Hi everyone, My dad has been having lots of pain in his throat. He is on 2 patches- one on each arm- and roxicet(spelling?). Is this a lot or not enough? He says this still doesn't stop all of the pain. He is really tough and doesn't like pain meds, but I think he should get more. Anyone here know something that works better?

Is it the fentynyl patch which strength? I found them very effective for whenmy tumor was causing me pain prior to surgery. I think he cold also have some other pain meds for when it peaks? I had Diloted pills for this in additon to the Fentynyl patch. Explain to your doctor the patterns of his pain and they can reccommend something to you. Comfort and pain management are important for healing.

Karen,
Your dad may need something short acting for brekthrough pain, or he may need to have his fentanyl patch increased in strength. Mention it to his Doctor, and they will get things set right
Wayne

Thanks. I didn't know that patches came in different stregnths.

Hi all, the patches are 50mg. Is that a lot? He changes them every other day.

I think they start at 25mg, and go to over 100mg/patch. Your Doctor will be able to adjust the dosage easily. One thing; DON'T EVER cut them in half to increase or decrease dosing. Thats a very damgerous thing to do, and can result in an overdose.

Your Dad's Doc will likely give him something for breakthrough pain...codiene, morphine, oxycodone, percocet, etc.

All are short term, fairly quick acting narcotic analgesics. They work with the fentanyl patches to smooth out the peaks and valleys of pain, and are an important part of effective pain management. Your Dad's entitled to having his pain under control, and the Docs will help him there
Wayne

Karen,

My sister is 3 weeks out from having completed 35 IMRT's and 7 cisplatin. She is also having pain, mostly tightening of the neck (scar tissue from radical neck dissection, seems to be in the 1 to 2 range all the time and when it escalates to a 4 to 5 she will take 1.5 ml of morphine, it's fairly fast acting. She also uses the fentynyl patch (25 mg) replacing every 3 days. It's important to get the pain under control before it escalates too high, otherwise takes a long time to feel relief and sometimes requires a higher dosage of med. My sister didn't like taking drugs before this whole ordeal started, but has learned not to let the pain get away from her, good pain management can make a difference. Your dad needs to heal, so getting relief from the pain is important.

Ok, for one thing, Roxicet is NOT Fentanyl (or Duragesic). It is a Morphine time release patch.
As Wayne suggests DO NOT EVER cut a patch (whatever type of patch it is) or use one that is damaged in any way. The narcotic is released through a permeable membrane on the skin side of the patch. Damage would release the entire dose at once. It can cause an potentially lethal overdose. Use great care or gloves while handling the patch and be very careful about strictly following the disposal recommendations of the manufacturer. The skin must be clean and dry and the patch applied to a hairless location for maximum effectiveness. I used either 99% pure alcohol (available in supermarkets -do NOT use rubbing alcohol as it has a high water content)or acetone to degrease the area where the patch is going to be applied. If the patch is peeling off prematurely then you have a problem. I have had batches of patches with bad adhesive - notify your pharmacist immediately. A properly applied patch will tolerate showers so bathing shouldn't be a problem. It's also wise to move the patch to different locations when applying new ones. Don't reapply them to the exact same spot right away. Give the skin application area a rest.

Fentanyl is a much more powerful drug than Morphine and is administered starting with 25 mcg patches and some patients can work up to 300 mcg (but I've never heard of anyone here getting more than 150 mcg - I was up to 75 mcg myself). It is a synthetic narcotic and 100 times more potent than heroin (which is 2X more potent than Morphine). It is indicated for 72 hour use and takes about 24 hours to come up to full therapeutic dose rate the first time the patch is applied. Subsequent application of patches will have a residual effect from the previous patch(es) and the transistion from one patch to the next will be seemless. This class of narcotics are specifically designed for "long term" pain management when months or longer of pain is anticipated.

He should also have a "breakthrough", fast acting, narcotic as well. These are typically also known as "short term" narcotics and are used when pain is anticipated to be of a short duration. Morphine is commonly used for this and the liquid form, oral or (PEG) tube applied, typically acts in about 4-5 minutes. Tablets in about 30 minutes.

Adequate pain management is a basic patient right and he should see his doctor immediately. Use the 0-10 scale, with "10" being the worst to describe his pain levels.

Roxicet is a liquid pain medication. This was most likely prescribed for the breakthrough pain. Is he taking the full prescribed dosage, as needed?

You're right - I didn't read the post closely enough. But some are on Morphine time release patches. The Duragesic information is good, although there is also a 15 mcg patch available when phasing out to avoid withdrawal.

Roxicet is actually Oxycodone with acetominophen. It is AKA Percocet. My PDR (a little dated) does not list a liquid form of this medication.

Compared to Morphine, Percocet is kind of wimpy.

The liquid variation of Morphine (Sulphate) is known as Roxanol.