Fentanyl to pregabalin switch

i have really bad back nerver pain in L4 L5 area of my spine i have had 2 operations and i have been on zomorph then went over to Fentanyl 125mcg per hour patch. and gapapentin 3000mg ia day. after my last visit to my pain clinic she wants me to come off this medication now and transfer over to pregabalin... as i am very druged up... but 80% pain free...she thinks the Fentanyl and gabapentin. will be causing me problems and the pregabalin will give me the same pain relief but make me less sleepy etc. can some on advise as after reading up on pregabalin. i dont think it will work as good as what im on

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  • Hi Mike. Snap. Same problem. Gaba and pregab didn't work for me. I have never been offered proper pain killing drugs sadly but it sounds like you get good relief at present. I survive on meloxicam an anti inflam which keeps me mobile and takes the edge off otherwise I wouldn't be able to get out of bed (I've tried it! More than once and it's not a pleasant experience!) a few glasses of wine works but for obvious reasons isn't an ideal solution and I've had to stop now as it was making me feel unstable emotionally. I think you should consider giving it a go as you won't feel so fuzzy headed and it might just work but they take time to build up in the system so what does the GP advise to keep the pain at bay in the switch over period? Plus, pregab may be better for your digestive system. Doesn't fentanyl wreak havoc with the bowel? Best wishes

  • Fentanyl dose cause Constipation but not as bad as zomorph did... i had to have a suppository every day administered by my wife. but now i go on my own but once every 4 or 5 days. as i sit here at 10:20 am ive been up since 08:30 and still groggy . i wont come round till about 1ish. but i know my pain relief works. im just scared of getting the full hit of the pain again im on crutches as i am but if it gets worse i cant move... she said shes going to take me off fentanyl and move me to pegabalin... no talk of the swap over period. and i remember the swap period from zomorph.. it was horrible.

  • I'm really cynical about drugs...suddenly it seems like everyone is being offered pregabalin. Shares must be doing well for the manufacturer! Seriously though constipation is no joke and if you're on crutches and foggy till 1pm maybe you do need a change of meds. If you're on high dose gaba maybe you can switch over without a build up? Can you make a list of questions to go back to clinic with? Also, I thought the pills are supposed to work by reducing pain so mobility can increase so you can get off crutches ? Is there a plan to get you off crutches? Best wishes.

  • i was in a wheelchair and crutches are an improvement but mobility is restricted by pain i have had a operation to reduce the sciatic pain on my right hand side and it did but the pain is slowly coming back.

    this is the best that i will be as i understand there is no more operations planned for me. and i am just managed on pain medication... it is now 12.50 am and i am just feeling a bit more better to type now and my typing has got faster than it was this morning.... but i am like this 7 days a week and i have no life.... if i have to do anything it has to be planned to happen after 13:00 so i know i can be ready.... but before the medication i was 100% wheel chair bound due to the pain if i was to sit or try and stand upright

  • here is a view of all the medication i have daily the patches are changes every 3 days

    dmkmedia.smugmug.com/Other/...

  • Mike, it's worth giving it a try. That's a lot of meds and narcotics are known to make people drowsy including the bowel! You can always swap back again. Is there no plan for physical rehab once the pain gets better under control? ;)

  • yes they are sending my to some sort of physio pain relief clinic to help

  • Hi Mike, I am off to one of those, 2 days per week for seven weeks, I won't say I looking forward to it but I will give it a chance. I am 64, had to take ill health retirement. the las 18 month my healh, ( arthritic pain in various places in particular back and neck). I am really fed up / depressed with all the drugs and feeling useless for most of the day. So I am really hoping that there may be something in this treatment, When do you start? please let me know how you get on. By the way where are you? I am in Chertsey, Surrey.

    Regards

    Alan

  • Good. Hopefully, someone will be able to get you going again. Often more and better mobility equals less pain equals fewer meds. This may be the positive start you need. Have you seen the link on this site that Joe posted for the neuro website? It has lots of info which makes good reading about getting your life back. There's a good video for a toolkit approach. I'll find the link and post it for you. It might be scary and seem like the GP is trying to take away your much needed pain relief but it sounds like they are trying to help. Sometimes we just have to try new things and hope to get moving again...I was like a china doll for years - couldn't move for pain and felt like I would break into pieces if I moved but lots of physio and deep breathing excises finally got me going. So, I can move but I still have pain. I know how to deal with any flare ups and if you saw me in the street you'd think I was normal. A mixed blessing in itself! ;)

  • I would have thought it better to swap the gabapentin to pregabalin first - as they are similar-acting drugs, ans SLOWLY reduce yje Fentanyl, as you could get a big pain flare. Have you experimented with TENS?

  • yes i have a tens machine and i am in oxfordshire, i will check out that site and yes it dose seem like they are taking the meds away id b happy to stay as i am. but as i know this is working id rearther have the side effects than the pain...

  • Hi Mike, I'm on both zomorph and pregabalin, neither work for me. Zomorph I have been taking for about 8 months, I went to pain clinic and they put me on pregabalin, that was about 6 weeks ago. I get terrible cramp in my arms and fingers, and also get dizziness, constipation and can't sleep at night. I am waiting for an appointment for a epidural injection.

    Good luck

  • isnt epidural a temp solution?

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