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Using Fentanyl Patch, having Break thru pain
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Using Fentanyl Patch, having Break thru pain

Hi y'all this is my first post here and I hope y'all can help me...I have lived with Chronic back pain for 12 years now and for the last 3 years my PCP would only give me percocet 7.5/325 until November when I had an arthritis flare that resulted in a diagnosis of spondilitis, osteoporosis, osteoarthritis, osteopenia and bone spurs on my feet. I am 48 and have the bones of a 70 year old. The flare lasted 5  months and was HORRIBLE pain. So my doctor put me on Fentanyl. Patch 25 mg. My problem is I have a natural high tolerance to narcotics and the patch along with my percs are not working well. I LOVE the Patch...best pain relief I ever had...but for the break thru pain I need something stronger and dont know what to recommend...do y'all have any ideas what works well with the patch? BTW Due to a gastric bypass in 1999, I can no longer tolerate NSAIDS but the problem with opiates is they dont last longer than a couple hours for pain relief. Any ideas on what to use with the Fentanyl patch would be appreciated and I realize you guys are not doctors...thanks so much
Tags: Fentanyl Patch, break thru pain, Pain, Opiate, opiate tolerance, Arthritis, Chronic Pain, gastric bypass
3 Comments Post a Comment
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I too use the patch. For breakthrough pain, I use Oxycodone 15mg IR.  It also comes in higher and lower doses. I like that there is no tylnol in it.  I think it works well.  just make sure that you ask for the IR not ER.
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1331804_tn?1336870958
Hi SherParker and welcome to the pain management community!

I also have been suffering from chronic pain for 12 years.  I am on the 50 mcg/hr Fentanyl patch that I change every 48 hours.  I take 2.5-7.5 mg of oxycodone IR for breakthrough pain.  Oxycodone IR goes up to 30 mg strength tablets.

I do have some questions for you so that I can better assist you:

1. How often do you change your patches (every 48 or 72 hours or something different)?

2. How many times do you have breakthrough pain each day?

Many find that they have a lot of pain on the 3rd day while on the patch and some doctors will write for the patch to be changed every 48 hours vs every 72 hours.  This may help reduce the frequency of the breakthrough pain that you are having.

If you are experiencing breakthrough pain more than 2-3 times per day, most often the better approach is to increase the patch strength.  This often reduces the frequency and potency of breakthrough pain and can make your current strength of breakthrough pain medications work more effectively against breakthrough pain.

If changing the patch more frequency and an increase in patch strength is inefficient, typically the next step is to increase the strength of your instant release medication.

femmy
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5651869_tn?1371688644
I am currently on FP at 25 duration every 48hrs. I have baclofen, which thus far, proves useless, and for some reason, xanax which this facility believes to aid in pain reduction. The problem, is pain, hip back and leg, and now legs swelling. The pain NEVER ceases. I am only 44 and in bed constantly. I do not know what to do, where to go, but those of you in pain, understand, fully. The pain, is unbearable, but the break through pain, is to the point, I am not living, just existing.
Thank you~
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