Hi all,
long time lurker, first time poster. Will start off by thanking all of you for years of solid advice, BL is always my first choice for research and I will be donating accordingly.
There are a lot of threads regarding the transdermal fent patches but I couldn't find anything regarding breakthrough pain.
I am prescribed 400mg oral ER morhpine (over 24 hrs) Mon - Fri, and 300mg IR Oxycodon capsules Sat + Sun. In reality I take 3-4x 120mg doses of the Oxy daily on weekends as I buy additional outside of my script (360mg - 480mg total). I have been on this schedule for approx. 3 months, prior to that I have been on higher doses of morphine ER only (started at 580mg/24hrs) and have been working downwards for around 4 months and prior to that using approx. 200-300mg oxycodon for 3 months.
I managed to get my hands on 4x 50mcg/hr plastic matrix fentanyl patches (non gel) outside of my doctors prescription. I intend to use them exactly as designed, transdermally. There is a lot of info surrounding dosing, for which the general consensus would be to start on 25mcg/hr and work upwards - however I have done multiple conversions basis my daily dosages of morhpine/oxycodon and they came up with a starting dose of 100mcg - 150mcg/hr. I therefore assume it is safe to start on a 50mcg/hr patch, any thoughts here?
My second question is regarding dosing oxycodon until the patch kicks in. Again, general consensus from searching here is that it takes 8-12hrs before the proper effects of the patch can be felt. I wanted to start the patch in the early morning today (around 7am) but after 2 hours of it on I realised my WD was going to be too rough till I got to this mark (especially as from the conversions it looks like I will have work up to min 100mcg/hr), I have therefore taken off the patch and dosed 100mg Oxy. I have read many places that fent patches are usually prescribed in tandem with short acting meds for breakthrough pain, I want to know if it is basically safe for me to put the patch back in the same place after the oxy dose I have just taken (which is 20mg less than my usual).
obviously I know everyone's body reacts differently, I am just looking for a conservative safe standard. Also I am aware that the fent patch will be far less euphoric than my oxy doses however I can save a whole weekends medication by performing the above - it is in my case essentially intended to be used as a maintenance for 3 days to save my script.
sorry for the long text, just wanted to give a clear picture with all the background info.