve root, thoracic herniation at the T-8 and T-9 Level, along with neckpain. I also been diagnosed with multi-level DDD. My question is, my Dr. is wanting to replace the Duragesic and Percocet 10/325 ( which I take 3 times daily, 90 per script) to Oxycontin. what Mg.. of Oxycontin would be required for me too take being that Ive been on pretty high doses of Duragesic and Percocets for years now? I certanly wouldnt want the dose too be too low, and have ANY withdrawl reaction from stopping the Fentanyl and percocet, but a dose that would be at least pretty much the equivelent and give just as much relief as the patch and percocet 10/325?

[Mollyrae]

Hello joerock; Welcome to MH.

This comment is only my opinion, I am not a Doctor.

I too use the Fentanyl 75mcg Patch along with the Oxycodone. There are many conversion tables available through the internet and Doctors also use theconversion method when finding the right dose for you. Fentanyl is one of the strongest pain meds on the market and it will take a high dose to reach the equivalency. For instance:

77.5mcg of Fentanyl= 150mg of Oxycodone per day. This calculates to approx.
2, 80mg of Oxycontin per day.

So in my OPINION, it would take at least that to reach your needed relief.

If I were you, I would have the Doctor increase the Fentanyl along with the Oxycodone without the Tylenol (liver damage could occure at higher levels of Tylenol on a daily basis). I fear that you will go through some type of W/D if that level is not reached.

REMEMBER, THIS IS ONLY AN OPINION.
Good luck in the future and take care, Mollyrae

[Tuckamore]

Hi Joe,

I'm glad you found us at MedHelp. We have many CP members like yourself. Mollyrae has some good experience with the drug. I am allergic to Fentanyl and therefore know very little about it. I am sorry that you are having pain and have multiple medical issues.

What I do know is there are conversion charts that physicians use to determine what dosage you will require when going from one drug to another. My question would be why your physician wants to change your medication when they are apparently working so well for you. Is this something you have requested or is he/she concerned about other issues. It was my understanding that most physicians would rather prescribe Fentanyl over Oxycontin but I do know they all have their own personally opinion.

And yes I would guess you would have some small withdrawal symptoms but the majority of them should be controlled by the new opiates you will be taking.

Please take care and let us know how you are doing. Best of luck to you with the new medication regime. Tuck

[parksean]

I was on a higher dose patch (200mcg). I switchted to oxycontin 80 mg, 3x daily, with 15 mg. oxycodone 4x daily for breakthrough, with no bad withdrawals. People in pain like us need the oxycontin 3x daily, despite it's "12 hour" rating or whatever you call it.

[daysmam]

I am also taking the  Fentanyl 75mcg Patch  with no other pain medication.  I have a multiple list of problems.  I am in constant pain yet the pain mangement center where i go refused to increase my dosage or switch me to something more effective.  They tell me that one patch is the equivilent of 16 percocets 7.5mg.  If that is true, then why do I hurt so much?

I am at the point that I just want to give in and pretend I am doing just fine!!  :) like a good little girl, except that I am going on 59 and I am really tired of being treated like a child or a potential drug dealer.  .  Is it right that I should suffer with such pain?  I have been taking these patches for about 2 years.  They just don't seem to work.  I tried going without them for a 2 week period to see if there was a difference in my pain level.  I can't feel any relief whether I take them or not.  I don't understand what all the talk about drug addiction is because I don't have a clue what it's like to be pain free.  Is it wrong to want to be pain free for a few hours a day?   I was in 2 auto accidents that left me with 17 broken/fractured bones.  I have 7 pins in my left wrist/lower arm, wire in my left knee, a metal plate in my neck fastened with 5 screws, where I had broken 3 bones.

I don't know which ones were broken, only that if it had been a 1/16th of an inch higher.  I would either be a parapalegic from the neck down or not here at all.  The initial nuerologist that started out treating me, moved to another state and since then went into Medical Research.   He told me that I would need to go on disability in about 5 yrs (that was in 2001) and when the time came to let him know.  (Problem, can't locate him and no other doctor wants to commit)!  I stopped going to him for a few months cause I owed him $800 in office visits then when I got the nerve to contact him again.  Poof!!!  He was gone.  In the meantime I was getting Ultrams off my regular physician, which wern't doing me much good so they refered me to a Pain Management Clinic who referred me to another Pain Management Clinic cause my Pain was too severe for them to treat.  (Yeah, really)

The accidents occured in 2001 and 2004.  Lately, I have been given the run-a-round going from doctor to doctor.  One refers me to this one who refers me to that one.  One doctor called me at home and told me I had lung cancer then told me to go to my local doctor right away who recommended me to see this one in the first place.  When I did see my local dr, he said it was just scarred tissue from pneumonia, which BTW, I have never had.  I am so tired, I can barely hold my head up, which oh BTW, I am only able to move my neck left or right by 5 degrees.    I have also been diagnosed with COPD, Fibromyalgia, Chronic Pain, Degenerative Disk Disease, Emphesema, Depression and I also allowed the Pain Center to put a stimulater on my spine.  Unfortunately, the stimulater dosen't stimulate the neck and shoulders and upper back where I need it.  They have re-programmed it over and over and can't seem to get it right.  I wish I had never had it done.  Now they cannot do any more MRI's on me because of it.  I will admit that at first when they first put the thing on my spine, it seemed like a good idea and I really liked it.  I think after 2 1/2 yrs, my body has done some major changing, thus the problems.  The Pain Center's only solution is to keep me on the patch and give me sleeping pills, since I have the stimulater device, from ANS.  

Sorry this is such a long read.  Am I the only one out there with this type of problem?  Some days, I think I should just give up the fight in trying to get help and suffer with this pain.  I am so sick and tired of having to deal with yet another doctor who gives me one of those blank stares.  I am on Medicaid and my doctor just don't give a flying fig.  I live in a small town and every time I get referred I have to travel 60 miles to the big city.  I have to use a transportaion service to take me and by the time I arrive, I feel like I have been used for a punching bag.  Well.....thanks for listening to me.  Sorry for going on like this.