Rx'd Nucynta along with Methadone

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MattMason
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Rx'd Nucynta along with Methadone

I am a 48 yr old male, with ideopathic osteoporosis, diagnosed when I was in early thirties. I have 6 thoracic compression fractures.

I have been on 40 mgs of methadone for 14 years, started seeing a new pain mgt. Doc 1.5 years ago,  that has kicked it up to 50 Mg's and added 30 mg's of oxycodone for breahthrough.

Today he gave me a script for Nucynta 50mg's 5 dailey.In place of the oxy. As I  Cannot seem to find much info on that new medicine.Anyone habe any ideas how it will act with the methadone?

Is it supposed to be non addictive? or does it act as a regular opiod with euphoric sensation..

 

Any input would really help.

Thanks

FeliksD
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He

gave you the Nucynta because the pharm. reps are giving him free trips to Pebble Beach for every script he writes.

 

tempspastic
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Wow...

That is a radical change in medication...

 

From wiki:

Tapentadol (Trade name Nucynta) is a centrally-acting analgesic with a unique dual mode of action as an agonist at the μ-opioid receptor and as a norepinephrine reuptake inhibitor.[2] It is considered to have a potency between morphine and tramadol.[3]. Tapentadol is a new agent with opioid and nonopioid acitivity in a single compound.

 

Interesting drug. Not much info on it. I Would not like to be the guniea pig on this one. Their own website cautions dosing with methadone. It could possibly potentiate it. So be careful.

https://online.epocrates.com/u/1045087/Nucynta/Drug+Interactions

Tacet-Conundrum
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My PMD said he would not be

My PMD said he would not be the first kid on the block dosing his patients with this new medicine. Funny after hearing him say that I see folks getting scripts for it. Though personally I would like to see how it compares with tramadol since it is the closest medicine to it. Most reports are not favorable citing headaches then discontinuation. Also heard that it didn't work on pain like people experiance with ultram. Heard also that this new med produces euphoria if you can get past the headaches. Personally I take ultram for my lower level head pain where it does help a little. Just don't feel like taking percocet all the time.

quincy
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To MattMason

Hi guy, this is Q. Welcome to pharmer. There's a real good thread on Nucynta on the "Chronic Pain and Pain Management"  banner. The Topic title is "A New Analgesic on the market". Check it out, it's still active and it has a lot of info on Nucynta as well as some first-person accounts. Hope you have a pain-free day new guy!

                                                                     Smile       Q       Smile

MattMason
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Nucynta and methadone

Quincy,

Thank You for welcoming me here.

I have taken the Nucynta along with the metadone since saturday.

Initially, I feel very dizzy, this morning while drinking coffee, I felt as if I were going to vomit. That subsided, has not happened again. Saturday, I had a low level headache, one that would not go away, but it did not put me down either. I also felt some GI spasms, albeit slight, but that scares me.

I also feel as if my speech is slurred, my wife said it is not, but my eyes are "glassy"

Is this the euphoric stage?

Being on the metadone for 14 years or so, I really cannot say that I get a "Euphoric" sensation. I do notice a bit more energy, but I also take it in the mornings, so not certain if the energy is from the [filtered word] or coffee.

Again, Thanks for your reply, and sharing of knowledge.

 

 

 

 

 

 

MattMason
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Wow

Hello,

Why would you say that is a "drastic" change in meds?

Is that due to the way the oxycodone and nucynta work?

 

I absolutely feel like a "guiniea pig" ny pharmacist ( Rite Aid) claims I am the FIRST script of this stuff.

They had no input to offer, since I am the first. I have dealt with the same Pharmacy since I started taking the Methadone, 14 years ago. Also same 3 pharmacists.

The reason I mention that is in the past when my Dr. wanted to try something different, I could always go to them-Rite Aid, and one of the Pharmacists could offer valuable input. Not this time.

 

quincy
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Hey Matt . . . Q here

Did you get to read that other thread? Your reaction sounds like some of the folks that posted their experiences on Nucynta. I haven't seen one post from someone that's taken it that didn't get a headache, that's bad. I think our tempspastic buddy meant that your Dr. has drastically reduced your effective available analgesia. What form was the "30 mgs ofOxy" in, Percocet 5/325? If so, your Dr. is following the FDA panel's absurd recommendation to ban all combo analgesics. By that I mean the opiate + Tylenol, APAP types like Percocet and Vicodin. Hope this helps you  . . . Q

MattMason
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Reply to Q

Hey Q,

 

To answer your question:

"What form was the "30 mgs ofOxy" in, Percocet 5/325?"

 

It was 5 mgs of oxycodone, from my understanding is the narcotic component of Percocet, less the acetameniphan (?) which I am fine with as it is supposed to be %@$$*## ones liver. Having been on Methadone for 14 plus years, and with no conceivable end in site as the available surgical procedures to rebuild my damaged vertebra are not recommended for me due to my age, and life expectancy.

Several osteo surgeons over the years have warned against vertebral reconstructive surgeries as they are geared more towards older folks. The cement that is used in one of the procedures breaks down over 10 years or so and I cannot recall the problem with the other.

My reason for the above explanation is that pain meds are my only real option, so I do not want to include any more work for my liver than required.

Do you have any experience with Methadone for chronic pain and what it can be used in conjunction with?

My PM Doctor is very open to my suggestions, he also trusts me, as I unlike the majority of his patients, I do not abuse me meds, show up early with BS excuses etc. I generally try and use less, some days I may use 5-10 mgs more depending on pain level. Which is directly related to my physical work level. I am doing a lot lately, so I have had more pain.

 

Thanks for You reply and suggestions, they are greatly appreciated !!

quincy
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Hi Matt . . . Q here

Sorry 'bout the delay in getting back to you, as you know . . . stuff happens. That's great that you had chosen the "straight" Oxycodone, 'cause as you said, the acetominophen messes with your liver big time. When I first began my cancer therapy that's what I chose for BTP along with OxycodoneER for the main dosage. I'm now Rxed the 72 hour Fentanyl 100 mcg p/h patch which is the equivalent of about 200 mgs of Oxycodone p/d. This cancer pain is intense but the Fentanyl lowered my self-reported pain level from 7-8 on 220 mgs of Oxy. p/d to 3-4 on the patch. The side effects are minimal, no constipation, euphoria, itching, etc. I will sing it's praises all my days . . . perhaps you should talk to your PMD about Fen. Good luck my friend and a pain reduced life to all of us . . . Q 

Mstrpain
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Methadone & Nucynta

Hi folks!

I'm brand spankin' new here, but by no means "Brand New" hehe, I'm 48 and have been on 240 mg methadone per day for 3 years and some. A few months back my pain specialist prescribed Nucynta 50mg tid for break through. this month he bumped it up to 100mg tid. That seemed to do the trick my friends. Tramadol, Ultram...You name it - they tried me on it. Nucynta is no joke - when I hear it compared to utram and tramadol I have to laugh! This &??$ is potent - not quite as OC, but for comparisons sake...100mg of nucynta is equal to about a 40mg OC.

As far as some of you Pharm heads know, it is a very simple molecule structure that work with reuptake of serotonin inhibitors (like other opiates),but seems to give a very satisfying pain comfort properties. For those of you who eventually end up taking this drug, PLEASE be careful of the dosing. Take it from me - I consider myself a professional after having chronic pain for over 8 years now, and so far to me nucynta and methadone (prescribed together) are by far the most successful pain management I've evr tried. And I've tried them all!

I hoped this helped someone out there! Later,

Mstrpain  Cool

(edited)