Father died from fentanyl patch/ oxycodone

[kjcromer]

My father passed away recently.My dad was going to pain management.  He had 3 things in his system per the tox report trazodone, fentanyl patch, and oxycodone all prescribed to him from pain management. The coroner said the cause of death was accidental mixed drug intoxication...he said it  was the combination of the fentanyl patch and oxycodone causing the respiratory drive to shutdown. That the two medicines together caused it to happen. He said if he had just been on either the oxycodone or the fentanyl patch that it wouldn't have happened. I just don't understand...from what I know my father had been on that combo for a while...so why did it happen now. I'll get his medical records early June and take a look and see if there were any increases...but I don't believe there was. Does anyone have any ideas or have heard of something similar to this? Thanks for any thoughts. I miss my dad dearly.

Jenn

[TJCLAYTON]

I am so horribly sorry for your loss, I cannot imagine the torment you are enduring.  I do want to tell you though from my own personal experience, using fentanyl patches and oxycodone - even oxycontin which is much stronger, will not cause death simply by being used together.  

I was on fentanyl, extended release oxycontin, and percodan, muscle relaxers, and various other medications for nerve pain and sedetating antieliptics without having any problems aside from still being in pain.

Everyone has their individual tolerances and sometimes a person can have a severe allergic reaction to something they've taken for years; that happened to me with morphone.

Again, I am so very sorry for your loss.  Pain specialists are not perfect but in all my years of treating for pain, they err on the side of EXTREME caution and I would trust them with my care over a family doctor or emergency room physician any day.

Many blessings to you and yours.

Janette

[Grreatful]

I am so sorry that reading this has made you nervous. But it really is a common PM dose that I have seen out there.  If you have concerns maybe speak to your husband's doctor about them, so they can tell you what to look for, just in case. Or if your adamant about him not taking this ask for a change.    I no longer take Fentanyl but I used to and it was accompanied by oxy for break through pain.  I never had a problem with any of the drug interactions, I just made sure I took them as prescribed.  
I had the Fentanyl patches that could not be cut so I was diligent in inspecting them for cuts or damage, never had a problem.  I hear they have better ones now.  
But the combination seems to work great to manage pain for some people.
But I wouldn't just take my advice I would ask for more information of people now on the meds.   But, you might want to post on a more active thread or start one of your own so people might see, as this is a old post.  Good luck I hope someone relieves your worries.

[Tuckamore]

Thanks for your input Grreatful. I didn't see this question tacked on to this old thread back in February.

I agree with all you have said to our poster. I actually remember this old original post. I've responded to thousands that I don't recall but this one stays with me.

I didn't have a good answer for the original poster in 2011 - and I don't have one in 2016. I wonder if it was the older, reservoir type and it slowly leaked given the poster's father a higher than expected dose of Fentanyl?

The key to our newer poster is the mention of "Chemo."   When our bodies are in true pain we utilize the opiates as intended - making an OD less likely. Not impossible - just less likely.

~Tuck

[Grreatful]

Dear Kjcromer,
I know this is a very old post so am not sure if this will ever find you, but I wanted to give you my condolences and say. I am so sorry for your loss.  I hope and pray you have figured out what happened to your father.  The loss of a family member can be devastating especially one we are so close to. I can't even describe in my heart how bad I feel for you and not having the answers to why, I hope the ME finally gave you that closure.

Your in my prayers,
Grreatful

[CKBEANO]

my husband is now taking Fentanyl 75mg and oxy and I am now so nervous that he is going to O D on this .He is also taking Chemo pill form and every other weds he gets infused with CPT11. can anyone help me with this.

[namnam46]

Hi kjcromer,

Thank you for the very kind words.  Thank you for mentioning about the Sleep Apnea.  This does add a new dimension to the picture.  As you may know this is a VERY dangerous problem that in itself can lead to death all by itself.  However, when it's combined with these meds it CAN be an ESPECIALLY dangerous combination.  My Husband passed away 14 years ago this June from complications from Diabetes at the age of 52.  He, ALSO, suffered from Sleep Apnea and I spent MANY sleepless nights laying next to him listening to him breathing so that I could shake him awake, if need be, when the breaths came too far apart.  This DEFINITELY, adds a new perspective to what the ME said about his death.  Sometimes, it just takes ONE episode that might, in some way, be slightly different than the others to trigger an outcome that we NEVER would have dreamed possible.  

What a FORTUNATE man your Dad was to have such a Loving and Caring Daughter that wants to know ALL of the answers!!  We'll ALL be looking forward to seeing your findings and I hope that you will be able to get your answers QUICKLY!!


God Bless you...........Sherry  :)

ddiane719:

First, I think you have me confused with the original poster, kjcromer, as it was her Dad who passed away, tragically, from the meds. :(

I, though, am VERY concerned about your Hubby and his sleep apnea while using this medication.  I TOTALLY understand your concern with this as My Husband, who died from complications from Diabetes 14 years ago this June, ALSO suffered from Sleep Apnea. I would DEFINITELY bring this to the attention of ALL of his Doctor's IF they aren't already aware of this.  

I can tell what a loving and caring person you are and he's VERY fortunate to have you.  I HOPE that you do as I did with My Husband and are in control of his meds and be sure that he takes them according to directions so that there is NO POSSIBILITY of an overdose as these ARE very potent medications.  My Husband, ALSO, had problems with remembering WHEN and WHAT to take so I did it all for him and that way our Doctor AND My Husband,as well as the Hospice Nurse, knew he was getting the meds he needed and at the proper time.  Sometimes, we wives, just HAVE to step in and take over to be sure that OUR Loved Ones are going to be around for as long as possible!!  :)

Best Wishes..........Sherry  :)

[ddiane719]

My husband takes fentanyl & oxydcodone plus several others prescribed by his PMP. He is large and on several occasions I believe he has had "near misses" when I found him slumped over and bluish barely breathing. In his case there are two factors, sometimes he will fall asleep sitting up after taking his meds. the slumped position partially blocks his airway. Sort of like sleep apnea. The other factor for him is that  sometimes he gets confused and forgets that he has taken his medicine and will take them twice. VERY DANGEROUS. This would not be the case for your dad since he was taking the correct dosage. I pray you will find some answers that will give you at least some peace of mind.

[kjcromer]

Thanks Tuck, I'm definitely going to ask questions and make sure I can understand as much as possible what happened. Sherry I am so sorry for all of your losses...I can't even imagine that...and thank you for your kind words. I don't know yet what the amount he was taking, but I should get the medical records at the end of the first week in June and I will definitely at that time post up that information. I do know that my father did have sleep apnea, the coroner said that maybe the combination of the meds didn't allow for his body to reset itself and start breathing on his own..if he had a episode of sleep apnea. He did tell me if he hadn't been on that combination of medicines that my dad would still be alive. He also said in his opinion those two medicines intensify each other. I really do appreciate your responses and help.

Jenn

[namnam46]

My dear,

I'm so sorry that I wasn't on sooner to see your post!!  My heart goes out to you and what you are going through at this time!!

I, too, have lost both my Dad as well as my Mother, son and Husband.  It breaks my heart that you are having to go through this with all of these questions on your mind, also.

I take Percocet (Oxycodone) 10/325's, 3 times a day as well as am on the Fentanyl Patches 87mcg's that I change every 48 hours.  I've been on this combination for over a year now and haven't had any problems at all with the combination.  There are many on here that either ARE on this combination or have been in the past. It's quite an ordinary combination as the Fentanyl is the long-acting medication and the Percocet (or Oxycodone) is for the BT (Break Through) Medication.  And just so you know, I have heart issues as well as CAD (Coronary Artery Disease) and have even had a heart attack and the Fentanyl and Percocet are perfectly safe for me to take. My Cardiologist KNOWS everything that I am on and there's NO problem the combination as far as my body is concerned.  I'm 5' 1 1/2" tall and weigh only 125 lb. I'm also on Valium.  So, basically, the same types of meds that your Dad was on.

Would you share with us the amounts of the Fentanyl and Oxycodone and Trazadone he was on?  This could help us a lot in trying to help you.  :)

I ENCOURAGE you to keep looking for the answers that you NEED to help you start to heal after your tragic loss of your Dear Dad.  I AGREE with Tuck, and ENCOURAGE you to POSSIBLY consider bringing the autopsy results to another ME and have them looked at again.  So often a "second set of eyes" can pick up something that is missed when something is first looked at.

Make appointments with ALL of your Dad's Doctor's and question them about ALL aspects of his health and let them know that you are looking for answers.  I'm just wondering if their is something there that might have been overlooked that one Doctor had diagnosed and the others might not have known about.  (Just trying to come up with ideas for you.)  I KNOW how DESPERATELY you want those answers!!

I wish you the very best and I want you to know that you are in my Thoughts and Prayers!!

Warm ((((HUGS)))) from one Daughter to another Daughter..........Sherry  :)

[Tuckamore]

Jenn,

Again I want to encourage you to ask lots of questions of the corner and your dad's PMP. I'd include his PCP.  They may be able to make more sense of his sudden and tragic death. As I said there are flukes that just have no explanations... but I would certainly leave no stone unturned searching for something that made more sense.

In years down the road I don't want you to think back and wish you would have talked to the physicians involved. You might even consider taking all the autopsy findings to another ME and asking for a second opinion.

As I said nothing will bring your dear father back.....but now you must go on and find some peace. Do whatever your heart tells you so you won't live with regrets or should haves in years to come.

I wish you peace and healing.. it will come.

~Tuck  

[mrfitman]

I'm 65, last 8 YEARS 6 bodypart replacements. 2 ARE SCREWED UP!!! NEED ATTENTION... PLUS LUMBAR and cervical PAIN...24/7 1-10??? 8...SO, 8-20'S OXYCODONE and 25 mcg fentanyl patch. now,ran out, early of OXY... Should I include morphine?? Or add another patch 25mcg???

[kjcromer]

Luv2bmomjen and Tuck,

Thank you for sharing your stories with me and I'm so sorry for both of your losses.  I'm hanging in there, but I just wish that this all made more sense.  I do believe that I'll see my dad again one day in heaven, so please know that your story (luv2bmomjen) was not out of place and very comforting.  

Jennifer

[luv2bmomjen]

I am so very sorry to hear of your loss.  I understand what it is like to loose your father and want answers all too well.  My father passed away in a small airplane reck in my childhood.  I am still looking for answers to this day but really I find even now that I have to set that aside and remember this........
We are on this earth for such a short time in the grand scene of things.  You will see him again before you know it, in a better place.  Think about how fast time goes by.  Everytime I find myself missing my dad so badly I go back to looking into the sky and saying "See you in a little while Daddy"!
I don't know your personal belief so I hope that was not out of place but I thought it might bring you some peace as it has for me.  I have also lost my brother in law in a boating accident recently and three grandmothers just this last fall all in six weeks time.  It can be very hard on you.  Try to take care of yourself.  Rest is key for sure.

As far as the medication I'm not sure that I can help that much.  I have been on a high dose of Oxycodone for three years and also a couple other medications that can cause resp problems but I have never had a problem personally.  Never been on the patch though.  Try to remember that your father needed to be taking this medication to live his life with any comfort or real "living".

Hang in there, we are all here to help in any way we can.  

jennifer

[Tuckamore]

Hi Kj,

Thanks for the additional information. It does sound like this was just a strange occurrence, a unfortunate fluke if you will. In my opinion and experience it is not usual that ppl suddenly go into respiratory arrest from the combination of medications that you father was prescribed. However I don't know how high the dosage was but certainly if the corner felt it was an unheard amount of opiates I think he would have expressed that to you. Again thousands of ppl are prescribed this combination and I have no great explanation for you. All of us that take opiates, especially in combination should know the risks, even though they may be minuscule....they exist.

Of course you want to know more details. It may help you to review his medical records, talk to his PMP and look for reassurance that this was unforeseeable, that no error were made....that is if the meds were prescribed with in the accepted parameters. There's a doubled check here. Not only is the PMP to prescribe appropriately, the pharmacists that fill the prescriptions have a responsibility to monitor the amounts and dosages. Again I think this was not the normal response. Nothing will bring back your father but I can appreciate the fact that you need to understand what happened and why.  

I am so very sorry for your loss. I know the agony of losing a beloved and wonderful father. I hope you will share with us what you discover.

You'll be in my thoughts and prayers.
~Tuck

[kjcromer]

It's okay I was wondering the same thing...but from what the coroner said it would have shown in the tox report if there was too much.

[flower12345]

Oops. I posted that before I realized that the toxicology would have told that.

[flower12345]

Hi. I am so sorry for your loss. The only thing that I wonder is if it is possible that the patch was faulty, or somehow released more medication than it should have. Could your dad maybe have been getting the flu or something--maybe a raise in temperature? It's a long shot. I don't really know if the flu effects the patch, but I know that heat does.

I hope that you get answers.

Hugs,

Flower

[kjcromer]

Thanks Tuck for your kind words.  In response to your questions, I can tell you that my father was 56 when he passed.  He did have type 2 diabetes, but per the coroner the blood sugar levels were also normal.  A full autopsy and toxicology report were conducted.  The coroner is the coroner for our entire county and he was the one to conduct the autopsy as well.  My dad was a large framed man, but not fat by any means.  He was roughly 6 feet tall and weighed around 250 lbs.  He did suffer from pneumonia several months ago, but I was fortunate enough to go to his last doctor's appointment to hear that his oxygen levels were back to normal.  The coroner also inspected his lungs and found no trace of pneumonia or anything else for that matter.  His heart was fine and there was some arterial blockage, but nothing that would've caused his death.  We were told that this was normal levels of blockage for someone his age.  So I'm left with unanswered questions.  

[Tuckamore]

Hi kjcromer,

Welcome to our Forum. I've seen many posts on numerous subjects on our forum...but never one like yours. My dad left this earth a year ago yesterday. It's so painful to lose your dad and my heart truly goes out to you.

I know you will be searching for answers until you can justify or make some sense of his death in your mind. I have a few questions, if you don't mind. How old was your father? Was he a small and/or frail man? Did he have any other medical conditions? How long had he been on the combination of meds? Was a full autopsy done and what were the credentials of the person doing it?

There are many, many ppl that take the combination of fentanyl and oxycodone plus other respiratory reducing drugs as mellie said ....and don't expire. The question then becomes...why your father? I am so sorry that I don't have those answers for you.

I've said repeatedly that our systems are all different and respond differently to medications. I know that doesn't help ease your grief but this just may have been a fluke. I don't think for a minute that the PMP was irresponsible. These drugs are frequently prescribed together. The toxicology report proved your dad took the meds responsibly. You can be proud of him for that! But I have a feeling that you have a lot of reasons to be proud of your father.

If my father died under the circumstances that yours did I would return to the coroner and ask this question, "Why did my father expire when there are thousands, maybe millions of ppl on this combination of drugs that don't succumb to the respiratory depression they produce?"  In my opinion that's the real question. It was the reason for my questions to you in the second paragraph. There has to be more to this situation...some contributory circumstances...Or again, it was just a fluke. In my opinion you need to question the corner's decision.

Nothing will bring your dad back. I believe he is in a better place. I have been told that a hundred times about my dad....but it doesn't ease my grief...and it probably won't ease yours. Time does help a bit. Please know that we are here for you. ((HUGS))

We also have a Grief and Loss Forum. It can be found under the Forums listing. If you're interested and can't find it please let me know. I'll look forward to hearing from you again.  

Peace,
~Tuck

[kjcromer]

Hey thanks so much for the response. The coroner said there wasn't anything extra in his system per the tox report and all the pills and patches were counted as well and he had the right amount left. I'll get all his medical records the first week in June and will look to see if he was prescribed a increase recently. From what the coroner said though it looks like he took everything as prescribed. Thanks for your sweet words.

[mellie4]

Hi.  I am so very sorry for your loss.  I can only imagine what you're going through.  Have you spoken with his doctor to see if an increase was prescribed?  Or maybe his pain was so bad he took extra??  I was on that combination (minus the trazadone but adding a few other things.)  I hope you are able to soon get the information you need and can find some peace.  I wish there were some words that would offer you comfort, but I know there isn't.  I'm sorry isn't nearly enough, yet it's all we have really.