Switching from Oxycontin to Fentanyl Patch

[Need an Answer]

I will be switching to the patch but I am confused about the dosage conversion.

If you put in 160mg oxycodone to convert to fent, it will tell you approx. 80mcg, but it asks for the daily total.

Well the daily total is 480mg because I have to take it thrice daily in order to maintain blood plasma concentration at 160mg

So when I type in 480 then it triples the fentanyl amount.

I am confused.

The patches are meant to maintain a certain level, so if I take 100mcg, I am on 100mcg all day, if Oxycontin lasted 3 days like the patch then my dose would simply be 160mg.

Since 180mg = 80mcg of fentanyl, wouldnt that stay the same, even though I have to re-dose the 160mg OC 3 times a day?

[Need an Answer]

sorry typo..

Since 160mg OC = 80mcg fent....

[MSO4]

Need an Answer wrote:

I will be switching to the patch but I am confused about the dosage conversion.
If you put in 160mg oxycodone to convert to fent, it will tell you approx. 80mcg, but it asks for the daily total.
Well the daily total is 480mg because I have to take it thrice daily in order to maintain blood plasma concentration at 160mg
So when I type in 480 then it triples the fentanyl amount.
I am confused.
The patches are meant to maintain a certain level, so if I take 100mcg, I am on 100mcg all day, if Oxycontin lasted 3 days like the patch then my dose would simply be 160mg.
Since 180mg = 80mcg of fentanyl, wouldnt that stay the same, even though I have to re-dose the 160mg OC 3 times a day?

Hmmmm.....There is a guy who works at CVS. He is a Pharmacist. I would start there.

[fallen eden]

Thanks for such a retarded comment dude.

(Pharmacists are very bad at this kind of thing by the way. I have lots of experience with this exact problem.)

So you take the 160mg pills 3x a day? The conversion caculators do use the total daily dose to convert to Duragesic; it's tricky because OCs are designed to last for 8-12 hours, whereas the fentanyl patch is a timed delivery system over 2-3 days.. so that makes the calculation a little weird. Just from experience, I can tell you that you'd need to switch to at least 200mcg of fentanyl (two 100mcg patches).

When I put it in the calculator I use (here: http://www.globalrph.com/fent.cgi ), it tells me 246.6mcg/hr fentanyl. I've noticed that converting OCs to fentanyl is usually somewhere close to half the dose of oxycodone. You could round 246mcg/hr to either 250mcg/hr (two 100mcg patches plus a 50mcg patch) or 225mcg/hr (two 100mcg patches plus a 25mcg patch). I switched from 240mcg OC a day to 100mcg/hr fentanyl and it was just about right, but not quite so that I needed 20mg OC about 2x a day on top of it. Also, a lot of people notice that they need to change their patch every 2 days instead of every 3 days (me included), so just watch out for that problem. If you get a generic brand, be sure to get the Sandoz brand rather than the Mylan brand because the Mylan patches are pretty well known to not work as well. Hope this helps you out!

[MSO4]

fallen eden wrote:

Thanks for such a retarded comment dude.
(!

Yep, I can see how asking a trained and educated pharmacist is not nearly as wise as asking you and your web based calculator. lol That is truly some funny sh*t slick.

[fallen eden]

Excuse me, have you ever dealt with pharmacists on conversions like this, especially a difficult one like fentanyl? Their most common answer is, "Uh.. um.. That's something your doctor should look at." Pharmacists have very minimal training- they're a reason they're not MDs, you know.. I know about how incompetent pharmacists have been; I went through this EXACT same transition from Oxycontin to Duragesic and had a hell of a lot of problems until I did my own research using opioid conversion calculators (specifically the fentanyl calculator). Their calculations are based on the manufacturer package inserts you'll find inside Duragesic prescriptions, which I happen to have inside my Duragesic prescription box at the moment- they have a long section describing conversions from morphine to fentanyl, oxycodone to fentanyl, dilaudid to fentanyl, plus pretty much everything else. Since all the information and dosages I find inside my prescription insert are identical to the information provided next to the online calculator, I see no reason why the conversion calculator could be inaccurate. Plus, I used this calculator to help myself switch to Duragesic and it's recommended dosing was almost exactly correct for me, so I had minimal problems switching over to the patch.

It sounds like you just want to make fun of people asking very legitimate questions, especially a question like this, and I will certainly call that retarded.

[MSO4]

fallen eden wrote:

Pharmacists have very minimal training- they're a reason they're not MDs, you know.. I know about how incompetent pharmacists have been;

Yeah, they only have a minimum of 4 years of diverse education and clinical studies. But please expect everyone to trust you and your trusty web based calculator. lol

[stoner]

the best i can figure is that 100mcg/hr patch is the daily equivilant to 360 mgs oral morphine which is equivilant to 180 mgs of OC. This is determined via utilizing the figures in the Duragesic insert. So, about 250mcg/hr should be equal to your daily dose of 480mg OC. of course these are guidelines and any md worth his salt will start you under this dosage suggestion and let you work up. Just try and not let the md make youi wait 30 days before adjusting up. one week at your new level should be adequate..
PS, be thankfull you can even perseude those md guardians of the goddess opioids pain killing properties to allow you their usage. i know many a wealthy business man that pay $200 a 100mcg patch and $100 for a 50mcg on the street.

[hmmm]

actually pharmacists are required to get their doctorates. 6 years minimum, most take 7 or more. So they are just a few semesters short of matching Md's time in school. don't be a retard about professions you know nothing about.

[Giveit abreak]

I know dumb ass doctors and dumb ass pharmacists. Take you information from as many sources as you can find and find the common ground. I don't understand the rude comments unless they are young writers or immature.

[Concerned Lady Andrea]

I have been switched from OC ER to the Fentanyl Patch and I am only on the second day and in a lot of pain already. I only switched because the generic of OC generic is no longer being manufactured and I can't my insurance doesn't cover the name brand. Now I was taking a total of 360 a day and my MD started me on the Fentanyl Patch of 50mcg and honestly I am in a lot of Pain right now and can't do anything about it for another 5 days til I see the MD so if someone can give me some input on this I would appreciate it.
Grateful,Lady Andrea

[Max]

I have extreme back pain. Dr. prescribed fentanyl patches. I started with 50 but didn't help. Was told to use 2 (100). It makes me feel lightheaded and seems like it only lasts 48 hrs not 72. Could anyone tell me if they are experiencing the same effects and if these patches are lasting 3 days. Thanks

[Concerned Lady Andrea]

I am taking my first 50 patch for the last 5 days and the pain is not being controlled and it only lasts for 2 days at the most . By the middle of the second day I am in serious pain.
Concerned Lady Andrea

[MSO4]

Concerned Lady Andrea wrote:

I am taking my first 50 patch for the last 5 days and the pain is not being controlled and it only lasts for 2 days at the most . By the middle of the second day I am in serious pain.
Concerned Lady Andrea

Go a couple of days without, and you will see that it really was helping. BTW, those patches are not nearly done in 1.5 days.

[Concerned Lady Andrea]

MAX, I saw my doctor on Tuesday , Oct. 6th, and he told me to change the patch first thing on the 3rd day. I am not having those side effects except on the first day and if I get really, really hot. But my pain has gotten better since he put me on a 100mcg patch. Hope this was helpful.
Lady Andrea

[Cecil Sensei]

fallen eden wrote:

Excuse me, have you ever dealt with pharmacists on conversions like this, especially a difficult one like fentanyl? Their most common answer is, "Uh.. um.. That's something your doctor should look at." Pharmacists have very minimal training- they're a reason they're not MDs, you know.. I know about how incompetent pharmacists have been; I went through this EXACT same transition from Oxycontin to Duragesic and had a hell of a lot of problems until I did my own research using opioid conversion calculators (specifically the fentanyl calculator). Their calculations are based on the manufacturer package inserts you'll find inside Duragesic prescriptions, which I happen to have inside my Duragesic prescription box at the moment- they have a long section describing conversions from morphine to fentanyl, oxycodone to fentanyl, dilaudid to fentanyl, plus pretty much everything else. Since all the information and dosages I find inside my prescription insert are identical to the information provided next to the online calculator, I see no reason why the conversion calculator could be inaccurate. Plus, I used this calculator to help myself switch to Duragesic and it's recommended dosing was almost exactly correct for me, so I had minimal problems switching over to the patch.
It sounds like you just want to make fun of people asking very legitimate questions, especially a question like this, and I will certainly call that retarded.

I don't know what year you think this is buddy, but try asking a younger, more trained and educated pharmacist and they will answer that question with ease. Pharmacy is now a doctorate degree and you make mention of them not being an MD. That's funny because have done this same conversion at the request of an MD that does not know the proper method. Inform yourself about a career before you generalize and foolishly bash something you clearly are ignorant about.

[Nurse09]

MSO4 wrote:

<quoted text>Yep, I can see how asking a trained and educated pharmacist is not nearly as wise as asking you and your web based calculator. lol That is truly some funny sh*t slick.

Instead of patting yourself on the back DR.PHARMACIST how about contributing to the peoples questions? If you have all the education you are bragging about maybe you can show some empathy (did they teach that in your Doctoral program?) and help these people with their concerns instead of jerking them around?

[Tryingpatchnow]

I am on the Mylan patch now after being on many different narcotics for RSD pain. My latest narcotic I have switched from was Oxycontin 40mg 2x's a day. I am also taking percocet 10/325 4-6 a day for breakthrough pain. My doctor started me with the 25 for 2 weeks and then 50 for a week and now trying the 75's for a week. I know they are working but just not working to well. I get relief after about 24 hours and then I feel I get the relief a few hours and back to pain. I am using alot of the breakthrough medication and also I am trying to stop Methadone that I was taking 35mg's a day. I am now at 20mgs a day since I have been on the patch. I have gradually decreased the methadone so I know the patch is doing something for the pain.

My doctor wants me to call her on Wed. and let her know how the 75's are doing. I think if I had the 100's that maybe I could cut back even more on the methadone. The reason for wanting to stop the methadone is because I have gained weight and sweating alot. I would just like to be off it. I would also hope to be off the percocets with the 100 patch but know that I would need them cause the patches seem to not last to long and take so long to work. That is the only company I can seem to find around here and I have tried two pharmacies so far. My doctor makes you sign a paper saying which pharmacy you will be using, so you cannot keep going back n forth to different ones.

[hopity]

i am in the process of coming off of oxycontin 80mg twice a day and changing to fentyl patch i was told to take my usual dose on applying the first then half dose at night then quarter then none just the patch i cant cope with the side effects so i took 20mg and feel better can anyone suggest an apropriate way of coming off the oxy as i m worried i should have stopped the oxy i am in alot of pain and needing my usual top up but limiting it as much as i can . i wonder what the norm is for changing over

[MSO4]

Nurse09 wrote:

<quoted text> If you have all the education you are bragging about maybe you can show some empathy (did they teach that in your Doctoral program?) and help these people with their concerns instead of jerking them around?

No they did not. Mostly the focus was on healing the patient, not contributing to the disease process, ie addiction.