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need help with med name please.

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Chronic Pain
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catahoula
Regular Member
Joined : Dec 2009
Posts : 184
Posted 11/4/2010 7:46 AM (GMT -7)
I need some help please. My PM wants to start me on some meds but says she does not have the proper liscence I know this is a "needle in a haystack" search but I've read folks signatures and recognized them . One is some thing like "provential" but its not that because that is a breathing med, the other starts with an S...soccccccc-something?
I know this is a huge request and I will continue searching signature because I will recognize it once I see them .( You know how the mind on narcotics works on memory, no?)
Apparently these meds are used to help with addiction ( which she doesn't think it is) but also work when morphine doesn't work ( which for me it never has)
Anyone?
thanks for your help in this tasking search
catahoula
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catahoula
Regular Member
Joined : Dec 2009
Posts : 184
Posted 11/4/2010 7:54 AM (GMT -7)
Suboxone!!!! ( went to the Chronic Pain 101) page and there it was )
I believe this is one of the meds she mentioned. Has anyone got any experience with this medication?
thx
cat
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Retired Mom
Veteran Member
Joined : Feb 2010
Posts : 1753
Posted 11/4/2010 9:31 AM (GMT -7)
Hi Catahoula,

You are correct about the Suboxone. That one is specific to Dr's who have been specially trained to prescribe it and cannot be given by just anyone. My Psych suggested it, but I'm not interested in the change yet.

I did want to let you know, however, that a gentleman I know (who has extremely horrible pain from damage to his back....from surgery) talked to me about this med last weekend. He was on "everything under the sun" for a while and was so medicated that he could not function or make complete sentences. His wife is an RN and insisted he find proper medical assistance....which came in the form of Suboxone from a licensed Dr. It has changed his life, much for the better, and made him able to function again. Although he will never walk without at least two canes and cannot stand or sit normally, he can function enough to have pain control and hold a conversation without sounding drunk or stoned. It has been a miracle drug for him and I hope it does well for you too!

Best of luck!
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catahoula
Regular Member
Joined : Dec 2009
Posts : 184
Posted 11/4/2010 11:41 AM (GMT -7)
thanks retiredmom. I have an appointment on the 15th with this doc. I'll go only if its for med management. Its a local shrink who I know from my days as a caseworker so hopefully it will go smoothly. I looked up subooxone and was disappointed to find that it is also a narcotic. I guess I just have this dream to be narco free but hey..if it works then I will go for it.
Thanks for the info.
once again my family on this list has come through again
cat
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ReactiveConstellationNE
Regular Member
Joined : Dec 2005
Posts : 256
Posted 11/4/2010 5:26 PM (GMT -7)
You may want to look into Low Dose Naltrexone. It works by boosting your own natural endorphins, so it has many of the benefits of opiates for pain (and then some) but it is non-dependency forming. You can stop it at any time without experiencing any withdrawal.

Buprenorphine has some benefits for preventing tolerance from further increasing, but its effectiveness on severe chronic pain is questionable. You may also want to consider Levorphanol, which is often a go-to medication for leading pain specialists who have patients that have tried everything else without success.
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antbuggey
Veteran Member
Joined : May 2010
Posts : 594
Posted 11/5/2010 4:54 AM (GMT -7)
Hi Cat,

Just wanted to mention that I was on Levorphanol and it was amazing! I felt better then I did in a long time! Only one problem....and it was a big one.....in February it went on backorder and as of September (which was the last time I checked) it still was not available! I went through terrible withdrawals and switched to morphine SR. For a long time I wanted to go back on it because it worked so well....but now I am scared of not being able to get it again! Anyway, just wanted to let you know!

Take care of you!
Beckey
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Hello~Kitty
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Joined : Jun 2005
Posts : 610
Posted 11/5/2010 5:12 AM (GMT -7)
I was on Suboxone for 2 years, but right now I take the generic Subutex, which is just buprenorphine by itself and no naloxone (and WAY cheaper). I find it to be wonderful for my pain issues, but some people don't. If you have any questions about it, feel free to ask me. I have over 2 and half years experience with taking it for chronic pain issues and it's been the best years of my life with chronic pain.

Also theres a Buprenorphine patch that the FDA approved JUST for chronic pain is suppose to hit pharmacy shelves here VERY soon, I think in March? could be wrong, but it's a week long patch...may wanna look into that as an option for when it comes out??

-kitty
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catahoula
Regular Member
Joined : Dec 2009
Posts : 184
Posted 11/5/2010 6:51 AM (GMT -7)
just a question, why can a psychiatrist order this stuff but not a pain doc? seems strange to me. The only issue I have with trying this is because of the provider I need to see to get it. HI worked with this doc when I was a caseworker. He went through some ethical issues ( a female client sued for sexual abuse!!) which made him flee the country. Hes' back so obviously the case was settled but it makes me uneasy as I have have the same issue and already feel prejudiced against him. It could be tricky.
cat
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catahoula
Regular Member
Joined : Dec 2009
Posts : 184
Posted 11/5/2010 11:55 AM (GMT -7)
for those who have used these meds, can you give me an idea of the cost? I just checked my insurance and neither are covered. I still owe $14,000 from when i was taking Actiq and can't afford to get any deeper in the hole.
thx
cat
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Hello~Kitty
Veteran Member
Joined : Jun 2005
Posts : 610
Posted 11/5/2010 1:15 PM (GMT -7)
A doctor has to take an 8 hour course to prescribe this medication for dependence/addiction, but ANY doctor can prescribe it off-label for chronic pain, but the DEA frowns upon that BIG time....if you go to the Suboxone's main websight, there's a place where you can either put in your zipcode and get a list of all doctors that can prescribe this medication or you can fill out a thing where the doctor's office will contact you if their is an opening, so you have choices in other doctors.

If your insurance doesn't cover this medication, your gonna be spending quite a bit of money!!! And generic Subutex is the cheapest medication (Suboxone doesnt come in a generic yet) but some doctor's wont prescribe Subutex unless your allergic or very sensitive to the naloxone in the Suboxone or your pregnant. Luckly for me, after 2 and half years, I only have to see my doctor once every 3 months for $90, and my medication costs $170 monthly, all out of pocket. But the fees to see the doctor the first time can be VERY spendy, mine costs around $500 for the first appointment, then $130 a week later, then another $130 every month for 6 months, then it was every 2 months for 6 months, and now I see him every 3 months, but he lowered his price for me since he knew I was suffering with finacial issues...

To me, it's well worth the money since this medication takes away my pain. I first started it to stop all pain medications (I was on a high dose of methadone and morphine with no pain relief and had a hard time tapering) so I decide to try Suboxone to help me taper so I could re-evaluate my pain, and I found out the Suboxone/Subutex was wonderful for my pain so my doctor and I have decided to keep me on it for pain control.

Also, every doctor is allowed to have so many patients on a thing where the manufactures gives the patients a years worth of free Suboxone, so you may wanna ask about that.

-kitty
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catahoula
Regular Member
Joined : Dec 2009
Posts : 184
Posted 11/6/2010 1:21 PM (GMT -7)
thanks "hello kitty". I did check the web site and was surprised to find a psychiatrist who I know and trust very much is also qualified so I will make an appointment with him. My pain doc will need to go along and I would imagine as she is pretty much turning over my med care she would want me to see someone I am comfortable with. I also went to the website and found a card that allows one to save up to $75 per script. That should help. Now all I can do is hope this med works for me as in ten years I have only found 2 that do.
thanks
cat
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ReactiveConstellationNE
Regular Member
Joined : Dec 2005
Posts : 256
Posted 11/6/2010 8:27 PM (GMT -7)

antbuggey said...
Hi Cat,

Just wanted to mention that I was on Levorphanol and it was amazing! I felt better then I did in a long time! Only one problem....and it was a big one.....in February it went on backorder and as of September (which was the last time I checked) it still was not available! I went through terrible withdrawals and switched to morphine SR. For a long time I wanted to go back on it because it worked so well....but now I am scared of not being able to get it again! Anyway, just wanted to let you know!

Take care of you!
Beckey

Thanks for the insightful post! I'm hoping that I won't run into supply problems; I'm trying to find a Medicare Part D plan that will cover it when the next open Enrollment Period begins in 10 days. My hope is to find a dose that doesn't require too huge a number of those little 2mg tablets and with the help of Ultra Low Dose Naltrexone, have that dose continue working indefinitely. What dosage were you on and what other dosages of other meds might you compare it to?
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catahoula
Regular Member
Joined : Dec 2009
Posts : 184
Posted 11/8/2010 12:53 PM (GMT -7)
well I got an appointment with a doc I do know for this wednesday. The receptionist said that Medicare does NOT cover this so the first visit is $200 and every following visit is $75. She said the appointment will take 5 hours.First he does an exam, then sends me for the meds, then administers it and has to wait and see what the proper dose will be. Again, has anyone else had this experience?
I will go for the initial visit but I have to hope he will be able to put me on the "free meds for a year" plan or there is no way I can afford this, just no way. I am a bit distressed that my doc made this decision without discussing it with me first. I'm not sure she even knows the deal as she was certain that Medicare covers this. I can't imagine being told that the only help is to be placed in such a financial hardship situation.
why can't anything be easy?
catahoula
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catahoula
Regular Member
Joined : Dec 2009
Posts : 184
Posted 11/9/2010 3:18 PM (GMT -7)
now i'm really confused. I'm already on embeda which contains naloxone. If suboxone contains naloxone, why not just add the subtex?
I am getting very confused about all of this.
cat
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ReactiveConstellationNE
Regular Member
Joined : Dec 2005
Posts : 256
Posted 11/9/2010 7:27 PM (GMT -7)
The naloxone in Suboxone isn't the primary ingredient. It's there to prevent people on it for addiction treatment from crushing the pills and injecting them. It serves no other purpose, though some people studying other opiate antagonist treatments (mostly based on Naltrexone) think that it could be providing an ultra low dose of naloxone which may be beneficial to some, though it can be a problem for others. The absorption of naloxone and naltrexone (as with most opioids, but particularly for these two) is extremely variable from person to person and even day to day for a single person, depending on whether it's taken with food, mouth pH for sublingual absorption, etc.....

The primary active ingredient in both Suboxone and Subutex is Buprenorphine.

Just to clarify, since it's not obvious if this is clear or not.
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catahoula
Regular Member
Joined : Dec 2009
Posts : 184
Posted 11/10/2010 12:14 PM (GMT -7)
Darn it!!!! My psych doc just called to cancel ( one hour before my appointment!!) He has an emergency BUT wanted to let me know he does not feel comfortable prescribing suboxone for pain...Now I am back to square one!!
I really think this is an omen. So much has gone wrong with my pain treatment and now this is the last straw!!!
I really think it is time to call "UNCLE"!!!!!!
really disappointed and ready to quit
catahoula
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purplereading
Regular Member
Joined : Nov 2010
Posts : 108
Posted 11/10/2010 10:10 PM (GMT -7)
The other med name you wanted is PROVENTIL.
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catahoula
Regular Member
Joined : Dec 2009
Posts : 184
Posted 11/11/2010 6:19 AM (GMT -7)
Proventil is an asthma med along the lines of albuterol...but you're close...I still can't think of it.
thanks
cat
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Tirzah
Veteran Member
Joined : Jul 2008
Posts : 2323
Posted 11/11/2010 4:14 PM (GMT -7)
Maybe Provigil? I know my PM sent me to a psych for it. It promotes alertness. Helpful when starting a new narc & you're feeling sleepy during the day.

Post Edited (Frances_2008) : 11/11/2010 4:51:07 PM (GMT-7)

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spinal soldier
Veteran Member
Joined : Dec 2009
Posts : 687
Posted 11/11/2010 7:10 PM (GMT -7)
thats it PROVIGIL which can even be a adjuvant to a pain med. the generic name is modafinil if i remember right and there is a new drug on the market which is very similar people are giving good reports about for narcolepsy and shift-worker-syndrome. as far as suboxone it is a good long term pain med for many people but i think the use of suboxone/subutex for pain is still off-label in the US. i took it for a year and it worked well when oxycontin, morphine, and dilaudid where not doing to good. the reason i D/C it was my insurance co-pay was over 500 /month, so i don't think it worked that good when generic morphine was 20. most psychiatrist who have a "suboxone waiver" on their DEA number are either outpaitent detoxing or matinance dosing their patients rather than treating chronic pain ; but some do. some pain mg. docs have the "suboxone waiver". the Embeda your on has naltrexone rather than naloxone. the IMPORTANT thing to remember is the opioid agonist/antagonist buprenorphine cannot be used concurantly with any other opioid pain medications. if your on a opiate agonist and you take a dose of suboxone/subutex it could cause immediate violent withdrawals, you have to almost be in a withdrawal situation to start suboxone comfortable. buprenorphine was originally marketed under the brand name buprenex and only in a pre-dosed injectable of 0.3mg which is equivilant to 10mg of morphine in IV administration and it had advantages with non-opioid dependent patients that had depressed respiration problems because it does not effect the breathing center of the brain as bad as MS. buprenorphine also has a ceiling effect at 32mg, which pure opioid agonist (morphine, metadone, fentanyl) do not. suboxone is a very interesting and complex drug. i wish you the best of luck with your pain mang.
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spinal soldier
Veteran Member
Joined : Dec 2009
Posts : 687
Posted 11/11/2010 7:15 PM (GMT -7)
p.s. if your insurance will allow Embeda than some other long-acting expensive meds may be an option for you like Opana ER, or Kadian, or a new once a day hydromorphone called Exalgo. best wishes
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purplereading
Regular Member
Joined : Nov 2010
Posts : 108
Posted 11/14/2010 2:58 AM (GMT -7)
The biggest problems with the new meds are the COST.  My insurance covers them, but they have made all non generic meds on a percentage pay basis. So for a formulary med, it is 20%  with a minimum of $20-to a maximum of $100, I think. and Non formulary if more with a minimum of $25 to maximum of $250 per med.  Methadone is the absolute cheapest long term med available. As Oxycontin has been reformulated and no longer available generically, I found it to run about $800 or more a month.  They have put out the cards for $70 -$75  off , but I think it is only with no insurance. I think it is strange that oxycontin never had much difference in the cost whether it was generic or name brand. BUT if I got generic and the actual cost was around $600, I paid $5, and if it was name branc and the cost was $700 or a little more, I paid $40, now all that has changed to where I would have to pay up to $250 per script per month. Makes no sense.

I thought you were looking for the correct name Proventil, sorry. I did not know you meant it sounded like it. One of the reasons that many meds are not covered by insurance, is that so many are used for things they were not originally meant for, and therefore the diagnosis and med do not agree.  It is pathetic that to use meds, to be able to get out of bed or move, we are labeled, and disdained. Some of the pharmacists are friendly, and treat me well while others treat me like I am breaking the law or something by filling my scripts every month. I have been a RN for a long time, and never judged anybody for their pain, and I rarely talke about mine, as nobody really wants to hear about it. I just take my meds in private, and keep quiet. Per my new dr. (the other left town) I was changed from methadone to oxycontin, Believe me it should always go the other way. I did it over 5 or 6 months, and still the methadone left my body missing it. The oxycontin I do not like. It gives me a headache, and makes me feel unwell, but the physcian likes it. Hopefully, now that my co ppay for it has risen so high, he will consider changing me to another med.

 

I wish you well,

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catahoula
Regular Member
Joined : Dec 2009
Posts : 184
Posted 11/14/2010 9:39 AM (GMT -7)
thanks for the info. I am still confused about all this and the way to take it. The last appointment i had scheduled was for a 5 hour appointment. Apparantly I would have had an intake, then they would send me for the meds, then the doc would administer until they had the right dose. This is the doc who cancelled an hour before my appointment. I have an appointment tomorrow with another doc but that appointment is only to last 1 hr..
The confusing part..my PM is keeping me on the embeda and norco until the end of the month but wants me to start the suboxone right away. I have read and heard from others that one needs to be in almost a state of withdrawal before starting this med. No doc has said NOT to take my pain meds before my appointment, including the doc who was going to administer the meds during that 5 hr appointment.
So..do I take my meds tomorrow...do I not take them, do I follow my PM and stay on the norco and embeda until the end of the month while starting the soboxone????
No one seems to be clear...I certainly won't mix but this is the problem I find when under the orders of multiple docs. One hand doesn't seem to know what the other is doing.
all i can say is tomorrow should be interesting...
I just wish i didn't have to take ANYTHING!!!!! Wouldn't it be great if we all woke upin the morning pain free forever??
we can only wish.
thx
catahoula
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spinal soldier
Veteran Member
Joined : Dec 2009
Posts : 687
Posted 11/14/2010 7:05 PM (GMT -7)
absolutley you would not want suboxone tommorrow if you took embeda today because it is so long-acting a little morphine will still be in your system and immediate intense withdrawals would be precipitated.i am sure the suboxone doctor has a plan of treatment for how long to wait and also for that period they may give you clonidine,ativan,trazadone,promethazine, or maybe hydroxyzine all based on treating withdrawal symptoms.amitiptyline can also help you sleep during the transition.keep us informed on how the suboxone doctor prceeds. best wishes.
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catahoula
Regular Member
Joined : Dec 2009
Posts : 184
Posted 11/15/2010 9:53 AM (GMT -7)
well...heres' the update. Doc ordered 8 mgs subutex 3 times a day to start and see how it goes. Right now I am waiting for he and insurance to approve payment ( they WILL pat for suboxone but not subtex..strange considering the price)
He also told me something interesting. I was taking 6 norco a day so my doc added embeda. After that I found it neccessary to go to the norco 8 pills a day. This is what prompted my PM to send me to the doc for suboxone ( which she is not licensed for). This doc today said it made perfect sense that I would need to increase the norco as the naloxone in the embeda, as an angonist, was stopping the effectiveness of the norco.
This doc also said there is not problem staying on the ambien ( which the neurologist and PM wants me to decrease cause it might cause headaches) Instead the neuro wants me to take zanaflex ( which does absolutely NOTHING sleep wise for me.)
So I have 3 different doctors telling me three different things.
How do we decide who to go with? This just proves to me that the job of the patient is to make the decisions about our own healthcare....
a confused
catahoula
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