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    DR. P - Chronic Pain-Fibromyalgia-Nerve Damage
    gsw021597 posted:
    Dear DR. P - How long does it take for Savella to start working? I just finished week 7 at 100 mg / day. All I have is side effects so far and I am needing a long term solution. For the last 10 yrs, I have 25mcg fentanyl patch and 60 mg oxycodone/day, but that cannot last indefinitely. I have to be able to work and of course the opiates lose their effectiveness. I have alread tried all of the other non-opiates (Lyrica, Cymbalta, etc) without success. I would appreciate any guidance you coud give me with savella. Thanks!
    Mark Pellegrino, MD responded:
    Hi gsw,

    Sorry you aren't noticing any benefits so far with Savella. In my experience with this FDA-approved med for fibro, it usually begins working within a few weeks, if it's going to work, but it may take up to a few months to get the full benefit.

    If my patient thinks the Savella may be helping, and it is tolerated, after a few weeks of the titration pack, I will usually have her/him continue the dose of 50 mg twice a day for another month and see if the therapeutic response (pain relief mainly) improves. Sometimes I will increase the dose to 100mg twice a day depending on the individual situation. If there is good reported benefit, I will probably continue the patient on Savella.

    If there has been no benefit at all after 2 weeks, or 7 weeks, I will usually opt to stop the medicine. Please discuss your results, or lack of response, with your doctor for additional recommendations in your specific situation.

    Good luck with with working and managing your fibro. I know how hard that is.

    Dr. P
    gsw021597 replied to Mark Pellegrino, MD's response:
    Thank you very much Dr. P. I appreciate your thorough response - gsw

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