Doc finally making a med change for me.

I've been struggling with the 20 mcg Butrans patches for three months. Too many bad days with the patches running out at day six every week, some weeks at day five. When he finally agreed "this isn't working very well", his first response was to go to fentenyl. But, after discussing my lifestyle, he said "no more patches" since he said the fentenyl patches were harder to keep on than the Butrans. I'm happy about that he switched me to Exalgo which sounded great... Until I had to pay for it.

It's about $400 for 30 8 mg pills! Fortunately, I have very good insurance, at least for now, so that's not a reason to try the medication.

So, now my question for the community. I did not get a good answer from the doc on when to take it. It's a once a day med, something I have zero experience with. His only comment was that it should be the same time every day. Any opinions out there? Morning? Evening?

What sayeth the experienced among us? TIA.

Lite the few that has posted here about it did not care for it, claimed it did not last long enough. Hopefully it will work for you. I would not go by what others say. We all metabolize our meds differently. Its what will work for you.

Let us know how things work out........Susie

Straydog,

Thank you the info, sorry to hear that it doesn't appear to meet what the expected performance verses cost should be. I agree we're all different but I usually do better on generics and older generation drugs than the newer, reformulated, one of a kind products.

I suspect this drug would not exist if it wasn't for the Federal DEA's "war on drugs". Very sad what we all have to pay because of abuse by a few

Yes, I did the conversion with the help of the equivalent strengths over at pharmer.org and I see that it was lower than I expected. Much lower.

The doc's explanation, almost sensing that I was going to question it, was that he converts then drops down by 25% and will titrate up from there, first looking for any adverse reactions. He has always been very conservative in his dosing which I know is the right way to approach this.

I'm developing what I feel is a decent relationship with him since he knows I do my research and since my background is engineering, the numbers come easy to me and he knows that - which is why I think he felt the need to explain his plan with the strength of the Exalgo. I would not question the dose, he is the doctor and I trust him and I think it is reciprocal at this point even though I've only been seeing him since July.

I had been keeping a rather detailed log with when I started the Butrans but dropped it as things became routine and the doc wasn't interested in the day by day, only the overall. Thank you for the reminder, it is time to start up again with that so I know how things are working. It is amazing how you do not remember unless you write it down.

Right now I'm 24 hours post Butrans with no oxy so far today just to see what the pain levels are. I will not have the Exalgo until late today. I will wait until the last of the Bup leaves my system - which I got pretty good at sensing due to the early exhaustion of the patches. So far today I'm at a 5'ish pain level-wise. I'm okay so long as I'm not moving around, sitting in the chair typing is okay. It's the up and down out of the chair and the up and down the steps of the house that really fire up the pain.

I really liked the consistency of the pain relief with the Butrans - in the middle two/three days of the up/down drug levels so I am not one that likes the "rush" of ir meds, I find it really destroys reading comprehension and is just all around bothersome. One of the things I have learned in this journey is that I do not like Vicodin for that reason - as when it gets to levels to be therapeutic, it leaves me completely goofed out in la-la land, not a place I like to be.

Here's hoping the Exlago works! I need to function every day, not be flat on my back in pain. Thanks to all for you input, suggestions and concern.