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The UKFibromyalgia Forums • View topic - dihydrocodeine and fentanyl patches



dihydrocodeine and fentanyl patches

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dihydrocodeine and fentanyl patches

Postby heavensent » Tue Dec 22, 2009 9:43 pm

Hi there everyone, just wanted to ask if anyone has been on any of these things for pain relief? My doc has put me on co-dydramol and then going onto fentanyl patches if they dont work.. has anyone had any success from any of these? My doc does not know what to put me on if these dont work as we seem to have worked our way through everything over the years to no avail.
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Re: dihydrocodeine and fentanyl patches

Postby LinzWorld » Wed Dec 23, 2009 10:42 am

Woah! You should NOT go from dihydrocodeine to Fentanyl. That is quite dangerous - in the US doctors aren't supposed to (legally) put a patient on Fentanyl unless they are already tolerant to an equivalent dose of morphine (the nearest thing in strength to Fentanyl - dihydrocodeine is a lot weaker).

Strong opioids are NOT recommended for Fibro as they cannot work as effectively in someone with Fibro but we still are at risk of all the side effects so that although they may help a bit, the risk-benefit ratio is bad.

I went to an NHS/DoH conference a few weeks ago and the sharp increase in Fentanyl prescribing in the UK was highlighted - the pharmaceutical companies are really promoting it and many doctors, especially GPs, don't realise the risks or the sheer cost!

If your doctor wants to try you on a patch, then lidocaine can be helpful. Or the Butrans patches are less strong than Fentanyl.

I'm afraid I rarely think it's true when GPs or patients say they've tried everything. Often it's more a case of not trying the right thing or not trying a multi-discpilinary approach or the patient stopping taking meds that might help because of side effects that might have been overcome with more support from the doctors.

What have you tried?
I run FibroAction, a small national charity raising awareness of Fibromyalgia Syndrome. I am not a qualified healthcare professional. If you would like medical references for any facts quoted, just PM me.
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Re: dihydrocodeine and fentanyl patches

Postby shazq » Wed Dec 23, 2009 9:08 pm

Hi
I have been on both Fentanyl & butrans patches in the past.
I started at 10 then went to 2 patches of 20. I started to scratch madly at them and they seemed to do nothing for me after a while, so Gp stopped them.
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Re: dihydrocodeine and fentanyl patches

Postby unigirl1981 » Sat Dec 26, 2009 8:01 pm

hi there, i have taken dihydracodiene before and i am now on fentanyl patches. i must both agree and disagree with Linzworld on this one!! (sorry lol!!)

i agree that you need to be on the equivalent dose of morphine type meds before you go on the fentanyl patch, it clearly states on the big document you get with it that otherwise you couldhave a cardiac arrest amoungt other nasty effects. your doctor should go through this with you but if not please mention it. always double check with a pharmacist too if you forget anything.

BUT i have to disagree that while opiates are not generally recommended for fms, personally the risk-benefit ratio for me is not bad, without them i would be bedridden and my kids would not have a mother.

its personal choice really and its what relief you get from them verses the effects. when i first took the patch i was dizzy for a few days but now i have had no probs and they work well for me.

when i first went on the patches and told people, a lot said things like "oooh i wouldnt take them" or "ooh,a bit strong and not very wise" and i was quite offended.

bottom line is if you need them and they work then take them.

many opeople have said "ah yes but i wouldnt want to be addicted to opiates" my answer has always been " i am probably addicted and I DONT CARE, sounds odd but i would rather be an opiate addict who can look after her kids, run a support group to help others and lead an almost normal life than a "clean" person laid up in bed all day screaming and leaving her kids without a mum"

when the time comes to come off them i will deal with it, until then i will continue to try and get on with life as best as can be.

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Re: dihydrocodeine and fentanyl patches

Postby Elsbeth » Mon Dec 28, 2009 11:07 pm

I know a lady who has just been in Hospital for a month and has just been told she has Fibro as well as CFS and the ONLY thing that worked for her pain wise for the patches so this whole not having morphine for Fibro is crazy.

If morphine is the only thing that will ease the discomfort then why shouldn't someone have it?

the following is taken from a Fibro information site

Do Opioids Help to Relieve Fibromyalgia Pain?
The effectiveness of opioids in fibromyalgia pain relief is one of the key components to the controversy surrounding opioid use. Though patients claim that opioids provide them with significant symptom relief, some health care providers disagree. However, research shows that opioids are indeed helpful for relieving fibromyalgia pain. A recent study performed on long-acting opioids, including oxycodone, showed that fibromyalgia sufferers gained great relief from long-term use of opioids. Users reported a 38% average reduction in pain symptoms and also experienced:


fewer sleep disturbances
less anxiety and depression
increased mobility and enjoyment of life

so tell me exactly why everyone gets such a bee in their bonnet when anyone says they are on morphine for Fibro coz I honestly do not understand it.
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Re: dihydrocodeine and fentanyl patches

Postby gillshutt » Tue Dec 29, 2009 8:28 am

My opinion is.. if they work then take them, if they don't then don't. As for addiction, you are only addicted if you are taking them and they aren't helping. Worry about coming off something when the time comes. FM is for life at the moment so you may never come off something so why worry about addiction.
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Re: dihydrocodeine and fentanyl patches

Postby shazq » Tue Dec 29, 2009 11:01 am

Hi
I have been on Opioids based meds long term, after a while i find my body gets used to them so my GP will swap me over to a different med also opioid based.
I found the Fentanyl patches did work for a long time, i had to up the dose after a while, i was taken of them as i had a reaction to the plaster.

Like Gill said if they work then take them, if they no longer work then stop them, as long as you do it slowly and introduce your new med slowly until you find the level that suits your body to cope.

You deal with it when its time to change dont worry about it all the time it is working for you.
I am taking oxycontin now along with other meds, they help reduce my pain, but i am never pain free.
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Re: dihydrocodeine and fentanyl patches

Postby Elsbeth » Tue Dec 29, 2009 1:39 pm

Exactly, they do help.

I didn't mean to sound all arsey but I get quite annoyed when people start spouting that they don't make any dfference when quite clearly they actually do.

If they didn't help at all they wouldn't be given seeing as it is a class A narcotic!
As for the addiction factor, tbh you can only become addicted if you have an addictive personality.

Personally I have been on Morphine for 7 years now, and I only take it if I need it. I admit to liking the way it makes me feel, and being pain free, but I have to be in severe pain before I even consider taking it, by severe I mean nearly in hospital.
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Re: dihydrocodeine and fentanyl patches

Postby unigirl1981 » Fri Jan 01, 2010 10:34 pm

Just because you have to park in a blue bay doesn't make you any less of a person!

I am the Chair of Doncaster and District Fibromyalgia Support Group; working with FMAUK and loving it.
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Re: dihydrocodeine and fentanyl patches

Postby LinzWorld » Mon Jan 04, 2010 2:47 pm

I run FibroAction, a small national charity raising awareness of Fibromyalgia Syndrome. I am not a qualified healthcare professional. If you would like medical references for any facts quoted, just PM me.
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Re: dihydrocodeine and fentanyl patches

Postby ladymanvers » Mon Jan 04, 2010 3:52 pm

I agree Linz...would be no good for me with suspected Central Sleep Apnoea (my sleep studies are coming up in Feb). I thought a lot of Fibro folk had sleep disorders...of the apnoea kind do you know?

Ju.x
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Re: dihydrocodeine and fentanyl patches

Postby LinzWorld » Tue Jan 05, 2010 11:32 am

Sleep apnea is a major trigger for Fibro as it's an ANS over-stimulator. However, the sleep issue common to all Fibromites is alpha-wave intrusion causing non-restorative sleep - basically when we try to go into deep sleep our brain jolts us partially awake so we don't get enough restorative sleep.
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Re: dihydrocodeine and fentanyl patches

Postby mica8633 » Thu Jan 14, 2010 12:49 am

Hi all

I have been taking fentanyl patches now for almost 3 years 50mg every 72 hours and also dihydrocodeine 2 tabs 4 times a day to top up pain relief and have found them invaluable. Not all tabs work for everyone so its trial and error what works for each individual.
I also take 2400mg gabapentin, 20 to 30mg piztofen, and 150mg venlaflaxin. Feels like i'm always taking meds but couldn't function at all without them.
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Re: dihydrocodeine and fentanyl patches

Postby HazelB » Sun Jan 17, 2010 12:44 pm

i was taking dhc 2 x bedtime and tramadol 6-8 x day combination until last thursday when i was changed onto butrans patch 5mg/hr.

i had to stop the dhc/tramadol combination on starting the patch ... and that is me on day 3 when the maximum dose is said to be reached. a lot of my background pain has been eased but i am still experiencing severe back pain, and moderate neck/shoulder pain (probably being aggravated by typing on laptop :( )

not being able to take any pain relief for the back, neck, & shoulder pain this weekend has been really hardgoing, but i appreciate that the pain clinic also need to see how the patches are helping without other pain relief.

when i discussed with family/friends that i was possibly going to be starting morphine strength pain relief .. i got similar response in that i would end up addicted (if you ask me i was already addicted to the pain relief i was on - as i couldn't cope a day without them), and that surely my pain isnt that bad (they ought to try living a day with it) ... but i came to the conclusion that i would try it and if it helped great, if not then try something else (the story of the last 16 years for me, as pain meds work for so long then i begin to tolerate them).

the pain clinic told me right from the beginning that these patches do not work for everyone ... but just because they dont work for some, is not a reason for dismissing them out of hand.

edited: sorry just realised that this thread is about fentanyl patches ... brain fog is really bad today.xxx
(soft hugs)
Hazel xxx
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Re: dihydrocodeine and fentanyl patches

Postby LinzWorld » Sun Jan 17, 2010 7:02 pm

Yep, butrans patches aren't nealy as strong as Fentanyl. A lot of pain docs are concerned about how well Fentanyl is being marketed to doctors, and how some doctors are jumping straight to Fenatnyl and not trying other options (including lidocaine & Butrans patches if patches are required) first.

Btw, needing pain meds everyday b/c of pain is not addiction, it's just need. If you were addicted, you'd want the meds even if your pain disappeared completely. :)
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