Oxycontin vs. Fentanyl patches?

Posted:: 14 Oct 2011 by tlc&more
Topics:: oxycontin, pain, fentanyl, oxycodone, breakthrough pain

Details:

I take Oxycontin and Oxycodone for breakthrough pain. The pain mgmt clinic I go to recently suggested that I might benefit from switching to Fentanyl patches. This suggestion came after (as posted in my first question) they took me (and all their patients) off Soma. Without the muscle relaxer that WORKS FOR ME, it seems that my pain meds are not touching my pain. So, I don't know if this would be benefical at all. Does anyone have an opinion or suggestion about this? I am really at the end of my rope. Any help is of course, greatly appreciated!!!

Added 14 Oct 2011:

I am also wondering if Fentanyl provides as much relief as Oxycontin? Would I still need to take meds for breakthrough pain?

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Enora

14 Oct 2011

Okay, let me explain the main difference between what you are taking now and taking one of the patches. You would wear on of the patches for 72 hours and once you start wearing the patches, basically to have a steady stream of the medication in your system.
Right now, taking medication when things get bad, all of a sudden you get a burst of medication in your system and then several hours later it bottoms out.
It seems that their plan is to see if a steady stream of medication helps you more than all the ups and downs.

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tlc&more 14 Oct 2011

That def seems to be the best way to go for me. But, do both meds provide the same type of relief?

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Anonymous

14 Oct 2011

Hi TLC,
I can only offer my experience with Fentanyl, it did absolutely NOTHING, nada, zilch for my pain. But that is just my experience.
Perhaps as the other poster (I'm sorry, I've forgotten your name!!) said, it would offer round the clock relief? I hope so!!
Let us know how it goes, would you please?

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tlc&more 14 Oct 2011

Hi sweet lemon -
I don't go back to the clinic for another couple of weeks but I will def let you know. I'm a little nervous about switching. I have been on oxys for about 4 years and am wondering if I will go through withdrawls even though I'm switching to a new pain med. Thus the question. I really appreciate all the feedback you guys are providing. Thanks for adding me as a friend. I had no idea I would find such caring people on-line!

Anonymous 14 Oct 2011

Hi again TLC,
I don't think you will go through any WD's, I just wanted you to know that that patch didn't do squat for me, that's all.
Yet perhaps you should pose a new Q, to the effect of "will I go through withdrawal if I switch to the patch from Oxy"... something like that, tis an idea?
And I so agree, who knew we would make such great compassionate friends on an anonymous website? Incredible say I !!!
Love,
Lara

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DzooBaby

14 Oct 2011

I had been on OxyContin and oxycodone for years then was switched to Fentanyl patches. At that time I was taking 40mg of OxyContin 3 times a day with oxycodone 30mg up to 4 a day for breakthrough. They switched me to Fentanyl 100mcg/hr patches. At first they wrote for a change every 72 hours but after the second day I was in agony so he let me change them every 48 hours. I liked the way Fentanyl worked. It covered my pain quite well (I also had dilaudid 4mg 3 a day for breakthrough which those did nothing at all) I like the fact that the Fentanyl kept a steady level of pain relief so instead of taking a pill and having it work for 6-8 hours then taking another-having all the peaks and troughs- I had continuous relief for two days. The problem I had with them was that they would not stick!!! I couldnt keep one on for more than a day.

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I even had them put me on the name brand (plus tried several generic brands to see if anyof them stuck to me better-the pharmacy, CVS, was great in trying to work with me on this) and with the name brand there is a number you can call and answer a few questions about your use and technique then they sent these big adhesive overlays (called bioclusive dressings-they were like plastic sheets with adhesive on one side) but even with them they didnt stick either. Then I started reacting to the adhesives and would get a red open blister like reaction that burned and hurt. I still have a scar on my chest from one of these. The Dr couldnt understand why I kept needing a refill after 15 days instead of 30. I kept telling him that the patch wouldnt stick and that a lot of times I woke up in the AM to find it rolled up or sticking to itself and I couldnt get it apart and had to apply a new one. I even came in one day with one half sticking to show him what they were doing and he acted like I was making it up or something and then when the blisters started he looked skeptical at that too!!)He kept insisting that I keep using them even though I started to blister and react to the adhesive-he refused to change to something else or put me back on the OxyContin so I finally left his practice and went to another where they put me back on my OxyContin and raised the dose after a couple months to 60mg 3 times a day. I really liked the way the medicine (fentanyl) controlled my pain.It does take about 2 patches before your blood level is up to where it needs to be so be sure that they give you something to tide you over that first week or so or you will be really uncomfortable and may have some withdrawal symptoms. If I could get them to stick, I would gladly go back to them. It was nice not to have to take pills every 8 hours but was very stressful to try to keep them on plus I wasnt happy with my breakthrough. If he had put me on the oxycodones for breakthrough and the patches would have stuck I would still be on them so I do highly recommend them. My skin is a bit oily-not too much but I do sweat a lot and I think this is what kept them from sticking. They would bubble up and get condensation under the areas that didnt stick. Hopefully for you they will stick well and you get good relief.

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tlc&more 14 Oct 2011

Well that gives me some hope for the patches. I'm just trying to find something that works!! Since being off the soma I am really having a hard time getting any kind of pain relief. I'm willing to try anything. I'm tired of being in this debilitating pain all the time. I'm no good to anyone like this!! If he will keep me on the oxycodone for bt then I will try the patches. It would be a big relief not to have to keep up with all the pills.

Anonymous 15 Oct 2011

Dzoo, you got me laughing this AM! I have heard someone on here say they make overlays for the patches because they don't stick. I use the Vivelle dot patch & it won't stick either, so I used alcohol on my skin to get rid of any oil or whatever, OMG! Don't do that. When I took off they patch, my top layer of skin came off too!I am very fair skinned & blonde, & where I put my little vivelle patch the sun has never seen so is really tender too. You won't be putiing it there so no worries, but DON"T clean you skkin with alcohol. Dial soap is a good clean soap to use.It doesn't have all the creams or lotions some of the others have, so try to clean the spot withit first, & blow dry it with your hair dryer or a fan. Towel may have residue sofenter or something on it. Just my thoughts...

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Thor283

14 Oct 2011

Hi tlc,

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I also added a comment in sweetie lemon's comments. I want to say that if you have an absorption problem inside you, the patch may be the best thing for you. I think the biggest problems are getting the patch to stick, and to stay stuck. You should always clean your skin before putting on the patch. And let your skin dry very well before putting it on. That cover someone mentioned is important when you shower. They say you can shower without the cover, but I couldn't. My neighbors were ready to call the smelly board of health on me. LOL It wasn't funny. I had to plan the shower for the days I was going to change the patch. My bigger problem was I sweat a lot. Some folks just do. Sweating used to make the patch get loose. It didn't fall off, but it no longer was stuck on good. Since I don't have a problem with stomach/intestinal absorption, putting me back on a pill was the easier solution. But if you can get the patches to stick properly, Fentanyl is supposed to be very powerful.

However, 2 more things.

With the patch, you won't feel the opiate effect. You won't get the narcotic feeling. It will simply kill the pain. So if you like that dope feeling, the buzz, forget the patch. You won't feel it. Although I once had a doc shoot me up with Fentanyl and wow, it felt nice. But you won't get that with the patch.

Second, they say Fentanyl is 20 times stronger than Morphine. Let me explain that. It doesn't mean Fentanyl kills 20 times more pain than Morphine. What it means is you only need 1/20th the amount of Fentanyl to get the same effect as Morphine. It seems all pain killing is measured against Morphine. Not sure why. I think it's because Morphine is almost a pure opiate. So theoretically, if you need 10 mg of Morphine to kill pain, you should only need 1/2 mg of Fentanyl. That's what 20 times more powerful means. Not 20 times BETTER pain relief. How good anything relieves pain is very individual. I seem to do best with Oxy. It also matters how the drug is administered. I do great with Morphine when shot into my arm muscle. MsContin not so good. I just wanted to explain this. I hope I was clear.

Sometimes I'm not.

And yes, you still need something for BT pain.

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tlc&more 14 Oct 2011

Wow thanks Thor. You sure have a lot of good info. I didn't know that about the Oxys. It's funny what you were saying about the buzz feeling. I never really got that. I know people that say they get a "buzz" from the meds and I don't know if it's that I'm in so much pain but I don't get that high feeling. As for the Morphine, I've only had it while in the hospital and in turned me into a royal B. I was not a very nice peron while on it. Anyway, thanks again for all the info. I still can't believe how great this site and the people on it are.

Anonymous 15 Oct 2011

Terri,
Wait a tick... morphine turned you into a b#itch? Really?
Mary, has morphine done that to you? Thor, uh oh I suppose you can't be a b#tch can you?
I was given demerol (sp) once and it turned me into one happy lil Irish witch!! I actually liked that feeling! Uh oh, note to self; no demerol for YOU!!
Have any of you ever been given demerol? And if so, what did you think of it? Just curious, taking a poll here!!
Lara (giggling!!)

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Anonymous

15 Oct 2011

Hi tic & I have tried the fentanyl patches ,but they made me very ill. Was throwing up etc... Some people swear by them at the right dosage. You need to understand that you will not benefit from the med for 12 hours after you put it on. so keep a couple of pain pills if you have them to carry you over, I think that's ok That's what they did to me in the hsopital. Gave me shots of demerol until they thought the patch would start. It might work wonders or you may not like it at all, Everyone reacts differently to every med. Just make sure if you tell them you will try them that you have the option to go back to your pain pills if you need too.Just my thoughts...

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Anonymous 15 Oct 2011

Hi DZ, Thor and Mary!!
That's some wickedly great info for TLC!! Nice job friends, much better than what I had to offer, for certain.
I didn't give the patch long enough to work and perhaps tis an option for me as well. I may ask my doc, as long as it doesn't 'zombify' me, I'm in!!
Lara
xoxo

Thor283 15 Oct 2011

If it does "zombify" you Lara, you'll be 1 of the cutest zombies walking around I've ever seen. :-))

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Doc Quack...

17 Feb 2012

Fentanyl is actually 00x more potent than Morphine, it is prescribed in micrograms while Morphine is measured in milligrams (1000 micrograms to the milligram). Usual dose is 50 to 100 mcg BUT when we give it IV for pain it requires hourly moinitoring and re dosing. It is that much more potent but has a shorter half life.
I miss the SOMA (the med, not the group) myself as it worked for me but now am taking a different muscle relaxant. It is just as it is broken down by the body not only does it release a muscle relaxant, it also becomes a potent narcotic analgesic. That's why they stopped prescribing it. You can thank the FDA for that.
Try and get some of the OP Cites ( a giant Tegaderm) to help hold the patch on. The are made for super sensitive skin. It is the clear material you see over IV insetion sites. I have them in 6x6 size.

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