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pain patches

what pain patches are better butrans or fentanyl.i am currenly on the butrans 20mcg but they are

$200 a month with insurance and discount program. I'm thinking of asking my PM to switch me

to the generic fentanyl patch. I have DDD ,pinched nerve in the L4 L5 area & slipped discs. Taking 7.5 norco

for break through. Any advice?


  • edited 03/18/2013 - 4:47 PM
    I believe fentanyl patches might be cheaper because I think they are generic (your pharmacist can tell you the cost based on your insurance etc. I'm sure even if you don't have a script ). When it comes to pain control everyone responds differently. What works for one may not work for the other. You can't go wrong asking your doctor to switch and see how it treats you. Your doctor might also be able to share techniques that don't involve chronic pain medications. It never hurts to ask.
    ALWAYS consult your health care provider before starting or stopping any form of treatment. Oh yeah, and you can't go wrong with a monkey.
  • fishermanffisherman Posts: 12
    edited 03/19/2013 - 1:45 PM
    Thanks Em for the advice. My PM Dr. OK'd a script for the Fentanyl patch. The PM said to wait 1 week for the butrans meds
    to get out of my system before applying the fent patch. I have to use the norcos in the meantime but I was sick of taking all
    the pills before I tried the patch. I had 7 epidural injections but only provided temporary relief. I'm trying to avoid surgery.
    Anybody have any advice or have been thru the same situation.
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  • Im also on the Butrans and it is expensive. I have never been on the Fentanol patch but I hear different things from diff people on it. Some dont like having to change it so often, and some say it works only half the time, others say they love it.
    See which one works best and if its the Butrans that works better, you can always contact the maker of the patch and some will send you the Prescription free or at a discounted price.
    I am not sure if Butrans participates in this but I do know that Oxycontin and several other do for people in need. I have a friend who is terminal stage 4 lung ca, when she was first DX she did not have insurance, and we had to contact several of the makers of her Prescriptions and with an actual Prescription, several of them helped her.
    Each person is different when it comes to response to medications so its hard to say until you and MD find the proper tx that works for you. I like the Butrans, it seems to work for me along with my other meds.
    Good luck in your journey and I hope it was helpful.
  • Thanks Kristen! I'm a newbie at all this chronic back pain & have been dealing with this for only a few yrs & have only been
    prescribed norco, vicodin & now the pain patch. I just took off the 20mcg patch and it left a huge red mark the exact
    size of the patch. I hope the fentanyl patch works without the sore redness. Best of luck to everybody who has to go thru
    chronic pain. It is no fun & I'm starting to see alot of people including loved ones don't understand what all of us are
    going through. It's hard to deal with chronic pain everyday.
  • MetalneckMetalneck The Island of Misfit toysPosts: 1,778
    I have been on Fentynl for several years now - it is a schedule II med. buprenorphine, an opioid agonist and is Schedule III med so it appears to be a lesser schedule which would imply its not as "dangerous" a med. As an agonist it counteracts the effect of "regular" opiates and blocks the "normal" opiate receptors. My concern would be the inability to use a break through med such a hydrocodone or oxycodone as the Butrans would block the effects of the break through meds.

    Suboxone which is used for opiate detox is naloxone and buprenorphine. I think ..... but my thoughts are cloudy!

    Consider all of the above to be mis-information and consult with your physician(s) for the real scoop!!


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  • fisherman said:
    It is no fun & I'm starting to see alot of people including loved ones don't understand what all of us are
    going through. It's hard to deal with chronic pain everyday.
    I agree with this. Having family that can't sympathize or empathize with you can make you feel alone. You just have to stay positive. It is VERY difficult dealing with chronic pain everyday. They may never understand and that's ok too.
    ALWAYS consult your health care provider before starting or stopping any form of treatment. Oh yeah, and you can't go wrong with a monkey.
  • I've worn the fentynal patch for a few years, a few times. There are things weird about them, once you remove a patch your skin will be just like you were in the tub to long, don't put soap on that area until the skin gets normal there or you'll get sores. In the summer I always wear a tegraderm overlay over it becuase they do not stick as well in the summer. I wear them on my upper arm, imagine where you see tatoos the most, and just switch each arm, those are the only places that I've made them stick the easiest. Good luck. let me know if you've got any questions.
  • Thanks everybody for your comments and looking forward to more advice.
    I know now that I'm not alone with this chronic back pain & having to take these meds.
    It's not easy and I appreciate everyones support.
  • If the size of this forum is any indication that you're not alone, I don't know what is:) I have only been around here for about a week and I can feel the support.
    ALWAYS consult your health care provider before starting or stopping any form of treatment. Oh yeah, and you can't go wrong with a monkey.
  • Metalneck, don't worry about the buprenorphine in the BuTrans patches blocking other opioid medication needed for breakthrough pain - it won't do that. It's a mu receptor opioid agonist, not an antagonist, and it's fine to take things like Percocet or Norco on top of it for extra pain relief. I've been prescribed it for well over a decade and have never had any problems taking oxycodone, hydrocodone, tramadol or morphine for breakthrough pain. It has an additive effect, resulting in more pain relief, according to the literature (and indeed my own and others' experiences).

    There can potantially be problems if a patient already dependent on high doses of another opioid agonist started taking buprenorphine before tapering off the original opioids, because buprenorphine has a very high affinity for the mu opioid receptor, meaning that it binds to it far more strongly than other opioid analgesics. But taking other opioids for breakthrough pain while having buprenorphine already in the system is not a problem.
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