Doctor insights on:
What Is Baseline Pain And Breakthrough Pain
Acute pain: Breakthrough refers to episodes of acute worsening of pain symptoms in a person being treated for chronic pain. If it occurs infrequently then immediate releasr pain meds are used to relieve discomfort. If it is occuring frequently, then an attempt to adjust the dosage of long acting analgesic can be attempted. The goal is to limit breakthrough pain and keep the patient as comfortable as possible. ...Read moreSee 1 more doctor answer
No: Breakthorugh (btp) pain is pain that is above the baseline pain. Not all episodes of btp require attention. 50% have no cause - it just happens. Btp usually peaks in 3-5 min and lasts about 40-60min. ...Read more
Maybe: Actiq is not the best breakthrough pain medication in my opinion. It is expensive and from my experience doesn't work better than less expensive oral options. Also, fentanyl has a relatively short half life and I find that most of my patients who are prescribed breakthrough pain medication almost never have any left at the end of the month, so they are really using it as maintenence medication. ...Read moreSee 2 more doctor answers
What would be a good med for me for breakthrough pain? Oramorph 10mg/5ml doesn't seem to help much.
No easy answer: As to be able to best guide you, one would ideally need to know more specifics about the exact causes of your pain, quality of your pain and what medications you have tried in the past. Sounds like you need the input of a pain specialist. Best of luck. ...Read more
Very short effect: For this reason this med shouldn't be used for non-cancer pain. The effect lasts for at most 1 to 1 hours. Tolerance develops rapidly because of the rapid, intense effect. This results in the need for higher and higher doses over a very short time. This med is most appropriate for patients not expected to survive for more than several months as the med becomes less effective rapidly. ...Read moreSee 1 more doctor answer
Maybe: The active ingredient in Actiq is fentanyl, the same medication in the Duragesic patch. As such, I tend to prescribe fentanyl products for breakthrough pain in my patients with chronic pain on around the clock opioid treatment. Actiq works well, but takes a while to kick in, and needs to be rubbed on the cheek for a while. There are other products that work faster and not swallowed as much. ...Read moreSee 1 more doctor answer
I have been wearing norspan 10 + 20 for 2 years and 5 months. Breakthrough pain is frequent now. Doc is reluctant to increase weekly dose. I am 72.?
Opioid issues: Some docs just don't feel comfortable increasing pain meds, but it sounds like you might be due for an increase. However, other things need to be considered, including other health issues, concerns about falls, and the nature of your pain. I would recommend seeing a pain specialist or physiatrist to discuss other modalities, functional issues and increase or change in pain meds. Best of luck! ...Read moreSee 1 more doctor answer
Impossible to answer: Chronic narcotic use has enormous risks, especially in a 35 year old. Without detailed knowledge of your history, this question is impossible to answer. From the list of your other medical issues I would urge finding other treatments to address the pain and anxiety/depression besides narcotics. ...Read more
As directed: As directed by your prescribing physician. Usually if you have been on a stable dose of oxycontn for several days, you have achieved a relatively stable blood level of the drug. This is why it is scheduled to be taken at regular intervals (eg. Every 12hr). In this case, bt medication can be taken irrespective of last long acting med dose. You really need to discuss bt pain with your physician. ...Read moreSee 1 more doctor answer
My doc just increased my meds (dilaudid) from 1mg to 2mg for breakthrough pain. Should I notice much difference?
Better pain relief: If you are having increased breakthrough pain and your physician adjusted breakthrough pain medication dose. You should experience better pain relief assuming your pain is opioid responsive. Since you are not opioid naive, you should not have much side effects, but also with increased dose you have to be vigilant about possible increased sedation. ...Read more
Is it safe to take 240mg of codeine daily and 5ml of morphine for breakthrough pain upto x4 a day? What ratio is codeine to morphine on average thanks
Probably too much:
Oramorph is much stronger, and shorter lasting, than tramadol, so it may work too well, for too short of a time.
It can be surprising, but sometimes these medicines do not work the same as you would expect. Their effects vary from person to person.
If tramadol usually worked, normally naproxen, amitriptyline or gabapentin would help for remaining pain. ...Read more
Doctor won't increase oxycontin amount, need something for breakthrough pain - what do you think?
Is it true that having an oxycodone prescription for breakthrough pain just makes people take more pain medication?
Oxycodone: Yes and no. Oxycodone is a frequently prescribed immediate release narcotic given to people who are on chronic opioid therapy with a sustained release narcotic taken orally or by patch. The key is frequent follow-up with your pain physician to get to a regimen of sustained release narcotic where you require the minimum amount of oxycodone/breakthrough meds for emergency only. ...Read moreSee 1 more doctor answer
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