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Slow release alternatives to Buprenorphine 35mcg patch

Posted , 3 users are following.

KathyM
KathyM

Hi people

I have become tolerant to buprenorphine after 4 years of increases and it is no longer managing my chronic pain. I am likely to be admitted to hospital today and before I go I am desperately trying to find more information on alternatives so I can make an informed choice when I am changed over. I currently use 35mcg Transtec patch every 3.5 days and 300mg Pregabalin a day. As of last night (emergency GP out of hours service who wanted to admit me) I also have a day's worth of Oramorph which I have used successfully in the past alongside, and also 4 diazepam 2mg tablets, two left now. I am particularly interested in finding out the equivalent dosages for Palexia/tapentadol and oxycodone as they are the "safest" two I have found so far. Morphine works well so MST dosages would be great too. Any info on which works better for both "mechanical" and severe neuropathic pain would be great as neither the buprenorphine nor the pregabalin are working at all for me. Many thanks!

0 likes, 3 replies

3 Replies

  • KathyM
    KathyM

    Posted

    From reading this forum, I'm fuming with my pain clinic doctor and GP now because both said there was "nwhere left to go" with pain relief, saying I was on the highest doses available. I now see this to be totally false and my agony could've been prevented all along. sad
  • Tarun
    Tarun

    Posted

    Hi Kathy

    The current strength of patch you are on is not the highest available for buprenorphine and I suspect the pain clinic are apprehensive about increasing this further. In terms of dose equivalences, tapentadol is a very new painkiller and experience with this is likely to be limited particularly amongst specialists, with even less information on a dose equivalence with other opioids. I'm not sure whether either can be called "safer" as there are always risks with opioid based medicines. There are no definite dose conversions between opioids because everyone responds to them in different ways. Happy to discuss further through a private message.

    Tarun (hospital pharmacist)

  • KathyM
    KathyM

    Posted

    Thanks Tarun, yes you're right I know, I was just trying to keep typing to a minimum and the diazepam has my word capability fuzzied up. I know there's nothing non-opiate they can do for me without surgery now, I want to go for the spinal chord stimulator trial as things have gone on too long now without other options coming about. I don't want to be on meds at all, but if they change me today I want to find one that works well in terms of long acting pain relief. Peaks and troughs of pain relief have had pretty strong effects on me in the past with Diconal and Buprenorphine sublingual tablets. An evaluation of the pros and cons of other slow release medications would be ideal - will try and work out how to PM on here xx
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