Lyrica denial for neuropathic pain

Alcie, although I have what is considered good insurance, I too have had meds denied on more than one occasion. However after a couple of appeals from my Dr, and even at times a phone call to the insurance company by him, we seem to somehow to get approved. It takes persistence sometimes.

If your needing a nerve damage med, then you might mention Nucynta to your Dr, as it has this property in it in addition to the narcotic property as well. Yes, its a duel property med! It changed the whole ball game for me! Had I not tried it, the next step was a trial for the pain pump. Something I did not want to do!

I remember when I first tried it, I almost gave up on it. However!…I asked my Dr to up the dose, as I wanted to make sure I did not miss an opportunity for pain relief, and was desperately trying to avoid the pain pump. Each time I have tried nerve damage medications, I have done this and pushed the doses to the maximum suggested by the manufacture.

Maybe you have tried Nucynta already? If you have not and you do give it a try, just remember that it is one of those meds that take some time to get into your system, and you may have to work a little at the correct dosage. I'm at 400mg a day, and I'm thinking that 600mg is the maximum daily dose for back pain.

On a side note,….I'm actually on both Lyrica (100mg), and the Nucynta(400mg), and have added Mobic (15mg) and Oxycodone (22.5mg)…these are daily totals.

One more side note here! My sister has also been on the Nucynta with excellent results as well. However, she had to get off of it for a while as it caused quite a bit of weight gain in her case. I believe she is now back on it at a lower dose. She is not doing well at this time, and maybe looking at another fusion. I feel so badly for her! There are 6 or 7 of us in the immediate family on my side, suffering from bad backs, including my own daughter. In addition to that, my wife has also developed spine problems, and the X-rays make me cringe.

She is not one to take pain meds, and will go as far as tears running down her face at night, before she will finally give in, with a little pressure from me to at least take a half a pill of her own scripted med. (Loratab)

Take care,

SE

Merrida!…Thank You for your followup response to her! I agree with you greatly! Good stuff you wrote here! This is what I love about this forum!…members who really care enough to take the time to share and write up a good, encouraging reply! It's what makes this forum so appealing to many of us.

also….one of our members wrote up probably the best informational post on Nucynta that I have ever seen here, or anywhere else on the web. I think it was written by Spinal Soldier, and very, very much worth reading! Maybe do a search on it here?... and give it a good once over review of it.



Thanks!

SE

Alcie,

Just wanted to pop in real quick.

I had to fight tooth and nail several years ago when my PCP wanted to me to do a trial run of Lyrica. My primary insurance had no issue covering it, but I have medicaid as a secondary and no amount of prior authorization's and appealing, we just couldn't get it through. My doc did supply a few months of samples but I had to stop taking it because of all the weight gain.

And like you I tried the neurontin and had to stop. For me it drove my blood sugar through the roof.

Has you doctor mentioned at all about trying a Topomax. They have been using it off label for a few years for nerve pain. And its been out in the generic topirimate for a while now. Might be worth a try. For me its one that does work for my radiculopathy and I had no problem with my primary or secondary insurance paying for it. The only side effect's I've had is soda tastes terrible and it has caused me to lose a few pounds. Of course for me thats not a bad thing. lol

Good suggestion, Just.
As things are going I might try it again, at very low dose, for the current problems. I tried it with worse side effects than the Lyrica, so far. I swell up a little on Lyrica during the day, but my kidneys are happy to take care of it at night. Again, so far.

Hi, Chart.
Thanks for the idea. I do have fibro. I'm getting a few things together to fax over to the clinic to argue with ins.
My other pain doc, a partner in the same clinic, just ordered another MRI. I'm expecting that to be denied too since I had a bunch or MRIs, CTs, and X-rays done just 3 months ago, and another bunch a month before that. It's not new pain, but worsening and the facet joint injection last Friday only worked to stop the tip of shoulder pain and some muscle pain, but not cramping. The neck and T1 pain are getting out of control. I have Vicodin 7.5, but no use taking it because it doesn't help anything from cord syndrome.

Is it for the brand or generic ? I know the FDA oked the generic in Oct, but I'm not sure if you can get it. I do know that there will be a stronger push that ever before for Medicare to not pay for brand name meds in 2014, due to costs.

Huh, I thought I already replied to this post but apparently I haven't. Just wanted to say to KEEP FIGHTING to get your medication. I was turned down numerous times (this is with my doc faxing over documentation) and finally just got it last week. I started on Saturday and have already had noticeable improvement (I have fibro, tho).

As for Nucynta, I am not a fan. It made me have horrible night sweats and really just made me stupid, didn't really help with pain. Even my mother in law who still takes it said just this Saturday 'it makes me not care, it doesn't get rid of it'. My previous pain doc (I moved to a different state) was very conservative and wanted me on Nucynta instead of regular opioids, to the point that I had the 150 ER twice daily and 75mg IR up to four times daily. I was in the thick of Nucynta for about 4 or 5 months. I have to say that Lyrica in these last two days has done way more (FOR ME) than Nucynta ever did. But....it's only been two days. hahaha For the rest, I have my b/t med. Keep in mind that I had pretty severe hand and foot nerve-based pain with my fibro and I woke up without it. That is a game changer.

Keep up the FIGHT!! :)

Man, they should really work on their customer service. When in doubt, cuddle with the kitty. They make everything better. <3

I am in the throes of frustration myself now. I got a different generic of my pain med and I am not reacting well to it (stomach ache, headache, localized pain for absolutely no reason) and while my pain doc is generously willing to replace the script with the generic that i was stable on, my insurance wont' cover another one. I am currently surrounded with printouts of differing formulas of this med that will work that they *might* approve (aka lower dosage, different OTC in formula, altogether different active ingrediants), and it's been the pits!

Lyrica has been *amazing* for my feet pain so I am glad to hear that yours is getting better, whether it's from Lyrica or just a fluke. I am currently on 50mg 1X day for a week (then 2 per day for a week, then TID going forward ) but got the approval yesterday to go ahead for 2 a day since I really haven't had any side effects. I am noticing that the feet pain comes back in the late afternoon and also noticed last night that I had shooting pain down my left arm while driving. So my body is definitely noticing the change - which honestly scares me. I don't need ANOTHER drug to be dependent on. Meh.

Weird things about Lyrica:
- I'm in a MUCH better mood. I am wondering if this is the 'euphoria' that people have reported. I don't feel like it's euphoria....just me without pain. lol
- It doesn't make me tired. Shouldn't it?? It's used as a sedative, I thought.
....These two things worry me that I like Lyrica more than I should. As in, it's making me a little manic (I am not BP, not that I am aware of). But to me, it just has deleted significant pain so I am feeling better. In fact, I haven't really been without pain and been stone cold sober (ie not feeling side effects of pain meds) IN A YEAR. This week has truly been amazing.

As for colder weather, I have been out and about with just 50mg a day and I haven't noticed that the weather made an impact, *unless* it was later in the day and the Lyrica had worn off.

What has been your experience, if you don't mind sharing? :)

AnnaBananna -

Sorry your pain med is giving you problems. Generics are notorious for different companies, who have to slightly modify the formula, giving different results. Talk to your pharmacist about what to do. When you find something that works, stick to the same manufacturer and have the pharmacist make a note in his computer.

Read up some more on Lyrica! It's not a sedative, although at doses you haven't reached yet it does just that. Yes, your mood should improve, although I wouldn't expect on only 50mg. It's approved for "general anxiety disorder." At two a day, you aren't on much of a dose, even by my sensitive standards. Don't go to 75mg unless you have to, and keep some 50s in case you want to come back down. Right now you are way below "theraputic dose." 75mg (just one of them) puts me to sleep, not just tired, crashed on the couch asleep, unable to function. The half-life is something like 6 hours. I've noticed the 75s affect me up to 12 hours.

Read about Lyrica withdrawal. It can be a major problem after long-term use. I got leg spasms pretty bad one night when I forgot to take the med.

I'm not entirely sure that I will stay on Lyrica at all. If I don't get pain relief at the 50mg level, maybe twice a day, without severe sleepiness, it may not be worth it. My pain level has only been reduced a little. I'm trying hard though, as it's my last hope. Central pain syndrome never goes away.

I wish I just had pain in my feet. With central cord syndrome from broken neck, and central pain syndrome on top, I have pain from toes to top of shoulders. Part of the syndrome is that the blood vessels can clamp down, especially when I get a tiny bit cold, as in the room goes below 70 degrees. It's odd that my head is fine, even without a hat. Out here means it's been 10 degrees in the morning. It'll stay below freezing for at least a while, and I am the only one who can drive the tractor and plow.

My only other pain med is tramadol. It helps with my fibromyalgia pain, raises serotonin which also improves mood. It does NOT touch this type of nerve pain. Nothing so far has proven useful for that.

If you're getting enough relief tell your doctor so he won't push you to go higher faster than you tolerate. I went up too fast. I should have listened to my own advice and stayed at 50 TID at least a week longer, then moved up to 50 BID and 75 at night.