HealingWell
Search Close Search
☰

Kinda of new :) Fentynal, klonipin help

Support Forums
>
Chronic Pain
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 12/10/2013 1:47 AM (GMT 0)
I have done a few posts, mostly on methedone withdrawals. Wanted to introduce myself more and ask a few questions.

I have been dealing with cp all my life, and my mother has fibromyalgia. First started with a low back injury at 18 while working as a cna. The last two years have gotten much worse (32 now.) I have partial lumbarization of my lower spine (right above sacrum)aim complaint now is my right hip. Have also been diagnosed with siatica bursitis of hip And tendinitis of the hip (2 tendons.) nothing compared to what most of you deal with but still in constant pain and looking for more answers.

I have had steroid injections in lower back and hip, PRP injection in hip, orthotics and physical therapy to help deal with pain. Aksumite ice on a daily basis and TENS unit as much as I can.

Last year started using medications. Started with ms contin, then methedone and now on fentynal patches. Currently at 100mcg with no pain relief (I use percocet 5/325 for break through medication.) will be increasing to another 50 mcg patch starting this week. Patch users, is this a huge jump that will be hard for my body to handle? Big enough to hopefully notice a difference? I have been using flexeril for muscle spasms. I have found klonipin (prescribed for methedone withdrawels but ok'd by dr for this use as well.) has anyone else found klonipin helpful for muscle spasms? If so did it stay effective for a long time before dose increase was needed?

Last question. After much research (a lot of it on this site) I believe something to help with nerve pain may helpy overall pain level Amd ability to function. I tried neurotin for 3 months. Eventually up to 1200 mg daily and it never helped. Any suggestions on a different medication?

I am so glad I found this site and have already found it helpful and encouraging. In a bad flare now and can barely care for 2 year old son let alone housework. I look forward to getting to know everyone better. Amy questions, please feel free to ask.
Posted 12/10/2013 2:41 AM (GMT 0)
Hey Ktk81 -

I've seen you post on a few threads, but glad you took the time to introduce yourself.

Re: your fentanyl question - I'd be concerned w/ you feeling "no pain relief" at 100mcg of fentanyl? Yes, going to 150mcg is a pretty hefty jump. I've been at that level before....... so YES you should notice a difference. I would really watch for breathing issues; sleepiness; etc. (Just a little surprised your doctor is jumping you a whole 50mcgs).

I've never taken Klonopin..... but I've taken other benzos -- and, not trying to put on my mom hat (sorry, I have 8 kids) -- but REALLY be careful combining that w/ 150mcg of fentanyl. I'm not one to be "over panicky" over meds and such - but really, I'd hold off on the benzo until you get stable on the new dose of fentanyl.

Re: nerve med -- usually w/ nerve pain, it can take getting to 1800mg or above to see results w/ Neurontin. But there are other ones to try as well.

Welcome aboard.... sorry you have to be here.... and good luck, and be careful, w/ those new meds. I do hope they help your pain though.

--Tina
Posted 12/10/2013 3:56 AM (GMT 0)
I do really appreciate your concern. I know it's a hefty dose
Of medications. I don't ever want to be over medicated, just needing pain relief and the ability live a normal life and get the pain to a manageable level. I did think a 50mcg jump was pretty big. I was on a very large dose of methedone so transition had to be high due to my built up tolerance. The other reason souch of a jump is going through insurance hoops took 3 months to even get on fentynal to begin with. 3 weeks to get the increases dose authorized. I appreciate your concern and reaponce. Thank you
Posted 12/10/2013 4:27 AM (GMT 0)
I totally understand what you are saying.

At one point I was on the equivalent of 650+mg of morphine......... and, like I said, I've been on 150mcg of fentanyl, changing every 48 hours. So it was no judgment all, just concern.

Let us know how it works...... --Tina
Posted 12/10/2013 4:40 AM (GMT 0)
I didn't feel judgement at all. :) tolerance is a scary thing when it goes up so quickly. Annoying too. Lol
Posted 12/10/2013 3:19 PM (GMT 0)
Hi Kt, sorry to read of all your problems you are going through. I too think the 50mcg is a pretty big jump. My thoughts are going up 25 mcg instead of 50 mcg because the 125 mcg may very well be the working dose. That way if an increase is needed later you will have that 150 mcg available. We can always add more but trying reduce a dose stinks. How often do you change your patch?

You mentioned being on Gabapentin at a dose of 1200mg, you still had some room to go up on it. Have your tried any of the other nerve meds? Narcotics are not that effective for nerve pain, thats why it is important to find one of the nerve pain meds that will help with the nerve pain. Some people are on Lyrica, Cymbalta & Amitriptiline to name a couple.

I do hope you can find the right meds to give you some relief. Take care......Susie
Posted 12/10/2013 5:24 PM (GMT 0)
Disclaimer: I have fibro - widespread muscle and nerve pain and have been trying to find the perfect pain coverage for a year now. I think I am almost there, which feels awesome.

Every once in a while it's important to jump down on your dosage to reset your tolerance, even though it seems to go against our need for quality of life. I know it really sucks to force yourself through withdrawal but it's the only thing I have found to help when my tolerance has gone sky high. I am on 25mcg and 12 mcg of fent, changed every 48 hours with 10/325 percoset as b/t meds, up to 6 a day. I agree with Susie that you should try a smaller jump in dose. Maybe asking your doctor to give you twice the amount of 25mcg just in case it doesn't work after a few patch changes.

I tried gabapentin (Neurontin) for a couple of weeks and it did not help my pain one bit...and made me very depressed -- so I stopped it. I started Lyrica on Saturday and its effect on my pain was overnight. I was shocked. While it's not helping my muscle pain, the pain that is always standard for me (severe foot and hand pain, shocking pain through arms, etc) is gone until about 5pm when it wears off. Have you tried Lyrica yet? I know it's expensive, but it is not 'the big brother of gabapentin' like everyone says (at least not to me). It doesn't make me tired and it actually helps my pain. So to me personally, it is nothing like gabapentin/Neurontin. If you haven't tried it yet, please give it a shot. I am only on 50mg at bedtime and am noticing such a huge change that I think it's worth a try if you haven't already.

That sciatica is a doozy. I can't think of anything else that would make me a bitter angry woman every day. Loathe sciatica! Do you have any other symptoms? Have you been DXed with fibro?
Posted 12/10/2013 5:27 PM (GMT 0)
I am on 75 mg amitryptilne daily. It was prescribed for my depression. Didn't know it was uses for nerve pain. I am really appreciating all the advice for nerve pain meds so I can go to my next dr appt with suggestions. I change my patch every 3 days since insurance won't pay for an every 2 day change. I didn't go up any higher on the neurotin due to side effects. weight gain, increase in depression and feeling very "blah" and in a fog. Thanks for your input and ideas!
Posted 12/10/2013 5:35 PM (GMT 0)
Annnabannana-

You have convinced me to inquire about lyrica at my next visit (24th.) like I said my mom has fibro, and sister but it hasn't been added to my "list" yet. The siatica runs down my right led to about knee area then have stabbing pain in my calf. Bad days it's hard to walk due to the way my back tightens up/freezes. Just looking for a better quality of life, and reduction of pain. I also want to be able to do stuff with my 2 yr old son. I don't want his majority of memories of mommy to be those of her in bed. :(
Posted 12/10/2013 6:15 PM (GMT 0)
Awesome! I really hope it works for you. I can't imagine being a mommy with what we go through. I know people do it every day, but we never got to that point and then the fibro hit. Fibro (or whatever is going on with you) and motherhood would probably kill me. lol

Lyrica for me was pretty much the last shot at anything other than opiates. I just hope it *stays* functional/helpful. Don't really have a whole lot of side effects. Oh wait, I do have a couple which I should disclose first but they're embarassing. 1) increased libido (some folks' body chemistry chooses food, mine chose something else entirely), 2) increased urination. I think it makes the kidneys kind of go into overdrive. So if you have any kidney issues, definitely ask your doctor if this is the right med or if there is a way to take it without injuring your kidneys. I would hate to recommend something and for it to give you stones (or worse).
Posted 12/10/2013 6:54 PM (GMT 0)
Thank you for the information!!!
Posted 12/10/2013 8:24 PM (GMT 0)
After reading this, I think I may try going back to Lyrica again.

I took it for approx 2.5 years about 6 or so years ago. It seems to work fine, then all of the sudden around may when it started getting hot, I started swelling up like a balloon. My doctor took me off of Lyrica and the swelling went away. I think it did help with the nerve pain.

I have tried nurontin several times. It does tend to make me somewhat emotionaless if that is a word, if not then I think you all know what I mean, nothing really phased me.

 

I wrote in the Monday update about needing to possibly up my medication. I am on 75 fentanyl and .15 oxy for b/t. This regiment has seemed to keep me pretty well for the last 4 years. I do not want to increase fentanyl at all. I was hoping to actually go down to 50 before I started back to work. Now with work pain has increased. I am hopeful for Lyrica, I never tried the other new "fibro" medication, after I read that it can increase your heart rate and other things, I was not interested.

 

Good Luck in your choice with your doctor.

Posted 12/11/2013 3:46 AM (GMT 0)
Lyrica was wonderful.. I was without pain - wow!! I remember thinking "oh yeah, this is what life use to be like ! "

Then side effects hit & I could not even take a second dose. ; (
I have several fibromite friends who swear by it though.

So far I have been unable to tolerate any of the 'nerve' drugs like gabapentin.

Re: Fentanyl patches. If possible, perhaps ask for the increases in the.25 strength ?

Good luck. !
Posted 12/11/2013 4:18 AM (GMT 0)
Diane, may I ask what side effects you had on Lyrica? I've been reading about some bad ones.
Posted 12/11/2013 8:34 AM (GMT 0)
Ktk81:
I am on 150mg lyrica daily and have no noticeable side effects. When I was on higher doses longer term I noticed short term memory lapses (forgetting names, etc. a frustrating deal).

I would also like to chime in about using benzos with big gun opiates. Benzos drop your breathing/respiratory level and can be dangerous in combination with other drugs (such as opiates, esp. morphine, methadone, fentanyl, etc.). Sometimes docs have over prescribed meds for me. I almost died about 4yrs ago - respiratory failure from "normal" use of methadone for pain mgmt. Be safe so you can stick around!

I've been off Methadone for 5 weeks now and am on Opana ER and IR (b/t pain). Percocet was really hard on my gut, constipation, etc. Opana IR took its place. I still have to take 5mg Percocet 1-2x daily on top of IR (w/ doc approval).

I've found that that meds have different effects on different people (age, body weight, tolerances, drug interactions, etc.). Hard to compare with others but like you I like to know how different meds are working, effecting others.

I hope the fentanyl works for you. You may want to look into Opana Ir for b/t pain in place of Percocet.
Praying you'll get the kind of pain relief that improves your quality of life and is realistic as well. I'd love to have 0 pain, but then, I'd probably O.D. to get there (lol)! -Mike
Posted 12/11/2013 4:28 PM (GMT 0)
Kt,
I take Lyrica just at night. Side effect is drowsiness for me -- that's it, though. I was on it during the daytime for a bit, but then had to take Provigil to stay awake (large amounts of caffeine also worked, but I get hives from caffeine, plus it makes me super jittery).
You can ask your doctor if you have the kind of patches that can be cut in half. Some brands you can safely cut the patch, other brands if you do that it will kill you. I've never been on more than 50mcg at a time, so I can't speak to what might be appropriate for you.
Amitryptilene has been shown to actually do better treating pain (usually at low doses) vs. treating depression (you need fairly high doses to treat depression with it; I was always told that low doses tend to worsen the depression, but I don't know where 75mg falls on the spectrum). I was on 25mg of Amitryptilene, but I don't tolerate meds well. It worked for about 2 years on my pain & then quit.

I've never had klonipin orally, but I did get one really helpful topical compound that had klonipin, gabapentin, ketamine & something else in the cream that I applied to my neck for nerve pain. Worked really well & topicals have far fewer side effects. Maybe you could talk to your doctor about whether a topical compound might help with your pain?
Posted 12/11/2013 5:49 PM (GMT 0)
I really like the idea of the topical medication. I will have to ask on that. Since the increase I haven't taken klonipin. I took the advice from some of you and am waiting to see how I do on the fent increase. I really was amazed though how much better klonipin worked for spams
And pain than flexiral.

I don think I want to switch break thru med at this time. I had has been my "old faithal" when it comes to helping with pain. I have used it for many years. My only concern is tolerance and putting that much Tylenol in my liver/stomach.

Thanks so much for everyones input, sympathy and concern for someone you haven't met. :)
✚ New Topic ✚ Reply