In pain

[staceymeows]

I've just been switched from Fentanyl 25mcg every 48 hrs to Oxymorphone 10mg every 12hrs. I feel way worse (pain) & was wondering if anyone knows what the equivalence is between the 2. I have a feeling I've just been decreased in pain relief. My dr & the pharmacist told me to wait a few days to "feel it's working" & in the meantime I'm in excruciating pain. Can anyone help with what I can do here? Btw...I've had chronic pain for 6 yrs & I've been rx'd almost everything. Oxymorphone was the only thing I haven't tried. Thanks.

[philnoir]

So you are using Opana ER 10mg twice a day?

Because of your many years of pain and opioid medication, you are highly tolerant to opioids analgesics. This means that you need more opioid to achieve the same amount of pain relief.

My question is: why does your doctor want to change the Duragesic to Opana ER?

Also, how long after changing from Duragesic to Opana ER did you begin to feel more pain?

A few facts:

Opioids like morphine, codeine, oxycodone, oxymorphone, and a few others, are known as "classic opioids." These medications belong to a chemical class called Phenanthrenes.

Fentanyl is an opioid of a different class, called Phenylpiperidines.

Both are opioid analgesics, meaning they have a high affinity to the opioid receptor in the nervous system that reduces pain, respiration, constricts the pupil of the eye, causes constipation, and all other side-effects associated with opioid medications.

The reason why different opioids are more or less effective in treating pain is due to how well that individual metabolizes and responds to those metabolites.

Because we're all different, equivalent analgesic dose tables are at best, approximations of how an individual will react when rotating from one opioid to another. This rotation calls for careful titration or the new dose and can require multiple visits to find that dose. The last time I rotated from oxycodone to morphine, it took about a month to titrate to the proper dose, which meant I was in the doctor's office about once a week during that month.

Undertreated pain is misery. Be persistent in your goal of properly tirating your new, effective dose. Keep a pain diary, and stay in close touch with your doctor's office. Ask to come in that day if necessary.

Feeling additional pain can only make your chronic pain condition worse. Stay on top of this.

Best wishes.

[remar]

Are you taking your medication on an empty stomach? It's very important that you do this.
I'm not sure how these medications compare to each other. I do know that we're all different and can respond to these medications differently.
I take it you made the change because the Fentanyl was not working for you?
Your Dr could very well be right. It may take a few days for this medication to start working. How many days has it been since you started it?  
I'm sorry that I was really no help at all. We're here to listen and support you though. I'm hoping some of our other members will be able to tell you how these two medications compare to each other and how long it takes the Oxymorphone to start working.
I just did some research and it looks like you should be able to take a break through medication on top of the Oxymorphone.Talk to your Dr about this because if this is true and you can take a break through medication while you're waiting for the new med to start working then this might be the answer.
I really wish I could have been more help to you. Please keep us up to date on how things are going.

[deancoleman]

does your Dr. or pharmacist said that you take oxymorphone 10mg? maybe the dosage is too low for your pain