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New to Fentanyl Patch - Side Effects?

AnonymousUserAAnonymousUser Posts: 49,899
edited 06/11/2012 - 8:23 AM in Pain Medications

I have spina bifida....dealt with it all my life. The past few years the back pain has gotten so bad that I started out on Vicodin, then Endocet, now my doctor (family doctor) has put me on the Fentanyl Patch. When I called his office to get a refill on the Endocet for break through pain he denied it. He is really against using the pills. He talks about how bad they are everytime I have been in to see him, and I do understand the dangers of narcotics, but I was taking them only as directed. I don't know what to do. The patch works fine the first couple of days but not so much the third day. I hate asking for medication and then being treated like I am asking for illegal drugs. I also suffer from migraines and actually ended up at the hospital with the last one. It's the first time I've ever gone to ER with one of these excruciating headaches because I usually just take the Endocet and a phenegran and try to sleep it off in peace and quiet. Last time was just too much to handle. Anyway, I have two questions....how does anyone else deal with a doctor like this and if you too are on the Fentanyl Patch, what if any side effects are you experiencing? Thanks for listening.



  • It has been my experience that only a doctor who specializes in pain management will be able to adequately control your pain. I am not on the patch but I take Opana ER 40 mg three times a day. I am going back to Oxycontin in a few days to see if changing from one extended release to another will help. My PM will not prescribe B/T medication either. He says I am at the highest dosage of pain medication he is willing to prescribe. My only hope now is a cervical SCS
  • I will definitely take your good advice to heart. I've been thinking about going to a pain management doctor anyway. Thank you for your reply and I truly hope all works out well for you.

  • I'm on Fentanyl 50 and I change it every 2 days like Paul. I had side effect before, like nausea, vomiting, dizziness, and spacyness. I told my pharmacist about it, and he told me the best place to put the patch on is your belly. I did that, and I never had problems again. It's got to do something with the concentration of fat tissue, and it works better there. I was putting it on my upper chest and was sick :&
    I hope it works for you, and remember that you'll go thru an acclimation time with it. Then after you won't feel a thing. You will notice that when it's time to change to a new one, your pain might increase. This is my experience with it. Take care :H
  • I do have to take Norco 10 mg for BT pain, Valium 10mg,Neurontin, Naproxen to handle the nerve and inflammatory pain.
    I think I'd be bedridden if it was not for Fentanyl. The pain would be a whole lot worse, and the medicine allows me to function.
  • I had a rough experience with Fentenayl. I was on 25 mg changed every three days, then later upped to 50 mg changed every two days. I ended up having severe enough vomiting and nausea that I had to stop using the patch because I lost so much weight. That might have been part of my problem, though, because even when I put it on my belly, I don't really have enough fat to really properly dilute the medication. Anyway, when I was on it I still had Percocet for BT pain. It still didn't control my pain enough, so now I'm a month out from a pain pump implant. That has worked out much better for me with much less side effects. The pump also allows me 'room to grow' if you will, because since my disease is unfixable and degenerative, I know that I'll continue to get worse and be in more pain. Because I was pretty much topped out on what my body could safely handle with oral medication, I had to switch to the intrathecal medication route, since it takes less dose to control pain.

    Give the Fentenayl time, though, because it's a medication that has to build up in your body to work. And I couldn't express enough how much a PM doctor can help - PCP's just aren't as comfortable dispensing such strong meds in such high doses, while PMs have much more experience (and therefore confidence) in doing so.

    Good Luck!!
  • :)

    All of you have truly been a big help. I am calling today to find out where the nearest Pain Management Clinic is and I will go from there. The patch (50 mg) is great and has helped me function a lot better than with just oral meds but for example yesterday was day to change the patch and my back was killing me. My regular doctor won't prescribed them for 48 hours rather than 72 and does not want to give me any oral meds at all. He is just totally against prescribing those types of meds to any of his patients. So, it's a "Catch 22" I guess. My condition is not going to go away either as it is a birth defect I was born with. I have curvature of the spine as well and a tilted pelvis. I am very lucky though....when I was born, of course my parents were told I would never walk...they did not listen. Because of their faith and patience with me I have lead a relatively normal life....no wheelchair, I do however walk with a limp. I thank God everyday that they did not listen to the doctor.

    I have always had pain in my back, and I knew it was probably only going to get worse...so that is where I am now. And what Paul said is so true, nothing gets rid of the pain totally, but I am hoping to find an understanding doctor who will be able to help me hit on the right combination of meds and whatever else needs to be done to hopefully stop the process from getting worse and alleviate as much pain as possible.

    Again, thank you to everyone who has replied. Your help is most appreciated.


  • Even though a lot of us are on heavy duty long acting narcotics, we need BT meds like Norco or Percocets. They act like a booster shot when the pain escalates. A pain specialist understands that better than a PCP. With all that you got going on, that is where you need to be. They can do more things for you there than a family clinic.
  • After about 12 weeks on Tramodol and becoming less effective in relieving pain I went onto 15mg Fentanyl patches. Initially felt very spaced out but still in pain I went onto 25mg and now into my second week, changing every 72 hours. I am still taking Paracetomol and Ibuprofen. It is all definitely taking the edge off the pain but now I'm really spaced out and feel very nauseous but also having periods of feeling very hot and spinning head but also periods of cold shakes. I'm also having to take something to help with the resulting constipation which I suppose may be causing these effects?? One thing I do get very good pain relief from is regular massage, albeit only temporary relief. But since increasing the doseage of Fentalyn I get the shakes very badly for about 30 minutes after the massage.
    Any one else had these side effects?
    I have to go back into hospital next week for tests and more facet joint injections and a review on medication.
    I am really so fed up with feeling so rotten as well as still having back pain after having this surgery.
  • Brian,

    The only side effects I have had with 50 mg Fentanyl patch is a little lightheadiness when I change it and it itches alot....that could have something to do with the adhesive. The patch does not last the full 72 hours for me and even on the second day of the patch I am currently wearing, my back was in excruciating pain. I had nothing but regular tylenol to take for it. Needless to say this did not help. I am finally going to a Pain Management Doctor on the 15th. That seems to be the best advice that I have been given.

    I hope all goes well for you.

  • that was my only issue with the patch was the itching oh me oh my. i was always itching around it. felt so good to change it, wipe everythign down and change the spot.

    i just want to wish you the very best of luck with pain managment. do your homework though.
    some only do injections/treatments
    some only treat just backs
    some long term pain relief for different medical issues.

    they are all different from what iv learned in my experience.
    my old pm would not RX anything but 4 different long acting meds and no break through meds.

    so i also am in the process of finding one closer to my home that is willing to work with my issues.

    >:D< >:D< >:D< >:D< >:D< >:D< >:D<
  • Sorry you're having a rough time. Can I ask you where do you put on the patch? Where you put it on can make a difference. I think I posted earlier about trying it on your belly. I went thru the same stuff, then switched to the belly area, and haven't had one side effect since. I started on Fentanyl 25, went up to 50 post surgically, and then to every 2 days, and I still have no problems.
    It does take about a month (everyone is different) to acclimate to this drug like any other medicine. Give it a chance, put in on your stomach ( don't forget to clip the hair, don't shave!) on the area above your bellybutton. Try that and see if it gets better.
    It can give you the sweats though. I try to control it with Gold Bond powder to help stay dry. It also refreshes.
  • Thanks meydey
    I was alternating on the tops of each arm until I read your previous posting. I had a very bad turn on Sunday morning because I think I was lying on it when it was on my arm and judging from your comments, it must have got hot and maybe released more and made me feel so bad. I now have it on my trunk just below chest level.Early days yet, but still feeling pretty bad and my back pain is worse today as well. What is Gold Bond powder??
    I'm hoping that when I go in to hospital next week I'll either be put right with the injections or I'll have a change in the medication maybe?
    How long are you post surgery now? I had mine 22nd April and disappointed that I still need pain medication after so long.
  • Thank you so much for the advice. From what I understand this PM Dr. is really good. He came highly recommended to me. It will be blessing and make my life even better if I could have something for the break through pain. The patches have been wonderful (other than the itching). However, you know as well as I do that once in a while that does not work alone. And I have had a few days when it was all I could do not to cry. But you keep on pushing through right!

    God bless all of you here and I wish you only the best.
  • just read your post and it was just like my situation with my G.P, I am contamplating a complaint proceedure, my g.p made me feel like a low life addict and told me i could not have my usual prescription of diazepam and dyhidracodein and instead gave me one for methocarbamol and fentanyl...i was always under the impression that it was dangerous to just stop diazepam????? plus fentanyl sound very bad. any opinions???
  • The fentanyl patch has the same stuff in it. You shouldn't even really feel the switch. Besides a little euphoric feeling but that goes away after your body gets used to it.I don't know where people are going with 3 days I have to take my patches off every 2 days. It even reads 3 days. I also take methadone and then at night a xnax. And a little more or less then half of the time I am okay. I was in Afghanistan in 03 and got shot in the jaw the neck and my L1 L2 took a hit and dropped me paralyzed right then. So for me there is no pain meds that I have not had to try and for me what I told you works for me but when the nerves are pissed off about something there is no pain meds that work I just have to take it I guess. The nerves seem to have a mind of there own and they seem to be the enemy. This letter doesn't mean that what I say will make a difference I do not know I'm just sharing my experience and you take what you need and throw away the rest.
  • :T o.k. Somebody help me out here , i use a 72 hour patch, and after every two days its out of med, ~X(

    i have told my doctor about that , and he said he was going to bump it up to 100 mcg/h, but i am really tired of this patch , is there something else i can use in a pill fourm that will help :''(

    Thank you....Rev Jackson
  • Welcome to Spine Health. You would get more replies if you made a new post for yourself. Look in the left hand column where it says create content or forum topics and post under pain medications. You may want to let your Pain Dr. know the patch wears off for you after 48 hours and see how your Dr. can help you. Best wishes. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • I have my patch plced on the back of my shoulders, i switch off every time i change it , it works best on my left side , placed on the soft part between the bone and underneath that bone , but i do not rest very well even with some sleeping meds just wount go to sleep, can you help me out on the sleep part .

    June 28th 2011 Rev.W.H.Jackson II
  • :| I try hard to keep the faith, sometimes the pain is so tuff to deal with untile i feel like just dieing to get it over with. the Fentanyl patch is good , it works , but it only last for a little while, and then its back to the pain....
    today i left it off for at least 4 hours , and nothing , and no pain, does that mean its over or just so much of it is in my body , it has to wear off ? lol let me i may be fooling myself .

  • :| I try hard to keep the faith, sometimes the pain is so tuff to deal with untile i feel like just dieing to get it over with. the Fentanyl patch is good , it works , but it only last for a little while, and then its back to the pain....
    today i left it off for at least 4 hours , and nothing , and no pain, does that mean its over or just so much of it is in my body , it has to wear off ? lol let me i may be fooling myself .

  • :| I try hard to keep the faith, sometimes the pain is so tuff to deal with untile i feel like just dieing to get it over with. the Fentanyl patch is good , it works , but it only last for a little while, and then its back to the pain....
    today i left it off for at least 4 hours , and nothing , and no pain, does that mean its over or just so much of it is in my body , it has to wear off ? lol let me i may be fooling myself .

  • :| I try hard to keep the faith, sometimes the pain is so tuff to deal with untile i feel like just dieing to get it over with. the Fentanyl patch is good , it works , but it only last for a little while, and then its back to the pain....
    today i left it off for at least 4 hours , and nothing , and no pain, does that mean its over or just so much of it is in my body , it has to wear off ? lol let me i may be fooling myself .

  • I'm not understanding your question now. If you had no pain without the patch, then why would not be pain free on that 3rd day when it isn't working any longer?
    I am on a 72 hour cycle as well and the 3rd day is ineffective for me too. As for sleeping, the Fentanyl is not a sleep aid. You would need to discuss that with your doctor and look to other options. I have found that a 3 mg Melatonin (bought at the Costco) is sufficient for me.
    Best of luck to you.
  • I am not on the patch. I do see a pain specialist and strongly advise that you do too. Get your primary care physician to refer you to a pain specialist. Be ware though most pain specialists want to shoot you up with a steroid nerve block that lasts about six months if it works at all and know you will have to come back...its a scheme and waste of money. If you can find a pain specialist that treats orally only. Most pain specialists will give you a control medicine such as MS Contin, Oxycotin, Methadone etc. that is extended release and gets it under control. Then they will give you another medication for breakthrough pain when your pain gets so bad your control medicine doesnt work suck as oxcodone, dilaudid, Percocet, Lorab, Vicodin or what ever your level of pain is and responds. They give you much more quantity and strengths. Most drug test you on a regular basis and get blood labs from you on a regular basis to monitor your liver enzymes. I have a very high tolerance to pain killers so I am on a regimin of MS Contin (Morphine Extended Release) 60mg 4x day. For my breakthough medicine he gives me a medicine made for cancer patients called fentanyl (the most strong pain killer on the market). Fentanyl comes in a variety of methods of application. You can get a fentanyl patch but that isnt for breakthrough pain. Then there is Oral Transmucosal Fentanyl Citrate otherwise know as the fentanyl lollipop which absorbs quickly through your gums. You can also get it in liquid injectible type which is only administered at hospitals because its so dangerous. Fentanyl is 100x more potent than morphine. He has me on the lollipop and they work great for when my pain gets really bad. They come in micrograms instead of miligrams due to there potency. The lollipops come in 200mcg, 400mcg, 600mcg, 800mcg, 1200mcg, and the largest 1600mcg. I am on 800mcg but when I go back next month Im going to get him to increase me to the 1200mcg lollipops after all I've been on them for two years and I've built up a tolerance to them and they dont work as well. I had two ruptured discs and two bulging discs before he talked me into surgery. It was a success but only relieved I would say about 30% of my pain. He now tells me my pain will most likely be with me for the rest of my life. My point is this after all that Malarkey, a pain specialist has a license to prescribe nothing but narcotics so they are more sympathetic to pain. It might take you a while to find one that doesnt just want to shoot you with the steroid injection (nerve block) or epidural whatever you want to call it mind you that is what is causing the outbreak of Menangitis at the moment but belive you me, when you find one you like its very rewarding and you can live pain free. Narcotics are addictive so when you want to quit you have to be winged off then or start a methadone redgimine to keep the withdrawal effects down. Methadone has a bad name it is a synthetic opiod pain killer but it is used to get people off heroin too. Your Primary Care Physician might know of someone who is going to treat you rather than stick you with a needle and send you on your way with that expensive nerve block. TO ALL OUT THERE WHO IS LIVING WITH PAIN DAILY: I FEEL IT WITH YOU AND WISH YOU THE BEST OF LUCK. I HAD THE BLESSING OF MEETING A NURSE WHO SAW MY PAIN SPECIALISTS HERSELF AND GAVE ME HIS NAME. SO WHEN MY PRIMARY CARE PHYSICIAN CUT ME OFF FROM MY PERCOCETS BECAUSE HE SAID HE DOESNT DEAL IN PAIN MANAGEMENT I JUST TOLD HIM TO REFER ME TO THIS DOCTOR AND HE HAS BEEN GREAT. DEFINATELY SEE A PAIN SPECIALISTS OVER YOUR PCP FOR PAIN YOU'LL GET MUCH MORE RELIEF AND COOPERATION AND SATISFACTION. IF ANYONE LIVES NEAR MEMPHIS I CAN HELP YOU OUT BUT IM NOT GOING TO SAY HIS NAME ON THE INTERNET. GOOD LUCK TO YOU ALL AND LIVE LIFE DONT LET YOUR PAIN GET IN THE WAY.......
  • jfay0831jjfay0831 Posts: 1
    edited 09/25/2015 - 7:06 AM
    I have several issues with back pain. Herniated disc, degenerative discs, arthritis in lower back and knees. I have had epidurals, cortizone shots, many different oral medications. Recently my PM doctor prescribed me the fentanyl patch 50 mg after fussing me out saying I had failed therapy because it is ridiculous for me to expect a zero pain level. well, I don't expect that but I also work in a law office and can't deal with the side effects of the morphine pills, and oxycontin. I was doing fine with oxycodone 10 mg 4 times a day until i somehow did something to aggravate my back. so she started on the 12 mg patch then told me to put 2 on if that didn't work with oxycodone 10 mg 3 times if needed which was needed. so then i tell her can i get one patch of 25 mg instead of trying to wear 2 and protect them with tegaderm dressing. that is when she went off? so she gives me the 50 mg patch and like some of you i gets incredibly hot like my body was on fire from inside then get cold. i feel so spacey i cant see or focus on computer or paperwork. when i am home i can lie down and it usually helps but at work i feel like I am tripping on acid or something when I try to fight the effect and continue trying to work. I have been using them for about 3 weeks, I will take into account the idea about the stomach area, but how do you keep it on when you move that area so much during the day. how long did it take for your bodies to adjust to it? I am teetering between just suffering the pain instead of dealing with the effects. any other advice would be most welcome! thanks for all your ideas though.

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