Pain control

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In a message dated 11/20/2004 3:06:14 PM Eastern Standard Time, RSD-CRPSofAmerica writes:

water in the bath set it off. It was really hot. My doc says I can onlly go up the 300mcg. of fentanyl. Do any of you guys go higher> And when that runs out what other meds can we take. Cus it sounds the way my doc says when I've reached the max he doesn't know what to do with the meds.

Hi Laurie,

With certain narcs there is a ceiling, meaning a person can go up to a max dose then it is not safe to take anymore. This is not so with Morphine. There is no ceiling, a person can keep upping the dose as needed. I worked a lot with terminal cancer patients with intractable pain. I have seen astronomical doses of morphine given to people. Don't get me wrong, a person has to work their way up the dosing scale. You cant just give someone huge doses if they have never had it before.

I am on Fentanyl too (Duragesic patches). I am also on 100mcg. It works great for me. I was originally on MSContin, extended dose morphine but it did not give me enough coverage. I was having peaks and valley, the pain control was not constant. I find with the Fentanyl it is more even coverage. Fentanyl is actually a drug used in anesthesia. It is used in smaller doses for pain control.

I have a question. Has anyone ever went from Fentanyl patches to Methadone? If so did it control the pain? How often do you take it? I ask because my doc and I were talking and I was just wondering about possibly switching because the Methadone is much cheaper. I have Medicare/Medicaid but it does not cover the whole cost of the Fentanyl which is quite expensive. I would appreciate any info on how Methadone works. Thanks guys, Love Jai