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Breakthrough Meds

I am currently on the fentanly patch (Thanks for the answers about that!).  I am using Hydrocodone for breakthrough pain.  I am getting a refill of the patch and was wondering if it is okay to ask for a refill of the breakthrough meds.  I don't know how often i should be getting that refilled and don't want to alarm them.  I have been using the breakthrough med quite regularly as we are still trying to adjust the patch levels.  I was wondering if they would think it odd to need a refill after a month or if that was normal.  I am hoping that this new level of patch will work fine but my father-in-law is dying right now and I am really pushing myself and just wanted some breakthrough meds in case I needed them.  Thanks for your input!!!
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954005 tn?1304626605
It would help if you told us what your actual prescriptions are (for both meds), and is your Hydrocodone prescription specifically for breakthrough?
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Avatar universal
If you are finding you need your breakthrough pain meds on a regular basis, there's a good chance that you need to have your fentanyl dose upped.  Ideally, breakthrough pain meds should be taken only for that - periodic times when the long lasting medications aren't quite enough.  They should not be used as "additional dosing".

I would suggest talking to your doctor about adjusting your fentanyl dose up, even slightly.  You may still need or want to request a refill on the breakthrough meds so that you have some on hand in case you find you need them.  So long as you're not requesting a refill on those early (based on what the instructions are for taking them), your doctor probably will not have a problem in approving the refill.  It may also help to tell him that you are hoping that by increasing the fentanyl dose, that you won't need as much of the hydrocodone - that not only shows him/her that you are using the medication as prescribed, but also that you are not just looking to have additional medications around.  he/She may decide to give you a lesser number of the hydrocodone pills if they decide to up your fentanyl, since they are to be used strictly for breakthrough pain, not continued management, so don't be alarmed or upset if that happens.

I'm sorry you're having difficulties in your personal life right now.  I know first hand how stress can make our pain levels much worse.  Best of luck and I hope you find some good pain relief with the patch.
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Avatar universal
Thanks for your repsonse.  They actually are upping my fentanyl dose.  I am on 25mcg and was told to up it to two patches if I felt it was not working.  I tried that twice and hated the way it made me feel.  So now I just got two prescriptions...one for 25mcg and 12.5mcg and am to wear them at the same time.  I was prescribed 30 10/500 hydrocodone and have almost finished them already...largely due to the meds and the stress of what is going on in my life.  I am sure it is not a big deal because the script is for 3 a day of the hydro if needed and the only time i was taking it was on day 3 of the patch because i felt the fentanyl was not working.  I have explained that to them...which is why they are doing the increase.  I am hoping that works because I am truly happy with the fentanyl and it has made such a difference already...I feel like i have my life back and my husband and I are so happy with it.  I just feel like with everything going on and no sign of it ending for at least another week or so I want to have some on hand in case the increase does not work.  I am sure hoping it will...having suffered for so long it is nice to feel good and able to do things like going to the grocery store and Target itn the same day!!!  Thanks for the input!
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Avatar universal
I'm glad to hear the docs are increasing your fentanyl dose.  Going from one patch to two was probably just too much of a jump for your body to handle.  Hopefully the slower increase will be much easier for you.

If you feel like you're going to need more of the hydrocodone, don't hesitate to talk to your doctor about getting a refill on it.  In my personal opinion, I would not wait until you were comletely out of it to request the refill, though, just in case there is a delay in getting the refill approved and filled.  I'm sure you know that once the pain levels get away from you, they can be much harder to get back to a more tolerable level.

One thing you might try, but definitely ask your doctor about it first, if you find that you're needing to use the hydrocodone for breakthrough pain, maybe try taking 1/2 a pill instead of a whole pill (if they are the 10/500) and see if it works.  You might also ask your doc about prescribing you the 5/500 instead of the 10/500 and writing it that you are permitted to take 2 if necessary.  With the increase in the fentanyl, you may find that you can get away with a lower dose of the hydrocodone.

Of course, like I said, DO NOT ADJUST ANY MEDICATIONS without talking to your doctor first.

I'm glad to hear that the patch is working so well for you and that you've been able to do some "extra" things that you haven't been able to do for a while.

Best of luck!
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1271743 tn?1320892461
I am on the fentanyl patch (100mcg) also, and my breakthrough medicine (oxycodone 15mg) are filled once a month just like the patch.  Normally the doctor will give you a month's dose and I would not hesitate to call in the refill or request for next months medicine as long as its not early.  I find I need both just as much as the other one...
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