question about dosing Zohydo?

[fxok425]

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Got a RX for Zohydro 40mg BID and fentanyl 25mcg/hr
pt was on 6 Norco10 per day and fentanyl 50mcg/hr.
From the PI: it says" when initiating Zohydro, should D/C all the around-the-clock opioids", so the pt shouldn't be on both Zohydro and fentanyl, right?
second question is the doing. Norco to zohydro is 1 to 1, so 60 mg hydrocodone = 30 mg zohydro BID. fentanyl 50mcg = 20 mg zohydro BID. I am not sure if I should add them up (50 mg Zohydro BID), or stay 30 mg BID, or do 40 mg BID as RX written? Also, the PI said: "shouldn't start greater than 40 mg BID".
I am confused.

 

[Dr Wario]

Zohydro is a stupid drug product, tell the Dr to change it

 

[waiter]

second question is the doing. Norco to zohydro is 1 to 1, so 60 mg hydrocodone = 30 mg zohydro BID. fentanyl 50mcg = 20 mg zohydro BID. I am not sure if I should add them up (50 mg Zohydro BID), or stay 30 mg BID, or do 40 mg BID as RX written? Also, the PI said: "shouldn't start greater than 40 mg BID".
I am confused.

What modifications to a C-II does your state allow?

 

[Carboxide]

There are no reasons why someone should be on a 25 mcg/hr patch and an oral drug. You should go up on the fentanyl before adding on, if that was what the patient was on before.