From Fentanyl to??

[trishtrb]

Is there anyone with advice as to switching from Fentanyl (Duragesic) to something else? I'm in Arizona and its starting to get hot, the patches are beginning to really irritate my skin. I have a doctor's appointment tomorrow and I'm going to ask for a switch. The last (and only time) I switched, I ended up in the ER with withdrawls. That time they switched me to Oxycontin. Even though I immediately switched to another narcotic, I got very sick. Is there anyone that knows what I can switch to without getting sick? I do have medical conditions that require pain control, so my doctor will let me try whatever I ask. So, I ask you, from Fentanyl to ??

[meeka]

While I read the title, I immediately thought oxycontin. But since you get sick while taking this then you may want to try diluadid pills. Or high doses of fast-acting oxycodone every couple hours, considering you must have a huge tolerance from the patches. I myself had to get off the fentanyl for nerve pain for the same reason, it started to really irritate my skin. I switched over to diluadid but I wanted an extended release pill so I went on to oxycontin.

[trishtrb]

Thanks! I tried the generic oxycontin a while back & they said I must be allergic to the fillers, they kept me awake day after day. The doctor just put me on MS Contin, again. It makes me very mean. They said they won't presscibe dilaidid or demerol, even though the patches are pretty potent stuff. I'll try the Duragesic patches in a couple months, in the meantime I'll just have to tough out the MS Contin with the 10/325 percocet. Ugh. Thanks!

[DrMuffy]

First of all SWIdr suggest that both of you read the rules before further posting to avoid any conflicts of self-incrimonation. Also, if SWIY (Someone who isn't you) does not perfer other opiates over fentanyl, maybe he should just stick to fentanyl. If the patches are bothing SWY, there are also the Actiq "Lozenge on a stick". It is basically a lollypop which contains fentanyl, SWIY might want to "google" it or use the forum search engine for more info.

[Psych0naut]

That isn't self-incrimination, they're asking for advice on pain medication for a legal reason, there's nothing illegal about that.
And Actiq is for breakthrough pain, it's way too short acting for 24/7 pain control, you'll be needing heaps of those lollipops just too get through one day, that's why fentanyl was made, to have a slow release fentanyl system.
There are also XR release hydromorphone pills, though SWIM doesn't know if they have those in the U.S. as well, otherwise you could switch too those, so you have an extended release version of hydromorphone instead of MS contins.

[trishtrb]

Thanks PsychOnaught. I thought we were fine. I wish I were able to continue Duragesic, however McDuffy didn't read my post before throwing in his 2 cents. I'm in Arizona and the patches are seriously damaging my skin. After 24 hours it is so irritating that it feels like a loose tooth that must be pulled. When I remove it, my skin has a hige welt under the patch as well as a bloody mark from the adhesive. My doctor put me on the MS Contin for now, but gave me the number for Actiq's Patient Assistance Program as my insurance doesn't cover it. He won't prescribe hydromorphone, for some reason. I may have to ask again. Ugh. I hate switching meds! LEGALLY! I do have several medical issues that require round the clock care. Thanks for the advice!

[DrMuffy]

Originally Posted by Psych0naut

That isn't self-incrimination, they're asking for advice on pain medication for a legal reason, there's nothing illegal about that.

Sorry about that, SWIdr did in fact realize the question was about legally prescribed narcotics, but in his oppinion, its always safer to use SWIM no matter what the topic of drug is. For instance, someone might regret revealing personal information like that to thousands of people online. Plus SWIdr has seen other mods use the same warning for people talking about meds they are prescribed, so he just assumed the same applied here...

Originally Posted by trishtrb

Thanks PsychOnaught. I thought we were fine. I wish I were able to continue Duragesic, however McDuffy didn't read my post before throwing in his 2 cents. I'm in Arizona and the patches are seriously damaging my skin. After 24 hours it is so irritating that it feels like a loose tooth that must be pulled. When I remove it, my skin has a hige welt under the patch as well as a bloody mark from the adhesive. My doctor put me on the MS Contin for now, but gave me the number for Actiq's Patient Assistance Program as my insurance doesn't cover it. He won't prescribe hydromorphone, for some reason. I may have to ask again. Ugh. I hate switching meds! LEGALLY! I do have several medical issues that require round the clock care. Thanks for the advice!

SWIdr did read your post befoe he posted his reply. He noticed you couldn't use the fentanyl patches due to the heat and irration, so he suggested another form of the drug instead. SWIdr now realizes (thanks to Psych0naut) that Antiq's are short-acting, so those are probably out of the question. An extended release form of hydromorphone would probably be best for this situation (as mentioned above). Also if you do not mind me asking, but what condition do you have(Its fine if you would rather not say though)? The reason for my asking is that certain sources/types of pain require different treatments and or different types of medication

[trishtrb]

I have pretty bad scoliosis, also degenerative disk disease, 2 buldging disks, one dissenerated (sp?) disk, arthritis in my spine and chronic myofascal pain. I also have a disk in my neck that is wedged and flattening my spinal cord on one side. Unrelated, I have a kidney stone that adds to the back pain. I think that's it for now. All the meds I take are prescribed by an MD. I have no reason to hide anything, I've already filed for social security disability, so the government is aware of what I take. LOL

[meeka]

Can I also suggest that you may want to consider getting a referral to see a pain management MD in which they have devoted their careers in order to help people become comfortable with medications and possibly physical therapy for desensitizing. And as the pain management docs are mostly all board certified anesthesiologists, they have the ability to perform various nerve blocks, spinal taps, sympathetic nerve blocks, all of which can be done right in their office rather than going to the OR or hospital. I have had at least 2 dozen of these spinal taps, all of which were successful in relieving me of 100% of all my pain for at least 2 weeks. This may seem like a miniscule success but for anyone who has lives with chronic pain of a constant 7 on the 0-10 pain scale will tell you that going from a constant 7 all day/everyday down to zero for two weeks is a huge success. These were the best weeks I have had in a long time! But the main reason I suggest going to a pain management specialist doc is that they will most certainly be willing to try any meds that have been already mentioned by you, myself or the other two responders. They may also want to try various nerve pain meds like Neurontin that may help with your back problems. I was maxed out on 3600 mg/day of Neurontin for nearly two years, it did not have any of the addictive, disrupting side effects that some narcotics when taken improperly. Well, at least for me it didn’t.