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Re: I think I should mention my pain medication kadykat

Posted by ed_uk2010 on April 14, 2014, at 15:09:13

In reply to I think I should mention my pain medication, posted by kadykat on April 11, 2014, at 3:54:53

>Fentantyl Patches 10 x 50mcg (Duragesic)
> Hydromorphone Extended-Release 32mg. (Exalgo)
> Oxymorphone 90 x 10mg. (Opana IR)
> Oxymorphone 30 x 40mg. (Opana ER)

Why 3 potent opioids at once? It's very unusual. As I'm sure you know, it's standard practice just to use one potent opioid at an appropriately titrated dose, except where a different drug is needed for breakthrough pain (most common when fentanyl patches are used + an oral agent).

I'm also surprised that your pdoc added so many drugs all at once. I find this rather reckless. In general, only one medication should be adjusted at a time. If not, you are left with no idea how each medication is affecting you individually and there is a risk of multiple adverse effects.

Due to your fatigue and excessive sleep, I think you should consider reducing your pain medication. I do not think that adding additional medication such as Provigil is a particularly good idea until this has been tried, assuming you haven't already. Fatigue may worsen initially as a withdrawal effect but should then improve. I don't think you need to look at Suboxone unless you have abused your current meds. A structured and supported dose reduction regimen would be more logical.

I do not understand the reason for prescribing Tranxene. Benzos should be reserved for severe anxiety, panic or severe insomnia. It does not seem that you have any of these conditions?

I am not judging you in any way, by your doctors prescribing is rather worrying. They are virtually throwing medication at you, and you are currently so tired it's hard to get out of bed. There has been lot of talk of multiple complex regimens on this thread. A sensible regimen should only been achieved by careful adjustment of one medication at a time, assessing the response to each change individually. You cannot find the best regimen by starting so many meds all at once based on what sounds good on paper. And why does everyone seem to want you on the highest possible doses? Not everyone needs the maximum dose. The best dose to take is the lowest dose which is effective for you personally.

Take care.

 

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