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Fentenyl to MS Contin....

MelWMMelW Posts: 427
edited 06/11/2012 - 8:51 AM in Pain Medications
It has been a loooong time since I have been on SH! I will try to make this a short and sweet as possible.

I was laid off from my job back in July and of course lost my insurance. I am now on my husbands insurance, which SUCKS! We have to meet a $6k deductible before they pay anything, and no prescription coverage. This is the last thing someone in chronic pain wants.

Anyway, last time I was on here I had started seeing an awesome PM. I am currently still with him and he is still a great PM doc. He put me on Fen patches (25mcg), roxi's for breakthrough pain, and Amrix for muscle spasms and severely tight muscles. I still have some pain but it is so much more manageable that I can tolerate the amount I still have. Well without decent insurance coverage I can not afford my patches, they are $140 for a box of 5 and I need three boxes a month. If this was the only med I was on then it wouldn't be a problem. As of right now, my son is on 3 meds and I am on 5, which makes our pharm bill well over $1k a month.

I called his nurse and told her there is no way I can pay for all of these meds and needed to switch to something else less costly. She said over the that MS Contin would probably be what he switches me to. So I go this afternoon for an appointment, and have to turn in all of my meds I have now. My questions are, what is the biggest difference between the 2 drugs, other than one is a patch and the other pills? Is there a big difference in price?

These patches have been a godsend and I am scared to death of changing to something else and it either doesn't work, or the side effects are awful.

Any info is greatly appreciated. Sorry this got so long! Like I said, haven't been on in a while so I got a little type happy :)


  • Call the pharmacy and get the price on the MS contin that you will be taking. Also have you looked at any of the assistance programs for meds for you and your family. I know through walgreens you can get a prescription card through them for a one time yearly fee which reduces the med in half, if you don't have prescription coverage. One of my dogs is on a med that has to be filled there and I have the card in her name and it cuts the cost in half, and the card cost me $25 a year, which I make up on the very first script. Also you can check some of the mail in pharmacy sense your using the same meds to see if the rates would be lower.
  • Thanks for your response!

    I have checked into the assistance programs but my husband makes too much, and I am still on unemployment. It is not so much that we don't make good money, just that the outgoing expense of meds is killing us, well over $1,000 a month is a lot of money. And go figure, I just had my scripts filled about a week ago and now have to turn them in to my doc. Grrr! I see why though. All of the abusers out there have made it hard on us who really need them.

    I use Walgreens so I will check with them when I leave my appointment this afternoon. I have seen the advertisements for their prescription card but didn't know how much it actually helps. I have also heard that Sam's Club has good prices on meds. We have a Sam's Club membership... I would just have to change my pharmacy with my PM because I am only authorized to fill at Walgreens right now, according to my contract.

    Thanks again!
  • Couldn't you wait and pick up your new prescriptions when you finish what you already have? I would definitely ask that question at your appt and just go back there and pick them up later.
  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    Been through the same issue with patch price vs MSContin .... MSContin at walgreen with there discount card is about $60 - $80. Beats the heck out of the $600 for my last rx for patches .... but MSContin now failing me ... I'm back to OxyContin ... haven't had the $ to fill the RX but expect it to be in the $400 - $500 dollar range.

    J & J had a patient assistance program for Duragesic ... you could call them ... i was denied last year because either I was getting a couple bucks beyond their monthly limit .... and they said the fund was out of money and to try again this year ... haven't again yet ... but maybe an option.

    take care and best regards,

    Spine-health Moderator
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  • I love my PM :) He just counted how many I had and told me to keep them. He said they have certain DEA guidelines they have to follow, as far as counting them and/or disposing of them. He just told me to keep them for a rainy day.

    He ended up putting me back on Vicodin, 7.5/325, 2x3daily.(and I am still on my Amrix) I have to go back in a month so he can evaluate my pain and adjust my meds as necessary. He said if I get insurance that covers them again, he'll put me back on them if I want.

    I also asked him if there was any light at the end of the tunnel (not sure why I did because I knew the answer, was just hoping for a different one I suppose),as far as whether I will be on pain meds forever or what. I felt like I had accepted the pain and was ok with being on pain medication, but I really haven't. I have been so depressed about it lately. I don't even remember a time without pain and pain meds. UGH.... Anyway, he said he really couldn't answer that and with what he has seen on my x-rays/MRIs, that it is unlikey I will be without pain. He said it is really on me whether I can learn to live with pain without meds, or whether I want to control the pain with meds. It was an honest answer so I was greatful for that, just isn't what I wanted to hear it. :(

    Oh! I called the Walgreens I go to, to ask how much the Vicodin will be. She told me it is $110 for 180, which is better than what my patches cost. Then she asked if I have script coverage and when I told her no she put me on hold for a few minutes then got back on and said she just got me a prescition card that is offered to people thru the county I live in and it gives me 50% off all of my scripts :) They are so awesome!
  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    I am concerned for you about the jump from patches to Vicodin only - may be a bit of a challenge .... I'm suprised he didn't at least give ya the 10/325's ... you may have some withdrawl and have a bit of peak and valley effect stuff. Not sure what mcgs/hr your patches were put oxycodone (Percocet) maybe a better option for step down from Fent. Just my unsoliceted 1 cents worth ... again glad you back!


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  • Thanks for the info and I did voice my concerns to him about the switch from Fent to just the vicodin. I thought that was an extreme switch. He said to go ahead and take my roxi's during the switch to lessen the withdrawl symptoms. I assumed he would put me back on percocet (that's what I took after surgery), but apparently I still continue in my adult life to find out what happens when I assume :D

    I hate going off of the patch. It has helped the most out of everything I've tried, and I actually can do most anything I want and not pay for it the next day. Before I got put on patches, I was severly depressed, could not clean my house, didn't go to most of my kids after school activities, etc., it was pretty bad; I really just existed. Plus the patches don't give you that loopy feeling some of these other ones do. I hate to walk around feeling higher than a kite! And I can't! I am trying to get through school, I am going for nursing, but right now I am doing prerequisites for my Assoc. in Science. My life is consumed by classes and studying and I do not want to get to where I can't even concentrate. Sorry I am just rabbling now.

    Anyway, I can not pick my script up until Sunday so I guess I will see how it goes with the switch. I am so afraid of being back to where I was pre-Fent.... It was an extremely miserable time for me and my family :(
  • That's a really big jump, in my opinion. Do you think that the hydrocodone will cover your pain? I hope that it does. Why didn't he want to try another long-acting medication?
  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    because the only brand that seemed to give me any relief was the Sandoz with the adhesive matrix ... the Mylans with the adhesive didn't work and the Watson (still with the gel pack) didn't work either ... so my PM just put me back on the dreaded OXYcontin ... day two and so far so good but I'm on a rather high dose 60mg three times a day .... and a cost of $800+ for a months worth. My SSD hearing is next month so hopefully many things will change ... I miss healthcare ... I was a paramedic for many years and moved into the busines and EHR side for the past 10 .... had to call it quits over a year ago ... could physically or mentally take it anymore.
    Between pain, meds, travel, training, consulting and 10 -12 hours a day .... it took me to the edge. I admire your strength to continue your goals in healthcare and your devotion to your family ... stay strong!! I'll keep you in my thoughts and prayers.

    Warmest regards,

    Spine-health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!

  • Metalneck - I really didn't do too bad with the withdrawls from taking the patch off. I was actually quite surprised.I had some but not as bad as I thought. Just annoyed that the pain is coming bad with avengence.... I think it is going to haunt me forever, it's been 2 years since I had surgery.I had a test today in one class and an in-class essay, and I thought I was going to cry because it hurt so bad sitting in thpse chairs for so long. UGH!!!!

    Most of the long acting meds are fairly expensive and with me having no prescription coverage, it is too expensive when I have 5 meds a month and my son has 3. I just can't afford a bunch of expensive meds and my sons medicine comes first, so it doesn't leave enough for me to spend well over $1k on my meds a month.

    And no it is not helping with my pain. It is barely taking the edge off.I was really hoping my pain would be better when I got off of the fent patch. I was wrong, it's as bad if not worse than it was before I was on the patch a year ago.

    I go back for a followup in a month so I am going to have to see what else I can get on that might help a bit more. I can't handle this.

    I am so over all of this pain crap....
  • I had a bad side effect from MS Contin. My "tink" felt like it was going to fall off it hurt so much. My wife read the side effects for MS Contin and it causes blood vein constriction.

    For me it created more pain. I had to quit using it and felt better without it.

    Always read the side effects paper that comes with the mediciation. Lesson learned for me, I thought I was dying..maybe it WAS killing me.
  • I also had to switch from Fentanyl patches to MS Contin due to cost; the higher the dose the higher the cost. I can't recall how much it was for 3 boxes of 100mcg's but it was way too much. I paid around $90 for the ER Morphine and $30 for BT morphine and this was nothing compared to the patches.

    I was also concerned about you going back down to Vicodin after Fentanyl, but I'm sure your doctor calculated it so that withdrawal would be minimal. I was a bit surprised that he didn't put you on MS Contin instead. I'm so grateful that I have a pain pump and the medication is included in the office visit charge #:S Take care
  • Well the amount of hydrocodone (Norco not Vicodin, which is why it is more expensive. If he would have written it for Vicodin, it would have only cost $50) he had to put me on ends up costing me $80 a month. If there is something that is going to work better and cost a little more, I rather pay the extra.

    I have been so damn miserable the last few weeks. It is back to where it is starting to rule my life again and I am constantly reminded of pain no matter what I do.

    It really is amazing how well the fent patches worked, kind of scary that they helped relieve that much pain, but it was awesome.

    I really feel like I should have another MRI because something isn't right, but I would have to pay for it totally out of pocket. This isnurance situation is so darn frustrating!!!!!
  • Hello,
    I was just put on fen patch i was on 4 percs a day since 1993 for failed fusion,try to to stay on patch,not hard on liver like the pills,
    Rick ncpa
  • please see my post under pain medications forum- title is Prescription Assistance/ Discounts- i have used BOTH of these programs- The Duragesic Patches are covered under the FREE and INSTANT program called TogetherRxAccess you can also get additional coupons by clicking on the drug and following links to drug company site... Avinza is on there too and i saw a $30 off coupon today as well as the % savings- you can use this all at Walgreens.
  • i took Methadone for PM for 3 years before switching to what i take now which is Oxycontin 80 mg and Dilaudid 8mg... Methadone is a very good medicine and it is CHEAP- $12.95 per month for 120/ 10mg tablets at walgreens using RxAssist- without the discount it is still less than $20 per month for that amount/dosage.
    Methadone is used as a long acting, and certainly considered comparable to Fentanyl patches...
    A good "cheap" BT med is Oxycodone (generic)/Oxy IR= 120/20mg pills at walgreens is $42.99 per month with RxAssist

  • Thanks all for your comments/suggestions.

    I have a followup appt with my PM this Friday and plan on talking to him about getting back on my patches. Sam's Club has them and it will cost me $97 a month for the patches.I am wondering if Walgreens misquoted me the first time I called and priced the patches, or they are just extremely high. If $97 is what will keep my pain at a tolerable level, I am willing to spend it. I was also on Oxycodone for bt pain, which I am assuming he will put me back on. He had me on 25mcg of fent patch and 5mg of the oxy's, 3xdaily.

    Rick - I was on percocet before I started with the PM doc and I voiced my concern to him about the affects on my liver, which is why he put me on the patches, as well as giving me around-the-clock pain management.

    I think the biggest realization I came to, which is depressing as I'll get out, was that I really hoped my pain level was not as bad and I could get off all of this pain medication... It is worse then before and that has really gotten to me. I have always dealt with depression, ever since my brother was killed it got a lot worse, so it doesn't take much to send me right back down depression alley.

    Queenjillybean - I will take a look at your post on discounts. Thanks!
  • Queenjillybean - I forgot to mention my doctor did bring up methadone. He said there is so much misconception about the drug because of all of the methdone clinics, he said it really gets an unnecessary bad wrap. He said he personally thinks it is a great pain medication, but with all of my concerns with weight gain, he thought it wouldn't be a great choice. He also said it is a beast to get off of. With all that said I told him I rather try something else.

    I go to see the PM doc this morning. I am going to see if he will put me back on the patches, which I know he will not have a problem with. He rather his patients that need around-the-clock pain management be on the patch or a long acting pain medication and he has said this to me many times. I know he will be happy that I've managed to find a way to afford the patches because that is really what he thinks I need to be on to manage my pain better.

    Every one I am around on a regular basis (family, friends, etc) said they have noticed a huge difference in my attitude (physically and emotionally) since I have been off my patches. Most of them didn't even know I was off my patch, just that they've noticed a huge difference in me lately, and not for the good.

    Since I have switched from the patch to Norco I have noticed that I have been extremely anxious, jittery, and just a plain grouch. I know some of it is the inadequate management of my pain because the Norco just doesn't last long enough and even right after I take it, it's like taking tylenol and really doesn't help. It is all just so darn frustrating. I can't even sit long enough to do my homework or study, which a month of this has really effected my grades (thank god I had A's and B's or I'd be a lot worse off).

    We need a little spine fairy! Yes I am delusional :) We can put our old crappy spines under our pillows and wake to find a pristine new one! LOL :D Wouldn't that be nice?!?!

    Ok, I have to get the kiddo ready for "favorite color day" at school today.... I'll let ya'll know how the doc appt. went.

    Take care all, and I hope for a pain free (or at least manageable) day for ya'll.
  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    Appointment go? Did you get put back on the patch?? I had my visit today and went back to a Sandoz 100/mcg hr 1 every three days .... I feeel better only a couple of hours after the first application.

    How about you ..... How ya doin??


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  • Hi Dave! Appointment went great, thanks for asking. Yes I am back on the patch. I feel sooooo much better! I guess I never knew how well the patches were working until I didn't have them.

    It is amazing how quickly I went back to not leaving the house, laying around, and just plain depressed over the pain. This patch is really a godsend. I think I have gotten more accomplished in the week I have been back on the patch then I did for the entire month I was off of them.

    I am so happy I am at least to a point where the pain is tolerable. :D

  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    From you .... glad the change has helped!!

    Ditto for me!

    I guess there's a reason they say its 100 X stronger than Morphine. I'm just glad it doesn't cost 100 X more!!

    Which brand are you on? .. cause for some crazy reason I only get good results from the Sandoz with the med in the adhesive matrix. I have been on the Watson Gel filled & the Mylan matrix and niether of them had the same effect.

    They actually increased the amount of Fentnyl in the Sandoz brand when (VS the Mylan) when then both went matrix - even though the MCG/HR is the same. THe Sandoz is actually "stronger".

    Keep that frown - upside down!!

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  • I am happy to hear they work for you too. I can not say how much I appreciate being able to be on something that helps this much. Everyone I know that I am around on a regular basis keeps commenting on how I am in such a better mood and don't look like death is knocking on my door.

    I am on the Watson Transdermal System, gel filled patches. I still have some bad days and have to usually change patches every two days as opposed to three, but its still way better then not being on them at all.

    I have not tried any other brands. I pretty much have to just get the cheapest one there is :)

    Take care!
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