changing pain meds

[fedupinmt]

hi folks have a some questions about changing pain meds. My mother who has cronic back and shoulder pain is being taken off of fentanyl 100mcg patch and 7.5/500mg and being put on morphine 60mg 2x daily and then morphine sulfate 15mg every 4 hours for breakthough pain. What I'm wondering is there going to be withdrawl or is the morphine going to have enough of the same stuff in it. If not what kind of withdrawl systems will there be to watch for. Any info would be great, I have my mom out here with me and she is not very happy about this switch, classic addict comment "I can't live with out my patch" For your info she is 77 yrs and very bull headed and it is very hard to explain to her it  will be better to control her pain. Any advice would be appricated. thanks terri

[fedupinmt]

Thank you, I can breath a little easier know that she shouldn't go through withdrawl. I don't want to see her in pain. If you find anymore info it would be great. thanks again for getting back to me. terri

[Jacqui805]

I will do my best to help you here, bear with me...

180 mg of morphine sulfate/day (given orally) is equal to somewhere between 50-100 mcg fentanyl/changed every 72 hours, transdermally administered, ie, the patch)

So, her dosage change is fairly equivalent with the added morph for breakthrough pain, but it is not exact.  If she does not get relief, or does experience w/d s/s, her doctor would want to know this and would likely adjust the dosage.  I don't have material in front of me, but will look when I'm up tomorrow just to see if there's a more confirming answer one way or the other.  What I have given you is based on both dose, route of administration, and whether or not the drugs are sustained-release or shorter acting drugs.  I know I have something on my bookshelf that gives an exact or near exact milliequivalency of these drugs, but I'm pretty sure I'm this it's pretty much right on with what I've said thus far.  Will get back with you tomorrow.