OKay, i dont wanna take oxycontin anymore the reason for this is so i can use it again in the future if i need to since my nerve damage isnt going to fix itself..
So on to another question, i was on fentynal a long time ago and it didnt go along with me very well since it was before i had such a high opiate dependency and i just didnt like the tired feeling and being groggy since i own a repair shop i cant be all messed up all day so he put me back on the oxycodone... but when i was on the fentynal i had some oxycodone for breakthrough pain.
So are you saying if i am taking methadone i cant take any oxycodone for breakthrough pain?
I have a very good relationship with my doctor, ive had HIV for 28 years, since i was born, and hes been treating me for like 15 years i dont hide anything from him, he is awesome. The whole reason for t his is because i asked to get off oxycontin i hate it. But i think now with my tolerance the fentynal would probably work pretty good.
Hes not treating me for addiction i am hardly a drug addict, i cant stand "being high" or "messed up" in any way shape or form, from all the medications ive taken throughout the years has caused me nerve damage in my legs and its killer just to walk around the store. I work very hard though and i need some kind of pain relief to be on my feet all day. I totally dispise drugs and people that abuse them. They make life hard for people with real pain problems .
When i asked him about suboxone he siad if i took that i would have acute withdrawals i need to get my dosage way way down before i could take suboxone.
Thanks a bunch.
Ryan
edited/please do not go around the word filters to drop the F bomb.
your gonna need alot alot of methadone if you take 500 mgs. daily
Def. try to talk him into going with fentanyl. Ive been on it for 2 years now and it really is a miracle drug. hardly any side effects compared to methadone or even oxy..Take care
Ray
...that's alot of oxy to convert to methadone. If you don't like "feeling messed up," the ammount of methadone you are going to require is going to be very unpleasant. It's tendency to accumulate b/c of the extreme half/life produces cumulitave effects when repeatedly dosed. Btw, you don't have any kind of heart problems, do you?
Only info I have on a conversion is as follows :
40mg of Oxy ER q. 12 hrs. = approx. 10-20mg methadone q. 6-8 hrs.
So you'll be up there dose wise if you choose to go that route. I would avoid it, strictly due to the terrible PROTRACTED withdrawal syndrome.
Are you a cantidate for Fentanyl? What about Oxymorphone? You've got other options...
I was once on methadone for p.m.It worked real well for me.
Methadone was originally developed for pain not for treating addiction. I believe it to be a great pain med ecspecially if you have nerve pain. Methadone not only reacts on opioid receptors but also on NMDA receptors which helps with nerve pain. Whats cool about methadone is that not only are you not in pain once you get your dose tailored but you arent watching the clock timing out your next dose of oxy. You also dont wake up in withdrawals since the half life is so long. Even at low doses once you get established with a steady level in your system you will notice some daytime tiredness brought on by your dose but nothing too extreme. Oh another good thing is that you can take BT meds while on methadone. When you take methadone for pain management its broken up into 2-4 or more doses per day so it doesnt build up this huge wall that other opiates cant get over like when you take a large once daily dose like with addiction treatment. One final good thing is if you are a constant over taker of your pills, methadone can be a great deterant for this since if you take too much methadone too quickly without building up a tolerance to it you will OD, it doesnt matter if you already have a tolerance to other opiates.
Thanks for all the info, im going to discuss all of this with my dr today and i see my pain dr tomorrow...
I take my oxys as prescribed i dont take more than im supposed to in a day, which is why i am in so much pain now and trying to get off the oxys. Over the last year hes just increased them and increased them and i had no idea what i was getting into. But obviously we cant just keep increasing them. Taking drugs kinda scares the heck out of me and what ive read about methadone and how complex it is and hard to figure out a good dosage is just scary to me.
All of this info is very helpfull to me so i thank you all!
One last thing, what are BT meds?
Ryan
BT= break through pain
in regards can i take oxycodone for bt pain is I prescripted methadone.
now this is nt fact
one of my 1st cousins told me yes that, the oxycodone would give You pain relieve, but no eurphoric feelings, but as You said You don t want be Messed up.
this is secondhand information an maybe We have another poster chime in regards to this question.
Woodstock
I know 2 people that went from oxycontin to Methadone in high doses. They both say it is the best pain relief they ever had, they didn't feel high, they had lots of energy, and they could take bt meds but didn't need them. They both said if you think you are going off your meds ever, it is EXTREMELY hard to taper off. I know that is one thing that scares people from taking it - the idea of possibly having to withdraw from it someday. I have also read on many sites that it is a great pain med. You are young though to take something so difficult to withdraw from. I would definitely discuss that aspect with my doc. Just my 2 cents!
The doc put me on fentynal today, im going to start it monday.. he said i should have a 75mc patch but started low with a 50 because i still have my oxyIR if i need it... He said its going to be kinda tough to switch over though because you dont want to risk having an overlap of oxycontin and fentynal so there might be a period of withdrawals and if that happens take some oxyIR.
the patches i got are teva are those any good? any advice on where to put em ?
When i used to take them i would get all freaked out if it wrinkled or something or got gaffed up i would think it was gonna release too fast and kill me. I am super paranoid about putting drugs in my body so any advice on this would be appreciated.
Ryan
Get the Mylan brand Fent patchs,they stick berret, and they dont contian gel, so there is no chance of leakage. They have done gret for me. Most bigger chain phars wont order what you want, sou might fing a mom and pop for your controlled stuff. That's what I did and they oreder whatever brand I want. Best of luck. By the wasy, if you dont mind me asking..what meds are you on for HIV adnwhat were your last VL and CD4 counts. I take Trizivir and Viread and my last VL was undetectable (yeah for triz and viread). Here is a a complete list of meds Im on. Most of these are PRN...I know it looks like alto to most people, but I'm sure Ryan will understand. Here is the completer list:
Current prescriptions as of:10/22/09
Current Medications as of 10.22.09
Ray
1) Trizivir- (1) one tablet twice a day
2) Viread-(1) one tablet each night
3) Phenergan 25mg-(1) one tablet as needed for nausea
4) Compazine 10 mg-(1) one tablet as needed for nausea
5) Effexor XR 75mg - (3) three capsules each morning
6) Lortab 10/500-(1) one tablet three (3) times a day
7) Fentanyl 100mcg-Place (1) one patch every 48 hours
8) Xanax 1mg- (1) one tablet three times a day
9) Trazodone 100mg- (1) one to (3) three tablets at bedtime
10) Protonix 40mg- (1) one tablet twice a day
11) Ranitidine (Zantac) 150mg-(1) one tablet as needed
12) Lisinopril 10mg- (1) one tablet each morning
13) Flexeril 10mg- (1) one tablet as needed
14) Benzonatate 100mg- (1) one gel cap as needed
15) Evoxac 30mg- (1) one capsule three times a day
16) Hyoscyamine .125mg- (1) one tablet as needed
Hope this helps..Ray(edited to remove surname)
Yeah, Mylan are the best patches or name brand Duragesic, they too use the silicone matrix now. It all depends on the Pharmacy or Pharmacist. Target will not order anything special for you, in fact the pharmacist has zero controll over which brands are sent unless its name brand "dispense as written" rx. I have had pharmacists at CVS and Walgreens order in specific generics for me or just plain start using the generic I want because others do not care. Then other large chains will tell you they have what they have.
Ray, whats CD4? Im assuming VL is referring to viral load.
&??$ i already opened the box i will go monday and ask flor the mylan ones my pharmacist is very good to me..
I dont take any HIV meds, i think they are poison and cause more harm than good.
If i took them when i was younger when i found out i was sick, i would be dead like everyone else...
I always goofed off when i took meds, never really stuck with it... ive been on everything under the sun, but regret it ... its the reason i am in so much pain....
the only meds i take are oxycontin, and oxycodone....... Switching to fentynal next week.....
Ive had single digit t-cells for quite a long time, and like 100,000+ viral load i dont know exactly, i dont really care either....
they are just numbers on a paper to me they dont really mean much to me.
I am like the longest living survivor turning 28 next month.... i must be doing something right.
Ryan
Oh, on where to put them. Im surprised the pharmacist didnt go over that with you. By your pic you look like a thin guy so it may not matter much. The best place to put it to get the most effect out of the fentanyl is usually the stomach or side/love handle. Thats because fat absorbs the fentanyl kind of like a little resivoir and the body uses it from there, to put it very simple. Depending on how well it sticks on you, seeing that you are an active guy, I find that the top of my arm, where you would often get a shot is a good place. The directions say not to put anything over the patch, because they dont want extra heat building up since that makes the patch release fentanyl at faster rate. However the really thin bandages like tegaderm or 3M tape can be used to hold it in place. I do notice a big difference in effectiveness when used on my stomach versus my arm, due to the extra lbs I put on after becoming a CP; getting less exercise and having late night OC sugar cravings. Be sure to avoid excessively long hot showers, hot tubs, heating pads, heating blankets, heated water beds and pay attention if you ever have a fever. Like I said, extra heat can cause extra fentanyl to be released, possibly a lethal amount if you were to fall asleep on a heating pad or something like that. Good luck, I hope they work as well for you as they do for me.
a lag time btwn the time the patch is initially applied, and when it reaches steady state. Additionally, once the patch is removed, you are still absorbing (some) active ingredient.
As for asking for Mylan, once that box changes hands at the pharmacy, and is opened, it is illegal for the pharmacy to accept it back, as a trade or otherwise. Sorry. I'm quite sure the Teva's will suffice for the time being.
Good luck to you Ryan.
P.S. Ray- sounds like your're not doin' too bad yourself! (VL) Good news my friend!
was supposed to switch today to fentynal but too much anxiety from it i backed out. Maybe ill start it tomorrow.
gooing to get the tegaderm tomorrow and hopefully give it a shot. Im very anxious about how its going to make me feel .
I have alot of work scheduled this week and cant afford being sick or 'high'
Ryan
Hey Ryan, I hope the Fentanyl does the trick for you. Sometimes a pharmacy will take the patches back since they're individually wrapped. The Wallgreen's here In Santa Fe did for me once. Yeah, you can't beat the Mylans, that's all I can use.
I'm now taking Fentora 400mcg for BTP, it has an onset of 5-10 minutes, peak at 30-40. Awesome for the type of BTP that my cancer brings on. It's expensive as all get out though, $3,890 for #120 of the 400 mcg tablets, if your HI covers it then it's worth a try . . . Q
PS: Fentanyl does not get you high!!!! That's why I love it, I can't stand the fuzz-head that others refer to as "euphoria". Don't worry about it, OK?
Be mindful with the patches. Someone here had a patch fall off while they were on vacation and lost it. They put another one on immediately and managed to get very ill and started vomiting. Started to overdose.
10/28/2009
Please note that what I wrote was second hand information and may not be accurate. I got it off of another post here from someone else, not me, who wrote it. This is highly unlikely to happen to you if you need to replace a patch for some reason. So please take it with a grain of salt. As always every substance will treat everyone differently; so as always YOUR MILAGE MAY VARY!
I remember that post. It does not make sense. I have had patches to fall off and immediately put another patch on. That is what you are suppose to do. I make sure I find the patch that fell off. I think the poster started going thru W/Ds. She also didn't wear the patch at night?! Some people don't understand that FTD is for around the clock pain control, not a prn med. To repeat myself, if a patch falls off you are suppose to put another one on. Just make sure the patch did fall off and isn't some where on your body (feet). Htmom
Do you notice the effectiveness to wear off after two days or so? Some doctors will prescribe the patches for 48 hours because of this. Ultimately it is up to the insurance company to authorize that dosing since they are suppose to be worn for three days.
My feelings exactly htmom! I was trying to post exactly what you said last night but started having problems with my broadband wireless card. Not to discredit Tacet or anything, but my doctor has always said to apply another patch should one come off, but just try not to have it happen too often in regards to supply. How could it over dose you when the new patch would release fentanyl at the same rate unless the old patch was nearing the 72 hour mark in which case it would be time for a new one anyways. I find that the patch goes dead at around 2.5 days and get in rx'ed Q48H, and it does require a PER.
Im curious as well to see how long the patch lasts for him. I wonder if it has anything to do with body heat, or what climate area a person is in as to how long it lasts. If extra heat makes the patch release fentanyl at a faster rate then it stands to reason that my body could be warmer under the sunny west coast sky & could be making my patch release fentanyl faster than someone in colder climates?? Or it could just be metabolism or personal response to fentanyl, what do you think?
Ok i just stuck my first patch on, i covered it with a 3m tegaderm, the tegaderm is sticky even in the middle is that okay ?
it says in the instructions only to cover with some bioclusive thing and nothing else, but the clear tegaderm is okay right?
Also the pamphlet it comes with has a conversion chart and only goes up to 200mg daily oxycodone = 100mcg patch.....
i take 450mg of oxycodone, and my doc started me on a 50mcg patch.... so if 200 = 100mcg patch, then i need 200mcg how is 50 going to cover me.... this is rough....
Ryan
Brandon my wireless card went out last week! Hopefully I'll get my laptop back by tomorrow, my desktop is down also. For me, if I'm less active, my patch does not last 72 hrs. Ryan it is okay to use tegaderm over the entire patch. I have been on FTD for almost 3 years. I also was not trying to argue with Tacet, but remember the crazy post he is talking about. Htmom
i had the patch on for about 40 minutes and i was having too much anxiety i ripped the thing off... this is really hard for me to deal with.
How much could have gotten released in the 40 minutes it was on ?
I took it off and that thing was on there gooood real good and washed the area with soap and water now im just confused and dont know what the heck to do. i was like having a panic attack i had to take it off.
Ryan
I'm not sure how much Fentanyl could have been released in that short time. I would not try to put the one you took off back on. I know starting a new med can be stressful. Maybe you need to call your dr about the anxiety you are having over FTD. If you keep taking them off, you are not going to have any to use when you or if you decide to use them. Even though most of us prefer Mylan, what you have will be okay. If you have any questions, I'm on 75 mcg. Take care,htmom
well the thing was stuck on reallllly reallly good it practicly tore my skin off and it was the patch not the tegaderm that stuck so good.
I have oxys to get me through but i just dont know how much got absorbed into me , and i washed with soap and water and then read dont use soap....
this is so stressfull for me :( and because the conversion chart shows the 50 only covers a quarter of the oxys that i take every day so obviously i'm going to have withdrawals....
Then i read about all the fentynal deaths and defective patches and such, this whole thing is just too much for me i cant handle this :(
The idea of having 3 days worth of drugs on me at one time is too much to handle.
and now i just dont know what to do because i dont know if the fentynal got into me .
isn't enough time for it to get in your system ryan. when i was on them my dr told me it took 8-10 hours to start getting absorbed so i'm sure you didn't get any. i found it alot better than taking pills all the time with fine results getting rid of pain, good luck,,~~
Ryan, sounds like you may need to address your anxiety issues. You are in the titration stage, yes you probably need a much larger dose than you are on, but a reasonable titration is necessary. After 3 days you will have a steady rate of absorbtion and if your pain is not controlled, take the oxy as your doctor told you to cover the transition and call him. I can almost guarantee you that he will tell you to come pick up a new script for a higher dose. Properly dispose of the patches you have now and start on the new strength. Depending on the doctor and how you handle the fentanyl, this may happen several times until you get proper pain relief. When you are on long term pain management you want to take the lowest dose possible to allow you to function, that way you have room to titrate up over the course of time. A big concern doctors have when you get up in dosage is that it will be very difficult to control your pain in a hospital setting should you get hurt and or need surgery. Ive heard of people needing up to twice the standard maximum dose of morphine or dilaudid after surgery to get adequate pain relief. Relax, starting at the 50mcg patch is not a terrible thing, and the oxy is your security blanket. Also if you were not able to trade patches and still have the gel filled patches, there is no reason to worry unless you tear the patch which is very uncommon, you'll be fine. Even if you were to tear the patch I dont think 50mcg is going to OD you right then and there given the dose of oxy you are/were on. Just for a comparison, Actiq, a fentanyl medication for break thru pain that is absorbed instantly into the mucosal lining of your cheek has the lowest dosage of 200mcg. Some CBT, cognative bevioral therapy might give you some strategies for controlling your anxiety, or possibly an anxiolytic as well.
Good luck, let us know how you are doing. Fentanyl is a great medication that is exactly what you are looking for, pain relief without the euphoric side effect. Ride it out and try it to your fullest abillity. If you still do not like it there is Opana you can try or staying on the oxy. Dilaudid is another potent analgesic but is better when used IV or IM as it has poor oral absorbtion. I think its as low as 17% of what you take actually gets absorbed, Im not sure on that one so if that is wrong, anyone feel free to correct me. You can look at the sticky thread Pain Medication Guide at the top of this forum to see some general consenus' of Pharmer members. It a basic FAQ type thread with lots of good basic info with members personal experiences and who to contact on specific medications. I hope everything works out for you!
Going to really have to get that anxiety under control for starters.
Fentanyl is your friend, it really is. It is a life saver for those who use it. Give it a chance. Call your doctor and see what advice he gives you. I'm really sorry you are having this issue with the change of your medicine.
so these teva patches are the ones filled with gel?
another thing to worry about since im so active ... Is it okay when they wrinkle?
...you remind me of myself. Maybe the fentanyl isn't for you yet. Save it for a last resort.
I agree whole heartedly with the other posters; it would be in your best interest to control your anxiety- at this point, it seems to be controlling you (i.e. preventing you from a successful drug trial).
It would seem by your writings that the prospect of the patch concerns you greatly.
Believe me, if you were taking that moderately high dosage of oxycodone, and make a conversion, you will be "covered."
Speak to your doctor about the anxiety and panic, mental anguish is just as bad, if not worse, than physical pain.
Good luck, guy. You'll find the right way to do things, just give it some time.
Duragesic is a better option if you dose multiple times through the day. Instead of taking a bunch of pills all you have to do is wear the patch; beyond taking doses of break-through pain meds.
I suggest not getting on the methadone unless its for a short period of time or if u like it and wanna use for the long run. Main reason being that methadone is notoriously hard to kick and withdrawl last much longer then other opiates so I would ask doctor if theres anyway that you can try either Fentanyl or Opana, or you cuold give the methadone a shot but i know that methadones analgesic properties wear off faster then other opiate painkillers and its withdrawls last longer- its like whats up with that. God bless hope u find relief
...eventually, some of us who are fortunate enough will require end of life analgesia. I certainly wouldn't want to be mega-dosed on fentanyl during a course of palliative care.
Until you get over the anxiety the patch has obviously caused you, you will not benefit from it.
Fentanyl is a great med for many at low to moderate doses, but if you have the option, and only you know the true situation, ask about extended release oral medication. There are many, OxyContin, MS Contin, and Opana. All of the aforementioned medications come in an instant release form as well for BT pain. There is also methadone, which is cheap, and works wonders for nerve pain. At the dose you would require however, it would certainly alter your mental status significantly.
Take everything you read on here, as far as suggestions, (including mine), with a grain of salt.
Don't let anyone railroad you into anything.
Saturated is right, every single post is just a suggestion, and should not determine your decision. Ultimately you know what is best for you, and you can use the suggestions to make an informed decision.
You will not know if the fentanyl will work for you if you dont give it a try. I think you are letting the anxiety build up too much. You havent even put a patch on and you have got yourself worried to death. Your concern for what you put in your body is great, but dont let it cripple you from getting proper analgesia. If you look at your current dose of OxyContin, its enough to do some serious damage to an opioid naive person. You are opioid tolerant and you will likely find with the patch, there is not much to it. You really dont feel it working, you just notice the pain relief. Definitely work on your anxiety issues and keep us updated.
has worked for me for many many years now...I just recently talked to my Doc about changing because I have been on it for so long I am tolerant... What he ended up doing was upping it to 150 mg. a day from 120 mg. and he took away my BT meds....that's not good.
But methadone is good for long acting pain...it is hard to get off of though. So, make sure they increase you enough so that you get enough pain control. Most Docs are a little leary of it and start you out really low...that usually doesn't help much at first so make sure you tell them if it's not helping and they'll increase you..
Let me know if you are on it and if it works for you.
Good Luck,
Rhonda
Thanks everyone, i got over it, did alot of reading and put the patch on, tonight at 8 i have to change it its the third day and im doing okay with the anxiety...
The only problem is that its such a low dose its like not even having it at all..... before the patch i took 240mg oxycontin and 210-270 of oxycodone.... so a 50mc patch according to the conversion chart covers like maybe one of my 80s not even close to the ammount of oxycontin i take, and nevermind the oxyIR.... so its basically like taking nothing at all and like the first day on the patch , i took 330mg of oxyir, which was good, but yesterday was a bad day i was in constant pain i took 530mg of oxyIR with the patch.... so it obviously has to be increased.... i just really do hate having 3 days worth of meds on my body, i dont mind taking more pills so i dont really see a point if alls i'm doing is switching from one narcotic to another one, if taking pills throughout the day doesnt bother me, then why should it bother my docs... at least with the pills i can control how much i take, like i said there are some days where the pain isnt so bad and i will take up to 150mg of oxys less , some days ill need more... it just seems better but anyways thanks for everyones advice and get me over my anxiety of the patch... just because i can deal with the 50, if they up it to 100 or more i dont know if id be able to handle that but well take it as it comes, i see my dr tomorrow. ill keep ya all posted!
thank you!
Ryan
but in your situation it's understandable... The only thing I worry about is that you are already taking one of the highest amounts of narcotics I have ever heard of...so where do you go from here? Did you discuss this with the Dr.'s when you first started down this rollercoaster? They should have known this day would come and had something in place. I mean, there are only so many pain meds you can take without having serious problems. I think that you have hit a wall... have they talked about the Pain Pump? That may be what you have to do next...at least then you could have the dose lowered because it goes directly into the receptors in your spine...and you need less. That way you won't have the same side effects like constipation, the high tolerance, nausea..... Ask if you are even a candidate....I think if anyone is it is YOU....
Good Luck.... And about the Methadone..I think it's worth a try, even if you have to start at a higher dose it still may work better.
Rhonda
I had been on fentanyl 150s when I broke my neck. I could no longer afford my meds and switched to the VA. I asked the doc for fentanyl again and she gave me methadone instead. I have nerve damage and it actually worked, with the fentanyl i was high as ???$* but I still hurt underneath. Now I'm addicted to my methadone and considering switching docs to go back on fentanyl or oxycontin 80s
to clarify the methadone DID work for me and nerve damage
I read the whole thread and see you got the fentanyl. You should really get the jelly Jansens, any of the other I used had matrix absorption that did not work for me since I have no body fat
i think the ones i have have gel they are aveva or teva whatever that is...
I did alot of reading and i think id rather stick with the gel ones, they have a membrane between the reservoir and your skin to limit the rate of drug flow....
I used to take the mylan ones along long time ago before i had opiate tolerance and they were too much for me, and it was basiclly just like a peice of tape and i guess from what i research the drug is in the adhesive and just releases through the adhesive..
I personally would rather have the gel with the membrane in between , if it is broken you would see its physically leaking or something, and i just trust that more than the medication just in the adhesive... i dont like the idea of having 3 days of drugs on my body at once its something ive had trouble getting over so im going to stick with these... thanks for the support, and advice this forum has helped me quite a bit.










Methadone is commonly used for Pain Management. It has, methadone that is, become more accepted amongst Pain Management doctors as an acceptable treatment for chronic pain. Makes a lot of sense really since it has a very long half life and is a full blown antagonist of an opioid. Its just methadone has been the primary substance of choice to treat opiate/opioid addiction since it has such an extremely long half life and blocks other substances that are similar to it so it helps in abuse avoidance.
Truthfully as of late Buprenorphine in Suboxone is a better treatment for addiction than methadone.
So don't "knock" methadone if your physician suggest it. If I were you I would just go along with him and let him give it to you. Depending on your relationship with your doctor, he might see you asking, if you do ask for it that is, for oxycontin as drug seeking. Again that is if he views it that way.
Give it a try.