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conversion to Fentanyl patch?

dmoonchildddmoonchild Posts: 383
edited 06/11/2012 - 7:28 AM in Pain Medications
My Dr suggested the patch at last appointment. I am seriously considering it. Does anyone know what my dose might me starting out? I am taking oxycontin 40 mg every 12 hours now. I ask so I can call my pharmacy to see what the cost will be before switching. Thanks!


  • that your Dr would start you on a lesser dose first. That is probably 25MG. There is a brand name Duragesic and generic ones. My Dr will only use Duragesic because he and my pain dr think that they work the best. Get ready for sticker shock. I just got a months worth of 50 Mg and my co pay was 304.00. Also, ask if you do go on them about handling instructions and storage. They are very dangerous, life threatning to children.
  • I started out on 12mcg then next month was upped to 25mcg, your body has got to get use to the drug. The first time I put one on it knocked a loop in me. I was walking around the front yard trying to get to the mailbox. I was drunker than a box of rocks lol it was funny to my neighbor but scary to me. I feel find now and drive even.
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  • It might not be a good idea to have one of those narcotic converters here. It might give patients the wrong idea about what dosage they think their doctors should put them on when going from one med to another.
    Also it does not take into account cross tolerance issues, which most of us know nothing about.
    It might give patients the wrong idea about what dosages to expect, when changing meds, and that should be left up to our doctors.
    I am just worried that someone will use this, and go in expecting one dosage and finding themselves getting a new script for less, and thinking that it isn't "enough" to control their pain because they used this before seeing their doctor.
    Sandi <-------- always a worry wart....
  • All I can say is please be very careful.

    I don't know if you saw my other posts but my new, and first ever, PM doctor started me on the 50 mcg patch and I ended up in the hospital for 3 days. It was not a very good experience. In my opinion, I would start on the lowest dose and work your way up if needed and tolerated.


  • Edited - didn't want to cause concern. Didn't know that would be questionable. I found it very helpful.

    When I was abruptly taken off my regular meds and thrown into a very serious withdrawal state during an emergency hospitalization in December, the "old school" doc literally told me he had no idea what to put me on, although he would not be giving me what I normally took, NOR would he call my pain management doctor. I was in a dangerous state by the time he decided to give me 12.5 Fentanyl patch, and this was while I was in the middle of an acute pancreatic attack AND pulled off all pain meds. It caused me such heart stress that I was given potassium boluses the rest of the week and delayed my release.

    He did move me to 25mcg and at that point, I was so scared of him and his playing around with the meds that I just tried to make it on that dose. I didn't know if that was too much or too little compared to what I had been on. The stress of that alone nearly killed me. I realize now I should have demanded a new doctor. The minute I got out of the hospital, I called my pain doc and they were speechless at how I was treated and what I was given. They advised me what to do and I was very thankful.

    I've not considered the patch because I am hot-natured and also, we have a pool and I will be wet all day all summer. I heard that can be a negative to using the patch.

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  • oh believe me I will be careful. My husband and I had a long talk about using the patch pros and cons. I am in so much pain right now, my meds work very little and I have no quality of life. I have 2 small children and they are my biggest concern. My husband will have them locked in the basement we just have to figure out a good disposal system. I am very nervous about using the patch but I am hearing nothing but good stories about how it gave life back to people. I want to be able to participate in my kids lives.
  • I agree with Sandi, and dose conversion should always be determined by a doctor. My Fentanyl was bumped from 75 to 100 mcg and so far I'm tolerating it well and had no side effects. The reason is probably because I've been in this med for over a year now. Everybody's tolerances are different and some people may start on 25 mcg while others start at 12.5 mcg. Fentanyl is a very powerful medication that should be prescribed by a knowledgeable physician and should be taken with caution.
  • Meydey, is it good pain med for you?
  • I think it is, even if it doesn't take the pain all away. Actually, no one medicine will. I will stay on it as long as they'll prescribe it. I like it because I can put it on and "forget" about it until it's time to change it. As you know, it sucks to take a whole bunch of pills. I use medical tape to secure it and write the date on it so there are no mix ups. You do however need to have a break through med with Fentanyl. They make Fentanyl lollipops (Actiq) but they are extremely expensive. I heard they are very effective in knocking off BT pain but I just can't afford them. Oxycodone, Dilaudid, morphine IR, or Norco are examples of suitalbe substitutions.
  • Hi Laurie,
    fentanyl should never, ever be used in someone who is opiate naive. It's scary that you were given that, especially at 50 mcg. Everyone should start at a low dose, only after they have been on other opiates for some time, if they start the patch, and if needed, work their way up to another dosage.
    A good PM will taper, slowly since it takes a few days for the med to get to a steady blood level once the patch is applied. And having someone come back every two weeks until they get the dosage correct is not a bad idea.
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