Pain Medication Stronger Than Fentanyl

beaver Says:

At the hospital with heart and chest pain. Already on a Fentanyl patch and its not working. Is there anything stronger than the Fentanyl patch?

29 Replies (2 Pages)

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Verwon Says:

No, Fentanyl is really the strongest narcotic on the market, since it's over 80 times stronger than Morphine.


However, there are medications they can give you that would work faster, but on that the relevant question is, what is causing the pain?

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John Says:

I need a dr in Binghamton area for my medications fentanol and Percocet my dr went out with cancer and the other dr is not weighting he scripts for anyone any more new York Binghamton vestal plead help

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Suze54 Says:

Ask at your hospital for the name of a Pain Specialist, or Rheumatologist. General Practitioners only know what the drug reps tell them. Attending a set of pain self-management sessions at your hospital's clinic will really help. I go every other year. I have been on Fentanyl for eight years. I started on 25mcg. The body builds up a tolerance to it over time. I am on 400mcg now. Half that amount taken by someone who had never used it before would kill a man. I am looking at Methadone next; since your body will not build up a tolerance to it! I hear that very weak laser treatments can eradicate soft tissue pain. You really need a specialist with all the new pain management protocols available now. Keep believing you are going to heal, never give up hope. We are wonderfully made!

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lmciver Says:

I have full blown ms. I am on percts 10/325 and oxycontin 30 mgs and the pain is getting worse what else would work better the pain in my legs N back wake me every night any suggestions. I see my pain Dr. Next week

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cucupuffs Says:

Yes there are about 8 stronger opioid/opiate pain meds then fentanyl and they are all derived from fentanyl which is actually an old med from the 60's made by jansen pharm. Most of these sin offs from fentanyl are currently illegal but their are a few that are on the market like Sufentanil that is 5-10 times stronger then fentanyl and is already in patch form in the UK because it lasts 7 days instead of just 3 days.

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cucupuffs Says:

Here's another... "Alfentanil (R-39209, trade name Alfenta, Rapifen in Australia) is a potent but short-acting synthetic opioid analgesic drug, used for anaesthesia in surgery. It is an analogue of fentanyl with around 1/4 to 1/10 the potency of fentanyl and around 1/3 of the duration of action, but with an onset of effects 4x faster than fentanyl. Alfentanil has a pKa of approximately 6.5, which leads to a very high proportion of the drug being uncharged at physiologic pH. This unique characteristic is responsible for its rapid onset. It is an agonist at mu opioid receptors.

While alfentanil tends to cause fewer cardiovascular complications than other similar drugs such as fentanyl and remifentanil, it tends to give stronger respiratory depression and so requires careful monitoring of breathing and vital signs. Almost exclusively used by anesthesia providers during portions of a case where quick, fast acting (though not long lasting) pain control is needed (i.e. during a nerve block, head pinning etc..) Alfentanil is administered by the parenteral (injected) route for fast onset of effects and precise control of dosage.

Alfentanil is a restricted drug which is classified as Schedule II in the USA, according to the U.S. DEA website.

Alfentanil was discovered at Janssen Pharmaceutica in 1976.

Side effects of fentanyl analogs are similar to those of fentanyl itself, which include itching, nausea and potentially serious respiratory depression, which can be life-threatening. Fentanyl analogs have killed hundreds of people throughout Europe and the former Soviet republics since the most recent resurgence in use began in Estonia in the early 2000s, and novel derivatives continue to appear."

Source: Alfentanil Details

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cucupuffs Says:

This is the strongest - even stronger than the last one and only should be used on large elephants and rhinos, another fentanyl derivative...

from Wikipedia:

" Lofentanil is one of the most potent opioid analgesics known and is an analogue of fentanyl, which was developed in 1960. It is most similar to the highly potent opioid carfentanil (4-carbomethoxyfentanyl), only slightly more potent. Lofentanil can be described as 3-methylcarfentanil, or 3-methyl-4-carbomethoxyfentanyl. While 3-methylfentanyl is considerably more potent than fentanyl itself, lofentanil is only slightly stronger than carfentanil.[1][2] This suggests that substitution at both the 3 and 4 positions of the piperidine ring introduces steric hindrance which prevents µ-opioid affinity from increasing much further. As with other 3-substituted fentanyl derivatives such as ohmefentanyl, the stereoisomerism of lofentanil is very important, with some stereoisomers being much more potent than others.

Lofentanil is very similar to carfentanil in effects, but has a longer duration of action.[3] This makes it unsuitable for most practical applications, with carfentanil being the preferred agent for tranquilizing large animals, and short-acting derivatives such as sufentanil or remifentanil being preferred for medical use in human surgical procedures. The long duration and high lipophilicity of lofentanil has been suggested as an advantage for certain types of analgesia,[4] but the main application for lofentanil at the present time is research into opioid receptors.[5][6]

Side effects of fentanyl analogs are similar to those of fentanyl itself, which include itching, nausea, and potentially serious respiratory depression, which can be life-threatening. Fentanyl analogs have killed hundreds of people throughout Europe and the former Soviet republics since the most recent resurgence in use began in Estonia in the early 2000s, and novel derivatives continue to appear.[7] Side effects from lofentanil might be particularly problematic given its reportedly long duration of action. Another side effect which is characteristic of fentanyl and its derivatives is their tendency to rapidly induce tolerance, due to their high binding affinity triggering rapid internalization of chronically activated opiate receptors.[8] This might be expected to be a particular problem with lofentanil as it is not only one of the most potent drugs in the series, but also is longer acting than most other fentanyl analogues, meaning that development of tolerance triggered by receptor over-activation is likely to be especially rapid, occurring with as little as a single active dose.

In addition to acting on the µ-opioid receptor, lofentanil has also been found to act as a full agonist of the ?-opioid receptor (Ki = 8.2 nM; EC50 = 153 nM; Emax = 100%).[9] "

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Ruoy Eman Says:

Fetanyl really isn't the strongest thing on the market. First of all the bloke at the top has just pulled that information from a web page (probably Wiki) because I've read it before. Secondly Lofentanil is the strongest opiod known to man.

Others are Carfentanil, Ohmfentanyl, Sufentanyl. Good luck trying to get the first 3 unless you work in a big zoo or a medical research facility.

Maybe opioids or fentanyl analogues aren't for you? Why not discuss it with your doctor?

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Chrissy Says:

Levorphenol is a great pain medicine although it is extremely hard to get a dr to write for it! It was prescribed to me several years ago when I had terrible cancer pain and was having surgery after surgery. Nothing was working for me. That medication finally did. But I only found one pharmacy that had it in stock, an hour from where I lived and my insurance company wouldn't even pay for it! And trust me, it's not cheap! But in my opinion, is way stronger than fentanyl and takes care of pain better and faster.

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justkjb Says:

I have an implanted pump that delivers a mix of painkillers and a muscle relaxer. The painkiller used in my pump is Sufenta, also known as sufentanil, which is about 5 times stronger than fentanyl. In addition, I take 15mg morphine sulfate up to twice a day for breakthrough pain. Perhaps the pump is an option for you? Because it's continual, people have found to need less overall and since it bypasses the usual oral route, it doesn't produce the "high" from working on other systems but rather goes right to the root of the pain and delivering a more profound level of relief.

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Aliya Says:

W-18 is 100 times stronger than Fentanyl. Am on Fentanyl & was concerned about that sort of thing too. Did have oral surgery & forgot Meds changed around same time I saw him last. Wasn't in pain but could have been my last mistake. Hope you feel much better.

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Rosen MD Says:

God help us all, when it states that a med is x times stronger than another med this is all bulls***. Fentanyl is not xx times stronger or more potent than morphine, which sucks anyway. The fact is mg to mg or mcg to mg yes it is but that is not the proper way to look at it. Look in the PDR from a few years back and it will say buprenorphine (subutex) in IV or IM form is 10000 more potent than morphine. A single dose ampule is .03mg. You have to convert these dosages.

It's all in the math which is manipulated. Did you know the United States uses over 95% of the worlds hydrocodone? Well of course we do, because most other countries do not use it. Go to a hospital in Europe and their first line moderate to moderately server pain med they start you with is oxycodone. The USA is wrong in many areas related to analgesics. Example, Diamorphone is a safer and better pain med than morphine and it affects the respiratory system less. That's why it's used in England and other parts of the world.

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Chisti Says:

I am currently on 100 fentanyl patch 48 hrs. Also 30 m morphine 3day. Dr. speaking to me about neurostimulator implant. Not sure how I feel about it. What meds would b step up?

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Of course, the patch is used more for chronic pain, even a hyromophone if would be better, or an i.v rent drip,

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christi white Says:

What would b strong enough if I quit the opioids
If I were to come off of the opioids because I'm hearing a lot of dangerous things about the opioids if I were to come off the fentanyl patch and the morphine what can I take that would help me with this pain and be as strong or a little bit stronger than the fentanyl in the morphine together

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Sleepy in Toronto Says:

Re: Verwon (# 1) Expand Referenced Message

There is one medication, however getting it is now impossible but it’s called cot-fentanyl. It is 100 times the strength of fentanyl. You must have a high tolerance.One sand of grain of it would kill you. It has to be delivered in micrograms.

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Chris Says:

Yes there is a drug only administered in a hospital that is called Desuvia and is more potent than fentanyl by 25 times. The FDA just approved it 1mo ago. Sulfentanyl is used for oral administration when pain relief isn’t able to be controlled under normal circumstances. Ask your doctor or nurse. My name is Chris

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Chris Says:

Re: Verwon (# 1) Expand Referenced Message

Desuvia is the strongest pain medication on the market. It’s pharmacology name is sulfentanyl. Recently approved by the FDA for use only in hospitals and emergency rooms. For acute pain only.

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Sleepy in Toronto Says:

Re: Chisti (# 13) Expand Referenced Message

Don’t do it.... I’ve had a deep brain stimulator installed last year. It was a horrible procedure and the electricity that passes through a damaged nervous system would hurt more then the original issue. I wouldn’t do it again if I had a choice. They don’t have it down yet and is highly experimental. I’d advise against it from someone who went through it for neuro pain brought on by MS.

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Chris Says:

Re: christi white (# 15) Expand Referenced Message

Methadone or suboxone if you are quitting opiates but still need pain control.....both are very well tolerable.

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