Hi,
I'm hoping someone can pls help me. For the last 10 months, I have been taking oxycontin er prescribed, for back pain. My dose started at 20mg and quickly was upped to 120mg (40 three times a day). Yesterday, my doctor, instead of renewing my prescription, gave me a script for a 25mcg patch of fentanyl. She said that I would be perfectly fine. Yesterday was my first day on the patch and I felt "strange", but today I've been depressed, crying, shaking non-stop, diarrhea etc.... Obviously this is withdrawal, so I took a 10mg oxy that I had and chewed it. It calmed me down a little, but not very much. Should I have done this? I don't have any more oxy at all, so I'm scared what to expect. I live alone and far from friends and family. I am so scared, especially of the suicidal thoughts...is this normal? Am I going to start the whole withdrawal thing all over when this 10mg wears off???? Please help someone. Thank you so much
robin
Robin- If you think you are addicted and are scared please seek to face to face support. You are welcome here and everyone will do what they can to help you. Your not alone I have come off oxy's (and evrything else) it can be scarey. But you probably wont die, you'll just want to for a little while. Did the doctor suggest anything at all or just the phentnol and out the door? Are you working? What is goign on? I am here to listen and maybe even help.
Love,
Jane
Love,
Jane
I think I may have misread that did you say 40- three times a day. Do you need the patch truly. As an addict our pain threshold is very high what would normally work for someone else feels like taking m&m's to us. Do you beleive you are an addict?. I ask because I wonder what brought you here. If you have legit pain issues why would you feel you are taking too many, or do you just feel like you are going thru withdrawals. Sorry lots of questions but the more answers yopu give the better everyone here can help you. Hang in there hon
Roxy
Roxy
Hello rlh,
Welcome to the board! I really don't have any experience with oxy's specifically, just other opiates. If I understand correctly you were taking your meds as prescribed. 3 x 40mgs oxy a day. Then your doctor put you on fentanyl patch and you seem to be having withdrawals? May I ask why your doctor switched from Oxy to Fentanyl? You were taking as Rx'd for pain correct? My best advice for what it's worth is to contact your doctor as soon as possible. Maybe the doctor could Rx you something for breakthrough pain? I would love to hear more of your story if you feel up to it.
Peace,
Jan
Welcome to the board! I really don't have any experience with oxy's specifically, just other opiates. If I understand correctly you were taking your meds as prescribed. 3 x 40mgs oxy a day. Then your doctor put you on fentanyl patch and you seem to be having withdrawals? May I ask why your doctor switched from Oxy to Fentanyl? You were taking as Rx'd for pain correct? My best advice for what it's worth is to contact your doctor as soon as possible. Maybe the doctor could Rx you something for breakthrough pain? I would love to hear more of your story if you feel up to it.
Peace,
Jan
Oh 3 40's aday so sorry I had a DA????? moment please share your story so you can get some input.
Roxy
Roxy
Hi and welcome. First off don't be so alarmed you are right what you are experiencing is withdrawl. No one has died from it but yes it is extremely uncomfortable. Please tell us why your doctor switched you. Did she/he explain. Does he/she know that you are addicted.....or do you believe you are dependant vs addicted. Do you abuse your meds?
What do you want to do? Please don't worry there are a lot of caring people here to talk to while you figure this out.
Perhaps if you don't need narcotics for excruciating pain its time to ditch the patch too.
Come on back and tell us whats up.
What do you want to do? Please don't worry there are a lot of caring people here to talk to while you figure this out.
Perhaps if you don't need narcotics for excruciating pain its time to ditch the patch too.
Come on back and tell us whats up.
The Dr. should have put you on something for breakthrough pain along with the Fentyl patch. That is the protocol. Changing you from that much Oxy to 25mcg of Fentyl is crazy, no wonder you are going thru withdrawals and they will be brutal for several days. I'm so sorry. You need to call your MD and tell her your symptons ASAP. If your MD wants you to come off the oxy's then she should taper you in a more effective way.
Please talk to your MD tomorrow.
Sharon
Please talk to your MD tomorrow.
Sharon
rlh,
I know others have already said this, but you need to talk to your MD right away.
120mg of oxycontin a day does not a 25mg fentanyl patch make. Plus, fentanyl transdermal patches take at least 24 hours to kick in so he should have given you some breakthrough pain medications for the transition.
Because you have been on the oxycontin for so long, your body is used to having the drug in it, and that much of the drug. Your body is "physically dependent" on the oxycontin. This does not mean you are addicted (if you think you may be addicted that is a question and thought for another time), it just means that your body is used to having a certain amount of the drug in it, and it is going to freak out when it doesn't. And now since you are on a significantly lower amount and it hasn't had time to kick in yet you are experiencing withdrawals from the drug. Just as if someone were detoxing.
It sounds like your doctor did not consult the Pharmacist or an appropriate equianalgesic converter to switch you over to the Fentanyl patch. You need to talk to him about the appropriate dosing of the patch in comparison to the amount of oxycontin you were taking and make sure you get an equivalent amount in your system.
I am so sorry you are having to go through this right now.
Please contact him as soon as possible, and although I am hesitant to say this and people can disagree with me, you might want tothink about taking a small amount of oxycontin (not 40 or 80 or 120) to help with this in the meantime. A SMALL amount. But that's just one opinion. The rest of this post is not opinion and I hope you ge the help you need asap.
Please keep writing,
Bridget
I know others have already said this, but you need to talk to your MD right away.
120mg of oxycontin a day does not a 25mg fentanyl patch make. Plus, fentanyl transdermal patches take at least 24 hours to kick in so he should have given you some breakthrough pain medications for the transition.
Because you have been on the oxycontin for so long, your body is used to having the drug in it, and that much of the drug. Your body is "physically dependent" on the oxycontin. This does not mean you are addicted (if you think you may be addicted that is a question and thought for another time), it just means that your body is used to having a certain amount of the drug in it, and it is going to freak out when it doesn't. And now since you are on a significantly lower amount and it hasn't had time to kick in yet you are experiencing withdrawals from the drug. Just as if someone were detoxing.
It sounds like your doctor did not consult the Pharmacist or an appropriate equianalgesic converter to switch you over to the Fentanyl patch. You need to talk to him about the appropriate dosing of the patch in comparison to the amount of oxycontin you were taking and make sure you get an equivalent amount in your system.
I am so sorry you are having to go through this right now.
Please contact him as soon as possible, and although I am hesitant to say this and people can disagree with me, you might want tothink about taking a small amount of oxycontin (not 40 or 80 or 120) to help with this in the meantime. A SMALL amount. But that's just one opinion. The rest of this post is not opinion and I hope you ge the help you need asap.
Please keep writing,
Bridget
One other option is to go to the ER tonight and explain what is going on, so they can get you set with some breakthrough pain medication and ease some of these unnecessary withdrawals. They will understand, especially if you are a chronic pain patient and you tell them exactly what happened. Which was crazy.
Bridget
Bridget
I agree Bridget...some Doctors are just plain dumb when it comes to this kind of situation. They freely rx the drugs that get people dependent and then scratch their heads when someone is in agony because the brain is now thinking it is dying and sending those messages to the body!
Crackery thats what I call it. Crackery practised under the guise of medicine!
Crackery thats what I call it. Crackery practised under the guise of medicine!
it's true, especially in the area of pain management. i just can't beleive he dropped her from 120mg oxycontin a day to 25mg transdermal fentanyl and then didn't give anything for breakthrough. it's not the right dose equivalent, first of all, and it's just unethical to not give her anything for the 24 hours it takes for it even to kick in. i am just appalled.
i will talk to my pharmacist at work tomorrow to see what the correct equianalgesic dose is to go from 120mg po oxycontin to transdermal fentanyl.
but in the meantime, rlh, do whatever you need to to help yourself feel better because you do NOT need to feel like this. at all.
i will talk to my pharmacist at work tomorrow to see what the correct equianalgesic dose is to go from 120mg po oxycontin to transdermal fentanyl.
but in the meantime, rlh, do whatever you need to to help yourself feel better because you do NOT need to feel like this. at all.
That is awesome of you Bridget...to help like. That Doc is a putz!
The sad thing about this situation is that someone who has signed a contract with a Pain Manangement Physician cannot go to the ER or anywhere else and get any kind of narcotics without the permission of that Doctor. That would violate the contract they signed.
I would seriously consider changing physicians to someone more knowledgeable and humane.
Sharon
I would seriously consider changing physicians to someone more knowledgeable and humane.
Sharon
Good advice Sharon!
Kee Kee,
I just can't believe the stupidity and uncaring attitude of that physician. I would like to give him a dose of his/her own medicine.
Thanks,
Sharon
I just can't believe the stupidity and uncaring attitude of that physician. I would like to give him a dose of his/her own medicine.
Thanks,
Sharon
Yes, but I think this is an extenuating circumstance if there was any. I mean, it's getting late now, so it might be too late, but if she can't get an appointment ASAP tomorrow, then what else can she do? I know about these pain management contracts, but I can't remember if there is anything that allows you to stay in the contract if you get narcotics but it was under an extreme circumstance.
Too bad you can't call him at home rlh. I would be on that f***ing phone in an instant.
Are you still tehre? How are you feeling?
Do you have a pain contract?
P.S. Thanks Kee Kee....
I just hate it when stuff like this happens when it doesn't have to.
Too bad you can't call him at home rlh. I would be on that f***ing phone in an instant.
Are you still tehre? How are you feeling?
Do you have a pain contract?
P.S. Thanks Kee Kee....
I just hate it when stuff like this happens when it doesn't have to.
P.S. I just found this online on a Medical School web site:
"When converting to or from transdermal fentanyl patches, published data suggest that a 25-mg patch is equivalent to 45 to 135 mg of oral morphine per 24 hours"
Now, the 20mg of oxycontin is the equivalent of somewhere between 30 and 60 mg of mscontin.
You are supposed to dose down a little bit when crossing over, due to cross tolerance, but it is very clear that you are on the wrong dose of fentanyl right now.
Check this out:
musc.edu/pharmacyservices/medusepol/OpioidAnalgesicConversionChart.pdf
It is a typical pharmacy opiod conversion chart used in these situations.
Maybe bring this to your doc tomorrow.
ARGH!
I hope you're all right.
"When converting to or from transdermal fentanyl patches, published data suggest that a 25-mg patch is equivalent to 45 to 135 mg of oral morphine per 24 hours"
Now, the 20mg of oxycontin is the equivalent of somewhere between 30 and 60 mg of mscontin.
You are supposed to dose down a little bit when crossing over, due to cross tolerance, but it is very clear that you are on the wrong dose of fentanyl right now.
Check this out:
musc.edu/pharmacyservices/medusepol/OpioidAnalgesicConversionChart.pdf
It is a typical pharmacy opiod conversion chart used in these situations.
Maybe bring this to your doc tomorrow.
ARGH!
I hope you're all right.
P.S. Sorry I keep posting.
Hey:
Fentenal (sp) is a strong drug, I was on the patch also while hospitalized BUT they were still giving me the oxy at the same time. I was on a much smaller dose of oxy, but they kept me on it for break-thru pain the whole time I was also on the fentenyl patch. SP is right, it takes about 24 hrs for the patch to kick in. Are your Dr,'s pain specialists? If so, they should know better. If not, please contact your dr. (contact him anyway, pain spec. or not). They should wean you off the oxy. May I ask why you're on the fentenyl patch? It's a pretty heavy drug. Do you have the choice of the fentyl or the oxy? My understanding is that fentenyl is one of the strongest, maybe you can ditch the fentenyl patch and go back to the oxy p.o.. I have an extremely high tolerence to opiates, but the fentenyl patch had me knocked out (I was also getting Perc & Oxy at the same time- they didn't abruptly stop those). I requested off the patch as it had me so knocked out.. So they put me on a less strong patch of fentenyl, for a day, then stopped that, per my request. But they never stopped the other meds, these were pain management specialists - so they seemed to know what they were doing. But they were very good at listening to my desires. I was onlly on 10mg Oxy, either 2 or 3 times daily. Plus 10mg percocet, which I hated (made me meaner than a snake), so I asked to stop that and go to 10 Lortab instead. And they did. You need to talk to your Dr. I hope he'll listen to what you have to say...(y'know some Dr.'s) Good luck, you do have a right to participate in your own treatment. Keep coming here, you'll get lots of support and advice from people who've been there.
Fentenal (sp) is a strong drug, I was on the patch also while hospitalized BUT they were still giving me the oxy at the same time. I was on a much smaller dose of oxy, but they kept me on it for break-thru pain the whole time I was also on the fentenyl patch. SP is right, it takes about 24 hrs for the patch to kick in. Are your Dr,'s pain specialists? If so, they should know better. If not, please contact your dr. (contact him anyway, pain spec. or not). They should wean you off the oxy. May I ask why you're on the fentenyl patch? It's a pretty heavy drug. Do you have the choice of the fentyl or the oxy? My understanding is that fentenyl is one of the strongest, maybe you can ditch the fentenyl patch and go back to the oxy p.o.. I have an extremely high tolerence to opiates, but the fentenyl patch had me knocked out (I was also getting Perc & Oxy at the same time- they didn't abruptly stop those). I requested off the patch as it had me so knocked out.. So they put me on a less strong patch of fentenyl, for a day, then stopped that, per my request. But they never stopped the other meds, these were pain management specialists - so they seemed to know what they were doing. But they were very good at listening to my desires. I was onlly on 10mg Oxy, either 2 or 3 times daily. Plus 10mg percocet, which I hated (made me meaner than a snake), so I asked to stop that and go to 10 Lortab instead. And they did. You need to talk to your Dr. I hope he'll listen to what you have to say...(y'know some Dr.'s) Good luck, you do have a right to participate in your own treatment. Keep coming here, you'll get lots of support and advice from people who've been there.
Me again:
The person who asked about narcotics on the pain management contract?? Basically it's for chronic pain for people who have to take narcotics for the pain. The contract basically says you will get your narcotics from them Only. I they find you're also viiting ER's or other Dr.'s to get narcotics - they kick you out of the program. The DEA breatehs down their neck so they have to be careful. My experience with pain management (and more than one, because I was in 2 different hospitals, each with their own in house pain managemnt groups), anyway point being - they were pretty good at listening to what I wanted. The fentanyl patch being so much stronger than the Oxy (at least in my case), they were more than happy to take me off the patch. But even only 1-2 days on the patch, they weaned me off. They were very carful to not put me into withdrawl. You deserve that too, so talk to your dr. Welcome to this forum, you couldn't have come to a better place for support, and good advice from people who've been there!
The person who asked about narcotics on the pain management contract?? Basically it's for chronic pain for people who have to take narcotics for the pain. The contract basically says you will get your narcotics from them Only. I they find you're also viiting ER's or other Dr.'s to get narcotics - they kick you out of the program. The DEA breatehs down their neck so they have to be careful. My experience with pain management (and more than one, because I was in 2 different hospitals, each with their own in house pain managemnt groups), anyway point being - they were pretty good at listening to what I wanted. The fentanyl patch being so much stronger than the Oxy (at least in my case), they were more than happy to take me off the patch. But even only 1-2 days on the patch, they weaned me off. They were very carful to not put me into withdrawl. You deserve that too, so talk to your dr. Welcome to this forum, you couldn't have come to a better place for support, and good advice from people who've been there!
