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Alternating narcotic pain medications for effectiveness

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:19 AM in Pain Medications
Does alternating narcotic pain meds help effectiveness?

My husband has disabling chronic (daily) migraines probably related to several head traumas in his childhood and one in adulthood.

He is on Fentanyl patch 100 mcg every 3 days for about 2 months or so now. It worked pretty well at first but for awhile now he has been having mainly bad days.

Also, lately he started having cold sweats and some of the symptoms of withdrawl by the 3rd day so we have gone to every 2 days.

I read somewhere that it is beneficial to change pain meds up and alternate them due to the tolerance that is built up.
So, every few months change to a different pain med and then return to the previous.

I want to ask his neurologist to do this rather than increasing his dose of the Fentanyl.

Does anybody have any information on this being helpful?

Thanks if you do!


  • I've been changing meds every 2-3 months and it's the only way for me, personally, to avoid the endless increase in mg's (or ug, for fentanyl), or heavy physical addiction. When I crossed over from fentanyl to morphine (extended release) I had no withdrawal symptoms, although it certainly is possible.

    Definitely a conversation for him and his doctor, and definitely worth looking into.
  • It is always a good idea to discuss with your PM Dr. the possibility of changing your meds every so often. Reason being is that different meds HIT on different receptors in the brain. This would make it easier to keep out of the way of that dependence/tolerance problem that every one of us encounters. I asked my Dr. how is it that if I'm taking a long acting Morphine Sulfate (24 HR) why does he give me Oxy for breakthrough and not a short acting Morphine Sulfate, ie MSIR. He told me that to keep me from building up a tolerance and to get a longer use out of the meds, he uses different ones that effect different receptors in the brain. It made so much sense, I felt stupid asking him that.
  • to get back to your question, i sometimes miss a dose of medication so i can build up a small store of meds for an emergency. it is impossible to get an extra script from my doctor and i really feel more comfortable having extra meds on hand. i have never thought about skipping meds for effectiveness but taking them consistently might outweigh that. for that reason i doubt it is a good idea to skip your regular meds for any reason. the doctor did not order them to be more effective and it might not be a good idea medically. a dose is effective for a certain amount and it isn't up to us to change that. [( Jenny :)
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