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Bupe Bupes Patch & Morphine

W

Wispa

Greenlighter
Joined
Apr 27, 2019
Messages
8
Hi, i'm new. Apologies if this requires moving.

I have been prescribed 10mcg Bupes patch and Oramorph for break through pain, though - this appears to go against everything that I have read on BL regarding using the two together.
Could anybody shed some light as to why she might have prescribed this to me?

Any help would be appreciated.

Edit: The Bupe isn't for a detox, but for a genuine back injury (not that any of you who take painkillers don't have genuine reasons or that it's my business, I digress.. )

W
 
Did she not give her reasons at the time? Both are terribly hit and miss in my opinion Wispa mate. Your bupe is essentially your modified release primary, and your liquid morph is your immediate release as you say. No interactions that I know of detrimental to the two in tandem, but Oral morphine has a shocking BA. I would have a chat about these concerns if affected!!
 
Thank you for replying so quickly.

The reasoning for the medication other than pain relief, no. I didn't feel I could exactly explain that I have heard people saying XY&Z on BL; so I left it.

I mean in terms of what I have read on this website, two things.

1) Most posts are saying that the bupe binds, therefore other medications such as DHC,codeine and morphine are ineffective.
2) Also, excuse my ignorance - but many people who are 'going onto bupe' seem to be petrified of it. I'm unsure if it's different if they are speaking about tablets/buccal as apposed to
patches, however i'm wonder what they're so concerned about. Especially considering I have been taking a high dose of DHC before this prescription.

Thanks again,
W
 
No problem, happy to help. Bupe in normal preparation as 0.2mg tabs etc would keep or kick your morphine out of the way, as it has a higher affinity for Mu receptors. This is the reason suboxone is used in opiate replacement therapies. As a transdermal drip fed through your skin that won’t happen. Give the patches a chance they can prove useful for some, but I would prefer the DHC to oramorph for breakthrough personally. You can always suggest you have a family member who is taking something with success, as oppose to referencing here.
 
Thanks.

So, as the patches are drip fed the risk of going into withdrawal is unlikely?
and there are no issues with using the both together? that's good to know.
 
I would have to get my books out to be absolutely certain, but I am happy to say that they should not clash. May I ask what pain you are managing, and what have you taken previously?
 
compression fracture of the spine.

Codeine
DHC
Oramorph (re-prescribed, but have had it previously)
Tramadol
Gabapentin
Promethazine (Still taking)
Pregabalin (still taking)

I believe as you mentioned, the patch is to ensure that the pain relief is 24/7. As when I wake up in the morning it's ten times worse, and one doesn't have 30 minutes to wait for a tablet
or other medication. So a small steady flow is probably better.

I have never 'abused' medications and have always taken them as prescribed.
 
It looks like a typical generic treatment ladder they have had you climb from the bottom, without any thinking outside of the box or individual options which may work best for you. You are still waking in pain, even with the bupe patch in full flow?
 
I have only just started it today mate, so I couldn't say. I was just wondering if I could use other scripts with it is all;
Not that i'm not going to give it a chance, but at least until I find that it has got to 'full flow' and is aiding me.
 
I was on Bupe and took hyrdocodone for breakthrough pain. I could still feel the hydro, but it definitely lost some of its effectiveness. Honestly I would get off that patch unless you notice a big change. For me, the patch did nothing to alleviate my pain and bc it interacts negatively with a lot of things I generally take, it was really inconvenient for me. Sending my best, hope you find relief!
 
Ah right, is it a 72hr? You should be fine propping up the settling in period with breakthrough meds I’m sure. I do know cases where they have been very effective for chronic back and other pain, as a good foundation. I suspect it will be the oramorph that proves to be like pissing in the wind!! About 20% oral BA if I remember anywhere close to correctly!!
 
The dosage you're on (10 microgram/hour) should be way too low to block other opiods from binding to the µ-receptor, so your oramorph should definitively help with breakthrough pain.
Due to the long half life of bupe it might take a while to reach a steady-state so give it a few days and see how you feel then :)
 
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