Weaning From 32 Mgs Of Hydromorphone To 400 Mg Lucynta

As a way to end a long battle with neuropathic pain from chemotherapy that started with hydrocodone and ended with 100 mcg Duragesic Patch/48 hours, I wanted to get off the patches and so first brought down, slowly, to 50 mcg Duragesic/48 hours and then I wanted to move to a different drug - we switched to hydromorphone, beginning at 8 mg 6 x day for 4 days, then 4 mg a 11 x day for 7 days, then eventually to 4 mg 8 x a day = 32 mgs a day. I am not metabolizing this well and in a lot of pain and discomfort, and so we are switching to a drug I am unfamiliar with, called Lucynta. I am to take 100 mg 4 x a day, and in two weeks go down 1/2 pill every 2 weeks until I'm done. Has anyone used Lucynta for weaning? I understand that I am fortunate to be weaning from hydromorphone rather than duragestic patch since the patch is so long acting...the withdrawal, particularly since I seem to metabolize the hydromorphone so inefficienctly, could be a bit less hellish. One time I had already taken 6 tabs of the 4 mg hydromorph before a visit to the pain clinic and when they did a urinalysis I came up negative for hydromorphone...it burns through my body like crazy. It was 4 in the afternoon by then and my legs were aching...I didn't think to take another pill while I was there, but still! 6 pills and a negative!!! Doc was not concerned at all about my honesty (my record is good) and believed that after so many years on duragesic I just don't metabolize the hydromorphone well. Which is why we are switching to Lucynta....and then off. I AM considering (at doc's advice) just going through complete withdrawal for next 5 days from the hyrdromorphone alone. I have not started the Lucynta yet...maybe I should just get this over with. I have Clonadine and Diazapam - neither of which I abuse and will be helpful in withdrawal. Anyway...anyone done a taper with Lucynta? Should I just see if I can handle the withdrawal for 5 days and be done (more or less) with the worst of it? it's been a long long time since I've been opiate free. I miss it. Thanks!!!!

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Hi, Jane! How are you feeling?

I'm sorry about everything you've been through, though I do have to say that you must be one incredibly strong and amazing person! :-)

The name of the medication is actually Nucynta, it contains the active ingredient Tapentadol, which is a centrally acting analgesic. It provides analgesia similar to most opiates, but with a more tolerable side effect profile, so it might help you.

Side effects include nausea, dizziness, constipation and CNS sedation.

Learn more Nucynta details here.

Have you decided what you're going to do yet?

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I have been with Kaiser and they have had me on Opiates for over 12 years. I had a successful nerve burn done 1-21-14. Pain free. I quit taking all drugs, went into self induced detox. My body was starving, for food, drink and sleep. I lost twenty pounds. I had to go back up the ladder with taking one tablet of dilaudid every twelve hours to try and back down. I am having major muscle and nerve pain but have not reached for additional pills. I guess I am just trying to wean down, but the pain in my neck and the migraines are returning back. I need to wean off the dilaudid completely, I. Feel like I'm just feeding the addiction and getting no help with the horrible pain coming back. I had some sort of old Tramadol in my cabinet and took one tonight for the pain tonight. Will Tramadol hurt me or if taken very cautiously will it help me? I read about Lucynta, would that be an option for the pain? I have been through the horrible withdrawals and I am sure that I have more coming my way. I refuse to start up the Dilaudid again for the purposes of pain as I still have 2 pills a day to rid myself of. I am trying to do this on my own as I leave the Kaiser health system in three weeks. If there is something that could help me until I reach another physician I would appreciate the feedback. I know exactly what I have to do and I never waiver but the pain is returning and I'm going to have to find a way to handle it. I understand that Tylenol and other over the counter pain reducers can cause low liver enzymes?

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Oh my, 5days? I wish he it was that easy, all opioids are the same, it depends how attached your body is to them, I have cancer and been on opioids for a couple of years now, stage 4, I do know if a miracle ever happened to me and I would have no more pain, I would need help to get off the opioids, I would have to go to a treatment Center, but that’s me, good luck and congratulations on becoming pain free

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