Need help understanding ER pain meds

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hpymomof3
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Date Joined Oct 2011
Total Posts : 66
   Posted 2/25/2017 8:24 PM (GMT -7)   
I was on Norco 7.5/325 four times daily for about 5 years. I have several painful conditions. The worst is symptomatic Tarlov cysts. I am getting surgery this summer. I also have ankylosing spondylitis and fibromyalgia. Since I've been on the same dose for so long it wasn't working as well. My pain specialist did not want to increase my dose.

Recently she changed me to Hysingla (extended release Hydrocodone). I started at 30 mg once daily but I was still in a lot of pain so she increased it to 40 mg. She also gives me 1-2 of the 5 mg Norco for breakthrough pain but not enough to take 2 per day. My biggest problem is the relief from the Hysingla is only lasting 18 hours instead of the intended 24. Also once I take a dose it doesn't give me relief for another 2 hours. So I only have relief for about 16 hours a day. Sometimes my pain will also spike randomly during the day.

I'm confused by several things. First I don't understand why she is willing to put me on 40 mg of the ER when that is 10 mg more than I was taking yet she wouldn't increase my dose when I was only taking short acting. Also she is only giving me 5 mg for the breakthrough pills. I realize this is because I'm already on 40 mg of the ER but the 5 mg doesn't do much. I searched online and it seems like most people who are on an ER are also given breakthrough meds. Why don't the ER meds work without taking breakthrough meds?

I am seeing my doctor next week and will talk to her again but I want to understand this before then. I'm just wondering what can help me. I know the ER meds are meant to release a steady amount of relief throughout the day and I shouldn't get an up and down but I do but it's not like I take the pill and 1/2 hour later I feel better. She originally felt I just needed to get used to not taking the short acting at regular intervals but it's been 2 1/2 months so my body should be used to it by now. Would it be better to take my Hysingla in the morning or night and how are the breakthrough meds usually prescribed? I really don't understand how it's supposed to work. This seems to be a new med to my doctor so I don't think she is sure what to do with me. I cannot function without more pain relief and was pretty much bedridden this weekend. I was better off on the short acting but am willing to do what my doctor says. I just want to be more functional.

Mercy&Grace
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Date Joined Jun 2013
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   Posted 2/25/2017 9:26 PM (GMT -7)   
It is common for doctors to prescribe extended release meds when immediate release aren't working well. One of the reason is fewer pills are prescribed. Extended release usually gives better pain management.

I don't know if this might be a factor or not, but some people believe it is. Hysingla has abuse-deterrent properties. There is another hydrocodone extended release pain med that does Not have abuse-deterrent properties. The name of that med is Zohydro ER. If I remember correctly Zohydro ER is more expensive than Hysingla ER and most insurance companies won't cover it. But, you might want to talk to your doctor.

Break through meds are Not supose to be taken every day.

The Full Prescribing Information for both Zohydro ER is at the link below.

Zohydro ER-
http://www.zohydroer.com/downloads/ZOHYDROERFullPrescribingInformation.pdf[url]

Post Edited (Mercy&Grace) : 2/26/2017 1:36:17 PM (GMT-7)


(Seashell)
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Date Joined Dec 2012
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   Posted 2/26/2017 1:43 AM (GMT -7)   
HpyMomof3:
That you have only recently been placed on an extended release opiate after 5 years on a short-acting opiate would give ample reason to suggest that your initial dosing of extended release medication may need revision and adjustment by your pain mgm doctor on your subsequent office visits/follow-up appointments.

That is, it is difficult to prescribe the optimal dosing of an ER medication on the first or second appointment - you indicted that you have been on the ER for 2 1/2 months.

Articulate to your MD exactly as you have here on your dosing experience. How long you feel it takes for the new dose to bring you relief and the short-falls that you are experiencing in break-through pain episodes and lack of full 24 hour efficacy of the ER hydrocodone.

I disagree with Mercy and Grace that breakthrough medications are not intended to be taken every day. I do take breakthrough medication every day. But I do not take breakthrough medication on a regular or scheduled basis. That is, I do not anticipate or plan to use "x" number of short-acting tablets a day. I use breakthrough pain medication when the uptick in pain is severe enough that it impacts my ability to be mentally or physically engage in my life. I use breakthrough medication when an uptick in pain would otherwise have me curled in a fetal position - going deep within myself mentally is a strategy that I employ when my pain level is severe.

There are always options that allow patients to take an ER opiate 2 times a day. There are always options where your MD can increase your ER dose slightly upward and/or increase the dosing of your breakthrough, short-acting pain medication.

I would hold onto the premise that the dosing of your ER and IR medications is still in the "work in progress" mode with your pain mgm physician. Two and 1/2 months is still early days in developing a narcotic dosing regime that will eventually be your optimal dosing strategy.

Continue to work with your pain mgm Dr on refining your medication and dosing strategy.

The Pain Society offers a pictorial functional assessment scale that I have found to be very helpful in conveying my body's pain experience to my medical team. The functional pain assessment offers several pictorial themes (walking, getting out of bed, cooking a light meal, showering, dressing and personal care, climbing a flight of stairs, getting in and out of bed) and how pain affects each activity of daily living. I highly recommend that you refer to this pictorial assessment as a means of conveying your pain experience to your pain mgm mg.

I will look up the web site for the pictorial functional pain assessment and get back to you. I recently provided the link in another thread.

Bottom Line: Keep working with your pain mgm MD on devising a better prescription medication dosing and timing strategy. At 2.5 months, you are still in the work in progress mode.
Pituitary failure, wide-spread endocrine dysfunction
Addison's disease
Mixed connective tissue disorder
Extensive intestinal perforation with sepsis, permanent ileostomy
Avascular necrosis of both hips and jaw
Receiving Palliative Care (care and comfort)

Alcie
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Date Joined Oct 2009
Total Posts : 4930
   Posted 2/26/2017 6:37 AM (GMT -7)   
I read various duration of actions for Hysingla ER on different sites. Anywhere from 6 to 30 hours. When I originally started on it, it was supposed to last 12 hours.

I take the 20 mg as late in the evening as I can to try to get through the night. I get about 10 hours out of it. First thing in the AM I get my AM meds, Hydrocodone 7.5 and tramadol 50 mg, off the bedside table before I even get out of bed, and then I wait a half hour or so for them to start working a little so I can get up.

No way is this (the 20 mg at least) a 24 hour pill! And it's expensive.

Maybe you could ask for the 20 mg twice a day. It may be running through your system too fast. Do you have an active gut? It may not do much once it gets too far along.

Or ask about tramadol. I have plenty of pain on this med, but tramadol helps me feel happy and I can ignore the pain.

I also get up in the middle of the night and limp around a while to stop my muscle spasms. I have another pill that helps with spasms and helps me get to sleep in the evening. The Hysingla is working just enough for some pain relief at that time.

(Seashell)
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Date Joined Dec 2012
Total Posts : 679
   Posted 2/26/2017 7:48 AM (GMT -7)   
Here is the information regarding the pictorial functional pain assessment. This pictorial assessment has been very helpful in communication between me and my Palliative Care team.

American Chronic Pain Association

www.acpa.org

Then go to the "Ability Chart." You can download the chart to print and use it to rate your own pain level to different tasks/activities as a way of communicating to your health care team.
- Karen -
Pituitary failure, wide-spread endocrine dysfunction
Addison's disease
Mixed connective tissue disorder
Extensive intestinal perforation with sepsis, permanent ileostomy
Avascular necrosis of both hips and jaw
Receiving Palliative Care (care and comfort)

hpymomof3
Regular Member


Date Joined Oct 2011
Total Posts : 66
   Posted 2/26/2017 12:28 PM (GMT -7)   
Alcie said...
I read various duration of actions for Hysingla ER on different sites. Anywhere from 6 to 30 hours. When I originally started on it, it was supposed to last 12 hours.

I take the 20 mg as late in the evening as I can to try to get through the night. I get about 10 hours out of it. First thing in the AM I get my AM meds, Hydrocodone 7.5 and tramadol 50 mg, off the bedside table before I even get out of bed, and then I wait a half hour or so for them to start working a little so I can get up.

No way is this (the 20 mg at least) a 24 hour pill! And it's expensive.

Maybe you could ask for the 20 mg twice a day. It may be running through your system too fast. Do you have an active gut? It may not do much once it gets too far along.

Or ask about tramadol. I have plenty of pain on this med, but tramadol helps me feel happy and I can ignore the pain.

I also get up in the middle of the night and limp around a while to stop my muscle spasms. I have another pill that helps with spasms and helps me get to sleep in the evening. The Hysingla is working just enough for some pain relief at that time.


What do you mean by active gut and the med possibly not progressing? I'm on the 30 mg Hysingla after trying the 20 for a month. I'm still in a lot of pain and there is no way it lasts 24 hours. It also doesn't start working for at least 2 hours. I took it 2 1/2 hours ago and I'm still in a lot of pain. Unfortunately Tramadol makes me very sick. How often do you find you need the breakthrough on average? I find I'm not getting much relief with the 5 mg as breakthrough. I'm wondering if it's because I was on 7.5 for so long.

I also get up in the middle of the night and stretch as well as take a muscle relaxer most nights.

hpymomof3
Regular Member


Date Joined Oct 2011
Total Posts : 66
   Posted 2/26/2017 12:31 PM (GMT -7)   
(Seashell) said...
Here is the information regarding the pictorial functional pain assessment. This pictorial assessment has been very helpful in communication between me and my Palliative Care team.

American Chronic Pain Association

www.acpa.org

Then go to the "Ability Chart." You can download the chart to print and use it to rate your own pain level to different tasks/activities as a way of communicating to your health care team.
- Karen -


Thank you.

hpymomof3
Regular Member


Date Joined Oct 2011
Total Posts : 66
   Posted 2/26/2017 1:01 PM (GMT -7)   
She initially put me on 30 mg of the ER Hysingla and allowing me up to 2 of the Norco per day. I was in a lot of pain so she increased the Hysingla to 40 mg but lowered the Norco to 5 mg but only 1-2 per day (not enough to last a month taking 2 per day). I don't understand why this dosing wouldn't work since together that's 15-20 mg more per day then what I was taking with the Norco. I'm also trying to figure out the best time of day to take the Hysingla. I want to be able to sleep but also want to be able to function during the day. Since it wears off after 18 hours (that's the point where I'm really in a lot of pain. I feel it wearing off before then) and also doesn't start working for a few hours I have a period of at least 8 hours without relief. And sometimes it will seem to be working but then I do something more active (like grocery shopping) and it sends me into a flare.

I really like the idea of an extended release but I don't like not getting relief when I really needed it like I could with the Norco. The 5 mg Norco she gave me works a bit but for some reason won't work as well as it did before I was on the Hysingla. Should 5 mg instead of 7.5 mg really make that much difference?

Apparently she called the drug company last time to see if she could give me the 20 mg twice a day but they said no.

Of course it's up to her what she wants to prescribe me but I'm trying to figure out solutions ahead of time that I can ask her about. I'm not sure if she will prescribe a higher dose of the Hysingla but I'm also not sure if that will work since my biggest problem is it not lasting 24 hours.

Mercy&Grace
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Date Joined Jun 2013
Total Posts : 1701
   Posted 2/26/2017 1:40 PM (GMT -7)   
(Seashell), One of the Moderators here said break through meds aren't suppose to be taken everyday.

hpymomof3, Zohydro can be taken twice a day.

Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 4930
   Posted 2/26/2017 3:47 PM (GMT -7)   
Hpymom -
"active gut and the med possibly not progressing?" I said the med may be progressing too fast through the gut if the intestines are overly motile - this would get the pill through the system passed through the gut before all the medicine is emptied out of the little hole in the pill. I was trying to not be too graphic as this is a family site. Do you have loose stools or diarrhea?

5 mg hydrocodone isn't much for breakthrough. I get 2 x 7.5 which is pretty good, but that has to last me all day. (But I also only get the 20 mg Hysingla ER.) I bite the hydros in half to spread out the effect over 12 hours. I always chew them up because I can't swallow dry tablets, and this also gets relief started a little faster, but doesn't make them last longer.

Go the Drugs.com site and print out where it says RISKS OF DRIVING
"Peak blood levels of hydrocodone may occur 14 – 16 hours (range 6 – 30 hours) after initial dosing of Hysingla ER tablet administration. Blood levels of hydrocodone, in some patients, may be high at the end of 24 hours after repeated-dose administration."

Take the printout to your doctor and complain that the Hysingla isn't lasting long enough and what can you do about it? Do you want to go back to IR?

hpymomof3
Regular Member


Date Joined Oct 2011
Total Posts : 66
   Posted 2/26/2017 4:16 PM (GMT -7)   
Thanks Alcie. Actually I have the opposite problem so I guess it shouldn't be going through my system too fast. I like the idea of only having to take one pill and if it actually worked having steady relief instead of the ups and downs of the Norco. Quite frankly I just want something that will help me be in less pain. I don't expect to be free of pain. I'm probably having surgery in June. I'm still waiting for the date. It's a pretty intense surgery and it will take awhile for me to recover but I'm hoping after that 3/4 of my pain wlll be gone. I seem to be in a flare with my fibromyalgia or my auto immune disease as I've had awful leg and knee pain and other bone pain this week, which isn't usual for me. I'm hoping it isn't a side effect of the med. Mostly I just want to make it to June and go from there but with the pain level I am at now I'm mostly in bed.

hpymomof3
Regular Member


Date Joined Oct 2011
Total Posts : 66
   Posted 2/26/2017 4:33 PM (GMT -7)   
Alcie said...
Hpymom -


Go the Drugs.com site and print out where it says RISKS OF DRIVING
"Peak blood levels of hydrocodone may occur 14 – 16 hours (range 6 – 30 hours) after initial dosing of Hysingla ER tablet administration. Blood levels of hydrocodone, in some patients, may be high at the end of 24 hours after repeated-dose administration."

Take the printout to your doctor and complain that the Hysingla isn't lasting long enough and what can you do about it? Do you want to go back to IR?


I am unable to find this. Is there an actual section that says risk of driving or is it under that particular drug. I cannot find it in either place. Thanks for your help though.

Alcie
Veteran Member


Date Joined Oct 2009
Total Posts : 4930
   Posted 2/26/2017 5:11 PM (GMT -7)   
Sorry, it was in the "professional" section /www.drugs.com/pro/hysingla-er.html then go down to the section on risk of driving.

There is also a User Review page on drugs.com
/www.drugs.com/comments/hydrocodone/hysingla-er.html
Some people love it, some hate it. It was rated either a 1 or a 10 a lot.

hpymomof3
Regular Member


Date Joined Oct 2011
Total Posts : 66
   Posted 2/26/2017 7:59 PM (GMT -7)   
Thanks

(Seashell)
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Date Joined Dec 2012
Total Posts : 679
   Posted 2/27/2017 9:17 AM (GMT -7)   
Mercy&Grace: I do not know which moderator indicated that breakthrough medications are not to be taken on a daily basis, but I would disagree with that standing.

Breakthrough medications are not intended to be taken on a routine and/or scheduled basis. Ex. Instant release Norco as a breakthrough medication should not be taken every 4 hours as a regular, scheduled medication.

Breakthrough medications can be taken on a daily basis. I certainly take breakthrough medication on a daily basis. The amount I take varies on the intensity of the pain spikes that I may experience. But I take breakthrough medication on a PRN basis, as needed. As needed when the intensity of pain spikes to a level high enough that I am relegated to tears and/or the fetal position.

I take Fentanyl as my long-acting medication. I have avascular necrosis of my hips, primarily, and jaws and right shoulder. Small fat emboli can cause an acute occlusion of the small blood vessels that nourish the bones of my hips/femurs - similar to a sickle cell anemia. The pain from an acute vascular occlusion is excruciating. I will reach for breakthrough medication with an acute occlusion.

Breakthrough medications are indicated to mediate pain that "breaks through" one's long-acting medication with piercing pain sensitivity. On some occasions, someone may take breakthrough medication on a daily basis . . . on other occasions, someone may not need breakthrough medication on a daily basis. The key is to use breakthrough medication with thoughtful care.

I always keep my other pain management tools in play . . . swimming; yoga for stretching and tissue mobilization; use of warm buckwheat packs; homeopathic creams (Arnica, Tiger Balm); distraction techniques - working on a jigsaw puzzle or cross-word puzzle, reading a good book, watching NetFlix.
- Karen -
Pituitary failure, wide-spread endocrine dysfunction
Addison's disease
Mixed connective tissue disorder
Extensive intestinal perforation with sepsis, permanent ileostomy
Avascular necrosis of both hips and jaw
Receiving Palliative Care (care and comfort)

straydog
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Date Joined Feb 2003
Total Posts : 15305
   Posted 2/27/2017 9:49 AM (GMT -7)   
Karen, my first pain pump did not have a PTM that allowed a bolus for BT pain, instead I was given something orally for BT pain. I was instructed by my PM dr that the BT meds were not to be taken on a scheduled daily basis, strictly for BT pain only. My 2nd pump is a Codman & it is the same set up. The reasoning I was given was if a person takes them daily on a scheduled basis our body will become dependent on that daily dosage. The very same thing was explained to me when I was on ER meds too. I have been told this by 4 of my PM drs over the years. They all said if the ER is not taking care of the pain it needs to be changed because they do not want the patient relying on BT meds that much. I have seen many members over the yrs be given the same explanation here at HW by their dr.

Your situation may be completely different because of all the different issues you are dealing with which causes immense pain.

Also, getting back to OP's question about BT meds, the best I can tell she liked the instant release meds better than ER. Knowing the environment of treating CP it looks like her dr is trying to find a decent median to help with her pain until she has surgery this summer. I am thinking the dr is not wanting to get her dosage up there because surgeons do not know how to dose post op pain with patients that has been on narcotics long term. The patient ends up suffering a great deal as a result of this very situation & they should not have to. With that being said it happens all of the time.

M&G I am one of the mods that has posted this here, lol.
Susie
Moderator in Chronic Pain & Psoriasis Forums

Post Edited (straydog) : 2/27/2017 9:57:19 AM (GMT-7)


hpymomof3
Regular Member


Date Joined Oct 2011
Total Posts : 66
   Posted 2/27/2017 10:37 AM (GMT -7)   
I like the idea of an extended release med and would prefer that if it worked. Unfortunately the Hysingla doesn't work very well and I'm definitely not getting 24 hours of relief. Once it stops working it really stops working. I thought an ER would be more gradual. Also it takes a long time for me to get relief after I take it again. I've only had a few hours of sleep a night for awhile since the pain keeps me up. I'm going to talk to my doctor about different ER options. Maybe Hysingla just doesn't work well for me and it doesn't make sense to keep on going on a higher dose.

I'm also concerned about the implications of the surgery. My pain specialist does not know I'm getting the surgery for sure yet as I found out just a few week ago. She knew I was having the consultation. I've been on pain management for 5-6 years but they kept on blaming the pain on something else. Now I know for sure what is causing it. I am a bit confused though since I had been on four pills of 7.5 Norco a day, which I don't believe is necessarily a strong med or dose. Now I am already up to 40 mg daily of the Hysingla and 10 mg daily of the Norco so about 20 mg more than I had been taking. She has also talked about Fentnyl patches but they make me nervous. Regardless I wonder what med would be better for taking while waiting for my surgery since I will definitely need pain management afterwards.

Post Edited (hpymomof3) : 2/27/2017 2:21:17 PM (GMT-7)


straydog
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Date Joined Feb 2003
Total Posts : 15305
   Posted 2/27/2017 1:22 PM (GMT -7)   
Fentanyl is an excellent pain medication. It has a much smoother effect in dealing with the pain. I was on it at one time & had good results with it. I am not sure I understand why you would be nervous about it.

Her idea of putting you on an ER is because of the guidelines & recommendations set out by the DEA, CDC & NIH. They always start at a low dose & increase if warranted. Your PM dr may also be conservative which many are these days. Drs are watched now, they know what dr prescribes what & how much & what is the reason for those meds being rx'd. They do not want to send up any red flags & get a visit from the DEA. The days of treating chronic pain has changed.

What do you mean by being concerned about the implications of the surgery? Not sure what you mean by that. I think if this surgery will improve your situation I certainly understand your reasons for having it.

Take care.
Susie
Moderator in Chronic Pain & Psoriasis Forums

Mercy&Grace
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Date Joined Jun 2013
Total Posts : 1701
   Posted 2/27/2017 1:25 PM (GMT -7)   
straydog, Thanks. I knew it was one of the Moderators. I just couldn't remember which one. Now days, a lot of doctors that use to give break through meds, no longer do.

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 15305
   Posted 2/27/2017 1:35 PM (GMT -7)   
M&G, you are so right. It all depends on the person's actual dx as to what their pain mgt will consist of. Those of us with neck & back pain, all I will say is its lean times in the pain medication department.
Susie
Moderator in Chronic Pain & Psoriasis Forums

hpymomof3
Regular Member


Date Joined Oct 2011
Total Posts : 66
   Posted 2/27/2017 2:14 PM (GMT -7)   
straydog said...
Fentanyl is an excellent pain medication. It has a much smoother effect in dealing with the pain. I was on it at one time & had good results with it. I am not sure I understand why you would be nervous about it.

Her idea of putting you on an ER is because of the guidelines & recommendations set out by the DEA, CDC & NIH. They always start at a low dose & increase if warranted. Your PM dr may also be conservative which many are these days. Drs are watched now, they know what dr prescribes what & how much & what is the reason for those meds being rx'd. They do not want to send up any red flags & get a visit from the DEA. The days of treating chronic pain has changed.

What do you mean by being concerned about the implications of the surgery? Not sure what you mean by that. I think if this surgery will improve your situation I certainly understand your reasons for having it.

Take care.


As far as the surgery I just meant I'm a bit nervous about pain control afterward. I will admit I don't know very much about ER meds but it seems like the doctor would rather I be on a lot higher dose of that then the short term meds. I almost got the feeling that she would rather increase the Hysingla again then increase my rescue med. it's just a big jump mg wise and I don't want to have trouble getting adequate pain relief after surgery.

As far as the Fentanyl patch I just thought they were pretty dangerous. My mom was on them during her final stages of cancer. I'm the one who had to reapply her patches and was warned by hospice how dangerous they were and how I could basically give myself an overdose if I touched the pad wrong. I'm open to anything that will give me more steady relief and a better quality of life with the least amount of side effects. I still need to drive occasionally (2-3 times a week). That's one thing that was easier with the short term meds. I could just take it when I was done driving.

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 15305
   Posted 2/28/2017 7:19 AM (GMT -7)   
The components between an ER & IR pain medication is different. Once again, because of the guidelines & recommendations in place I am surprised she left you on the IR's as long as she did. If she was rxing IR meds to most of her patients, she could have been flagged.

If she wants to increase your dose on the ER that may well be the magic dose for you. You will not know until you try it. Yes, Fentanyl can be dangerous & deadly if a child got a hold of a patch. Hospice was required to tell you the info they did about the patch. A person that has not been on narcotics could OD depending on the dosage. The patches are in micrograms not milligrams. The lowest dose is 12.5mcg & that may be the dose she would start you on. Keep in mind new meds, lower starting dose.

If you have surgery in July depending on what you are on & how long prior to surgery you may not run into a problem. For now try not to let the what ifs get the best of you, its too stressful.

Take care.
Susie
Moderator in Chronic Pain & Psoriasis Forums

(Seashell)
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Date Joined Dec 2012
Total Posts : 679
   Posted 2/28/2017 8:39 AM (GMT -7)   
I will always admit when I have made a mistake, and I have done so in my posts on breakthrough medications and frequency.

I talked with my palliative care team yesterday afternoon, wanting to understand breakthrough medications and my own narcotic "cocktail" that includes both an extended release medication (fentanyl patch) and instant release medication (dilaudid). In my case, the ER and IR medications combined and in full are intended to be my daily dosing to manage severe avascular necrosis.

Susie is correct. Breakthrough medications are not intended to be taken on a daily basis nor on a regular or scheduled basis. Please refer to Susie's comments as factual.

My situation is atypical and should not be seen as a situation readily available. I did not knowingly mean to confuse anyone. My apologies.
- Karen -
Pituitary failure, wide-spread endocrine dysfunction
Addison's disease
Mixed connective tissue disorder
Extensive intestinal perforation with sepsis, permanent ileostomy
Avascular necrosis of both hips and jaw
Receiving Palliative Care (care and comfort)

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 15305
   Posted 2/28/2017 9:27 AM (GMT -7)   
Absolutely, no apology needed Karen. You have very unique health situations that you are dealing with. Knowing some of the facts of your situation your regime of medications are what you need to have some QOL. I applaud your healthcare team for having the knowledge of your needs.

Take care.
Susie
Moderator in Chronic Pain & Psoriasis Forums

hpymomof3
Regular Member


Date Joined Oct 2011
Total Posts : 66
   Posted 3/1/2017 4:57 PM (GMT -7)   
I saw my pain specialist today. She was very understanding and feels that my body is just used to the Hydrocodone since I've been on it so long. She wants me to try the Fentanyl patch. It's strange though. She Prescribed 10 mcg and all I can find says the lowest dose is 12.5 mcg. I hope it's not a problem with the pharmacy.

I'm a little worried about such a low dose. I know they start low and it is a strong medication. I was on 50 mg a day of Hydrocodone between the Hysingla and the 2 Norco. I am starting the patch on Friday and she is not giving me anything for breakthrough. I'm a bit worried that my pain won't be covered and it is the weekend.
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