Exalgo vs. Fentaynl Patch

Hi Everyone,

I was wondering if anyone is on Exalgo? If so how do you think it works and what dosage. I was on fentaynl patch 75 mcg for almost 4 years and just within last 2 mths I've been getting terrible rashes from the patch. Also it seems to not be working very well. So the doctor put me on 16 mg tabs take 2 a day together. Doctor says the pills are equal too 75mcg patch.

I also am worried about withdrawl from the patches. He gave me 5 more patches but 25mcg to take with the exalgo and he says that should be fine? I heard its really hard to stop patches. Anyone have any info you can share with me?

Thanks so much!

The great part about the Exalgo is it's only taken every 24 hours...the dosage goes from 8mg all the way to 64mg in a day..

A good Dr. will always start you on a lower dosage of a new medication and then tirate up as to watch for any side effects or allergies to it..

The big thing is to just go in with an open mind...Everyone's experience is different...Just because it doesn't work for one person...it works well for others...

And unless there is a life threatening side effect...usually giving a new medicine up to a month is a good trial period to see if it is working well...It takes time to build up in your system...

The main thing is to work with your Dr. and keep a log of how you are feeling each day...and then after some weeks...he may need to up the dosage to get the proper pain control..so it's being a little patient with a new medicine at times and work together..

If your Dr. was ok to prescribe you the Fentanyl patches...then he seems to be a caring Dr. that wants to help with your pain..

Just FYI...this is an extended release medicine that is to never be chewed or crushed to take with food...take whole...

And remember that medicine is just one tool we have in our toolbox to help with our pain...there are many ways like light exercise, stretching, acupuncture, aqua therapy...CBT, a muscle relaxer...etc....this way we never expect a pill to take away all our pain..

I do wish you luck...there are lots of people out there where this medicine works great for them...I hope that will be you!

If the doctor does the conversion correctly, you shouldn't have any difficulty with withdrawal symptoms. All he is doing is taking one medication away and replacing it with another.
The last time I went off the fentanyl patches and back onto oral medications, there were no problems with the transitition. I used tegaderm to hold them in place while I used them but found that they weren't sticking as well over the summer and being in the pool or outside in the sun made them less likely to stick.
Snowbunny is correct, most PM doctors when converting from one medication to another, take the old medication, daily dosage, and convert it to the new medication and may reduce the total daily dose amount by 10% or so for cross tolerance. Many patients find when a medication is changed to another, they don't need as much of the new medication, and the reduction is done to make sure that there won't be any problems with switching out medications. If you need to increase the dose, you can do that in a week or so, after this new medication has time to build to a steady blood plasma level before deciding whether or not the dosage needs adjusting.

FIRSt off the oringianl response was wrong in so many ways... I have been prescribed every strength of vicodin, percocet, hydromorphone both er and ir and it doesn't come in er form in 10mg, only 8mg,12, and 16mg and ir in 2, 4 and 8. Then the part where hydromorphone or dilaudid is 5x the strength of morphine which is all kadian er is. Kadian is just a er form in a capsule without lactose. If he was on 20mg of hydromorphone a day or 100mg of morphine than and that didn't work then 20mg of morphine definitely wouldn't do the trick. I have my doubts that he has ever taken any of these drugs based on how little seHaving said that I was taken exalgo er and it didn't help my pain at all. I took 16mg a day and about 40-50mg of OxyIR. Fentanyl patches along with percocet of dilaudid for breakthrough pain has worked best for me. I am more than familiar with pain as I am only 25years old and have had 2 spinal fusions and have 8 herniations from top to bottom of my spine.

Maybe he didn't like the hydromorphone bc he was looking for more of a high from it which won't be the same as oxycontin or percocet or every vicodin. Hydromorphone is a lot smoother drug than these are that produces a less euphoric effect but for breakthrough pain I have found nothing better. I don't know what to tell you if a 75mcg fentanyl pacth doesn't help you though? I mean there isn't anything stronger out there other than the 100/mcg/hr doses and the Instant release lollipops. Good luck to anyone in pain in getting it under control and get a clue to the idiot who would rather take 20mg of ms contin than dilaudid. Honestly don't listen to anyone who cannot spell VICODIN correctly, not vicadin chief.

Samsonfred...

Welcome to HW...

Just FYI but the post you are responding in is 10 months old from last year...

We would like to get to know you better and the best way to do this is to start your own thread with the Post New Topic button...

It sounds like you have a lot of experience with chronic pain...So if you want to start a thread filling us in on how your journey started and what your pain issues are...you will get many more welcomes..

Thanks:)