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Not a fan of Fentanyl

AnonymousUserAAnonymousUser Posts: 49,670
edited 06/11/2012 - 8:31 AM in Pain Medications
I was recently switched from Morphine ER 60mg 3x Daily, to Fentanyl 25mcg/hr patch because of tolerance.

I've been told, and by the conversion chart that it's low for that dose. I should probably be on the 50mcg/hr patch, but I don't like it at all. It really doesn't work in the least, not to mention how easily the patch seems to come off as well.


  • Chronic,
    They have to take into account any issues with cross tolerance when you are moving from one med to another, and it is protocal to start somewhere between 10 -25 % below where they believe you might wind up with when starting a new med. There are a few reasons that they do this, first being cross tolerance as I mentioned already, secondly to see how you will respond to the fentanyl. It can take a few days to build up a blood plasma level in your body, so that is part of the reason that you may not be getting good pain relief from it yet, and another is that they typically start you on a new med at a lower dose and then can raise it higher if you don't respond well.
    When do you see your doctor again? You have to give him and the medication time to see how your body responds and then go up a dose or two and see how that works. This takes some time.
    As far as the patches not sticking well, when you first apply then, have you clipped any hair on your arms or chest or whereever you are applying them? Secondly, you need to keep your hand over the patch for at least a minute to help it adhere well. You can buy nexcare clear bandages called tegaderm to cover the patches with. You will find that these help the patches stay in place much better.
    Some people can use adhesive tape and that works for them but I have found that using tegaderm or another bioclusive dressing works better.
  • I used the 100mcg patch for awhile and it worked very well for my back pain and muscle pains but did not work very well on my nerve pain which is my biggest issue. Fentanyl is the strongest pain med their is for use in medicine I believe(in the us) but everybody responds to every medication differently.
  • Hi,
    Fentanyl is an opiate pain reliever. Opiates/narcotic pain meds will not relieve nerve pain. For that you need something that is for nerve pain specifically. Lyrica, topamax, neurontin, some of the old SSRI's work really well for nerve pain.
    Unfortunately with our conditions, it is usually a mixture of both neuropathic pain from damage to the nerves and mechanical pain from the structural problems that we have.
    Both conditions need to be treated separately but at the same time if that makes sense. What I mean is that we need medications to treat both types of pain. One that is geared toward nerve pain is not generally going to relieve our mechanical pain and our mechanical pain meds are not going to get rid of or make our neuro pain any better.
  • I was on the Fentanyl for a month, and just switched back to the morphine at a lower dose. So far the morphine's already working much better, even at half of what I used to take.

    I have considerable nerve pain, and the morphine has always helped with it, but the Fentanyl didn't. I've tried Lyrica, and even mild anti-depressants to no effect as well.
  • I've been on Fentanyl for a 1 1/2 and I have tolerated it very well. It's true what Sandi says that they will start you on a lower dose to lower risks such as respiratory failure.

    I am aware of Fentanyl being 80's stronger than morphine, and the doctor might have you take a break through medicine until a therapeutic level builds up in your system. They have me on a 2 day schedule because the patches don't last 3 days like the manufacturer says. I use medical tape to secure them to my skin, and it stays on well when I take a shower or while perspiring (that's one side effect I get from it)

    Well, try to be patient and give it a while to work. A pharmacist told me it can take up to 3 weeks, but until then, keep taking you BT meds as usual. What has helped me avoid nausea, vomiting, headaches, and dizziness is wearing the patch on my belly because it is absorbed better in an area of more fat distribution. I don't feel a thing and get no euphoria from it, so it doesn't stop me from driving. Of course everyone is different and you should always see first how a medication will effect you before going out driving, operating dangerous machinery, etc. There, I threw in my disclaimer ;) Take care :H
  • Thanks meydey, but I'm already done with them :)

    Even at half my original morphine dose, the morphine works and the Fentanyl didn't after a month. It may have at a higher dose but I try to resist upping doses as much as I can. I'm only 23 with chronic pain, I don't need to become tolerant to everything already.
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