Monday, May 07, 2007

Fentanyl patches

After a few months of tweaking my Oxycontin dosage, I asked my doctor if I could try the Fentanyl patch.  The Oxycontin/Oxycodone combo was working fairly well (20mg Oxycontin every 8 hours, plus Oxycodone for break-through pain), but I don’t want to have break-through pain.  I just want to be pain-free, period.  I want to wake up and not feel like weeping when I try to get my sore old body out of bed, and Oxycontin just wasn’t giving me that extended relief.  Fentanyl is supposed to last for 72 hours, and even if it only lasts for 48 hours as anecdotes suggest, that could still mean I’d have two nights of pain-free sleep, and two mornings of feeling almost normal.

I put the first patch on Friday evening, and will change it later tonight.  I’m taking Oxycontin concurrently, to wean off it and will be on Fentanyl only by Thursday.  So far, I feel quite normal, and haven’t noticed any odd side-effects.  I’ve had a couple of “hot flashes” for lack of a better word (short, quick instances of perspiring and feeling warm), but they pass quickly and could just be weather-related, or even fatigue-induced.  Today I had itching around the patch site, but I think I’ve got a skin allergy to the adhesive I’m using to hold the patch on (it started to peel off, so I put medical tape around the edges to keep it in place).  I’m notoriously allergic to those sorts of adhesives, and one of my concerns about Fentanyl patches is whether or not my skin will be able to handle it.  So far the skin I can see under the patch (it’s clear) looks perfectly fine, so it may just be the extra medical tape which is giving me trouble.  Apparently the manufacturer of the patch makes an adhesive cover for people who have trouble with adhesion, so I’m going to price those when I get a chance.

Price-wise, the Fentanyl patches are a step in the right direction.  My doctor says that my 25 mcg patch is the equivalent of taking 30+ mg of Oxycontin per day.  If that’s true, then the patches cost about $50 less than the Oxycontin tablets.  I could save even more money by switching to a different brand of patch (one is about $25 cheaper than the Sandoz-manufactured one I requested), but I’ve read Internet stories from folks who didn’t feel the cheapest patch was of very good quality.  Because of that, I picked the mid-priced one, but I could also get the real thing for about $50 extra.  The cost for a month’s worth of 25 mcg patches is about $150 (for the Sandoz brand).

The negative part of using Fentanyl is that there’s no quick and easy pill for break-through pain, and the only option is the Actiq “transmucosal lozenges” (I think they’re like lollipops).  Doctors don’t want you to mix and match your drugs in case you develop a tolerance to one and it stops working, so I have to give up my Oxycodone completely and just stick to meds from the Fentanyl family:  the patch and the Actiq supplement.  The Actiq costs $500 for 30 doses, so I’ll want to avoid that completely!

I’ve got an appointment with the doctor again at the end of this month, and I’ll decide then if I want to continue this experiment.  My sleep is getting worse and worse, and my morning pain is becoming so debilitating, that it was either switch to a longer-acting drug or start a whole cocktail of sleep aids, and more pain meds, and then stimulants to help me stay alert during the day.  I want to take as few things as possible, (both for health reasons and cost), so maybe a long-acting pain solution will help me regain my sleep and I’ll wake up feeling rested.  I’m keeping my fingers crossed!

Posted by Leigh-Ann on 05/07 at 03:22 AM
FMS medications • (2) Comments • Permalink
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