fentanyl vs oxcontin

[Halloween jack]

just was wondering how if at all one of this pain killers works better then other ....i myself take fentanyl +oxcodone please i would like to hear from any body takeing this prescrip meds for pain and how well it works for your pain or if it does not .......

[Brian]

These meds are complimentary medications. The fentanyl is long acting, so if you are on the correct strength of fentanyl, you should not need too much of the break through medicine.

The type of oxycodone you and I and many other that are on this therapy get is known as immediate release oxycodone and works quickly for a short time to combat the breakthrough pain. The reason they prescribe the breakthrough meds is because there is no medicine that will make chronic pain dissappear all together so prescribing a short acting med will allow for the fentanyl to continue to be in the system and work on the "chronic" pain while the oxy IR is hitting the "non-chronic" pain so that you can continue to function. The important thing to remember is that when you end up needing the breakthrough medicine, you are probably doing more than you should be doing and your body is telling you that you need to stop and rest. Take the B/T medicine and rest and allow the long acting medicine get back to its job and try not to make yourself hurt.

In the real world, the doctors that are trained in pain management know that it is impossible to not need break through medicine and as time moves on and your body builds the tolerance to the medicines that you are taking, the natural course is for you to need stronget combinations of medicine and so they slowly work to keep you out of pain.

If you think about when you first started on the road of pain management, you probably had vicodan and darvocet and then percocet and vicodan and then all of the sudden you may have gone to oxycontin and percocet but the docs do not want to keep a patient on tylenol for too long so to get around that the next step is to go to either oxycontin and oxy IR or duragesic and oxy IR. Since fentanyl and oxycoone are different medicines it makes sense to give fentanyl and oxycodone vs. oxycodone (oxycontin) and oxycodone IR.

Hope this helps,
Brian

[Halloween jack]

brian how is it you know so much about this stuff i think its great like haveing a 2nd doc well i tried to talk to my doc about the tylenol in the oxcodone i have takein over 6 years now he feels as long as it not over 4000mg a day not to worry but i do worry i feel thats whats going to hurt me the most long term i do take 4to6 a day for break thur pain a day you see im a meat dept guy in a groc store in minnesota an its a bitch some days work restictions mean nothing some days i have to fight with management over this at least once a week tough job to have my doc told me to quit my job he said i cant be doing this anymore but i told him i need my pension he was not going to take care of me so i go to work 40hrs a week and after 3 to 4 hrs i have big problems with back pain ...so i have to do fentanyl and oxcodone

[Brian]

I know as much as I do because I read and research as much as I can and I ask a ton of questions. I am a new father and my health is very important to me.

As far as your doc telling you that as long as you do not exceed 4grams a day, that is fine for the short term but in the long term even as little as 2.5 grams or 2500 mgs a day can and will do damage to your liver.

Hope this helps,
Brian

[Halloween jack]

well just did a liver funcion test and kidneys and it was still in the normal range i do this twice a year so i guess this will have to do .....thanks brian i hope all the best for you and yours and the family...boy i do know my stress in my job will get me before the drugs will i work in a meat dept and i bet at least 2 to 3 times a week i have to go round with some manager about my work res. what ever they can get me to do outside my box if they dont want me here they should retrain me for some other job ouside this company and i would be gone they just want me to quit so what am i to do i just try to keep them happy but make me feel like shit in pain most days .....

[autofill]

I am taking perodan 4.5 mg. not helping my pain, I went from darvon 65 mg. 6 tablets daily. I am taking 3 perodan a day. I am interested in this fentanyl, but i have a bad liver. I liked my darvon pills because of the caffine in them, they gave me energy, but i fell like crap on these perodan with taking only 3 a day. My tolerance was built up from the darvons already when I started taking the perodan, I am wondering if something like fentanyl would help me deal with my pain and help me live a some what normal life style.

[Halloween jack]

you have to be be takeing at least 60mg or more of opites to star fentanyl and there have been deaths of over dose seen with the patch i take 100mcg every 2 days helps but no cure 120 people die thus far on the patch sinces 99also very costly to buy 850 bucks for 15 patchs

autofill wrote:

I am taking perodan 4.5 mg. not helping my pain, I went from darvon 65 mg. 6 tablets daily. I am taking 3 perodan a day. I am interested in this fentanyl, but i have a bad liver. I liked my darvon pills because of the caffine in them, they gave me energy, but i fell like crap on these perodan with taking only 3 a day. My tolerance was built up from the darvons already when I started taking the perodan, I am wondering if something like fentanyl would help me deal with my pain and help me live a some what normal life style.

[Brian]

Halloween jack wrote:

you have to be be takeing at least 60mg or more of opites to star fentanyl and there have been deaths of over dose seen with the patch i take 100mcg every 2 days helps but no cure 120 people die thus far on the patch sinces 99also very costly to buy 850 bucks for 15 patchs<quoted text>

There is a very low dose patch made by Janssen at 12.5 mcg/hr. Its intended use is for people to titrate down from the higher doses to weening off totally. Given that knowledge, doctors are using it as a new starting point for patients as well.

Autofill, you are on very low doses of opiate meds. There are many choices out there that will not hurt your liver. Percodan and Percocet are similar with the difference being that percodan is asparin and percocet being acetomenophin.

You should sit with your doctor and discuss your plan of care for the next 3 or 6 months. I would ask what the doc has planned for you, physical therapy, epidural injections, bed rest, light duty at work, no work and then ask about your meds and how he plans to help you with pain management from a pharmacutical standpoint. As long as you don't sound like you are hunting for meds but you are truly interested in your whole physical picture, he/she should not have a problem discussing meds with you.

[Richie]

I am a persom who am currently taking 10/325 oxcodone 3 times daily as well as 50 mcg of the generic duragesic patch which I change evey 3 days!
the combination has given me my life back in so many ways! The only down side is I have become so dependent on thes drugs and that to me is scary!
I also know that if I am to work I have to do what I have to do!! Pain is a terrible thing to live with at only 32 years of age. It is nice to know that there are others that are going through the same thimg I am. KEEP ON KEEPIN ON!!

[Halloween jack]

hello richie how it going me the same bs with the insureance company they really dont want to pay for my meds but i really dont want to live with back pain either but i do so must they any way i was takeing 6 10mg of oxcodone but now down to 4 a day and was on 100 mcg fentanyl patch but now down to 75 thanks to the insureance company talk to my doc witch is a ganst the law to do so my atty let them know this state fund ins is a bunch of jerks if i could give them my pain i would ....any way nice to hear from a fellow pain guy and knows what it is just to try to have some what of a normal happy life latter starman

[Rob]

Happy to have found this board. I was just Rx'd a 30 day supply of the 25 mcg transdermal patch of Fentanyl. I've been a back back patient for approx 17 yrs now (I'm 43) & was diagnosed in 90' w/degenerative disc disease at 3 levels...L3 (25% gone) L4 (50%) & L5 (75% gone) & this was in 90' so I know they've regressed since then.

I was a Teaching Tennis Pro who also played competitvely for approx 14 yrs...a few of those yrs were on the semi-pro Open Circuit. My back diagnosis was of course the reason I had to quit all sports cold turkey back in 90....so I went from a full throttle athlete to pretty much a couch potato overnight. I did of course deal w/a fair dose of depression for the 1st yr or 2 following my diagnosis but have been over all that now for many yrs & have come to accept this for what it is.

I get 1-2 epidurals a yr which give me some relief for a few months at best. Lately though I find that I'm not gettin the results from these injections (at L5 & L4) that I once did. I've been taking approx six (three 2 x's a day) 5/500 vicodeine's a day now for a few yrs & find that I'm needing to go to 9 a day...which I do not want to do. So my Dr Rx'd the Fetnanyl patch today to take in conjuction w/the 6 vicodeine's a day. The hope is that w/the patch I should be able to take less vicodeine's per day. My liver test came back well w/in the normal range so I know I'm still under the radar as far as the vicodene goes but of course do not wish to take more than 6/day.

So my main concern is this....I am a full time stay at home w/my 2 daughters (5 yrs & 18 mos) & need to stay alert & on the ball at all times. I've been reading lotza warnings & such w/re to the fentanyl patch & how potent it is. I'm just wondering if this is something someone should be taking while caring for a 5 & 1.5 yr old? I surely wouldn't want to be taking my kids to a childcare provider that I knew was on the patch so this is my dilemma.

On the other hand I trust my Dr & he does know of my situation so I guess he feels it's OK. I was just curious to see what Brain, Jack or anyone else has to say on the matter.

Sorry for the ramble....I just wanted to provide as much background info as I could.

Thanks in advance!!

Rob
Nor Cal.

[Halloween jack]

hello rob i can tell you you feel it at 1st but after aweek or so you will adjust but you will have to watch your vicdone intake as im sure that will help you be more sleppy i my self take a 75 mcg patch was on 1000mcg but insance company had a talk w/my doc and things changed after that but i also take 4-6 oxcodone a day for break tru pain and i still work around saws and knifes meat dept in groc store and drive with no problem im sure if some cop ran a test i would be intox driveing under infueance of narcot but i have been stop once for speeding for some reason i like driveing fast oh well and he just gave me a waring so he did not do a surch my car or me or he would have found my drugs fentanyl and oxcodone and vic and hand gun but i have a permit to carry any way good luck to you i also am 48 years old and have worked 31 years on same job latter starman....

[tamadrummer]

Rob,

If you have been taking opioid meds for 19 years, than the 25 mcg/hr patch will not affect your disposition with the kids. I am also a stay at home father with a 16 month old, the continuous med allows me to be a better father. You wont be wondering "gee I am in pain is it time for more pills?"

I am just about free of breakthrough medicine. I can take it 2xs a day if needed but many times I simply do not need it because I am well controlled with the patch. There are days that I am super active and need 3 doses so it all makes up for itself in the end.

Personally I would not hesitate to take the patch. It will be life changing as long as it is used as prescribed.

Good Luck,
Brian

[Rob]

Thanks for the replies guys. I just now have a moment to sit down at the computer as the 5 yr old (well she really turns 5 on 4/5) is @ preschool & the 18 monther is nappin so it's my break time for the day.

1st off I should say that I have not been on a steady dose of vico's for 19 yrs...more like 5 yrs & before that it was approx 2-3 days a week & 2-4 tabs on those days. But I think I understand the point of having built up enough tolerance...even if it's only been 5 yrs on vico's @ approx 5-6 per day.

Here's what I did....I took my usual 3 vico's this AM upon waking up. I was in more pain than usual as L5 is twingin w/the sharp consistent pain so I know I'm at the stage where I gotta be real careful w/what I do or else I'll surely lock-up & spasm out..then I'm really screwed. Approx 2.5 hrs after takin the 3 vico's I put the patch on....after reading both of your replies to me I felt more confident that it would most likely be OK....which it has been. The patch has now been on for 2 hrs now & I think I began feeling the initial effects after approx 30 mins. The good news is I surely don't feel the need at this point for my typical 2nd rd of 3 vico's right about now as the patch seems to be doin it's thing. Hopefully I wont need the next 3 vico's at all today but I'm not so sure quite yet...of course I'll play that by ear.

So again, thanks for the help & support. I've bookmarked this site & will surely visit often & contribute as much & where I can.

& Brian, your lil 1 is a cutie indeed....thx for sharing. When I find some more time I'll try & put up a pic of both my pride 'n joys, Haley & Jamie.

Rob

[Rob]

3rd attempt at a post...1st one never made it up....I saw that my 2nd attempt made it up right away & now for some reason it's gone...so now I'm gonna try w/my firewall off...tho my firewall was on last night & I posted w/out any probs....Hmmm?? This time I am copying & pasting the text & will save it in case it doesn't make it up yet again.

Thanks for the replies guys. 1st off I should say that I have not been takin vico's for 19 yrs now. I've been taking approx 5-6 a day for about 5 yrs now. Before that it was more like 2-3 days a week & 2-4 tabs on those days. But I think I understand the point being made that I've built up enough tolerance over the last 5 yrs so I should be OK. So here's what I've done after reading both your relpies this AM. Upon waking up I found myself to be in more pain than usual as L5 was twingin w/the consistent sharp pain...so I took my usual 3 AM vicos fairly early...before 9. I know I'm at the stage where I gotta be real careful with whatever I do or I'll surely spasm out & lock-up..then I'm really up a creek.

Approx 2.5 hrs after taking the 3 vico's I put the patch on as I felt more confident after reading both of your replies. Approx 30 mins later I began to feel the initial effects of the patch. It's been 2.5 hrs now since I put the patch on & feel no need at this point for the usual 3 more vico's on the day. Good deal indeed. I'm not sure if I'll need those 3 more later on but of course I'll play that by ear...hopefully not of course.

I've bookmarked this site & will surely try to visit on a daily basis whenever I can. I'll also do my best to contribute whenever & wherever I can. Though from the looks of the experts around here I'll most likely only be able to offer "color" commentary...lol Or just relay my own experiences should someone be bored enough to actually wanna hear'em...lol

& Brain, your lil 1 is a cutie indeed....thx for sharing. When I find more time I'll try to officially join & post a pic of my 2 Pride 'n Joy's...Haley & Jamie.

Thanks again for the help & support, it is truly appreciated.

Best of health & happiness to all.

Rob

[Rob]

Well wadda ya know...now I've posted 2 x's...apologies....guess the server was a lil slow earlier. Next time I'll be more patient & wait several mins prior to trying a repost.

Rob

[tamadrummer]

Rob wrote:

Well wadda ya know...now I've posted 2 x's...apologies....guess the server was a lil slow earlier. Next time I'll be more patient & wait several mins prior to trying a repost.
Rob

Well that is great news Rob. Remember that now you are on a long acting medicine and so the need to take the vicodan may not be necessary at all. You will have to be the judge of that. Remember the definition of break through is that it is not scheduled but a spontaneous pain that is excruciating and so your dose of vicodan even when needed should be the lowest dose possible. One tablet max at first for as long as that works.

Congrats on the job, there are very few of us daddy home makers out there but we can do just as good of a job as our counter parts. My wife is just a total career woman and I still need to finish 2 years of school.

Keep in touch,
Brian

[brightstarlites]

Rob wrote:

Well wadda ya know...now I've posted 2 x's...apologies....guess the server was a lil slow earlier. Next time I'll be more patient & wait several mins prior to trying a repost.
Rob

Hello Starman, Brian and Rob, I hope all is going well for you! I am glad to hear you tried the patches and they are working for you Rob. I had been on vicodin and was afraid to try something different too. These guays on here have been on the patches and in terrible pain, so they were a great help for me at least trying the patches, I was a little more than frightened of all the negative stuff I had heard about them. I had the patches for a week and didn't use them until I found this site,(thanks again guys!), when I did try them I was amazed at the pain control I could get from them. I will probably never be completely out of pain, but the pain level is so much better. I also tried the loratab 5/500 instead of the vicodin. They are almost the same, but the difference was so much better. Wehn I first tried the patches I felt kinda tired and a little in the clouds. It wore off quickly and now I just feel normal, I have been on the patches since December. I saw my doctor again today and again I thanked him for giving me back my life, I can curl my hair (sounds simple but with 2 bad shoulders it was ot possible) walk, and do so much more. I told him my only fear is coming off the medicine and being in pain again. He assured me he was was happy the meds were working and he wouldn't let that happen. These patches have been life altering for me. They may not be for everyone, but for the people they help who are in pain, they are wonderful. The things you probably already know are these..don't put heat around the patch, always especially with little children, fold them and flush them down the toilet, I always make sure they are flushed too, and keep them way out of reach of the children or anyone else, don't borrow them to anyone. and if you use the kind with the gel, which I don't prefer, make sure the inside liner is not torn. Well, there is probably more, but be safe and I am so glad they help! All the best to you and my guys...brightstar

[tamadrummer]

brightstarlites wrote:

<quoted text>
Hello Starman, Brian and Rob, I hope all is going well for you! I am glad to hear you tried the patches and they are working for you Rob. I had been on vicodin and was afraid to try something different too. These guays on here have been on the patches and in terrible pain, so they were a great help for me at least trying the patches, I was a little more than frightened of all the negative stuff I had heard about them. I had the patches for a week and didn't use them until I found this site,(thanks again guys!), when I did try them I was amazed at the pain control I could get from them. I will probably never be completely out of pain, but the pain level is so much better. I also tried the loratab 5/500 instead of the vicodin. They are almost the same, but the difference was so much better. Wehn I first tried the patches I felt kinda tired and a little in the clouds. It wore off quickly and now I just feel normal, I have been on the patches since December. I saw my doctor again today and again I thanked him for giving me back my life, I can curl my hair (sounds simple but with 2 bad shoulders it was ot possible) walk, and do so much more. I told him my only fear is coming off the medicine and being in pain again. He assured me he was was happy the meds were working and he wouldn't let that happen. These patches have been life altering for me. They may not be for everyone, but for the people they help who are in pain, they are wonderful. The things you probably already know are these..don't put heat around the patch, always especially with little children, fold them and flush them down the toilet, I always make sure they are flushed too, and keep them way out of reach of the children or anyone else, don't borrow them to anyone. and if you use the kind with the gel, which I don't prefer, make sure the inside liner is not torn. Well, there is probably more, but be safe and I am so glad they help! All the best to you and my guys...brightstar

Hiya Starlites,

Its good to hear from you again. Glad all is well with you and that you are doing even better than expected. Have you found that you are getting less help with the patch yet or is the 25 mcg/hr still as effective as it was?

It took me about 6 months and I ended up moving up to the 50 and then about 6 more months to go up to the 75 but I have been steady on the 75 for about 9 months now and I don't feel that I will need to go up anytime in the near future. In fact I think I am going to go in next month and see if we can half the power of my break through medicine since I am feeling less pain and using much less break through.

(About 3 or 4 months ago I began to use the BT med as that, not scheduled medicine but truly as BT and it has changed the scope of my medicine. I only take it when things are super bad otherwise, I don't use it and sometimes I have been able to go 2 or more days without a BT incident.)

[brightstarlites]

Thanks so much for the hello! I am doing well, I am stillon the 25mg, every 2 or 3 days. If I take the bt meds a little more I can change the patch every 3 days, if I take it less it is every 2 days. I really take so much less of the bt meds. Within days of taking the patch my bt meds dropped from every 4 to 6 hours (usually waiting for the 4ht hour to come in pain) to every 8 hours. Now I take about 2 tabs a day, on a bad day 3. I think if I went to a 50 patch I could probably drop even lower, but I am comfortable right now so I will wait until I really need to. Not having to go pill to pill has been so liberating! I knew, but I didn't realize how much my life was so controlled by the pain, living day to day my thoughts would end each night with 'God give me the strength to do this another day'. Now they end with 'thank you Lord for another day that not only pain, but the joy of living each day is possible'. Only those who have walked in the heavy shoes of chronic pain can truely understand what a blessing that is.....all the best, brightstarlites