Need Help

[Mollyrae]

Hi Everyone, it's Mollyrae.

I have been using the Fentanyl Patch for a couple of years now and it's really helped tremendously with my pain. The downfall which I'm sure some of you are aware of is the constant tiredness that comes along with it.

I read that Sandee has switched to the Hydromorphone and is having great luck with it not only controlling her pain but makes her less tired. My question is, has ANYONE that was using the Fentanyl Patch switch to something else that worked as well.

One of my problems is, because of the potency of the Fentanyl, I'm afraid that if I were to switch to something else that wouldn't make me so tired would also send me into W/D's. I went through something similar a year ago when my Doctor took me off of the Fentanyl due to the drowsiness and replaced it with Oxycontin 20mg every 4 hrs.
Let me tell you that it did create some unpleasant w/d symptoms and this went on all weekend until I could reach my Doctor on Monday.

Has anyone been successful in switching from the Fentanyl to something else and had good pain control along with not feeling so tired?

Any responses would be appreciated.
Thanks so much,
Mollyrae

[Sarajmt]

Hi Mollyrae:  I am sorry you're having these problems.  We are all so different.  I couldn't tolerate the patch.  I'm on Lortab and I would bet that is not sufficient for you.  Good luck.  You give  a lot here.  I wish I could give back.
Sara

[sandee1818]

Wow Mollyrae I can imagine you were in pain and w/d as the 20mg Oxycontin can't compare to the dose of Fentanyl your on. I think the dosage I am prescribed would do well for you at least to begin with and go from there. 8 mg every three hours sounds excessive I know but as I said I am only taking them every 4 to 5 hours.
I am going to keep the paper prescription of oxycontin and not fill it unless something changes and have the Doctor change it to the ER formula of Hydromorphone.
Anyways I posted in the other post concerning your questions too:)
I hope you find something that works better for you! It is hard to get anything done when your always tired.

[Mollyrae]

Thank you, both of you.

Sandee, I was floored too when My Doc said that 20mg of Oxycontin was equivalent to the Fentanyl. I was shocked and tried to explain this to him but at the same time, didn't want to sound like I was just wanting a higher dose.

I was going to call a Pain Specialist in our City that deals with nothing but pain. My Mother used her when she had back surgery. I thought about a consultation just to see if my Doctor was wrong or there were alternatives.


After reading your post, I am going to make that call. I don't want to offend my Doctor, he has been so good to me and on the other hand, he also brought up the possibility of Pain Management. This Pain Doctor is one of the very few we have in Madison.

Thank you so much for the reply. It really helped.
Molly

[sandee1818]

I wish you luck and really hope it works out and you do get more options. I believe PMP are better at treating pain then the PCP as the PMP deals with pain and that's it. They have more time to devote to research and new studies and so forth where the PCP has so much on their plate they just do not have the time to do so. They are also more familiar with the medications and treatments for pain.
I am keeping my fingers crossed for you Mollyrae:)

[optimus22mac]

I posted to you and Sandee on the other post (Sandee's)...Hope it was helpful:)

I was concerned with withdrawals from the oxycontin and percocet when I switched to the hydromorph contin and dilaudid.  My doctor actually took out a chart to make sure he prescribed me the correct dose of the hydromorphone meds so that I would be covered for pain and avoid withdrawals.  I would hope that there would also be a comparison for fentanyl.  Since fentanyl is known for it's very harsh withdrawals, I would hope that your doctor would consult something like this, or maybe you can look it up on the internet, so that you would have the correct information going in to your appointment.  I was taking 40mg oxycontin twice a day, and 10-12 5mg percocets a day! Another huge concern for me was all of that tylenol! We could've tried the 80mg oxycontins with percocets, but I was literally getting NO relief from this drug any longer, so we tried the switch---and I am VERY happy we did.  Anyway, with that amount of oxycodone, we began with 18mg hydromorph contin twice a day, and 2mg dilaudid---1-2, every 4-6 hours.  I had NO withdrawals symptoms AT ALL.  So I think if you are put on a comparable amount, you should be ok.  Make sure to check my post on Sandee's thread also, and whatever you decide, I wish you success:)

[Tuckamore]

I know you have struggled with fatigue since beginning with the Fentanyl. I am sorry that is has not eased. Usually it does given time.  

I think it worth discussing a change with your physician. What can you lose? We never know what what other meds may offer. Yes fentanyl is potent. As you know I was prescribed it until I blistered from the adhesive. I didn't like the side effects but it did decrease my pain.

I was recently prescribed Oxycontin and it is more effective than any other opiate I have been prescribed. However I think the dose is a bit low. But still better than the Fentanyl.

We are all different. I encourage you to talk to your neurologist. There may be better pain management meds for you.  :)  Good Luck!

My Best to You,
~Tuck