percocet vs pain patch

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mtgman
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Date Joined Mar 2005
Total Posts : 1289
   Posted 6/9/2011 10:47 PM (GMT -6)   
hi there.  i have crohn's disease and for approx the past 8-9 months have been taking percs to deal with the pain.  i have had crohn's for over 20 years, but the pain is a fairly new sympton (2 years or so)...my dose has steadily increased from 3/325 3-4 times a day to 10/325 6 times a day...it still does not provide excellent relief but it makes life and work tolerable.  the doc was thinking oxicontin but i said no for a few reasons- the percerption plus the fact that with a digestive condition the pills tend not to absorb well so i feel the benefit of extended release would be lost.  the other idea besides increasing the percs again is a pain patch.  i know nothing about them other than they sounded a bit scary from the info i found on the net...any thoughts?  are they strong?  do you feel a strong narcotic effect?  I don't from the percs and i can do anything when i take them (work etc...) that's why i'm a  bit scared to change...any thoughts would be much appreciated.  thanks!

Monty's Mom
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Date Joined Aug 2010
Total Posts : 664
   Posted 6/10/2011 9:50 AM (GMT -6)   
Hello mtgman!

I am on the fentanyl pain patch and wanted to give you some of my experiences. Keep in mind that not everyone has the same type of reaction or relief from medications. We are all very unique in our range of experience with medications.

That being said, I love the relief I get from the pain patches. It is much more constant. Without the highs and lows of taking pills, I was better able to concentrate and interact with my family. When we decided to begin the patch it was rocky. I don't tolerate narcotics well because I don't like the woozy feeling they give me. I had a week of good pain control, vomiting, and dizziness and stopped taking them. When I went back to pills I realized that I still had a degree of both of those symptoms, but was in much more pain than before. My doctor encouraged me to try another medication which did not work, and I agreed to go back to the patches. After the week of adjustment, the vomiting and dizziness was gone. I have good pain control now most days, but I tend to have a rough day on the 3rd, or last day of the patch. That is just me.

I hope that helps you. The reality is that there will be withdrawals if you don't take your medication properly, as there is with any type of narcotic pain control. There can be problems with sticking, but I find that there are tapes out there that help. It is not for everyone.

Good luck and I hope you find the pain control you are looking for.

mtgman
Veteran Member


Date Joined Mar 2005
Total Posts : 1289
   Posted 6/10/2011 10:41 PM (GMT -6)   
thanks! i appreciate your sharing!
37 year old male living in AZ. Diagnosed with Crohns at age of 15.
Currently on 20 mg prednisone. still taking Asacol. Done with Remicade- antibody level was over 8! Waiting for scope results to see about Humira or Cimzia.
In the middle of a bad flare now for 2 years...it's been one heck of a ride!

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16411
   Posted 6/11/2011 12:09 PM (GMT -6)   
Hi Mtgman, I was on the Fentanyl patch for a while and had to go off of them because once my dose was increased for the 2nd time I was not able to urinate and that is a potential side effect of them. I think it was when I went from 50 to the 75.

I had very good relief on them until summer hit here in Tx. I am outdoors a lot and in the heat. When my body heated up the patch released way too much medication and it made me feel terrible. By too much medication being released it also cause the patch not to work correctly by day 3 and I was beginning to have withdrawal symptoms. It was horrible is all I can say. So, when my other problem came about I was more than happy to get off the patches. You have to avoid anything that will increase your body heat, hot showers, jacuzzi's and things like that too.

Good luck.
Moderator Chronic Pain Forum

mtgman
Veteran Member


Date Joined Mar 2005
Total Posts : 1289
   Posted 6/11/2011 12:26 PM (GMT -6)   
wow thanks Straydog. being in Arizona maybe the patch is not a great idea...i just need to find something or a dose that works better. i guess i'm in the same boat as everyone else-- find the correct solution that aleviates the pain and lets us lead a normal life...have a great weekend!
37 year old male living in AZ. Diagnosed with Crohns at age of 15.
Currently on 20 mg prednisone. still taking Asacol. Done with Remicade- antibody level was over 8! Waiting for scope results to see about Humira or Cimzia.
In the middle of a bad flare now for 2 years...it's been one heck of a ride!

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16411
   Posted 6/11/2011 4:10 PM (GMT -6)   
Mtgman, if you are having constant pain around the clock you may do much, much better with a long acting medication and then a short acting for BT pain. Are you being seen by a pain mgt specialist? if not, I would certainly ask to be referred to one. A good PM dr will have much more expertise about pain medications and how they work over our PCP's or gi drs..

I ended up with Lupus from Remicade infusions. I was on it for 3 1/2 yrs and built up antibodies to it. I am now on Humira which can cause the Lupus too, so I am on active treatment for the Lupus even with Humira. I love the Humirra, it has worked better than anything for me. I use the pens and they are very easy to use. Humira stings for a couple of minutes & then its gone no big deal. No gi will not put any of his patients on Cimzia, he says it is too unsafe for him to consider rxing to his patients.

Good luck.
Moderator Chronic Pain Forum

Angeleyes13
Veteran Member


Date Joined May 2011
Total Posts : 636
   Posted 6/11/2011 10:52 PM (GMT -6)   
I have been on the fentynl patch for several years. I use a 25 and a 12.5. For some reason I can not go up to the 50, it just hits me to hard after about 18 hours. If I could work thru the side effects of the next dosage I may have much better pain relief, but with work and little ones around I cant do that. The dr has recomended it many times but it just never worked.

I also have issues in summer with the patch. For one thing they have a hard time sticking if you are real sweaty. I use tegaderm over them to keep them in place. I can say that when I was in Florida I had problems with feeling a bit woosy, as well as last week when we had a couple days 95-100 degrees, that is definetely something to keep in mind. When I had my hot tub, I would only go in the night that I took off my patch and then put a new one on afterwards. That way my skin had a low amount on it and no patch that could release extra due to the heat. It does take some planning,lol.

Certain "brands" give me blisters too, I wish my pharmacy would stick to one type. I do find also that by day 3 I am feeling some significant increases in pain. The doctor can prescibe these for every 2 days as well, which I did for about a year, I needed insurance approval for this. I do find that the only area I can wear them is on my upper arms, which my doctor says is OK, but the info says anterior chest wall (I think).

I am also heavily affected by oral meds and this was such a great option. I dont feel any goofy effects on an average day, but I take a fairly low dose. I really do like the patches even with the issues.

I wish you luck
DX: CRPS/RSD full body, Fibro, CP, DDD, DJD, OSA, Syringomyelia, Arachnoiditis, failed fusion non union with hardware issues. Fusions C5-6, L5-S1. SCS trial successful awaiting placement after fusion revison 6/11.
MEDS:Fentanyl Patch 25 & 12.5 mcg, Fentora 100mcg, Oxyfast 10mg, Morphine Sulfate 15mg, AtacandHCT32/12.5mg, Clonidine, Zofran.

grainofsalt
Regular Member


Date Joined Aug 2010
Total Posts : 215
   Posted 6/12/2011 4:31 AM (GMT -6)   
Hi Mtg,

I have to agree with Monty's Mom that experiences from one person to the next can differ greatly and that we can only "expect" a certain response to certain medications with no degree of certainty.

For example, many people put down Soma as being ineffective but for me it works well as an adjuvant for pain, although a short lived adjuvant.

I think you do have a lot of options though. Have you considered hydromorphone? Its a powerful pain medication but for many people it is more tolerable on the side effects than some opioids. There's also newer medications like Tapentadol (which I'm on) that have less negative gastro side effects, but do have a risk for side effects like seratonin syndrome.

As for the "pain patch", I've never been on it personally, but from what I understand, if you already have a opioid tolerance (as you do have atleast some being on them for a few months), the transition should be tolerable. From my understanding the patch is very potent and works well for some without too many side effects. For others, there can be the issue of improper patch absorbtion and not getting enough medication. I've also heard people claim it works very well with long term relief.
MRI revealed disc bulge and test injections revealed RA. Radio Freq procedures helped for months, but pain is up and im having the procedure done again. Currently on 75 mgs of Nucynta (tapentadol - A MOR + NRI) 2 to 3 time per day and Soma 350 as needed.

mtgman
Veteran Member


Date Joined Mar 2005
Total Posts : 1289
   Posted 6/12/2011 10:20 AM (GMT -6)   
thanks for all the info. i am currently seeing a pain spec. i take so many meds for crohn's that i hate changing or adding so i've been tempeted to stick with the percs and get by with adjusting dosage etc. but i know at some point there's the possibility that other options will be better. my absobtion is terrible so the extended release pills like oxicontin probably will not be the best option for me after researching them. straydog i am on humira as well- i started about 3 months ago after my body started producing crazy amts of antibodies...the $17,000 shots were doing zero for me. humira seems to be working a bit- not feeling great yet but seem to be trending in a better direction. the heat issue with the patch seems to be a big one for me...i love the hit tub- i'm in one at least a few times a week- helps relax me and also with the pain for a bit...plus being in AZ and outside in the summer might be a big prob...maybe some sort of combo of the patch and percs for times when the patch's effectiveness is mitigated? i'll definitely discuss with the doc during next visit.
37 year old male living in AZ. Diagnosed with Crohns at age of 15.
Currently on 20 mg prednisone. still taking Asacol. Done with Remicade- antibody level was over 8! Waiting for scope results to see about Humira or Cimzia.
In the middle of a bad flare now for 2 years...it's been one heck of a ride!

stingray
Regular Member


Date Joined Oct 2009
Total Posts : 175
   Posted 6/13/2011 5:22 AM (GMT -6)   
Hi MTG
There's some very common experiences with the patch , like the third day being alot less effective. I have used the patch before and it worked fine for me but I won't bother with the details as everyone has given you a pretty clear picture of what it does. I just wanted to mention that I used to use percocet as well but asked my doctor to switch it to straight oxycodone without the added tylenol as from what I've read, having all that tylenol isn't good for your liver or kidneys. I presently take 20mg tabs of oxycodone and as far as I know there made in 5mg and 10mg without anything added. Just thought I'd mention it because the last thing you need is more problems. Take care and best of luck.
 
                                  .Stingray

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 16411
   Posted 6/13/2011 8:24 AM (GMT -6)   
Mtg, Stingray hit on one I totally forgot about. I do seem to remember some yrs back here at the forum, several people were having problems on the 3rd day of not getting much pain relief. Some of them were allowed to change the patch every 48 hours instead of 72.

I am in the same boat on the absorb problem, why is it crohns can cause so many extra little nasty things, lol.

I cannot complain about the Humira so far I have been real happy with it.

Let us know what happens with the dr. Take care.
Moderator Chronic Pain Forum

mtgman
Veteran Member


Date Joined Mar 2005
Total Posts : 1289
   Posted 6/13/2011 11:24 PM (GMT -6)   
thanks stingray and straydog! i've been wondering about the acetominophen component as well. my doc did mention that if we go to 15 mg tabs it will be wothout the tylenol- so that might be something to talk to him about. why can't there just be an easy solution to all of this? haha
37 year old male living in AZ. Diagnosed with Crohns at age of 15.
Currently on 20 mg prednisone. still taking Asacol. Done with Remicade- antibody level was over 8! Waiting for scope results to see about Humira or Cimzia.
In the middle of a bad flare now for 2 years...it's been one heck of a ride!

Zap2
Regular Member


Date Joined Oct 2010
Total Posts : 20
   Posted 6/26/2011 5:01 AM (GMT -6)   
I'm on butrans, which is Buprenorphine in a patch form. I'm on the lowest dose and wow, night and day! Took a few days to start up, but I switched from Vicoden, Tramadol and Lyrica to Butrans, Tramadol and Lyrica.

I miss the ability to stop pain basically instantly, but the Butran allows me to avoid the ups and downs, but over all, day to day, this new combo is much more effective. And my tramadol is much more effective with Buprenorphine(for my use), while things like perocet get much less effective.

The best advice is to be honest with your doctor, explain you're fears and what you are hoping to accomplish. Then talk all the roads you can go down, you could ask about trying something new, but also you could ask would the doctor be ok with default back to percocet if the patch(or whatever you both end up agreeing on)

Also I think the patch fights fear and shady looks relating to abuse of medicines.
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