Dilaudid And Fentanyl What Is Stronger

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Alexander Says:


my fiancée is on 25 mg of fentanyl she was on 12 mg of exalgo. what is the difference and what is stronger? the pain management company she is dealing is very hard to talk too and get ahold of. she has a lot of breakthrough pain. can anyone help me with these questions please and thank you.



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Verwon Says:

Hello, Alexander! How is your fiancé doing?

The Fentanyl is actually the strongest narcotic available, but she may need a stronger dose of it.

This is a narcotic analgesic, so it has the potential to be habit forming and may cause side effects, such as nausea, dizziness, drowsiness, dry mouth and constipation.

Has she consulted her doctor?

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Alexander Says:
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She has called a couple of times. She has been on them for about 7 days now. How high will they put her just to get to the break though pain? She is having tests done next week to test out the nerves in her arm and hand. She has had the sympathetic blocker shot and it didn't work. They will not open the hand up for surgery becuase they feel that it will not make a difference.

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djoyg Says:

Hi Alexander,

I had osteomyelitis with septic arthritis in my right hand. They said if they had waited til morning to open it up I would have lost my hand. They had to debride bone, muscle, tendons, etc. Basically they used something like a dremel to remove neurotic bone, I actually don't know or don't remember how they cleaned out the neurotic muscle and tissue. The left the surgical site open after surgery. I didn't know the extent of what they really did until they took the dressing off in the morning, I could not handle it emotionally. I mean, I could rationally listen to everything they said but once the bandages were off I wanted to crawl into a psychosis and disappear. The next day I had a demon for a nurse, took her 2 hours to bring my pain meds. By then the pain was completely to far gone. So overwhelming that it took all of my strength and consciousness to breath and not scream. Doctors were all crowding around me, "Maybe she sleeps with her eyes open, maybe it's a catatonic state?" I finally groaned through clenched lips, "Maybe it takes all my effort to cope with the pain!!!"
I don't know where you live or if your girlfriend's pain management doctor knows how to do this or if he would. They gave me an inj. in my armpit and completely paralyzed my arm for 30 hours. Ok, it was not 100% paralyzed, it still had that buzz like if your foot falls asleep. I think they thought that was a neuropathic pain and they still gave me dilaudid to deal with that. To me, that wasn't pain at all, it was like an annoyance because I was comparing it to the worst pain you could never ever imagine. Like it would feel if they cut your hand open and took a dremel to your bones, scraped away muscle, left it open and had you look at it. So with this long needle, the bupivicaine, and something else, sorry I can't remember what, it didn't just numb my arm it paralyzed it completely. I would think I was moving it and it wasn't moving. I had to have someone carry my arm when I went to the restroom, or it would flop around, deadweight, no feeling or control. They didn't want me to use a sling because of the open wound. IT WAS HEAVEN. The pain instantly went from completely uncontrollable, off the charts to absolute nonexistence. They said if after 30 hours I still couldn't handle the pain they would do another inj. to give me another 30 hours. Exactly 30 hours later I started to feel my shoulder to elbow coming back, they hit me with dilaudid to prepare for me to feel my hand. When the paralysis wore off completely I realized the pain was tremendously reduced. The 30 hour total pain vacation reset my ability to cope with the pain or with the dilaudid already on board it started me on a schedule of adequate pain relief. They said it was a technique that wasn't often done and a bunch of doctors had come in to watch and ask questions of me. They all wanted to know if I would recommend it or do it again. Absolutely. It was shocking. I thought after 30 hours I would be screaming for the nurse every hour or 2. But when the paralysis wore of and I could feel my arm and hand again the pain had morphed into "normal" pain. When I left the hospital they had me set my phone alarm to take dilaudid every 3 hours. Then 4 and then it was take as needed. It's been a year and a half and now voltaren gel really helps. But. There's always a But....

I just started fentanyl with dilaudid for break through for another condition, so it is entirely possible that pain meds used for my abdominal pain are also keeping my hand pain controlled. I had been taking 28 mg dilaudid a day for permanent severe abdominal pain, which was completely ineffective. I've been bedbound, only leaving the house for doctors appointments for just under a year. The dilaudid did do something, just barely. My doctor just started me on the 12.5 patch 4 days ago. We started on the lowest dose because there's a huge list of meds that are unsafe for me, others I'm allergic to and still others that I have a genetic resilience to. Wasn't expecting it to help with my pain until we worked it up to a higher dose. Surprisingly, it is working! To the point that I think I should only have to go up to 25 mcg. I drove my son to school today. No pain. No dizziness or issues from the fentanyl. Haven't driven him to school the entire school year. My pain doctor assumed on the 12.5 patch I would still be taking the 28 mg of dilaudid a day. I have tried to use it for break through, more like at 12 mg a day but I've noticed the fentanyl and dilaudid together and I'm extremely nauseous. Like keep that bucket nearby cause I'm about to heave. And a little bit dizzy.

So here's what I'm thinking. I don't know what's wrong with her hand and arm but I wonder if the pain has gotten to the point like it did for me in the hospital, so insane that it's simply beyond her control and with no matter how many meds she can't get on top of it. I wonder if she would be able to get that paralyzing inj. like I did, if the same effect would happen. Then slap a patch on every 3 days and be able to love life! I'm optimistic that the correct patch dose will give me back a life. I'm not sure I'll use the dilaudid for break through, now that I've experienced superior pain relief with the fentanyl I realize how little dilaudid helps and I don't love the nausea.

Huge reply!!! I really hope I've been of help.

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Grandbeauch Says:

OMG I am in shock hearing what you went through Fricken jaw dropping. I understand the brain reset with the paralize proceedure. I know it works with irregular heart beats (by stopping the heart and starting it up again) but had no idea how well it works for uncontrollable pain. THANK YOU for the heads up

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tammerz Says:
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Hi there. I could be totally wrong but I would almost guarantee that the dilaudid she is prescribed is for breakthrough pain and the fentanyl is for long term use. Fentanyl is the stronger med (100 times stronger then morphine). I hope this answered ur question

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Pimmsy Says:

Heroin is 100 times stronger than Morphine. Fentanyl is 80 times stronger than Morphine. Dilaudid is 6 times stronger than Morphine.

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Brittany Says:

Fentanyl is 80 times stronger than morphine and approximately 74 times stronger than Dilaudid which is what is contained in the other Rx. The Exalgo is a time-released medication and because of it being time-released, the euphoria associated with opiates is not there if taken as directed.

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Sandy Says:
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Hi Alexander, just my experience with all narcotics and can tell you that although the Fentalyn Patch can work it is deadly! I worked my way up to 150 mcg of the patch as well as OxyContin and Percocet for breakthrough. I was a mess and not all there. After ten years I got extremely sick and went to Hosp for 3 weeks and came off all. And quit smoking. I was very sick and in terrible pain. I felt amazing in my mind but pain was critical! Finally I started 3 mg long acting diluidid and 2 mg for breakthrough. I've had to up my long acting since then. I feel so much better off the patch! Please tell her to try and get off the patch and try something else. Good luck!

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Brittany Says:

Please inform the percentage you were able to come off and then what the end result was since they increased it again? That is great you were able to get off everything and now are taking a minimum and not over-analgesia from what you were taking before. Congrats! That could not have been easy.

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Brittany Says:

After reading and considering the posts, it seems to me that if you use the 12.5 or 25mcg patch and it works, there is no need for you to take Dilaudid unless you are really in terrible pain. It is a PRN for break-through pain and hopefully you are unlike me and just take it because you can. in the long run, this doesn't help you. Otherwise, you are left with an increased tolerance to opiates in general and may have to do another (best case scenario).

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djoyg Says:

Hi Brittany,
I'm uncertain if your input was for me as my reply was posted about 1 year ago. I was on the 25 mcg mylan fentanyl patch for just about a year with 4 mg dilaudid for break-through pain, anywhere from 0 to 3x a day. Those meds were for pain due to permanent nerve damage from a genetic condition and unfortunately have no effect on the residual pain in my damaged right hand. Strangely and fortunately I have found that the topical preparation, voltaren gel, eases the pain in my hand whereas nothing else has, short of the extreme nerve block I mentioned earlier that was done in hospital. My good news! An unrelated medication has been found to help my genetic condition! No one really knows how or why but as long as I take it 4x a day I no longer need narcotics! I have been cutting down the patches under my drs supervision and should be off of them within a month. I've completed stopped the dilaudid but my Dr has still rxd in case I miss a dose of my new medication. So far I have cut the fentanyl from 25 mcg to 12 mcg and cut out all dilaudid, no problems, nor any signs of withdrawal! I'm wary of withdrawal but also so excited to be narcotic free and happy beyond words to begin to live again. Even with the fentanyl patch and dilaudid I was considerably disabled with pain, until this new treatment I simply hadn't realized the level of pain and limitations I had deemed acceptable and learned not to expect better. Wishing everyone as much life free from pain as possible...

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Sandy Says:
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Alexander, I really feel for your fience as I also live with chronic pain. I also started at 25 mcgs of Fentalyn and eventually got up to 150 mcg! Plus oxyneo and Percocet. Please tell her to be careful with that patch. It is highly dangerous but she needs something for break thru pain such as dilaudid or Percocet. I am now off all of that and only take long acting dilaudid and short acting dilaudid for break thru. At least I now have my mind and do t sleep all day. She should also know that being on these narcotics for long can cause sleep apnea because your brain forgets to breath. I now have it. The patches are very expensive and you now have to return the empty patch back to the drugstore to get the next refill. I don't know the difference between the 2 drugs you mentioned. Please wish her the best! Good luck!

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SJ Says:
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Ask your prescribing doctor AND your local pharmacist. They will know best.

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Nottoosmarttobefooled Says:
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You are incorrect. Fentanyl is 100 times stronger than morphine. Heroin is much lower. And I think we're comparing prescriptions not street drugs. Get a life.

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Curious Linda Says:
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I have been taking 60mg of morphine sulfate for a very severe lumbar issue. I have been told that i need to have my whole lumbar broken down and reconstructed after 3 previous surgeries over a 30 yr period. The pain is excruciating and now Dr wants to change my meds to Exalgo 24mg per day. Which is stronger? Exalgo 24mg per day or 120 MG morphine per day with 10mg of percoset 4 times daily for break through. I appreciate anyone who can answer because I am concerned that the Exalgo won't work even though the morphine isn't controlling my pain. Hopefully there is someone out there who can shed some light on this. In advance ...Thank You!

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PharmerDave Says:

Your post was from long ago, but in case anyone reads it and uses it as a Fentanyl dosage guide, I’d like the chance to point out a potentially deadly flaw:

Your bf is likely not taking 25 milligrams of Fentanyl. Fentanyl is measured in micrograms or “mcg”... making that 25mg dose 25,000mcg.

When they say it is a much stronger opiate, they ain’t just whistling Dixie. Why is there a pain reliever this strong? I have no idea. We should have stopped at Morphine and said “that’s all, folks”.

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