Tramadol (Ultram, Ultracet)
I copied this from her journal..it looks pretty close to the other conversion charts I have seen..but again..
There is now oral Fentanyl in a dissolvable tablet called Fentora but it is indicated only for cancer pain. However, there are a few patients with chronic non-cancer pain that have been prescribed Actiq (the fentanyl lolipops) or Fentora if and only if all other treatments failed and they are experiencing intractable pain, also known as suicide pain.
http://www.globalrph.com/narcotic.
I do trust my doctor and he is a very reputable physician that has been featured on the local news in our state but despite this, he did not apply a cross tolerance at all when he switched me from morphine ER to opana ER (you may remember responding to my post on this subject awhile back). In fact, it was even more medicine than I was already taking in both morphine ER and breakthrough pain medicine in the two 30 mg opana ER pills I take per day.
Before I left the office she was kind enough to relieve my discomfort witha 10mg shot of morphine to cover the transition time. By the time I got the Rx filled an the patch on me ( that was about 4 hours ago ) most of the nice releive i got from the morphine was gone. I am now getting the creepy crawlers much like withdrawl and am very very cranky. My question is: Is 12mcg/hr of this stuff very much. The info I can get tells me its about 1/10 of a 500 vicodin an hour.
High dose before hip surgery due to chronic pain from loose stem and need for revision. Dr. wanted me to drop 30 mg morphine every 2 weeks which was too fast so I thought going to subutex would help get me off high dose. 2 weeks ago I detoxed and have not stabilized. Started at 6 mg. now at 4 mg. Also wonder if traded bad for worse habit. I don't feel good on this med. Go between WD symptoms to fogginess and dizziness.
Didn't know where else to put this, but I was recently switched from Morphine 60mg ER to the Fentanyl Duragesic patch. I thought the weird flu like symptoms might be a result of the new drug, but apparently it has to be withdrawal from the Morphine.
I'm kind of miffed neither the doctor nor pharmacist even mentioned this could happen. I was naive and thought the new medication wouldn't create an issue with the switch, I was wrong.
I was also on Methadone, which worked great, but when we moved to Seattle, I could not find a doctor willing to prescribe Methadone and had to switch back to Morphine. I have been on the Morhine for 2 years now, fentynoal 1 year prior to that, Methadone 1 year prior to that. The only options I have are pain medication or the freezing and destruction of my abdominal nerve centers.
800mg Fentora 6x/dayand 100mg morphine extended release 3x/day.which would be the safest way to take Suboxone.
It looks like we posted at the same time! LOL
But I'm pretty sure, even though I had trouble understanding the post as well, that they were moved to MSContin 30mg at 3 times a day (every 8 hours) so that is another long acting medication.
And I agree...conversions can be very tricky and just wanted to add that I only posted what I did based loosely on a chart that some Drs. use.
(To the OP)....
even small doses are powerful but it is misleading because there is no euphoria with methadone as for morphine your conversion seam off.....when deciding to jump ship that is why I always suggest single digits it will make the withdrawal a whole lot more doable good luck and God bless........
Earlier this year when I switched from morphine to Opana ER, I noticed that the conversion added 60 mg of morphine to my current dosage and I discussed this with my doctor to make sure that he wanted to increase my dosage by that much when switching me from morphine to Opana ER and he confirmed that he did.
Two months ago, I had a patient who was in severe pain and I had to give an IV morphine push through his heplock. After fixing the syringe to the heplock port and pushing the morphine, the gloves torn (they were tight) and I noticed that there was a dry drop of blood on his heplock and my hand touched that DRY drop. I don't know how long was the drop there. I then got an urgent call for a critical patient that lasted 10 minutes and didn't clean my hand until the end of the call.
There are many other meds available at much lower doses. Fentanyl is approx 88 times stronger than morphine. I am just bewildered as to why he would start with 50mcg, maybe it was a mistake.
The advice above is very good. Especially in the summer, you need to watch that the patch stays on, because they fall off and then you have to make sure that your mother doesn't get overheated, because the medicine can be released at a much faster rate...
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