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Perocet and Fentyl Resistance over time, any recommendations?I have been on 15mg Perocet (Oxycodone) straight (no acteominphen (sp)) for breakthrough pain, and a regular pain maintenance of 75mg. of Fentyl (Mylan Patches), for about two years now. I find the breakthrough meds not working anymore, the percocet. I am wondering of other have run into this and if you have any recommendations? I am thinking about cutting back on the Fentyl patches and asking for a new breakthrough med? I have read you build up tolerance over time? I take a patch every other day, rather than the 3 days they recommend. My doctor and I found out I must have a higher absorption rate, because the patches were doing nothing on the third day. So, technically, with my script, that works out to a patch on each arm, every other day, so I think I might be able to cut back on these. BUT, my problem is for the breakthrough pain, the pure 15mg. percocet is not working anymore. I have had suggestion of possibly looking into Oxycontin, or Opana to replace the breakthrough med? Any experience or suggestions are appreciated! This is our forum, so I am open to suggestions. I really think I shoudl try and cut back on the Fentyl, and use a new breakthrough med. when needed. But, I want some ideas or suggestions I can bring to my doctor and see what he thinks. I have learned through life, that experience is the best teahcer, so I am asking you, my fellow sufferers! thanks for any input. NJDarkViking (BTW - I take these meds for back pain, bad stenosis (arthritus) and two ruptured discs). ( categories: Chronic Pain and Pain Management )
Tolerence issues
Your experiencing tolerence issues.But It all depends on what you want to do if you want to taper the fentenyl patches go for it. If I were you I would prefer to be on oxycontin with 30mg Ir's for break thru but thats just me. You could also talk to your Dr. about moving from 75mcg patch to the 100mcg and for the break thru talk about the 30mg Ir. If you want to change the breakthrough med maybe go with the fentenyl pops or dilaudid, oramorph.....ect. good luck bud.
hi, i think it is easy to
hi, i think it is easy to build a tolerance to all these drugs. i take (8) percocet 10/325 per day and (1) 120 mg. Avinza (timed release morephine). this combo doesn't work quite like it use to, but it has proven to be a fairly good combination. good luck I have many back issues also
I have many back issues also and here is what worked for me. I will start from when I was on the 75's and perc. like you. After some trial and error, I kept the 75's @48hrs. and added dillauded 4mg. 1-3 q 4-6 hrs. This worked beautiful for over 2 years. I think going to the actiq right away is only going to build your tolerence to fentynal faster. Now, eventually, if your back issues are like mine, you will continue to move up, but like I said over two years of working was a blessing, that's the longest I've gone without a change. Now my problems have not been so quiet since and over the past 1 1/2 years have moved up to: 100's on the patch @ 48hrs., 1-3 dillauded for mild to mod. BTP, 800 mcg actiq every 4-6 hrs. for mod - severe BTP, flexeril PRN, I also use the lidocane patches and voltaren gel directly applied to whatever joints are affected at the time. Not to mention NASID's, biologics, MTX, dexamethasone, provigil (to keep me awake) and more. Arthritis SUCKS!!! I am only 37, I have HLA-B27+ PSA/AS; RA; Osteoarthritis; and all that goes with those ie. tendonitis, fibro, chronic fatigue, etc.. I have had 15 major surgeries, the last of which was an emergency cervical fusion of C-4 thru C-7 (no accident or injury, just rapid disease process) I am now (1 year later) having cord/ root nerve compression @ C-3 and T-1&2, and in the lumbar/ sacorilliac area. Sorry if I sound bitter, I really did just start out to help w/ the BT med question.  MEDS
I am on the same as you except 5mg IR for BT pain.Going to the doc Mon and I am going to ask about changing the patch every 2 days and switching to dilaudid which I have heard has worked well for many people.I am going for my 3rd spinal surgery next month so I feel for you. Good Luck and let us know how you make out.Nancie I just wanted to add that
I just wanted to add that these "percocet" arnt really percocet they are roxicodone. You can either go up to 30mg which is the next highest dose or you can switch to one of the many other IR meds. My next suggestion would be Dilaudid but you can always look into Opana IR, MSIR, or actiq. I wouldnt suggest switching to actiq because your tolerance would rise too fast. I think the best course
I think the best course depends on if the oxycodone is not working because it is not strong enough, or if it is not working because it wears off to fast. Let's say your doctor gives you 120 oxycodone a month, and you were taking four every day at six hour intervals. But now you need to take them every four hours, so you are using up (theoreticly) 150 or 180 a month. In this case increasing your Fentanyl (maintenace med) would probably be a better choice. On the other hand, let's say your doctor give you 120 oxycodone a month and somedays you might take 8 tablets and somedays you might take no tablets. But now you find you must take two tablets at a time to get relief, so some days you take 16 tablets and some days you take no tablets. In this case increasing the dosage of oxycodone (or giving you more pills per month) or changing you something like Actique or Fentora may be a better choice.
 Perocet and Fentyl Resistance
Thanks for all the great suggestions and if anyonehas any more, I welcome them! So far, I think I agree, I should try and stay away from the Actiq, simply because I am already on the Fentyl patch. I'm leaning towards looking at Opana ER or Dilaudid which seems to be the common comment, and what most have found relief from. I'll tkae a look at those two and see what seems best. My Doctor is funny too, he just wants me to come in every month and get my "scripts" and call it a day. He seems to get upset when I start discussing other mediciines, I think he is feeling the pressure of perscribing Opiads, but yet, he is sympathetic to our suffering, he has neck and nerve problems himself. But, one can only try, and it is fruitless to just keep "popping" these 15mg. Roxycodones when they don't seem to be working any longer. Thank God for lists like this, at least I can get educated and try to present a knowledgeable solution with my doctor! Thanks everybody! Keep them coming! i have ruptered discs too.
i have ruptered discs too. i am at the limit with my doctor i think. i get 240, 10/325 percs and 30, 120mg avinza each month and i've pretty much been told she is at her limit. no way can i go in talking about i want to try this or that, or she would probably flip out, so if you can do that, you are luckier than you know. thunter percs and doctors
Wow! You can get 240 a month of the percs, that is good! My doc wouldn't even give me 120 for the longest time, he "claims" the Feds don;t like to see that kind of dose unless you're a cancer patient. I've NEVER heard this claim, but hey, these Docs gotta do what they gotta do I guess. I can't imagine without the Opiates, they let me lead a semi-normal life at least. But I had heard nightmares from others at work about trying to talk to their doctors and them not having any of it, so I do realize I'm kinda lucky that way. Then again, I know a couple people that have "'script" doctors, and get all the pills they want, so go figure. My doc also makes his patients wean off, meaning twice a year, (July & January-the J months), he gives his patients less pills, 100 vs. 120, so he can prove that he is trying us with less pain mediciation, I find that weird too. Anyway, I can talk to him, but he may go off anyway! LOL. Hang in there! NJDarkViking KAdian
Forgot to mention I had started on Kadian, which is a time realeased morphine, and I didn't like it. To me, it gve me horrible constipation, (not that they all don;t), and didn't seem to do much for me. I suspect that is pretty much the same as the Avinza your on. |
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I guess I must have needed to vent (someone told me yesterday that I was only sick when I wanted to be). Good luck, I will pray for you! In my experience, I try to go up as little as possible for as long as possible cause with chronic, progressive pain, your options become limited with time. Again, I apologize for my long winded rant. Please forgive any SP errors.
Joined: 2008-08-12