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15mg Oxy q4 down to 5mg Oxy q6 + 25Mcg Fent

My doctor reduced me to the above dose and its going terribly. The conversion for the fent for that dose is 50 to 75Mcg. My dr said to try changing the patch every 2 instead of every 3. My insurance won’t pay for this non-standard dose. Idk what to do. I’m in constant pain, sweating crazy - i’m in a nightmare.
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20803600 tn?1546262537
COMMUNITY LEADER
Fentanyl conversion is not a atraight conversion from one opiate to another. Because the delivery systems are very different- oral versus transdermal.
It is very likely the conversion dosage rate is fine- however since you are going from oral meds to transdermal - it needs to build up in the bloodstream and the tissues so that you are receiving a steady dose. This occurs over the first two or three patch changes and the breakthrough during conversion is usually handled by allowing a small dose of oral meds (5 mg or so of old med) during the first week while changing opiates/delivery system.
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Avatar universal
There is likely some info I don't have, but it is abundantly clear that EVERYONE responds to pain meds individually. There is no exact conversion ratio among opiate pain meds that fits everyone. First and obvious is to go back to what worked. Then, if you have a real need to change to fent, titrate slowly down w oxycodone and up w fent.
Second is to understand why the decision to switch. Fentanyl patches are great for some people. Not for everyone.
Insurance is another question. They're just being the cold blooded, money grubbing scum both insurance and Pharma always are while bulking you out of $$$. Keep after them for coverage and for fair price.
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1 Comments
Patients can NOT and should NEVER change medications or dosages, or resume old medications without the PRIOR approval and consent of their physician. Doing so endangers the patients relationship and on going treatment with their current physician and can ruin chances of finding another willing to treat.
Converting oral meds to an entirely different delivery system- as in this case is tricky. Oral meds are absorbed in the stomach and intestines and distributed through the blood stream. Transdermal medications must cross the skin barrier, be absorbed into the tissues first, then dispersed through the body.
This takes time- typically two to three patch changes when going from oral meds to transdermal delivery.
Since we are not physicians- ‘advice’ given by other patients should not be followed and members should consult with THEIR medical provider for medical advice and dosage, medication or conversion info.
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