Sister's helper

[Sharleyraye]

My sister's doctor says he can't perscribe Actiq for her any longer because she doesn't have "active" cancer.  She gets severe attackes in her throat (especially when she tries to eat) because of radiation treatment.  Is there any truth to what her doctor says?

[Dee1956]

Hi I am really sorry for your sisters pain.  Yes, the doctor is correct.  Many many doctors prescribed actiq when they knew it was only meant for cancer patients.  When it first came out Medicare paid for it, then around 2007 Medicare decided it would no longer pay unless the person had cancer, many insurance companies followed suit
Now unless the doctor is a pain doctor they are not allowed to prescribe such high dose pain meds
Can your sister ask for a fentanyl patch?  It is the same thing only in a patch form so she would not have to swallow a pill
There is also liquid morphine that is very concentrated and I believe you take drops of it.  Not really sure of all options, just wanted to try to help
Best of luck to you and your sister

[femmy29]

I agree with Dee on this unfortunately.  There are strict lockdown controls on the fast acting fentanyl medications like Actiq.  I agree that you should have your sister talk to her doctor about the Fentanyl patches.  I am on the 50 mcg/hr patch and it works really well.  I do have breakthrough pain so I have to take oxycodone IR for those times.  Your sister might need a stronger short acting pain medication to compliment the fentanyl patch such as liquid morphine (what Dee mentioned) or liquid oxycodone.  There is also short acting dilaudid (hydromorphone) or opana (oxymorphone) - oxymorphone is stronger than hydromorphone.  The fentanyl patch strengths go up to 100 mcg/hr and the prescription leaflet shows dosing up to 300 mcg/hr so there is a lot of wiggle room with the fentanyl patches to hopefully give her some relief.

That is fabulous that her cancer is in remission!!!  Often even when this occurs, extreme pain can still be left behind from the treatments - especially radiation therapy.

The FDA and DEA are very hesitant to open up the prescriptions for Actiq for chronic non-cancer pain due to the potential increase of diversion onto the black market.  I have read that it is a very fast acting medication that works really well.  I am sorry that she no longer qualifies for it but it is blessing that she is no longer fighting for her life.  It may take some trial and error to find out which medication combo works best for her so if the first set of medications don't work, don't get discouraged, just go back into the doctor and ask to try something different or a higher dose.  

Take care and keep us posted if you can.

femmy