I have had numerous steroid shots which did not work, a course of facet shots which didd not work and after a few years of being prescribed various pain meds I can't find a drug that works well for me. I am also highly allergic to morphine as it stops my breathing. Currently taking 80mg OxyER 3x per day and 30mg Oxy IR every 2-3 hours. I have tried Fent patches but they hurt my skin-cause redness and itching. My PM doc is very understanding and wants to help me. Any advise is appreciated. Thank you.
You may also need to adjust your expectations and realize that pain medication is not going to make you pain free. Most of the time, the best one can hope for is tolerable pain. You may already realize this but many patients expect to be pain free when it is just not possible. You are at the top dose for Oxycontin/Oxycodone. If you cant tolerate morphine, fentanyl or Dilaudid ( 12 mg of dilaudid is equivalent to oxycodone 30mg BUT you may not have tolerance from one drug to another so you may need less of a new drug-any good PM doc should know this) this doesnt leave much to work with. Nucynta may be an option. This is one I have not personally tried and I have tried just about everything. Buprenorphine (Butrans) patches, for one thing, wont be strong enough for you and for another, they will likely give you the same trouble because it is usually the adhesives making your skin red and itchy, not the drug. I have been in pretty much the same boat as you. Oxycontin wasnt working anymore (I was on 60mg three times a day for years with 30mg Roxicodone for breakthrough up to 4 times a day then my Drs clinic got scared and started scaling everyone back until I was on next to nothing and suffering terribly when I finally found a new doc who is like yours-he wanted to get my pain under control and get me to a tolerable level but I learned long ago that pain free is not an option unless I am unconscious) Luckily I can take morphine so we rotated to MS Contin and it seems to be doing pretty good. Unfortunately that is not an option for you so you are pretty limited. The only other drugs I can think of would be methadone or Opana ER. Opana ER might be the better choice-it is stronger than oxycodone so the milligrams will be lower, so dont think that it is less strong because the drug itself is more potent. Opana (oxymorphone) is twice the strength of oxycodone so 30mg oxycodone will equal about 15 mg Opana and they would replace your Oxycontin 80mg with Opana ER 40mg . I would wait until you have no other choice before going to methadone.
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