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de88ey
Newbie
Reged: 04/18/02
Posts: 39
Loc: CA, USA
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Well, I go in Wednesday to discuss going on the pain patch with my doctor. What would y'all suggest for strength (25mg, 50mg?) I've had 10mg hydro for years for pain. Is the 25mg very strong or should I start at 50 or 75mg? Any suggestions will be greatly appreciated.
Thanks.
Debbie
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trixxie
Member
Reged: 05/23/03
Posts: 121
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Is the change in medications to the duragesic at your request? Or is your doctor wanting to change to a LA med?
If this is at his suggestion, perhaps he would be best able to say the best dosage. You didn't mention how many you are taking of the 10hydro. I was on those, and started at 25mcg, then a follow up visit with the PMD a couple of weeks later to make the determination if I needed to ramp up to 50mcg.
I stayed at 25mcg for about a 1 1/2 months before I changed to the 50mcg. I was unable to go any higher due to adverse reactions, even though I continued to try and try.
Good luck with your appt! Sounds like you have a great PMD...
tc
trix
--------------------
The truth shall set you free!
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Stardog
Member
Reged: 08/28/04
Posts: 195
Loc: Where it all Begins
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I love trixxie's advice. I can only add that 75ug and higher are explicitly only for previously opioid-experienced patients, but we're not talking about hydro here, we're talking major cancer pain meds like Dilaudid.
And the dosage refers to how much you get per hour, right? I found that an initial administration of 50ug was very helpful, and lasted about exactly 1 hour. But with the patch, we're talking 50ug per hour, EVERY HOUR, FOR 3 WHOLE DAYS! I wonder if your doc will do what trixxie had prescribed and start you off on 25ug. It seems the most logical.
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kimbell1
Enthusiast
Reged: 08/20/03
Posts: 274
Loc: Route 666, Painville, Texas 6...
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I was on the patch for about 2 months until the 50 unit patches became unavailable in the Dallas area due to manufacturing prblems involving the 75 unit patches and people were using a 50 unit patch in conjunction with a 25 unit one.
The patch was unconfortable, kept coming off, the 50 micr unit actually leaked one me twice. It never lasted the promised 72 hours and did not replace the 4 lortab 10/325 I was taking before the patch.
Some people do like them and doctors like to prescribe them since they feel that their is less chance for abuse.
Personally, I did not like the patch at all. I posted several threads concerning the patch. None of the people who posted to my thread like them except for two people out of about 2 dozen.
If you want a class two pain killer, you might try the newest one that I know of and I have been taking it called Avinza which is time release morphine thatlast 24 hours a pill. The dosage I take is 60 mgs. The thing about the capsule is that is is the only one designed for long term chronic pain use.
BTW. The dosage goes up to 1660 mgs. Also any type of morphine does have a quicker tolerance build up than the hydro.
Hope this helps
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lespierce
Journeyman
Reged: 11/25/03
Posts: 53
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I have been on the 50ucg for about 8 months now. At first, I had a real hard time with them coming off in the shower, or when I sweat. My Doctor recommended "Tegaderm" which is a translucent patch that covers the patch to help keep it on. I always wondered why they advertise a birth control transdermal system that stays on for 7 days, but Duragesic has a hard time after 24 hours.
Anyway, since I started using the Tegaderm, the patch stays on fairly well. I also had my prescription changed to every 48 hours, instead of 72 hours for replacement. This made a huge improvement, since the third day was very brutal. I would also exhibit withdrawal symptoms, and need lots of rescue meds. Now that I am replacing the patch every 48 hours, things are much better.
I will take the patch over pills any day. With Pills, I was always "putting out the fire". It was always too late, and it would take a good half hour to 45 minutes before I would get any sort of relief. Now, I keep the "fire" wet, 24 hours per day, and rarely let it get out of control. Sure, I still get some break through pain, but nothing like the pill poping days.
I'll give a thumbs up to the Duragesic patch. As long as they can come out with a better adhesive, and maybe change the recommended dose to replace the patch every 48 hours, I'm staying with it. Plus, I don't think there is any way to abuse it, so I don't have to worry much about theft.
I think they were first designed for terminal patients, who did not move much, but with more and more indications for usage in active people suffering chronic pain, they may have to design a patch that is smaller, and sticks better.
Good luck!
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