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Needing Feedback on Break Thru Meds

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Posted 3/9/2015 8:28 AM (GMT 0)
I am currently taking Fentanyl 50mg every 48 hours and Norco 10mg x3 a day. I have moderate scoliosis and other back issues. I have a strange reactions to medications and I have been on my current medication for almost 2 years. The Fentanyl works great for maintaining the pain, but I barely make it to the 48hrs. The Norco is what I have the issue with. It doesn't help at all. I will get relief but its for 2 hours maybe. So I will stop taking it for 3 weeks to see if I have just built a tolerance and its the same. I have tried Oxycotin and had no change but it was in place of the Fentanly not the Norco. Any Suggestions?
Posted 3/9/2015 9:52 AM (GMT 0)
Welcome Sooner to the CP forum at HW. Tolerance is different in each person but 3 weeks after two years is not enough time to clear your entire system and see much change. After saying that the same holds true for how long it takes to build up tolerance. Many folks can use their bt meds many years and be fine while others cannot get the same relief for very long. My advice from personal experience as well as many years here as it's more productive to change completely that bt med every so often. A ir med such as oxy wouldn't likely give you the same coverage as fent so that's not surprising. Oxy ir in conjunction with the fent or even Percocet if you tolerate the Tylenol well would be a good thing to do for a while to offset the tolerance for the hydro. If not their are many ir meds out there but getting Drs to prescribe along with the fent every 48 is a challenge. They tend to avoid the morphine and hydromorph because of the risk of developing respiratory problems.

Talk to your Dr and keep a journal or log with your pain spikes.
Posted 3/10/2015 3:12 AM (GMT 0)
Thank you for the advice.. Thats what my discussion was going to be with my PM, but I was trying to find a med that worked for me for break thru. Have you heard many things on Tapentadol? for me the things that have worked for me ok have been, hydro, tramadol (but hate tapering off it), fent, cebox. So far the fent and hydro have worked the best thats why I have stuck with it and afraid of changing. Thank you for educating me btw.
Posted 3/10/2015 6:51 AM (GMT 0)
Lot's of information here about Nucynta and not much of it's positive. You can go to the search options at the top of the page and enter anything you want to check out and if you enter nucynta you will see every post anyone's ever posted. Lots of great information and I believe experience is helpful when choosing anything whether it be medication or procedures. We currently have a new member thread about nucynta now,have you read it? Several past users have replied to it.
Posted 3/10/2015 11:41 PM (GMT 0)
I have most relief with Norco and morphine. I had absolutely no luck with fentanyl,nucynta,opana,and tramadol. For various reasons. The best it med for me is morphine sulfate 30mg, and oxycodone ir 10mg.
Posted 3/11/2015 12:59 PM (GMT 0)
I've been taking Nucynta 200 ER along with Opana IR 10/325 for awhile now and together they work great. I'm also on the Fentanyl 50mcg patch every 72 hours and with all this I'm pretty much covered through the day. I will eventually have to get a 2nd neck surgery but for now this gets me by. Although Percocet IR 10/325 worked the best for me I could no longer get my scripts filled for it so I had to switch to Opana.
Posted 3/11/2015 5:22 PM (GMT 0)
In my experience, its been much more effective to rotate meds than it is to stop taking them for a week or two or three. Especially if youve taken them long term.

I use oxycodone IR (plain oxycodone without a booster) OR percocet (oxycodone with acetaminophen) for my break thru med. Either of those might be an option. Or a low dose of dilaudid.

Your best bet is just to ask your doc for suggestions. Each doc has meds that they prefer over others, I've noticed.

But ideally (at least scientifically) the idea is to use a med that acts on different receptors than the norco does, so that the receptors the norco acts on can get a bit of a break. That way when you switch back to the norco, the chances increase that it will be more effective than it was when you stopped it.

It's not a guarantee by any means... it just ups the chances of effectiveness.
Posted 3/18/2015 2:07 PM (GMT 0)
So I have been moved to Percocet 10mg for my breakthru, I did speak to PM about Nyctan (or whatever its called) and he said due to a anit-depression medicine that I am at higher risk for serotonin syndrome. He stated it was a theory but he didnt want it to happen on his patient. I appreciate everyones help. Its been very helpful.
Posted 3/18/2015 3:56 PM (GMT 0)
Hey Sooner.
I'm glad your Doctor has prescribed you something effective.

I took Nucynta.It didn't help.It made me sleep 15 hrs a day.

The Oxocodone should work better than the Norco.

Take care and God Bless.

Rick
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