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Opioids New to Fentanyl patch, need advice

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PaulaPA

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Jul 3, 2010
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I have had chronic neck pain since a car accident 5 years ago. I have been taking ten mg lortabs 3 times per day for a while now. I admit I DO take more than prescribed by pain doc (little thing called tolerance) so usually end up taking 40 to 50 mg of lortab a day for good pain control. Then I'd run out early. Then I'd call people...you know how it is.

Well I had a stomach bleed, eneded up in the hospital for a week, and had to stop taking most oral meds, including my Lortab (unitil stomach heals in 2 weeks or so).

Doc put me on 12.5 MCG Sandoz Fentanyl patch: one every 72 hours. I am less than impressed! I can tell I'm on "something" but I felt none of the Lortab "high" at all. Also, reason I'm here, I'm getting shitty pain control as well. I work in a NH, so I have nurse friends, and I asked one and she said 12.5mg was "nothing" when it came to this stuff.

With all the Lortab I've been on, I should be able to handle more than 12.5, right? So I should be able to wear two of the 12.5 patches this weekend until I talk with my Doc on Tuesday without dying, right? Any help appreciated. I didn't know this place even exisited.
 
it's stated on the janssen cilag site that a patient should only be started on the 12mcg/hr patches if they've been on pain management equal to 40mg continuous release oxy (60mg morphine) daily for at least 2 weeks prior.

even though you may not be getting the pain relief you'd like right now it's in your best interest to wait and see your doctor to speak to him about your options. don't go upping your fentanyl dose by yourself, especially if you're home alone. i wouldn't call you a very tolerant user by my standards and bumping up to 25mcg/hr could be overwhelming for you, possibly OD territory. i'm not saying this to scare you either, fentanyl really is as potent as made out to be.
 
I agree with Leftwing. You have a small tolerance and I would not recommend doubling up on the patches. Fentynal is a very scary drug that gets the best of many people very easily. Talk to your doctor and ask his advice.
 
I would reccomend cutting the patches into about 4-8 different little squares and placing them one at a time under your tounge until you feel the relief. Definitely works faster/stronger. Just gotta be carefull
 
jamesBrown said:
I would reccomend cutting the patches into about 4-8 different little squares and placing them one at a time under your tounge until you feel the relief. Definitely works faster/stronger. Just gotta be carefull
Click to expand...

do not do this fentanyl is verry strong and like said above you have a low tollerance this could easily kill you
 
also like said beffore i would talk to your doc beffore increasing your dose when i was on fentynal i did it myself and my doc did increase my patch's from 50mcg to 75mcg but there sooo expensive insurance wouldnt pay for it so had to go thru a week of w/d usually if your perscribed the patch you will be also perscribed a "rescue" medicine like 10mg perc's 2-3 times a day
 
jamesBrown said:
I would reccomend cutting the patches into about 4-8 different little squares and placing them one at a time under your tounge until you feel the relief. Definitely works faster/stronger. Just gotta be carefull
Click to expand...

the OP isn't wanting to use the fent recreationally. they don't need to start dabbling in subligual fentanyl with such a low tolerance to opioids.

while most people under doctors supervision are usually fine to start on the 25mcg patch, it's not unusual to start on the 12's and working up from there.
 
Aside from the fentanyl question, I would recommend doing a cold water extraction (CWE) on the lortabs if you continue taking them. You can search the direction on how to perform the extraction on BL, or just google it. There is also a youtube video showing how.
 
well he is using the pain pills for pain and apap helps reduce pain... also if he takes 5 pills max a day it would be 2500mg far less then 4000mg (assuming there 500mg apap i used to get 10/325's) in the long term 2500mg's a day is alot of apap but he is switching to fent patch's so i dont really see a reason to cwe any rescue med he may get
 
i have seen countless threads with the words new and fentanyl go down in flames because of how scary that shit is or how scared people are of it. never tried it so i cant say.

take it on the light side. better safe than sorry.
 
PaulaPA said:
Well I had a stomach bleed, eneded up in the hospital for a week, and had to stop taking most oral meds, including my Lortab (unitil stomach heals in 2 weeks or so).
Click to expand...

I realized that it wasn't a high amount of apap, but recommended the CWE since the OP mentioned stomach pains. I also thought they meant that they were going to take lortabs again after the stomach heals, or maybe I misread this.
 
Sorry to clear up the confusion I will be going back on some pill or other after my stomach heals. It may not be the lortab (the Doc thinks all the lortab and ibuprofen caused the stomach problem to begin with).

I had Percocet 10 mg 3 a day before and after my neck surgery and those worked great for me. I ended up being slowly weaned off of them and eventually just took over the counter stuff.

Then about 2 years after the surgery I started getting bad neck pain again and was sent to a pain management doc and now here I am with a broken stomach.

I want to ask to be put back on the percocet or some other good pain drug without all the tylenol!

Anyway, I am just using the one 12 mcg patch. Better safe and still hurting than dead, right.

Thank for all the helpful info.

Any suggestions on what pill I could ask for in a couple weeks?
 
there are oxycodone formulas without apap, namely oxycontin which is continuous release, roxicodone being instant release.

we're not here to suggest what pill for you to ask for though, that's for your doctor and yourself to decide. you can of course ask questions relating to the drugs, but can't flat out ask what you should ask for.

The Pain Management Mega Thread - for all your questions on dealing with chronic pain is a thread worth reading through and asking these types of questions.
 
I would only use Fentanyl if the short acting opiates do not really help you. If Lortab has worked for and Percocet, tell your doctor this. I was only put on Fentanyl after I tried most of the short acting opiates and none gave my chronic pain relief at all times. So I was on 12.5 mcg/hr patches for a month, then I went to 25 mcg/hr after that month. I was originally on Dilaudid and Percocet for pain, so I had a tolerance of like 20 mg oxycodone, 6 hydromorph when I started the patches. The higher dose gave me better pain relief and no real high.

If you tell the doctor Percocet works for you, but you do not want to take acet. or anything of the sort in conjunction. I don't know what he'll give you, but hopefully it will help.
 
In my experience fentanyl doesnt give any high like the the other opiates do. I used the 100mcg patch for awhile and thought they sucked, for pain as well.

Probably your best bet if stuck with the patch is to cut it open and get a little gel on the finger, and rub it onto the inside of your cheeks or gums. This can be dangerous because you could keep searching for the feeling you got from your hydro which never comes. And you have to be very cautious because of fentanyls potency. The feeling I got from fentanyl was a body buzz a bit like after drinking alcohol. Also a buzzy head feeling. After using a lot of it it was obvious it was in my system working, it just sucked.

I have now heard of people putting the gel onto a glass surface like a mirror and then blow drying it until its dried and can be made into somewhat of a powder to be snorted. I didnt know to try it this way when I used it though.

The #1 thing though is toi be careful because of Fentanyls potency. It would have been nicer if the doc could have given you another pill without the apap.
 
^they've got the sandoz patches anyway which are the polymer matrix, not the gel reservoir. even then it's still not great advice telling an opiate naive person to start taking dabs of an unmeasured amount of fentanyl and stick it between their gums.

to philly - if it's chronic pain(which is what i'm guessing after the post about having to see a PM doc), then after continuous release pills i'd maybe go the fentanyl route.

if it's the apap that's relative to the stomach problems then there's a few options before jumping straight to fentanyl for long term care. this is all imo. pain management boils down to the doctor and patient.
 
leftwing said:
there are oxycodone formulas without apap, namely oxycontin which is continuous release, roxicodone being instant release.

we're not here to suggest what pill for you to ask for though, that's for your doctor and yourself to decide. you can of course ask questions relating to the drugs, but can't flat out ask what you should ask for.

The Pain Management Mega Thread - for all your questions on dealing with chronic pain is a thread worth reading through and asking these types of questions.
Click to expand...

Sorry I didn't know! Anyway, thank you for the advice.
 
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