Buprenorphine tablet's refused....why ?

[Danni54]

I have, yet another, short story! I had spoken to the Pain Clinic Specialist Nurse about changing from the Buprenorphine patch to tablet's and she agreed to write to my Dr. and ask him to change over because I am having a reaction to the gum on the patch and the itch is driving me nuts! I have been given a Steroid puffer to spray twice before putting the patch on which helps for 3 day's. Then....this evening, I have had a phone call from my Dr. and was told that the Nurse has suggested Tramadol and another couple of tablet's but didn't mention Buprenorphine! I am so angry, anyway, with the Pain Clinic about my cancer misdiagnosis and now this! I will write to the Nurse tomorrow and ask why. Apparently the equivalent tablet of the 20 mcg patch is far too high and they don't like prescribing it! I'm afraid I broke down and my Dr. knows that I can't take Tramadol because I had a bad reaction to it previously. I gather it's not good for RLS ! I can't remember the names of the other tablet's which she suggested! I told my Dr. that if I go back to having severe RLS then I will fall apart! I can still feel it lurking. He said that he wants to see me in 2 week's as he is keeping me on the patches for now but giving me different pill's to take as well as the patch. They are to help the pain of the nerve damage with the fractured vertebrae. I can't remember what they are called but will ask here before I take them!

For Jools and Sue and Chris ... I'm going to print information for my Surgery...again...and make sure this time that they take notice! Any suggestions gratefully received! Also any comments. I must admit to being quite upset tonight because the medical profession keeps messing up on me and have left me a wreck and the Nurse, definitely, said that she would speak to the Dr. and ask him to prescribe Buprenorphine so, why didn't she? I feel so let down...yet again!

Thanks, in advance, for all the help ! x

[Joolsg]

Many GP surgeries 'don't like' prescribing oral Buprenorphine pills, BUT if the pain clinic has recommended the switch, the GP should follow the recommendations, unless Buprenorphine pills are red listed where you are. If so, the pain clinic will have to prescribe the pills and monitor you.The dose equivalence of 20mcg is Buprenorphine patch is around 36 -48mg of oral morphine and 1.2mg of Buprenorphine pills.( 8mg morphine = 200mcg pills)That's the AVERAGE dose according to the Mayo Clinic Algorithm. The maximum dose is 6mg pills.

All I can suggest is that you again show the Mayo Clinic Algorithm to your GP surgery and ask the pain clinic to recommend pills.

[Danni54 in reply to Joolsg]

Hi again! Sorry Jools but I need more advice! My Dr. rang and it was the Pain Clinic who haven't prescribed Buprenorphine tablet's and he can't understand why but he can't prescribe them without their say so ! The Pain Clinic have told him about 3 different pill's that I could try . One being Tramadol which I can't take because of a bad reaction previously so, this morning I have been given Nefopam 30 mg. tablet's and while I realise that they are to help the pain from nerve damage in my stomach and vertebrae fracture's, what are they going to do to the RLS. They want me to stay on Buprenorphine patches and use the puffer spray to stop the rash! That puffer lasts for 3 day's and then I have to peel back the patch , spray and stick it back on with a plaster. I am going to write to the Pain Clinic Specialist Nurse and ask her what the .... is going on! I'm so sick of them not listening to me and not looking at the Mayo Clinic or any of the sites you and other's have advised. They want me to take the Nefopam along with the patches.I'm not going to take them until I know whether they will make the RLS worse. I hope that you are O.K. I'm so sorry to keep bothering you but I'm getting very depressed with their attitude. Take care.

[Joolsg in reply to Danni54]

Nefopam won't do anything for your RLS. It won't make it worse either. It's a non opioid pain killer.I suggest your GP calls the pain clinic to explain he WILL prescribe Buprenorphine pills but they have to sanction it.

The nurse clearly didn't listen to you.

It is SO frustrating to get through to people.

You and the GP will need to write asking the pain clinic to prescribe Buprenorphine in pill form, as requested, to stop the allergic site reaction.

[Danni54 in reply to Joolsg]

Will write to her now. I'm not happy because I told her that, if I go back to the severe RLS then I really will crack up. They, obviously, haven't looked at any of the link's I have sent them after all, what do I know....I am just living it! Itching as I write !Thank you, again, Jools.

[wildlegs]

Hi Danni, I’ve had RLS for over 25 years. I’ve been given many different drugs that supposedly will help. The only one the really helped was Tramadol. I’ve been taking it for 10 years and it works 95% of the time. They come in 50mg tablets and I take 3 a day. I moved from Florida to Wisconsin four years ago and it took me 3 doctors to get what I knew would help. Because Tramadol is concidered an opioid it is sometimes difficult to get a doctor to prescribe 150 mg but it dose work the best for me, I know everyone is different. I take one at 5:oo pm, one at 6:30 pm and on at 8: pm and go to bed around 11:00 pm. Good Luck !

Wildlegs

[Danni54 in reply to wildlegs]

Thank you so much. Unfortunately, I had a bad reaction to Tramadol a couple of year's ago. My Dr. rang a couple of evening's ago and he can't understand why the Pain Clinic wouldn't prescribe Buprenorphine tablet's. I live in Scotland and apparently, our Surgery aren't allowed to prescribe Opioid's without back up from the Specialist Nurse at the Pain Clinic! Considering I was on Diconal off and on for 25 year's for Endometriosis, adhesions etc. , I find it totally ironic that they can't, now , prescribe other Opioid's. Diconal was , abruptly, stopped here and I was not put on a withdrawal programme so that was hell and not good for any part of my body..or head ! I could be write a book about the appalling bad treatment I have had from our hospital and Pain Clinic and I'm not the only one! I could go on but won't!! When I wrote to her, the Specialist Nurse had agreed to recommend to my Dr. that I am to be given Buprenorphine tablet's but then wrote to him naming 3 other tablet's, 1 of which is Tramadol! I'm going to write to her again shortly and ask why !

Having RLS is a nightmare....an awake one and i can't imagine how you and other's coped for 25 year's and I'm so pleased that Tramadol has helped you. Please take care. Best wishes.