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Trouble with Buprenorphine (Norspan) Patch

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    Trouble with Buprenorphine (Norspan) Patch

    Hi,

    I hope someone can help me.

    I have been on a truckload of medication for the past 5 years for chronic nerve pain. This includes-
    oxycontin 30mg morning, 20 mg afternoon, 30 mg evening
    Neurontin 1200mg x3 daily
    + others
    I have also had pain procedures like ketamin infusions and nerve blocks, not to mention extensive cognitive behavioural therapy.

    Recently for no reason, I have had a substantial increase in feeling & sensation, which has only increased my nerve pain.

    My pain Dr. has recently prescribed me a 5mg Norspan (buprenorphine) patch. The plan was that if the patch worked I might be able to try and reduce some of the oxycontin (which I have been on for 5 years now). He also gave me a prescription for a 10mg patch if the 5mg one didn't work.

    A few days after starting the patch my pain only increased. I managed to wear the patch for 6 days but could not continue it any more. Since removing the patch 5 days ago the pain has not decreased back to its normal level.

    Has anybody else had a bad reaction reaction like this?

    Also, is there any information comparing the relative strengths of buprenorphine to oxycontin?

    Many thanks!
    Luke
    Last edited by luke00; 20 Jun 2007, 4:29 AM.
    Anything else is a bonus

    #2
    i just read where a clinical trial was scheduled to start comparing tramadol to norspan for osteoarthtics hip pain.
    i would consider tramadol a bit weaker than oxycontin.
    i take tramadol with Oxycontin , i find it works pretty well.
    i prefer to take tramadol/ultram for breakthrough pain during the day rather than oxycodone.

    it sounds like norspan is somewhere around the level of tramadol, which if it works would be good.
    why your pain is increasing is the mystery, it sounds like it was increasing before the norspan and it is continuing to increase,
    maybe there is something going on that is causing the increase, changing to generic version or changing the manufacturer of the generics of your normal meds may also do it,
    cauda equina

    Comment


      #3
      medication

      that link you gave does not open . can you check it. thanks
      SM/ACM Surgery in 1999

      When the world says "give up"; hope whispers "try one more time"
      -anonymous

      Comment


        #4
        buprenorphine is a partial antagonist of other opiates, (as well as a partial agonist).
        the partial antagonist quality of buprenorphine can put you into withdrawals to your oxycontin....even though both oxycodone and buprenorphine are derived from the opium alkaloid thebaine....they are very different.....if your doctor didn't know this he is not
        learned on the subject....it's almost malpractice if you ask me
        Last edited by Steven Edwards; 13 Feb 2010, 12:54 PM.

        Comment


          #5
          Buprenorphine is used as for veterinary analgesia. But I have not generally heard of it being used for analgesia (pain relief) in humans. It is sometimes used when people want to get off narcotics, to help prevent withdrawal.

          The previous poster is correct - buprenorphine as a partial agonist may block some of the effects of the oxycontin.

          If a patient is on buprinorphine, they may actually require higher doses of opioids such as oxycontin. Here is one source:

          http://www.doraweiner.org/PAI2137_Pa...renorphine.pdf

          This site is a charitible foundation that has to do with the treatment of addiction, so I cannot say how impressive their credentials are. However, at least in the US, buprenorphine is used the most in the treatment of addiction, and what they say does sound correct.

          "The basic issue with analgesia in the buprenorphine-maintained patient is that while buprenorphine has analgesic properties, it is a partial agonist. This means that not only will it block the cravings associated with opioid dependence, but because of the high affinity of buprenorphine for opioid receptors it may also block the analgesic effect of other opioids."

          "In a situation requiring additional opioid analgesia, the dose of the full opioid agonist required may be greater than usual. It is known that, depending on the effect measured, using higher doses of a full agonist opioid may overcome the blockade caused by buprenorphine."

          Comment


            #6
            I am on a 5mg Norspan patch together with clonazepam, it is working on me. Remember it should be placed on the breast or stomach. I am changing once a week and I feel it if I forget to change.

            But I have never eaten morphine, I get sick from it, I get sick from Tramadol too.
            TH 12, 43 years post

            Comment


              #7
              buprenorphine patch

              After having chronic pain for 12 years, I have been trough many treatments. I have been stable on buprenorphine sublingual tabs(8 mg tid) for several years now. I had previously been on Duragesic patches and oxycontin tabs which worked well for 2-3 months and then of course you get tolerant. Also it seems so of the responders are confusing suboxone(which has narcan in it) to subutex(pure buprenorphine). However, there is not one pill of any type that does it all. For me, I incorporate Remeron(an antidepressant which also helps pain), an NSAID such as etodolac or aleve, together with Glucosamin/Chondoitan(NO MSM). Also Baclofen for breakthrough. I am fortunate in that my pain source is in my thoracis spine which is close to the surface and therefore I occassionally use a lidoderm patch for 3 or 4 hours for temporary relief. Not a fan of opoids because All of them have tolerance probems after 2 months or so and then they just don't work at all and in fact make the pain worse. Unfortunately about the only way to get off them
              is to undergo some type of rehab. Been there, done that. I will answer email

              Comment


                #8
                The Norspan patch is 5 microgram, not mg, and I have used it for three years and not increased it. But I have never increased any pain medication I have got, it is still working the same. I have tried to stop but the pain is coming back.

                The only bad thing is that it is going to be changed every week and it is scratching if I don't put it on the right place.

                My daughter is working as a cancer nurse and they use Norspan patches too on the cancer patients when they are in pain. We are very different when it comes to pain medication, some things are working on some people and not on others and the dose depends on the body, not on the pain. My ex father in law used 75 microgram in the end and he had no pain. He had prostate cancer who spread to the skeleton.
                TH 12, 43 years post

                Comment


                  #9
                  Originally posted by metronycguy View Post
                  .
                  i take tramadol with Oxycontin , i find it works pretty well.
                  i prefer to take tramadol/ultram for breakthrough pain during the day rather than oxycodone.

                  ,
                  I do the exact opposite
                  I take Tramadol ER 200mg in the morning and a Oxycontin 5mg in the evening for breakthrough

                  I have never heard of Norspan.
                  T12-L2; Burst fracture L1: Incomplete walking with AFO's and cane since 1989

                  My goal in life is to be as good of a person my dog already thinks I am. ~Author Unknown

                  Comment


                    #10
                    Oxy and tramadol

                    i take tramadol with Oxycontin , i find it works pretty well.
                    Hi Mike,
                    I take 80 mg Oxycontin extended release (40 mg am and pm) and have oxynorn (oxycodone) for breakthrough pain. I vary this regime with a tramadol one consisting of 200ER and 100 IR for breakthrough pain (up to 400 mg a day). All this under supervision of my pian consultant. I much prefer tramadol to oxycodone and would rather use this with Oxycontin for breakthrough pain than the oxycodone. My pain consultant wants me to take oxycodone when I take Oxycontin (because they are the same “family” of opioids) but I would prefer to take tramadol immediate release. So I was interested to here that someone else is taking oxycontin with tramadol for breakthrough. I will discuss this with my pain management dr. Thanks for posting this info.

                    Comment


                      #11
                      ? Bup. patch

                      Hi, This is my first time posting on this forum. Today my doctor recomended the new bupenorphin patch to me. I am currentley on a 100 mcg fentanyl patch changed every 48 hours with hydrocodone 10/325 for breakthrough. I just wanted to as some other people who have been and will be dealing with chronic pain for most of their lives. I have had a few problems with the duragesic patches sticking and causing skin irritation. Because of this my doc did try to switch me to 40 mg. of oxicontin 2x per day. It did not control my pain and had alot of side effects so I went back to the duragesic patches. Despite problems with the patches I think overall they do help me with my pain more than any other meds that I have used. My doc told me it was my choice and I am gonna stay with the duragesic for now but I would be very interested to hear what others who are switching from fentanyl to bupenorphine patches have to say in terms of pain control and side effects. Any information would be greatly valued: p
                      Thanx and god bless

                      Comment


                        #12
                        Norspan10 - Durogesic50[Disaster] -back to N10!

                        Hi all, This is my first post. I live in Australia. My two sources of chronic pain are: Lumbar/Sacro disc degeneration [1978] and Parkinson's [1996].
                        You don't need me to list the plethora of drugs from Codeine Forte to Oxy something or other [opioid] which has bought me to this point. Two years ago my GP prescribed Norspan5 for me but researching the side effects put paid to that. Pain forced a revisit and introduction of Norspan10 some 18 months later [mid 2012]. This went well with no noticeable adverse effects for several months when in about November an itchy rash developed which became a significant issue such that on 16Jan13 I applied the first Durogesic50 patch. By noon the following day I was on the 'phone to my GP with severe nausea & headache with thick white tasteless froth coming from my mouth. On doctors advice the patch was removed and he wrote a script for Norspan10 which has been filled and the box is waiting to be opened, but I am reticent to go there as the itch drove me to distraction. This morning since 04 I have searched on-line for an alternative but there apparently is none. Has anyone had a similar experience with a happier ending? I have connected the rash onset with severe heat wave conditions during the same period. Is this valid?

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