Conversion of my Oxycodone to Fentanyl

[luv2bmomjen]

I am wondering if the new patch I am trying that is 12mcg/h is equal in conversion to the 50mg of Oxycodone my doctor took me off of?
Anyone know how to convert?
I'm scared to switch.

Thanks

[manicrose]

I have been on 125 fentanyl for 3 years. I was taking 8mgs of deludid 8x a day along with that but just recently  got off those. Im finding that the patch is not working every 72 hours but 48 max. How many Norcos would it take to the third day to not have that withdrawal? I am allowed to have one for breakthrough pain, but at this point I want relief the third day until I see my doctor next week! I can go through more "3 days" with that last day being miserable! THANKYOU!

[luv2bmomjen]

Well let's see.  It has been four days and I am getting use to things.  It has been much easier than I thought it would be.  I am getting use to not reaching for pills and actually not even remembering my BT meds every three hours when I am not needing them which is hard for me to even believe.  I have been using the two patches.  My doc called me herself this morning because she knows of the issue I have had with the only nurse in the office.  She was very happy that the patches are working and said she was proud of me and I was doing a good job.  WOW WOW WOW never thought I would hear that out of a doctors mouth at that office.  Anyway, she wants to bump me to 50mcg.  I am not sure that I need that and told her I felt ok on the 25 other than a little night BT pain due to not taking Oxy at night.  She said to try to add one more patch this morning putting me at 36mcg Fentanyl and take my BT and take less during the day so I would have some for middle of the night as needed.  I was taking Tramadol ER 200mg before we made this change and she never told me if I should continue or not so I had NOT been taking that at night.  This morning she said I could either take it or not it was up to me.  Kinda weird.  Not sure that I need it or want more meds on board at this point.  This afternoon I hate to say after adding the third patch I feel demotivated again and sluggish.  I think maybe it is too much.  I see her in the morning to make a final decision as far as an ammount on the patch and the Oxy.  She would like to see me off the oxy but I like to have it on hand for BT.  I just have that kinda over medicated feeling this afternoon and I don't like it.  I'm sure I will get more use to it.  
Overall though I am feeling much happier, laughing again, paying more attention to what is going on around me, noticing things.  I see now that I had been pretty much checked out for a long time while on so much short acting medication.  So for that I am glad that I made the change to long acting.  I don't think the fear of reacting bad to the medication or something scary happening on it will ever leave me but I feel better about the change than I thought I would for sure.  And other than some middle of the night aches I can happily say I have been completely PAIN FREE for three days. ;-)  Most likely why I am so happy!!!!!

[mellie4]

So glad you're feeling better!!  I guess sometimes when you're used to taking pain meds orally you might sort of miss the action of doing it.  But if you feel like you really need your BT meds every two hours, then you should talk with the doctor.  It's possible you need a different dosage or a different BT med.  Finding the right combination of medications can sometimes be a real challenge.  But it sounds as if you're on the right path.

I can understand if you've had problems with the doctor's office staff that you're anxious about things they tell you.  I think a good staff is half the battle in finding the right doctor to treat you.  I'm very fortunate in that the staff at both my pain management office and primary care office are top notch!!

As far as your emotions being all over the place, that happens when you lower the dose on some meds or add a med.  Usually, like most side effects, it will even out in a few days or a couple of weeks.  I had some side effects with Neurontin when I first started taking it.  It actually made me feel sort of "high" and it made me really slow with my thoughts.  At the time, they told me to stick it out a couple of weeks, but I was sort of working at home and I couldn't communicate well with the people at work; so I stopped it.  We restarted it a couple of weeks ago, and even though I still had those side effects, this time I was able to wait it out, as I'm not working.  I was willing to try to stick it out and I can see the side effects slowly diminishing.  Another week or so and I'll be able to tell if they go away or if there at least tolerable.

I think you probably will like the way the patch dispenses the medication.  Hope you'll keep us updated on what's going on.

[luv2bmomjen]

Hey just checking in to say a big THANK YOU for helping me through the last couple days, for pushing me to start the patch, and helping me remember to just do what my doctor says.  My dr is a very young woman, younger than me and I have had mulltiple promblems with the office in general so I have a hard time trusting everything around what I am told at times.  I know she knows best when it comes to this though.
SO......... I did add the second patch yesterday as I was not getting enough pain relief by the second day on the first patch.  I started feeling much much much better last night about bed time which was 12 hours after the second patch was added.  The only trouble I have had with the bt meds is that I "feel" like I need to take something every two hours and so does my body because that is what I have been doing for like 3-4 years now.  So going 4 hours plus in between taking my BT was weird.  I did still have some pain but not the pain and then relief cycle that I usually get.  Or the up's and down's.  It is definitly going to take some major time and effort for me to get use to but in the end a good decision and will give me the best pain relief.   I feel a since of relief and feeness from the pills at the same time as like something is missing.  
On another note I have been either very happy laughing a lot which I don't do often anymore or very very mad and downright nasty.  My emotions are all over the place.  But I feel more in the moment then I have in a long long time.  I can concentrate better, pay attention to what is going on around me, get things actually done around the house and joke around with people.  I feel like my old self before pain pills and pain 24 hours a day but I am still getting relief.  Why would the patch be any different from the oxycodone I was taking?  Or is it just that I am not having the up and downs and taking smaller amounts at times and larger at others depending on my pain?

[mellie4]

Wondering how you were doing today??  You got some great information and advice from Tuck.  And she's right about following your doctor's orders.  Even though there is some great information on the internet and there are some extremely knowledgeable people on this forum, everyone is different.  Our doctors prescribe things for each of us in whatever way they do for a reason.  What works in one person could be dangerous for another person.  When I read something here that pertains to my issues, I will often talk to my doctor about it.  And sometimes the information I garner brings change to my treatment.  But I would never apply something I read without first talking to my doctor.

I was recently hospitalized.  When they were going to give me a very strong antibiotic, they asked me had I ever had it before and I said no.  They gave me a test dose first to make sure there were no allergies or adverse reactions.  When they saw I was able to tolerate it, they began the treatment.  It's always better to err on the side of caution.

I hope your patch has kicked in and it's not troubling you in any way and you're getting better pain relief today..

[Tuckamore]

A Conversion chart says 50mg of Oxycodone a day converts to approximately 25.7mcg/hr on the Fentanyl (Patch). However and again ONLY your physician can do the correct conversion based on your opiate history. Plus it's very common to begin at a lower dose to determine how effective the Fentanyl is for the particular patient and how well it is or isn't tolerate. It's always safest to start at a lower dose and increase if needed and as instructed by your physician.

DO NOT rely on me or anyone on the Internet to tell you what the right dosage is for you. This is between you and your physician. This conversion may or may not be exactly correct. Some differ a bit. FOLLOW your physician's orders.

Take Care,
~Tuck  

[mellie4]

I'm not sure what the conversion chart she used would be, but I don't think you need to worry about that.  I don't think you need to worry about withdrawal.  I'm sure between the Fentanyl and your BT meds, you'll be okay.  And you also have the option of putting on another patch if you need it.  It seems like you are getting really anxious over what the conversion is.  Trust in your doctor!!!  And if you really are that anxious, just call the pharmacist.  Tell him what you were on before and what you've been changed to.  Then ask if he thinks that you'll be okay on the new meds/dosages.  The pharmacist is very well versed in medications and you can rest easy after talking with him.

[luv2bmomjen]

good to hear from you too.  I just have second as it is a crazy busy night of running between football, dance and fittings for costumes.  
Anyway, why I wanted to know is because she was going to give me what the conversion would have been but I was so scared I turned it down.  So I am wondering if I did myself more harm than good.  She basically game me half or less from what I understood of what she wanted to of the patch.  So I'm curious how far under I am due to being afraid so that I know what she may move me to next week when I see her again to tell her if the patches are working.  So far I think they are going to. ;-)  
What would the conversion have been from 50mg of oxycodone to fentanyl????

Thanks and take care, have to run now.  Check in later.

Jen

[Tuckamore]

Hi Jennifer,

Haven't heard from you in awhile. Glad you have posted. It is best to keep all your questions in one post as noted by Mellie. It's my guess that you are seeking a specific answer to the conversion question. Yes I do know how to convert but that is not really of importance as this is what your physician has prescribed. I am confident that your physician used a conversion chart when she ordered the change.

If I understand this all correctly you were told to begin with the 12.5 Fentanyl Patch. That's common. It's also how it was prescribed for me when I was first changed from short to long acting opiates. It's to determine how your system will respond to the Fentanyl. You may only require the 12.5. Our systems are all different.

Follow your physician's directions. If after the first 48 hours you are not obtaining relief from the 12.5 then go up as directed. If this is not enough info for you then please contact your pharmacist. He/she is the expert in medications and best of all their advice is accurate and basically free.

I understand your concern. I felt the same... but I found that a long acting medication along with a break-through was much more effective in controlling my pain. It will even out the highs and lows that come from short acting medications. I know you are a bit afraid... that's normal. But please trust your physician enough to follow her/his suggestions. If there are bumps in the road you can try something else. Good pain management is a trial and error process.

I wish you well and hope you will find the Fentanyl effective. I'll look forward to your updates.

Take Care,
~Tuck

[mellie4]

I commented on your previous post just a few minutes ago.  Also GeminiGirl commented as well and gave some great advice.  Check your earlier post for these new comments.

I think you can google a conversion chart, though my understanding is there may be more than one and you don't know which one your doctor used.  Again, you could talk to your pharmacist; they will be able to tell you whether the conversion is appropriate or not.  And if it's causing you this much anxiety, you should talk with your doctor.  It can be very scary switching meds.  Is there a reason you're so worried?  Do you trust your doctor in making this switch?  Did you ask your doctor if the Fentanyl would cover the amount of oxycodone you've been taking?  I can't imagine he'd switch you without making sure the dosing was correct.

And it may be better to stick to one posting, unless you're posting a new subject, so people can keep up with your questions, others' responses, etc.