I understand that Methadone is a large molecule and covers the opiate receptors really well, so not much else will work. I've been using Fentora for breakthrough pain, but my doctor doesn't want to prescribe that anymore. One idea is oxycodone - are there other medications that might work? Thank you for your answer.
For those on Methadone for chronic pain: What medications work for you for breakthrough pain?
Question posted by Anonymous on 2 Dec 2010
Last updated on 11 January 2018
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7 Answers
Dexter1
9 Aug 2017
I haven't had relief with oxycodone or oxycontin
Inactive
26 Nov 2011
When I was on methadone 150mg the only thing I could feel was fentanyl
Inactive
26 Nov 2011
Thanks Heather. I've been on Methadone at the 70mg dose since March and take Oxycodone 22.5 mg (1 and 1/2 of a 15 mg tablet) once, occasionally twice a day for breakthrough pain. I have used the Fentora while on vacation - it made the trip possible. The oxycodone doesn't help much, I must say. I've been on Amitrytptaline 25 mg prn since spring - I find if i take one of those along with a Flexeril 10 mg it helps just as much as the 22.5 mg Oxycodone does. I don't know what to make of it, I'm just glad that it helps. I really don't like being on Methadone - the incredible! sweating and I find that I am SO hot if the temperature is over 70 degrees - even inside the house. And I sure don't like this dose of Oxycodone not making much of a difference. I have an upcoming surgery and my doctor has prescribed a box of the Fentora - I think that's the only thing that is going to touch the pain. Methadone just won't let any other pain killers through! Thanks for you comment.
Peterws9
3 Sep 2011
Hi.
Possibly Oxynorm... Or Oramorph Oral solution 10 mg/5ml. I know that Methadone is difficult as far as increasing the dose and adding more drugs is concerned. I was given Tramadol and Paracetamol for breakthrough pain. However they did no good at all. Am having a meeting in the near future. If anything else comes up I will let everybody know.
Peterws9
Inactive
4 Sep 2011
Thank you Peterws9 - I see it is the equivalent of U.S. Kadian or Avinza. I will have to look into it further - I appreciate the advice. Since I wrote this question I have gone down on the Methadone from 90 mg to 70 mg/day, so that gives me a little wiggle room - I could increase it back up for a surgery (which is what I really need the breakthrough meds for now. The oxycodone just isn't doing much - even at 22.5mg. It takes a few 30 mg to make any difference and no way will my dr prescribe that much. Sure is tough when you're at the highest dose of things and still need more help. How I wish I could get off this stuff! Regards -
Larry76
10 July 2017
There is an awesome pain medication called Toradol that in smaller doses with Methodone! Ask your Doc.
MizTee
11 Jan 2018
Toradol is a fabulous pain reliever as it like a megadose of ibuprofen/NSAID all at once. However, not really a practical solution for every day use, as it only is given IM, not available in pill form. My dr. said if you took that much in pill form, your kidneys would shut down within 3 days. So it is great for a flare up or when narcotics aren't required or available, but not a med for everyday use... just an FYI :)
christineATU
2 Dec 2010
Oxycodone is commonly prescribed for breakthrough pain. What worries me is the Fentora. It is very powerful and normally prescribed for cancer pain. You'll be taking a step down in the pain control scale. As oxyaaron indicated, overdose is a strong possibility with any strong opiate added to methadone. Please be safe and have a talk with your doc. You're better off increasing the methadone dosage and lowering the breakthrough pain medication. If the right dose is taken each day, normally very few breakthrough meds are needed. But Fentora is VERY strong. Be safe.
Best wishes,
chris
Inactive
3 Dec 2010
Thanks Christine - I always appreciate your answers! My doctor says there is a federal regulation prohibiting him from prescribing more than 90 mgs of Methadone for a chronic pain patient. I posted this question before, but didn't find out anything. So, I can't go any higher on the Methadone. I've been using Actiq/Fentora now for 8 years, and have been using 56 of the Fentora per month, along with the Methadone, for 2 1/2 months, and haven't had any problems with it - I've been very careful to space it out to 4 hours, and not use more than 3 in one day. Thanks for your concern - you are always looking out for us like a mother hen! Take care Christine!
christineATU
3 Dec 2010
Mother Hen, huh? Ok. I'll take that as a compliment! I wasn't sure if you were used to the fentora or not. But since your system is adjusted well, you'll probably need a stronger oxycodone than the standard 10mg. What about maybe 8mg dilaudid? Really your doc is the pro and sounds like he's been taking good care of your pain so far. It's just that fentora is a hard drug to match in the breakthrough pain control department. Be sure and write down any and all possible meds to discuss with him.
Best wishes and hope it goes well!
q33blues
11 Nov 2017
Need LOTS of best wishes here! I've been on m'done for over 20 years, got to 300 mgs/day. Started a taper and stopped at 90, now at 45 mgs. Of course there is NO pain relief & Percs (oxycodone) doesn't touch it, any insights on help? Thanks! I am a chronic pain pt. Sooo tired of it, ya know?
Inactive
11 Nov 2017
Continue to taper off the opiates. I did a 26 month taper to get off Methadone and Dilaudid - been off ALL medications for 6 months now. I’m still in pain, but no worse than I was on all the meds and am SO much healthier. All those pharmaceuticals (22 in all) were killing me!
daughter1970
2 Dec 2010
you could try kaidian it is a type of morphine i was on it for lower back problems and headaches i dont think that is the proper spelling but the doctor should know let me know if anything works
oxyaaron
2 Dec 2010
well if the fentora is working, why would he want to change it as there are not many other painkilers stong enough, maybe try some naproxen or advil, because if you use other stong opiates with methadone you run the risk of overdosing
Inactive
3 Dec 2010
My pain specialist (the dr. that does my procedures, not the dr. that prescribes my pain meds) will not keep me as a patient if I continue on the Fentora. He says it never was intended for chronic pain patients, just for cancer patients. Ridiculous, but that's the way it is, and I need him - he helps.
oxyaaron
6 Dec 2010
oh ok i thought it was someone doing it out of sight, sorry didnt mean to be rude
pharmasight
2 Dec 2010
Generally, medications that work fast are used for breakthrough pain. Immediate release formulations of morphine (MS IR) or oxycodone (Oxy IR) are used commonly.
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shnanigan
19 March 2012
I am currently on this quest with my own pain management Dr. I've been on Methadone 90 mgs 3 x day. I've been on various breakthrough medications, all of which have failed to work at all: vicadin, percocet, Morphine, oxycodone, tramadol, etc... But nothing has worked so far.
I've been reading up and I'm finding that Fentanyl (spelling?) works the best with Methadone because Methadone blocks opiate receptors, but there is something about the make up of Fentanyl or Fentanol that works with Methadone.
Good luck if you find one that works!
~Shawnie
shnanigan
19 March 2012
Correction, 90 mg per day total. 30 mg 3 times per day, I"m sorry for the previous error. ")
Related topics
fentora, opiate withdrawal, pain, methadone, breakthrough pain, chronic, opiate
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