We always initiate duragesic in opiate-naive patients

[npage148]

"We never have any issues going from tramadol q4h to fentanyl 12mcg, it's a common jump . And I called around and other pharmacists would fill it, I don't understand why you won't release the script the patient is in pain." My conversation today with an office today regarding one of our little old ladies




/rant

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[radio frequency]

"We never have any issues going from tramadol q4h to fentanyl 12mcg, it's a common jump . And I called around and other pharmacists would fill it, I don't understand why you won't release the script the patient is in pain." My conversation today with an office today regarding one of our little old ladies




/rant

Hey, at least they weren't totally opioid-naive, like I've occasionally seen...

 

[quickpic007]

"We never have any issues going from tramadol q4h to fentanyl 12mcg, it's a common jump . And I called around and other pharmacists would fill it, I don't understand why you won't release the script the patient is in pain." My conversation today with an office today regarding one of our little old ladies




/rant

plot twist-little old lady has been getting norco 10 at a supermarket pharmacy 3 towns over because of the "preferred generic"

 

[CetiAlphaFive]

"We never have any issues going from tramadol q4h to fentanyl 12mcg, it's a common jump . And I called around and other pharmacists would fill it, I don't understand why you won't release the script the patient is in pain." My conversation today with an office today regarding one of our little old ladies




/rant

"So tell the other pharmacist to fill it"

 

[npage148]

That was the ultimate resolution. Threats of sending it to someone who will fill it instead of recognizing maybe the rems program is in place for exactly these sorts of situations and maybe a different LA opiate might be a better option.

Likely nothing would happen but if something did you hung yourself. I run into more headaches with fenantyl than all other opiates combined

 

[zelman]

To be fair, transitioning to duragesic is described in the prescribing info to start at 25mcg per hour. There is no concrete info regarding the appropriate way to start 12mcg/hr. I still wouldn't fill it, however.

 

[SoylentGreen]

I got an rx once for duragesic 50mcg for an opioid naive patient who had previously been taking just NSAIDs. I talked the doctor down to 12mcg and filled it, she was ok and is still getting it a few years later. Apparently she was allergic to everything.