Pain meds to be changed

[DollyDutchGirl_1946]

I’ve been attending the pain clinic for a year - and it is now suggesting that my pain relief meds should be changed. I am currently taking Dihydrocodeine plus two Paracetamol 4 times a day - plus, 70mg Amitriptyline each evening at 6 pm to help me sleep through the night. They want to swap the Amitriptyline to Duloxatine and the Dihydrocodeine to Buprenorphine (possibly via patches). Have any you wonderful people had either of these meds - or been changed to them...? If changed to them how did that work for you…?

[Madlegs1]

I haven't personally experienced these. But there is a lot of discussion about buprenorphine on the Restless Legs site.

It might be worth your while to have a search over there.

The patch has a history of not lasting the week, so you may want to mention that to the prescribers ,to allow for changing every 5 days if that arises with you.

It can take a few weeks to get used to the buprenorphine -- usual opioid issues-- but you probably have got over those with your current regime.

Anyway - good luck with your new journey.👍

[DollyDutchGirl_1946 in reply to Madlegs1]

thank you for your kind response it is sincerely appreciated. 😊

[hezzamj]

Hi I changed from slow release morphine capsules to buprenorphine patches while in hospital. I had no problems with adjusting to them but they are a bugger to keep on especially when you’re warm. Luckily I have to change mine every 4 days. Only issue is now about 2 months down the line it’s started to leave an itchy rash. Not everytime and not every patch (I have 85mg so need a large 70mg patch and small 15mg one.

As I said though there’s been no issues apart from the first day as expected when you change over it takes sometime for the patch to kick in but they gave me fast acting hydrocortisone liquid as and when I needed it. Luckily I was in hospital when the change was done so it was a bit easier.

I have no experience of the other medication I’m afraid as I went to hydrocortisone as my fast acting.

Hope you get sorted and it all works well xx

[DollyDutchGirl_1946 in reply to hezzamj]

that you so much for your kind response - it really is appreciated. My concern with the patches is - that I have pretty sensitive skin and a mild latex allergy. My GP has arranged an appointment for the 28th of this month, so hopefully will be able to sort things out then. I hope that you are okay now and managing your pain. Thank you again for your help….😊

[OSTEOARTHRITISRA]

Hi yes Everyone different though

Some meds if yiu get some relief should not be messed with as can take years to find solution

I have mixed messages with pain clinic

Different views

Hade good pain nurse not now she suggested

More meds lower dose is better

Doc agreed

Paracetamol first starting point

Then add ons

Dehydracodine

I'd be wary about

Swapping the Dehydracodine

I get

The

Patch (fentynal) on top of the Paracetamol Dehydracodine low dose the fentynal is good as its a 72 hour and change every 3 days

As sometimes you miss Dehydracodine doses

Amitriptyline duloxatine are similar and for nerve pain as well

My doc had enough with the sleep issues

And halted both above

And

Got

Trazadone

For the sleep

If any nerve pain

Pregablin

Good luck with your meds

[DollyDutchGirl_1946 in reply to OSTEOARTHRITISRA]

Thank you for taking time to reply to me. It’s truly appreciated. I’ve been taking the dihydrocodeine and paracetamol for two years and now it’s loosing it power with me, so hence the change of meds. I’m also 78 and know that the body can get used to the pain meds….so fortunately, the Pain Clinic got that - and have written to my GP about changing them. I hope you are getting the relief you need…😊

[OSTEOARTHRITISRA in reply to DollyDutchGirl_1946]

Yeh Good luck

Hope the change helps

Constipation can also be an issue with

Dehydracodine and paracetamol

Good luck with new meds

[DollyDutchGirl_1946 in reply to OSTEOARTHRITISRA]

Yes - constipation is a big problem. In the beginning, the hospital loaded me up with huge boxes of Senna to help with the problem - then my GP gave me some orange powder that I had to mix with water. Currently I’m trying Duculux stool softeners but, need to take 5 a day to help things along. Another thing to mention at my GP appointment, when he’s going to talk me through coming off the Dihydrocodeine and also coming off the Amitriptyline - and starting the Buprenorphine (possibly via patches) and the Duloxadine. Ido believe it will be one change at a time, so that may/may not make things a little easier. Thank you again for your kind help…😊

[OSTEOARTHRITISRA in reply to DollyDutchGirl_1946]

That's good The tapering is a bit easier when stating new drugs at same time ,

If changeing Constipation drugs in future

If not tryed

I found

After trying a few

Lactulose

Very good got on repeat

[Betsy50]

Hi I'm currently on the patches and duloxetine as for the irritation on your skin use becomes Nadal spray on your skin before applying patch it stops the irritation and that came from my pain consultant. I have no issues with these meds the duloxetine calmed the pins n needles on my toes. Hope this helps x

[DollyDutchGirl_1946 in reply to Betsy50]

Thank you Betsy, your reply is very much appreciated. I will ask my GP about Nadal Spray before applying the patches, as I’m willing to give anything a try. I have a lot of lower back pain, that means I can only stand for a couple of minutes at a time and can only walk for a few minutes before I have to sit down. However, I have a wheeled walker that I use for very short distances and a small mobility scooter for longer distances., and that can help a lot. I also have a walker with a little tray for inside the house but, try not to use if I can. I hope that the combination of the patches and the duloxatine helps you with your pain. 😊

[Betsy50 in reply to DollyDutchGirl_1946]

That was ment to say beconese nasal spray my pain consultant recommended it and it works for me. Yes we are all different and our bodies react differently but when your at your wits end you'll try anything for pain . Good luck and take care x

[DollyDutchGirl_1946 in reply to Betsy50]

Aahhh. Nasal Spray makes sense 😂🤣. I use the nasal spray as part of my Asthma armoury….. so certainly will give that a try. Thank you so much for getting back to me - that’s truly appreciated….😊

[cyberbarn]

My son was changed from amitriptyline to duloxetine and it was a disaster for him. He went back to amitriptyline and has been on that for several years now.

It is worth remembering that everyone metabolises drugs differently. For every four people given amitriptyline only one person will get a benefit. It's called the number needed to treat (NNT). The NNT for duloxetine is something like 5-6.

But the difficulty is we don't always know which people will respond to which drug. So my son was the 1 that got benefit from amitriptyline. But a friend of mine was one of the people to benefit from duloxetine.

Until you try it you won't know.

[DollyDutchGirl_1946 in reply to cyberbarn]

Hi Cyberbarn, thank you for your kind comments - it honestly is appreciated. I’ve been taking the Amitriptyline for two years, just at 70mg to help me sleep through night. Unfortunately, I've now been getting night time breakthrough pain and waking several times a night - so hence we are considering the change to Dulixetine. Fingers crossed that it works for me…😊

[MSTKing]

I would have a think about what you are on now- does it manage your pain well?

Are the side-effects not causing you any issues?

If the answer is yes to these questions I would resist making such a big change.

[DollyDutchGirl_1946 in reply to MSTKing]

Unfortunately, I’ve been getting night time break through pain and so am waking up several times a night. For me that’s not a good thing - as I need my sleep to be able to function somewhat…🤦‍♀️. The pain clinics is suggesting that we do one change over at a time….which is the sensible way to do things. Daytime, the Dihydrocodeine and Paracetamol aren’t cutting it any more beyond the first hour and half/ two hours. Hence the pain clinic suggested the changes - but, one at a time. 😊

[MSTKing in reply to DollyDutchGirl_1946]

sorry about that - I’m the same the Morphine and sleeping tablets used to stop me from waking in pain but now I am awake 2,3 times a night. But, bar that - they work. I know if I approach my GP instead of increasing they will want to decrease my meds - which is why I keep on them. As mostly they do work.

[MyStar86]

you might find trouble sleeping as the patches gave me insomnia for a while and the duloxetine does not help with sleep like Amitriptyline does so I’m not sure about the rational for the change in meds…..did you say you felt the ones you were taking were no longer helping? Maybe you could arrange a follow up with your gp for 2/3 weeks after starting the new meds so you can change back if needed as that’s a big change all in one go for your body to get used to the patches a lot were a big shock to my system and I started on a low 10mcg dose so take care and keep your doctors updated as I’m very suprised they want to change all of your meds xx

[DollyDutchGirl_1946 in reply to MyStar86]

I’ve been getting breakthrough night time pain with the 70mg Amitriptyline so wonder if that is their reason. I will talk this over with my GP next week, to enable me to make an informed choice. I truly appreciate your input regarding the Duloxatine….so many thanks for your help. 😊

[MyStar86 in reply to DollyDutchGirl_1946]

I do also get a sore rash from the plasters I dropped down to the 5mcg patches which are smaller and have a lot less side effects as they seem to give me terrors everytime I go to sleep I get these awful terrors it started on the 10mcg patches and I didn’t feel myself but they did help more with the pain than the 5mcg patches but I couldn’t take the side effects I went suicidal at one point it was very scary I’ve been ok on the 5 mcg patches and the rash is a lot less I use an adhesive remover wipe after and I agree with what someone else said they do not last 7 days 5 days if you are lucky but everyone is different I hope they help you and the doctor can give you some help as well. Good luck xx

[DollyDutchGirl_1946 in reply to MyStar86]

Thank you for your kind reply - I truly do appreciate it. I’m making notes of things people are saying - so that I can be fully informed by the time I get to see my GP next week. Thank you again…😊

[MyStar86 in reply to DollyDutchGirl_1946]

Good luck I hope it goes well xx

[DollyDutchGirl_1946 in reply to MyStar86]

I truly hope that you have/are receiving the help you need re; the awful side affects you were having from Buphrenorphine patches. The night terrors must have been/ must be absolutely horrendous. Fortunately, to date, none of my extensive medications have caused that problem that you have endured. Hopefully, neither of the two new one will cause any issues for me….

[MyStar86 in reply to DollyDutchGirl_1946]

Thank you for being so kind!! Even the lower dose patches still give me terrors nothing like the 10mcg patches with those I would wake up screaming and my pillow soaked with tears it was awful. Ive never had that kind of reaction before to any medications so that made it even more scary. I’m learning to tolerate the terrors now they are milder and I’m no longer suicidal but I had to totally come off them patches and go through withdrawal which was actually worst 😱 that’s how I ended up back on the weaker patches as my body had become dependant on the patches but I’m getting on ok with the weaker ones I just have to take codeine as well and diazepam.

The best thing I find with medication is don’t read the side effects just take them and see how you get on as sometimes you become to hyper aware it can make you worry about side effects too much so try not to worry about how others have gotten on except the rash that’s definitely a pain but it depends what dose you are on as they stronger ones are bigger patches and also there are lots of different brands so it could be a matter of trying different brands to find one that doesn’t cause a rash xx

[Poppy_Ann]

Hi there, I use to be on the patches for pain until they started to blister the skin after using them for several years my doctor suggested dihydrocodeine which I said I would give them a try and I have been on them for several years now without a problem, I am now on :-

1. Dihydrocodeine 120mg twice a day.

2 . Pregabalin 150mg one capsule twice daily

3. Nefopam 30mg tablets I take two 3 times/day

4. Omeprazole 20mg tablets take one daily

5. Amitriptyline 50mg tablets one or two To be taken Each Night

I take other medication but not for pain relief I also have morphine available for when the pain is very bad but try not to use it.

Good luck finding something that works for you.

[DollyDutchGirl_1946 in reply to Poppy_Ann]

Thank you for so kindly replying to my query, it is truly appreciated. It really helps me know what questions to ask my GP before going ahead with the changes. I’m 78 - and because of my age and the required use of heavy steroids, my skin is very thin and bruises easily. I also have a mild latex allergy that can make my skin blister badly if the wrong plasters are applied to my skin, so I am a little wary on going down the patches route. I feel it will be a. Interesting discussion with my GP….😊

[DollyDutchGirl_1946 in reply to Poppy_Ann]

As a side line to my answer - I’m currently taking Dihydrocodeine with 2 paracetamol x 4 times a day, plus Omeprazole 3 times a day, along with 70 mg Amitriptyline each evening at 6pm (otherwise I can’t shake the sleep from my eyes in the mornings 🤣😂). I also have a host of Asthma meds, alongside those for age related ailments….and to throw another spanner in the works, I have CKD stage 3…..and, a congenital blood clotting gene…🤦‍♀️ LOL - this getting old certainly isn’t for wimps….🤣😂🤣

[OSTEOARTHRITISRA]

The fentynal are a good alternative If you have issiues with the ones you are getting

Plus a bit simplified

Every 3 days they last 72 hours

Small patches

[DollyDutchGirl_1946 in reply to OSTEOARTHRITISRA]

Thank you again for for your kind help - I really do appreciate it. 😊

[Hzhr7]

Hi , I've just recently gone back on to Buphrenorphine patches after struggling with just Oramorph, paracetamol & amitriptyline 20 mg at night. I find the patches last nearly 7 days I use Oramorph & paracetamol for the breakthrough pain. I have slept much better since being on the patches & don't have an issue with my skin despite it being sensitive . They are best on your upper arm & stay on swimming & showering every day . Hope they do help you xx

[DollyDutchGirl_1946 in reply to Hzhr7]

Many thanks Hzhr7, I really appreciate you taking the time out to share your experiences with me. It’s a great help knowing how people respond to various meds….and gives me great information for when I see my GP next week. Again, thank you so much….😃

[Baileydog]

yes tge duloxetine are a good pain relief. I had my needs swapped also. I was wary at first but after a few months am doing ok on tgem

[DollyDutchGirl_1946 in reply to Baileydog]

I’m really pleased that Duloxetine is helping you Baileydog - and the positive comments about it are making me feel more comfortable with the change over. Obviously the change of meds will be done one at a time - so it will interesting to see how it goes….😂🤣

[Bantamdyno]

Have you found trigger points [pain points}and get your endorphins to go to them. using Tsubo🤔

[DollyDutchGirl in reply to Bantamdyno]

Hi Bantamdyno, I have fibromyalgia - so that means pretty much constant aches and pains throughout my body 24/7 - as well neurological pain, facet joint hydropathy, bi-lateral hip replacements and arthritis, so unfortunately, I have had to accept that I am living with pain. Fortunately, I am still pretty strong minded and, as the pain clinic stated, acceptance of living with pain is a major step towards learning to deal with it - and the realisation that, in cases like mine, it’s not going to get better, so the medication is the only way to find some kind of relief. I truly appreciate you comment regarding Tsubo - and I am fortunate enough to be surrounded by nature - that I truly do appreciate and can become quite absorbed by it. Thank you again for your kind comment…😊

[Bantamdyno in reply to DollyDutchGirl]

Hi you sound just like my wife,75,pains all over with fibro and just had a new hip replacement but she only has two co codamol a day,but keeps active, she has weighed 9 1/2 stone since i've known her but she has put on 1/2 stone and she thinks its effecting her leg pain,

Myself I have peripheral neuropathy treat the pain points with moxibustion🤔

[DollyDutchGirl in reply to Bantamdyno]

Crikey Bantamdyno, I truly admire your wife just managing on two co—codadmol a day !! I can hardly put my feet to the ground each morning, before I take dihydrocodeine and two paracetamol. Then, it’s two Bumetanide (water pills), two Carbocisteine (a mucolytic. That helps clear the chest by making the phlegm (mucus) less sticky and easier to cough up.) - I have severe Asthma, so my consultant added Fexofenadine (an antihistamine), Montulukast and Fostair 200/6 - a steroid inhaler - used as MART (maintenance and reliever) 2 x inhalations am and pm, plus, up to 4 extra inhalations throughout the day. If that doesn’t do the trick - it’s “call an ambulance immediately”. I also take a steroid nasal spray in the morning and at night. The Dihydrocodeine and paracetamol are taken every 4 hours. I am currently tiltrating down from 70mg of Amitriptyline - whilst gradually tiltrating up the Duloxatine to 60gms twice a day. Once I’ve become used to that - we will change the Dihydrocodeine and paracetamol for Bupronorphine patches - to see how I fare with those…whilst still taking the paracetamol four times a day. If that’s not enough, I have to take the usual meds for old folk - Amlodipine and Losartan for HBP, Astorvastatin for High Cholesterol and 75 mg Aspirin as I carry a blood clotting gene Factor 5 (V) Leiden. As I’ve said before - this getting is old definitely isn’t for wimps….😵‍💫🤣😂