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Question for pt's who have tried methadone and fentanyl patches..

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Posted 12/7/2012 9:34 AM (GMT 0)
I've been on both medications but mostly methadone. I was up to 220mg's daily and have worked my way down to 90mg's and oxy's for breakthu. When I take the methadone after about 30-minutes I am able to dress make breakfast basically do what I have to for a couple of hours if needed.

When I tried the patches I didn't receive that kind of relief even on a high dose it just didn't give me that relief to be able to do things I am able to do on the methadone.. Any comments would be appreciated.

My dose was 150mcg's for the fentanyl. I was using 2 patch's at a time..

Thanks Again Randy

Posted 12/7/2012 3:27 PM (GMT 0)
Wow, sounds like pretty high doses to me. Sure hope you get some relief. I have tried both, certainly not at those doses, but did not get any relief. But i don't think I am your typical pain patient and nothing has helped my pain and I have tried everything.
Wishing you much luck for decreased pain levels.

suzane
Posted 12/7/2012 3:30 PM (GMT 0)
Hey Randy...

Not sure what you are asking since you say you have had experience with both of these medications?

Is the Dr. saying they want to switch you from the Methadone to the Fentanyl?

It's kind of strange that you get such a quick drop of pain relief within 30 minutes of taking the Methadone since that has such a long half life....Same thing with the Fentanyl...These are two medications that build up in the blood serum levels.

Could you explain a bit more of what the Drs. are saying they want to do next?
Posted 12/8/2012 7:49 AM (GMT 0)
I just read it and forgot to ask the main question...

What would your preference be? Methadone or a Duragesic patch every 72hr's
Posted 12/8/2012 9:36 AM (GMT 0)
Hi randy, my choice would be the one that works. I need pain relief, plain and simple, I don't care what delivery method, or what the med says on the label. I'm of a mind set that I'm very thankful that we live in a society where ther is relief available, but I want what works.
Posted 12/9/2012 12:32 AM (GMT 0)
Hi Randy I have to say that I prefer my methadone to any type of patches. That's because my skin is so thin from being on steroids so long that my skin peels off when changing the patches.

I would also agree with Matt you need to pick the one that provides you with the best pain coverage. I'm hoping that my latest increase works well for me and I DO NOT have any issues with my QT interval, like I did a year ago.

Wishing you the best, I hope they can get your pain levels under controll to where you are comfortable. Have you had any issues with your QT interval? I sure hope not, let us know which you chose to take.

Hugs,
Barbara
Posted 12/9/2012 2:37 AM (GMT 0)
Randy,

I am on fentany patches. 75 mgm switched every 48 hours. they generally work well for me, i couldn't imagine a doctor having a patient using (2) 150 patches at the same time, is that is what was dosed by a doctor for you, or something you are doing on your own? fentanyl is a potenially deadly med, even when used correctly. just want to make sure you are on such an extreme high dose under doctor's advisement. i am a cancer patient dealing with perm. and increasing cancer pain, and my oncologist would not bump me to a level like that, least not at this juncture in time.

david in sc

ps i am not critisising you or judging you, so don't take my post wrong, just concerned based on what you wrote
Posted 12/9/2012 7:43 AM (GMT 0)
Just a quick thought about medications ---

Fentanyl is definitely a strong medication.... but everyone is different in terms of how their bodies metabolize things, tolerance and so forth. So, it's not that someone has *worse* pain, necessarily, because they are on a certain med, or a certain dosage....

A few years back, I also was on 150mcgs of fentanyl (2 75mcg patches) changed every 48 hours. This was shortly before I did the pump trial....

I'm now on other meds, but still on oral fentanyl.

Randy - I'm w/ everyone in that I would just want what works better, with the least side effects. I've been on both (methadone and fentanyl) - both at high dosages. Methadone wasn't a good med for me. Fentanyl works the best for my pain, but had too many issues w/ trying to keep patch on and also the patch would cause rashes on my fair skin.... so that's why I'm on oral fentanyl (as well as other meds).

Good luck on finding the right med for you... --Tina
Posted 12/10/2012 3:34 PM (GMT 0)
Yeah I agree with Tina. My patch is 250mcg every 48 hours tho. Works well for me but some days I don't even wear it and just take the Fentora. I never feel any type of withdraw so that's good. But h do try to keep the patches on everyday.

Can't see what I am typing this morning. Cateract surgery is Wednesday whoohooo!
Posted 12/10/2012 10:49 PM (GMT 0)
Hello Randy!

Can't help on the Methadone question, but I have used the Fentanyl patch for a few months. I have to ask if you are using the Matrix tape type or the gel filled type. I found that the gel filled type worked best for me. There are also quite a few reports on how there is a difference with different brands. My Dr confirms this as well.

I myself work in a warm environment, and the patch was dispensing way too much of the med too quickly. Generally, many patients find that they have a need to replace the patch every 48hrs instead of the recommended 72hrs. These are just a few things that you and your PM may want to discuss as you seek out a better pain management med.

Good luck!..and take care!

SE wink
Posted 12/11/2012 5:09 AM (GMT 0)
funny how different people can be on the same med.

for me, the gel resovoir type fentanyl patches didnt work well with me, they used up too fast, even though my patches are swapped every 48 hours. the non resovoir type are what i have been using for months - they never come loose, never have had to tape on one.

david
Posted 12/23/2012 8:37 PM (GMT 0)
non reservoir type, can you remember what brand those were. I have watson 75mcg atm, but i've already printed the coupon for next time duragesic.
Posted 12/24/2012 12:18 AM (GMT 0)
I use durogesic, have been on them for years. Never once had a problem with coming loose, falling off etc. was switched to the reservoir kind once, I came out in a rash and had to ask my doctor to prescribe durogesic, nothing else. Don't think you'll be disappointed in this brand, you hardly know you are wearing them...other than they help the pain of course lol!!

Good
Uck

Jane
Posted 12/24/2012 12:34 AM (GMT 0)

Hi Randy. Im wondering whose choice the change was? Yours or Doc? If your getting good pain relief from the methadone why change it or add to the mix? I have been on both but methadone alone for about 10 years and like you as long as I have not missed a day or dose I pretty much get relief in under an hour,note here 10 years with this med in my system so each dose is like a booster to my already maintained system level. Just how methadone is designed.

I never got that kind of relief from the fent or any other meds we have tried. I do however dose differently than most using the clinics once a day dosing but leave myself 20mgs I can take if it beomes needed later in the day. This works best for me and my Doc allows me to do dose however works.

I do have to say that if your now taking the fent,methadone,and oxys at those doses together that you be extremely careful for even opiate tolerant folks such as we have gone to sleep on fent/meth alone and not gotten up again. Not sure from your post how your taking this combo but just wanted to express concern especially in light of the 48 hr fent dosing.

If you want to pass on a little more info maybe we can help more.

Good luck but it looks as if there really isnt a issue as everyone said go with what works and dont fix it if it isnt broke.

Posted 12/24/2012 6:51 AM (GMT 0)
I love the fentanyl patch, it has given me my life back! I am on the 75mcg every 72 hours, gel type. It's nice to always be getting a steady supply of medicine without the highs & lows of pills. I take 15mg oxy for BT pain.

But as others have stated, stick with the one that works. Why fix what's not broken? yeah
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