How to safely start Fentanyl patch when already on opioids?

[Verbena1]

I’ve been on 2mg of Hydromorphone (Dilaudid) for a couple of months now for hip and bone pain. The pain has gotten much worse, so my oncologist upped me to 4mg each time. (I’m still taking 2mg, I just take it every 3 hours now instead of every 6 hours).

He also just prescribed me a 3 day release fentanyl patch (25 mcg). I’ve never had Fentanyl before and whenever I try to research it, I mainly see all the horror stories of ODs and deaths. However it seems like it would be a very helpful pain reliever for me, since the pain comes back right away once the pills wear off.

To be on the safe side, I took the pharmacist’s suggestion and got an OTC norcan to have on hand for the patch. But I still have no idea how to continue taking the Dilaudid pills until the patch kicks in, since I see it can take a day or so.

I just don’t want to be taking the normal Dilaudid pill dosage and then boom - suddenly the patch kicks in and I’m unknowingly OD’ing on opioids or something.

Anyone have experience with this or insight into how to do this in the best and safest way?

thanks 🌸

[Sparky95]

Hi

So sorry to hear you are experiencing more bone pain. I was on a low dose fentanyl patch years ago but was concerned about the addictive properties. My palliative care physician switched me to a Buprenorphine patch it has been very effective and I do still take an oxycodone or Tramadol for breakthrough pain.

Praying they help you get your pain under control.

[Verbena1 in reply to Sparky95]

thanks for this, I hadn’t even considered that there might be other safer patches. I’ll look into that too~

[Sister3nkc]

I'm so sorry for your pain issues. I have lesions on my spine and right hip. There is just no way to understand how horrible bone pain is until you experience it yourself. I can most certainly relate.

I don't think anyone on here is really qualified to suggest how to start phasing is the use of the Fentanyl patch. To be safe, please please, please call your doctor about this.

Wishing you the best and some pain relief very soon.

Namaste

[Verbena1 in reply to Sister3nkc]

Yes it’s quite a beast! I will definitely take that suggestion and speak to the doctor. I think when he prescribed it, he just somehow assumed I would know the ins and outs of it. With a powerful drug like this, I don’t want to take any chances!

[nonna70]

Your pharmacist would be able to explain things to you and might be faster than the doc.

[TwithBC in reply to nonna70]

Agree.

[CTGirl1962]

Hi!! Definitely ask your pharmacist for advice. The pharmacist is the expert. If you are working with palliative care as part of your team (which I would HIGHLY SUGGEST), they are also excellent advisors!!

Good luck!! 💚🩵🩷

[TwithBC in reply to CTGirl1962]

Yes!