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What is the next step above hydrocodone 10/325?

Tomorrow I go to the pain doctor. For the last 4 months I have been seeing a neurosurgeon who took over my pain medications because I was going to have surgery. I was 3 days away from having surgery when I started having chest pains and I had to postpone. Discovered it was due to a medication I was on and some other interactions going on.

I will be rescheduling, but in the mean time, I can't manage with the pain meds that I have. I used to have tramadol for breakthrough pain but I stopped taking that because it didn't help. So all I have is hydrocodone. I have a grade 4 tear in L4/L5 and I have already been down the path of aqua therapy, regular therapy, chiropractor, etc.

I know there are so many pain meds out there, and I know better than to suggest a certain one to the doctor, but I am just curious as to what the next one (or several) are in line? Especially with recent crack downs.

I, like everyone, am just so tired of being in pain. Currently my script reads "Take 1-2 pills every 4-6 hours as needed for pain" and the qty is 150. So I interpret that as I can take 6 pills a day? If I am reading that right, it means it is a 25 day script. I can't just take 1 pill at a time, that doesn't do anything. If I take 2 at once, it works for about 2 hrs, then the next 2 hrs I am putting ice packs on, biofreeze, doing meditation, back brace,etc, just so I can make it to the next dose. So If I take 2 at 8am, I am ready for 2 at 12noon, then last dose at 4pm which means I am in pain from 6pm all through the night until the next morning. It is torture.
Tracy,

Grade 4 tear in l4/l5 was missed in first MRI so did injections for a year
SI joints "messed up" not sure if I will get them fused at a later time
Had Open PLIF L4/L5 5/28/13
Woke up to permanent nerve damage in legs and feet.
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Comments

  • meydey321mmeydey321 Posts: 2,435
    edited 07/25/2012 - 3:19 PM
    Sorry about your pain. I can relate bc I've had 3 surgeries due to herniated discs & instability. My pain is managed by a dilaudid pain pump & other oral meds.
    Well the next up from hydrocodone 10/325 mg is Percocet (oxycodone/tylenol). Its stronger and is used for break thru pain. I'm on 10/325mg of it too & the pump took place of the extended release med such as Oxycontin, Fentanyl.
    Let your docor know your issues with hydrocodone. For now you could try taking 2 at 7am, 2 at 4pm, 2 at 10pm or bedtime. You need 240 pills a month at the rate you are on, thats for 8 pills a day. I get 90 pills a month for taking 3 percocets daily. Let your doctor recommend any changes, dont ask for specific meds. Take care
  • Meydey321, I appreciate your reply. I was wondering if it would be Percocet. I worry so much about the Tylenol in that and what I am taking. I have heard conflicting stories on how much you can take in a 24 hr period. I didn't think I could take 8 a day, but somedays I just can't stand it and must take something. Also, I cannot take any NSAIDS due to having gastric sleeve and issues with severe reflux. I work from home and get out to do aqua therapy 3x a week. That's it, if I do much else I wouldn't be able to function on the pain meds I have. I hope they will give me something that will give me a better quality of life.
    Tracy,

    Grade 4 tear in l4/l5 was missed in first MRI so did injections for a year
    SI joints "messed up" not sure if I will get them fused at a later time
    Had Open PLIF L4/L5 5/28/13
    Woke up to permanent nerve damage in legs and feet.
  • my pm doctor, just presrcibed me nucynta, but i have not taken any yet, i will probably start tomorrow
  • techgurl1988ttechgurl1988 Posts: 108
    edited 07/26/2012 - 7:34 AM
    I am surprised. I just got back and they gave me the Fentanyl patch. I had not been to them since they had referred me to the surgeon. She asked why I had not had surgery and went through the whole story about the chest pains, then using short term disability, and now I must wait before I can use it again at my job, so I am rescheduling for the fall. She asked me how many Vicodin I was taking and I just looked at her and told her "To be honest, some days I take 8 a day. I know I shouldn't, but the pain is so bad. That's why I am here." She said "Yeah, that is not good." and then told me she was giving me the patch. I had brought all my meds with me expecting them to want to take them or something so I could start fresh with them but no, she just told me she wants me to try and wean down to 4 or less of the Vicodin while using the patch. I have done a little research on that patch and have read the good, bad, and the ugly.

    I am praying that I don't have problems getting addicted or having withdrawals when I no longer need pain medicine after surgery. I appreciate any positive thoughts or prayers!
    Tracy,

    Grade 4 tear in l4/l5 was missed in first MRI so did injections for a year
    SI joints "messed up" not sure if I will get them fused at a later time
    Had Open PLIF L4/L5 5/28/13
    Woke up to permanent nerve damage in legs and feet.
  • I was on hydrocodone 10 mgs/325 for a couple of years. I had so much "break thru" pain that I have reluctantly added a 25 mcg/every 3 day fentynal patch. It has helped but I'm not happy with side effects. Am trying to get used to them. Addiction - no. But our bodies do become physically dependent. Reversing or getting off of any of these drugs needs a measured approach. I am so very sorry for you awful pain. I will keep you in prayers. (I graduated from UTD and lived in Plano)
  • Hi Techgurl.

    I'm in your same situation. I was taking 10/325 vicodin, allowed 6 a day and as my pain was worsening, I went to see my surgeon. After my MRI, he could see why my pain was increasing - due to facet problems and spondylolisthesis at L2/3 and L3/4, just above my L4/5 fusion. So we tried facet injections and of course, they did nothing.

    So on my followup visit, he put my on oxycontin. I tried it for the first time yesterday and hated the side effects (I was at work) and went back to my vicodin, deciding to try it today as I have today off and don't go back to work until Monday. I think that should be enough time to see if it's going to work. I'm on 10mg, but can take 20mg at any time if I experience more pain and have the vicodin 10/325 for breakthrough, allowed 3 a day.

    I hope your fentanyl patches work for you just as I hope that the oxy works for me. It's hard to change medications because you have to get used to it. I'm hoping that by Monday, I'll be tolerating this med and not calling my doc saying I can't handle it. I hat having to take it, but the alternative is worse.

    Take care and keep us posted on how you're doing on your new meds.
    Cath
  • techgurl1988ttechgurl1988 Posts: 108
    edited 07/27/2012 - 8:11 AM
    Nothing has "kicked in" for me. It's been 24 hrs. I heard it can take more time so I am trying to be patient. I hope the Oxy's work for you cath111. I've never tried them before. I am still taking the Vicodin while I wait for the patch to kick in.
    Tracy,

    Grade 4 tear in l4/l5 was missed in first MRI so did injections for a year
    SI joints "messed up" not sure if I will get them fused at a later time
    Had Open PLIF L4/L5 5/28/13
    Woke up to permanent nerve damage in legs and feet.
  • After taking Vicodin and now norco for over three years, my physical medicine doc wants me to start taking suboxone. From what I've researched, that stuff scares the crap out of me.
    Disability retirement
  • At 1:30 today was the 24 hr mark and nothing had kicked in. I took my second dose of two 10mg Vicodin at that time. At 5pm I realized I was still experiencing pain relief which is normally not the case after 3 1/2 hrs of having taken the Vicodin. It it now almost 9pm and I have not had to take any more Vicodin. So suffice it to say, my patch kicked in approx around the 28th hr. I still have pain but it is manageable. for the first time I am not watching the clock for my next pain med dose. I hope this lasts.
    Tracy,

    Grade 4 tear in l4/l5 was missed in first MRI so did injections for a year
    SI joints "messed up" not sure if I will get them fused at a later time
    Had Open PLIF L4/L5 5/28/13
    Woke up to permanent nerve damage in legs and feet.
  • About an hour after I posted my last update, the pain started trickling in. I waited another hour and a few ice packs later decided to take 1 Vicodin. I guess I had waited too long because after an hour I was still in pain so I took a second Vicodin. I know I still have to be patient and try out the second patch tomorrow but I am thinking I need the 50mcg patches. I've also read that it makes a difference on what company manufactures it. Mine is the duragesic brand made by Mallinckrodt or Lts lohmann ( it has both on the box).
    Tracy,

    Grade 4 tear in l4/l5 was missed in first MRI so did injections for a year
    SI joints "messed up" not sure if I will get them fused at a later time
    Had Open PLIF L4/L5 5/28/13
    Woke up to permanent nerve damage in legs and feet.
  • I don't know much about suboxone. Maybe you can post that as a separate thread for more responses or search the archives? I've only heard they give it to people who may be addicted or become addicted to pain meds.
    Tracy,

    Grade 4 tear in l4/l5 was missed in first MRI so did injections for a year
    SI joints "messed up" not sure if I will get them fused at a later time
    Had Open PLIF L4/L5 5/28/13
    Woke up to permanent nerve damage in legs and feet.
  • j.howiejj.howie Brentwood, Ca., USAPosts: 1,794
    edited 07/28/2012 - 11:54 AM
    Duragesic is the expensive stuff. Most insurance co. will only allow the generic. 25 is a small dose. Maybe you should talk to your Dr.
    Jim
    Click my name to see my Medical history
    You get what you get, not what you deserve......I stole that from Susan (rip)
    Today is yours to embrace........ for tomorrow, who knows what might be starring you in the face!
  • mla412mmla412 Posts: 3
    edited 07/29/2012 - 10:53 AM
    @techgurl I'm in exactly the same boat you are. The good news is that you may not necessarily have to move up to the 50s. There is a difference between generics and the Sandoz brand has a significantly larger amount of medicine in their patches. Mallinckrodt has put me in withdrawal after using Sandoz. If you go to a privately run pharmacy they can special order them for you. Good luck!
  • mla412 THANK YOU for replying to this! I had a feeling after I had read some other posts about the difference in brands that this might be the case. I will call my pharmacy and see what they can do. I get my rx's at Kroger.

    I put my second patch on yesterday and within 30 minutes felt stoned and anxious-but no pain. After my hubby took me for a drive the anxiety went away, but the pain returned. Today I woke up and had to take 2 vicodin. Then at noon I was feeling like I needed to take more vicodin but I took a shower first. I made sure the shower wasn't too hot and also made sure I barely got my patch wet. However as I dried off I got that stoned feeling again and the pain was gone. Then an hour later, pain is back. This brand of patches seem very inconsistent!
    Tracy,

    Grade 4 tear in l4/l5 was missed in first MRI so did injections for a year
    SI joints "messed up" not sure if I will get them fused at a later time
    Had Open PLIF L4/L5 5/28/13
    Woke up to permanent nerve damage in legs and feet.
  • Oh one question, so the Sandoz brand is not a generic correct? I wonder if my insurance will have a problem switching to non generic? Hmmm..
    Tracy,

    Grade 4 tear in l4/l5 was missed in first MRI so did injections for a year
    SI joints "messed up" not sure if I will get them fused at a later time
    Had Open PLIF L4/L5 5/28/13
    Woke up to permanent nerve damage in legs and feet.
  • hamrs_62hhamrs_62 Posts: 38
    edited 07/30/2012 - 12:02 PM
    said I should be on it, it is mainly use for addiction, my wife has been on it for awhile, eventually to ween off, depends on the length of addiction, they use it allot in other countries for pain relief,,,,,,
    hamrs_62
  • sandisandi Posts: 6,556
    edited 07/30/2012 - 8:10 PM
    Before you go assuming that you need to jump up to 50 mcg /hr of fentanyl, you need to be aware that depending on where you place the patch, how much fat is in the area, heat, the dryness of your skin, and your body's absorption rate all effect how quickly, your body will start to build a steady blood plasma level of fentanyl in your system., This can take up to a week for someone just starting out on the patch ( at least two, maybe three changes of patches) before your body builds up a blood plasma steady level. Give the fentanyl a couple more patch changes, and try cutting down to one tablet of vicoden if you must take it instead of taking both tablets at once on top of the fentanyl, It may very well be that the combination of two tablets of vicoden, along with the building levels of fentanyl in your blood stream are causing the "stoned" feeling and the anxiety....
  • Hi catfishman, I can tell you the Nucynta has been a God send to me. I started having severe thoracic spine pain that radiated around left rib cage and upper abdomen. Fortunately my primary doctor whom I also work for knows how I have a hard time taking pain medications. The side effects: vomiting and nausea as well as the feeling of my skin crawling. She started me on Nucynta in Feb. and have been taking 50mg x2, 3 times daily and happy to report no more side effects other than drowsiness. I hope itworks well for you:)

    hugs,
    kelli
  • sandi said:
    Before you go assuming that you need to jump up to 50 mcg /hr of fentanyl, you need to be aware that depending on where you place the patch, how much fat is in the area, heat, the dryness of your skin, and your body's absorption rate all effect how quickly, your body will start to build a steady blood plasma level of fentanyl in your system., This can take up to a week for someone just starting out on the patch ( at least two, maybe three changes of patches) before your body builds up a blood plasma steady level. Give the fentanyl a couple more patch changes, and try cutting down to one tablet of vicoden if you must take it instead of taking both tablets at once on top of the fentanyl, It may very well be that the combination of two tablets of vicoden, along with the building levels of fentanyl in your blood stream are causing the "stoned" feeling and the anxiety....
    Sandi,
    Yes I've been reading on another thread about the different places toput the patch. I had placed it on my chest above my breast on the left side as my doctor instructed that the chest was the best place. However I see from reading that it is best in a fatty area so maybe today when I do my third change, I will move it to my side or arm.
    The Vicodin are short acting so when I was getting that "stoned" feeling (my doctor used this term :) ), it had been 6 hrs since I had any Vicodin. For me, taking just one doesn't work. I tried that but ended up taking another an hour later.
    Tracy,

    Grade 4 tear in l4/l5 was missed in first MRI so did injections for a year
    SI joints "messed up" not sure if I will get them fused at a later time
    Had Open PLIF L4/L5 5/28/13
    Woke up to permanent nerve damage in legs and feet.
  • Thanks for the info kelli, i appreciate it.
  • Just documenting my "journey" with the Fentanyl patch. Today I put my 3rd patch on. The last two times I placed a patch, for whatever reason, I got very anxious to the point I was afraid of having a panic attack. So today, about an hour before I put the patch on, I took a low dose of Xanax that I have for the rare moments I feel one coming. (This panic thing is very new for me, just started in May right before I was supposed to have surgery.)

    So I placed the patch and waited to see what would happen. I did get that stoned feeling but it was light and went away after 20 min. I had a doctor appt so I went to that. While I was out I received a call from my pain management doctor and she said to go ahead and put a second patch on since I had not had much relief from the .25. So when I got home I put a second patch on and prepared to be drooling or something. But nope, no drool, and no stoned feeling, but also no pain relief. I realize I need to give it time, I am just reporting that back for others who will come later and read this. So approx 6 1/2 hrs here I am and I need to take a vicodin because if I don't I won't be able to sleep. BUT that makes only 4 vicodin today so I am making progress down from the 8 a day I was taking.
    Tracy,

    Grade 4 tear in l4/l5 was missed in first MRI so did injections for a year
    SI joints "messed up" not sure if I will get them fused at a later time
    Had Open PLIF L4/L5 5/28/13
    Woke up to permanent nerve damage in legs and feet.
  • techgurl1988ttechgurl1988 Posts: 108
    edited 08/07/2012 - 4:22 PM
    Last week my doctor upped the dose to two .25 patches. Today I put my third dose on of the two patches. In the past when I put the patches on,I got that stoned feeling. Today I did not.in fact, today ai have had to take 6 Vicodin. I do not understand how my body has gotten accustomed to two patches so quickly but I am still struggling with getting to the right dose.

    However in my research over the difference in patches, I have come up with the amount of fentanyl per brand/generic patch. There is a HUGE difference in the amount of Fentanyl in the brand I currently have. My doctor is supposed to give me a new prescription tomorrow and I will be ordering the name brand.

    I hope this list can grow if others can help me out. If you look on the patch package, it will say the total amount of fentanyl per patch.

    Mallinckrodt
    Dose hr/ Total per patch (24 hr)
    .25mcg = 2.75mg
    .50mcg=5.50mg
    .75mcg= 8.25mg
    .100mcg=11.0mg

    Duragesic
    .12mcg=2.1mg
    .25mcg =4.2mg
    .50mcg =8.4mg
    .75mcg =12.6mg
    .100mcg=16.8 mg


    Sandoz
    .25mcg=?
    .50mcg=8.4mg
    Tracy,

    Grade 4 tear in l4/l5 was missed in first MRI so did injections for a year
    SI joints "messed up" not sure if I will get them fused at a later time
    Had Open PLIF L4/L5 5/28/13
    Woke up to permanent nerve damage in legs and feet.
  • I have the Durgesic or just says Fentanyl on it and find it helps more on my abdominal area but I`m trying it again on my leg because I had to have an abdominal ultrasound today and find not as much relief as a fatty area. I hope it helps. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • just when I thought my pain doctor was doing ok with me, they went and pulled a fast one on me. They have me the prescription for the .50 mcg fentanyl but said I could have no more then 2 Vicodin a day for breakthrough. That's it, I have nothing else to take. I did get the different brand of patch, the Mylan, because I could not find the sando
    Anywhere. And yes, it is much better than the Mallinckrodt, like night and day different, but I still think I need at least 4 Vicodin between the day time and the night time. Also, it took them 4 days and me
    Talking to 8 different people to even get the prescriptions! I was out for 2 days and then when I got the prescription, they had written one wrong and I had to go back. If anyone lives in Arlington, Tx and can reccommended a pm
    Let me know!
    Tracy,

    Grade 4 tear in l4/l5 was missed in first MRI so did injections for a year
    SI joints "messed up" not sure if I will get them fused at a later time
    Had Open PLIF L4/L5 5/28/13
    Woke up to permanent nerve damage in legs and feet.
  • oxycontin /oxynorm would be the next step .starting at 5mg they go all the way up to 80mg [in the UK] and 20mg in the oxynorm instant version.good pain relief but very addictive .
    tony [UK}
    1997 laminectomy
    2007 repeat laminectomy and discectomy L4/L5
    2011 ALIF {L4/L5/S1}
    2012 ? bowel problems .still under investigation
    2014 bladder operation may 19th 2014
  • Un4tune81UUn4tune81 Posts: 1
    edited 08/14/2014 - 4:50 AM
    Mine all started with my back going out on me, myself and and my PCP thought nothing of it. Put me on #10-500 Hydrocodone and got a couple of X-rays which showed nothing. Well it didn't get better and worsened so started seeing specialists and most were jerks that said I wasn't hurt and go back to work. Finally I found one decent Dr. and he sent me for a battery of tests, CT Scan & MRI's. Well, well came back and this is what came of it. I had Rheumatoid Arthritis (RA), Anklylosing Spondylitis (AS) and Fiberomialgia as majors and then degenerative disk, bones spurs, neck is almost completely fused and then the list goes on. No one will do any type of surgery because most of the worse part is in the Thoracic part of the spine and the have to crack the chest open to get to the spine and success rate is very low. Oh and then check this out, after 2 years of this I finally got a chance to see a specialist at the EDITED TN, and they verified the other results but they also found a fracture in my lumbar lower section and said it didn't heal properly. Go figure.

    I have been on Fentanyl Patches off and on for 7 years, mostly on. When I first went to a PM Clinic the first thing they put me on was #10-500 Hydrocodone and .100 mcg patches at first I could feel the effects of the Fentanyl and I got an energy boost from them.

    I had started having trouble sleeping when all this started, but now with the patches after keeping track of things, the patches actually created a worse sleeping pattern. The first night after placing the patch I would not sleep at all, the second night I could sleep for an hour or so and wake, & then on the third night I could sleep a couple hours at a time. This went on for a couple years and I tried everything over the counter for sleep aids and then went to prescription, nothing help except made me more tired then before. I could pretty much fall asleep standing up but would only drop off for a few minutes and same for when I sat down any where.

    I can't believe they started you with the .25 Fentanyl Patches, when I was on the 100's I started having withdrawals on the 3rd day after being on them for about a year. Whatever you do, do not stop cold turkey the withdrawals are worse than the pain you're experiencing before hand, the knees and elbows for me was the worse, felt like I was on a stretching rack and being torn apart. Slowly drop the doses and wear the patch longer. I wore my last few patches 5 to 7 days each. Also the sides of the stomach are the best place I found. I even tried putting them directly on my back where it hurt and I don't think it helped one bit. I have always been the same as you. I have found nothing yet that has helped me enough to put me back into a normal routine yet. I spend about 2 hours after taking my Hydrocodone with the patch on where it is tolerable but then it starts getting worse for the next 6 hours and by that time one pill doesn't get me out of where I am at. I know you are suppose to take meds as prescribed but sometimes you have got to do the wrong thing just to stop hurting. I have found that if I have the patch on and take a Hyrocodone every 3 hours I am at a place where I can live a half normal live, but that doesn't matter to anyone in the Medical Field because of all the restriction put into place by people that don't know what it is like to live in pain 24/7/365. I hate to say it but I have wished it on a couple of Dr.'s I have seen and been abused by.

    I even went to rehab because I hated how I felt, I hated myself and everything. I found my bad place. So I figure like everyone kept telling me that it was the drugs that was making my head think I was in pain, I kept telling them it's not my head that hurts it's my back, but I went anyways. They are all set up the same, mind over matter EDITEDI tried really really hard, they said after the 5th day it would get better. I was on the 8th day and I hurt so bad I couldn't stand it any more. I tried all the yoga, breathing exercises, and meditations. Nothing. There were people coming off a lot worse than I was and they were all kickin it up and having a good old time. That afternoon I started having groaning pain and I knew exactly what it was, I had them a lot. A Kidney Stone, need I say more. It was stuck and not going any where. That night they called an ambulance and ER here I come. I had all my papers stating I was in rehab and could not get anything of prescription strength. So, what did they do, as soon as I was in the ER area they shot me with a double dose of Dilaudid and I was off and flying in like 2 minutes. Released from rehad at that point. So I had to go through the rest of the withdrawals from the Fentynal but my PCP put me back on Hydrocodone for awhile until it wasn't enough and went back to PM.

    I am starting at a new PM this month and I am so hoping to get something other than the usual #10 Hydrocodone & Fentynal Patches because of the sleep issue I have I do not want the patches any more.

    I hope I didn't ramble on to much and bore you, I was just trying to give you some info that might help.



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    Gary
    Living in pain and feel for everyone that has to.
    RA, AS, & Fibromialgia
  • sandisandi Posts: 6,556
    edited 08/14/2014 - 4:58 AM
    Welcome to Spine Health.
    http://www.spine-health.com/forum/announcements/spine-health-announcements/welcome-message-resource

    Your doctor made a mistake in starting you off on fentanyl patches at such a high dose. Jumping from percocet to fentanyl is a huge jump in pain medication strength and potency. There are many other medications in between those two that should have been trialed at a lower dose. It is no wonder that you experienced sleep issues.
    As far as taking more than prescribed or more frequently than prescribed is putting your pain management at risk and leads to chronic misuse and can lead to addiction.
    As difficult as it is, the extended release medications should manage most of your day to day , "normal' pain levels, then the use of breakthrough medications should only be used when other modalities at trying to manage the increased pain levels fail. Too often, the proper use of breakthrough medications are not explained properly, and thus patients wind up taking them as often as they are alloted per day, leaving them nothing to manage true breakthrough pain.
    Since you are just starting with this new pm doctor, it is important to work with him to get a proper extended release dose that manages most of your daily pain, then not to use the breakthrough medications as you currently are.
    Doing as you are currently leaves the patient with nothing to manage those flares and ultimately, leaves your baseline levels of opiates higher than your extended release can handle because your body quickly adapts to having those immediate release medications in your system/blood stream.
    I am including a few links that may help you to understand the proper pain management treatment steps so that you start on the right foot with this new doctor.

    Chronic Pain Treatment
    http://www.spine-health.com/forum/pain/chronic-pain/chronic-pain-treatment-step-step
    http://www.spine-health.com/forum/treatment/pain-medications/dos-and-donts-pain-management
    http://www.spine-health.com/forum/treatment/pain-medications/pm-your-first-visit-what-expect-what-ask
    http://www.spine-health.com/treatment/pain-management/pain-management-chronic-back-pain
    http://www.spine-health.com/forum/announcements/spine-health-announcements/blend
  • sandisandi Posts: 6,556
    edited 08/14/2014 - 5:06 AM
    The use of breakthrough medication is not meant to be a supplement to fentanyl. It is only to be used for true breakthrough pain. Taking it too often or with any regularity on a daily basis only increased the total amount of opiate in your system and leaves nothing for true flares of pain. The increased fentanyl should be more than adequate to cover your daily pain, and the use of the breakthrough medications are only for emergencies. Many doctors aren't using breakthrough medications because of patients who regularly use them in conjunction with their baseline ( extended release ) medications and causing tolerance issues for themselves.
    The doctor doubled your dose of fentanyl, and you shouldn't need to take the breakthrough meds every day. Try ice, heat, heat patches, anti inflammatory medications, and possibly a muscle relaxer, but there shouldn't be any reason for you to need to continue to take the breakthrough medications on a daily basis.
    It might be worthwhile talking to your pm doctor about how you are supposed to be using the breakthrough medications because I see you making a mistake that many others before you have made in regard to how you are using them improperly.
  • I have been on this patch for about 3 months and 10/325 norco. Well this patch after 5 days now puts blisters and like burn marks on my skin so after seeing PM he said to try Nucynta er and it. That was Wed. and my pharmacy will not have it in until Tuesday so I will continue to use my other meds until comes in. My problem is that other then the 1st month after my 4 level PCDF I have not taken a schedule II opiate. So. anyone with experience with Nucynta 50 er an 50 it please let me know.
    Vicki
  • nucynta er did wonders for me, i started on 50mg, then went up to 150mg, unfortunately my pain management doctor said he will not be prescribing opiates anymore. i was on it for a year and a half, along with doing daily stretches, and a few other things i was at least 90% better. no i am tapering off, i am not hurting, but feeling crappy.on a better note, my mother just had a fusion l4,l5, 1 week and 5 days ago, she is doing great, released to drive already, moving around well, she is one tough woman, i called her to see if she needed me to pick her anything up, she said i can drive, i was shocked. she is 71.
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