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Talk to me about the patch

happyHBmomhhappyHBmom Posts: 2,070
edited 06/11/2012 - 8:44 AM in Pain Medications
I just need to be convinced that I will not now be turned into a drug addict overnight. Because my pain is so severe right now and nothing is lasting long enough, this was my PM's idea to give me a little bit of a leveling off all day, and I thought it sounded plausible.

But damn, that package insert has me quaking in my boots!

Also, I am scheduled for an endoscopy under twilight sedation on Thurs, and need to make sure it won't mess with that.

So talk to me, peeps (yes, I know I need to call the gastro, but y'all can tell me your experiences in the meantime!).

It's the fentanyl patch, 25 mcg/hr.


  • in here - she's familiar with the fentanyl patch
    so sorry you hurt my friend
  • MetalneckMetalneck Island of Misfit toysPosts: 1,378
    Hey Happy,

    I am happy to say that I have been on the patch for several of weeks now and it has provided the best pain refief I have had for over 4 years.

    Are you switching for another controlled release opiate for moderate to severe pain that you have been on for a number of months?

    The patch is NOT for what is known as an opiate niave patient or for short term relief. You must be opiate tolerant. But of course now I'm just repeating what you have hopefully read in the insert.

    And yes ... make sure that whoever is managing your "twight" anethesia is VERY aware of any and all medications that you are talking regardless of the method of appplication - intake.

    Good Relief!

    Spine-Health Moderator
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  • No, but I've been taking hydrocodone and tramadol for quite a while and am fairly tolerant. The issue was that Norco (10/325) was wearing off too quickly. Oxycodone has pretty strong gastrointestinal side effects for me.

    So I guess that is more a yes than a no. I am not narcotic naive.

    Of course, I always try to be very thorough with my meds list!
  • My PM doctor is good in that he can separate the truth from the propaganda, too. I guess I need to relax a little, if it was gonna kill me he wouldn't have given it to me!

    It can't have kicked in already! I only put it on an hour ago! I'm sleepy.
  • Yep, the Mylan. I still have the Norco as well, though- the Fentanyl is to replace the Ultram ER I was taking.

    He wants me to not take the norco though. Or, I should say, he wants me to not need it. At least, not as often.
  • My experience for what it's worth:

    I've been using it for over 9 months. Started at 12mcg then went up to 25mcg.

    Like you I had trouble with pill forms of pain relief wearing off to quickly and the ups and downs were driving me to distraction. With the patch I found the third day I didn't get the relief so my doctor has me changing it every 48 hours. It did take me some time, a few weeks, to adjust. (But that's par for the course with me.) Once I did it was much more effective. Wearing it on my stomach helps eliminate the side effects.

    I still use something for break through pain but many days I can go with just the patch for pain relief.)

    I have to say once I got on the Fentanyl patch, for the most part, my pain did become easier to manage. As easy as managing pain can be I guess.

    Good Luck!
  • MetalneckMetalneck Island of Misfit toysPosts: 1,378
    Is probably a side effect of conversing with me!

    Just curious ... which brand did you receive?

    Mylan, Sandoz, Name Brand (Duragesic)??

    The Mylan formulation is different as the med is impregnated in the adhesive, the others actually have a reservoir of gel.

    In my experience the Mylan brand is MUCH less effective. There are several complaints about the Mylan system. Of course there are complaints about the Sandoz and Duragesic type also.

    Of course any med will effect any person differently.

    Good Relief?,

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  • I'm glad people are liking it. Hope I do too!

    Now to get through my abdominal ultrasound tomorrow, and my endoscopy thursday. Sigh.
  • MetalneckMetalneck Island of Misfit toysPosts: 1,378
    Per the other thread ... it would appear that your PM doc is replacing a long acting non-opiate with a powerful long acting opiate not meant for opiate naive people. (people that have not been on a long acting opiate for a period of time and not received adequete pain control) Norco is a short acting opiate. Makes me go hmmmmmm?
    But again ... your PM Doc carries the malpractice insurance not me!!

    Confused .... must be the meds!

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  • The leaflet says "opiate tolerant" are those who have been taking at least 30 mg or more of oxycodone for a week or longer. I can't take oxycodone, and hydrocodone doesn't come in a long-acting formulation. I've been taking hydrocodone in varying amounts for 2 1/2 years, 30 mg a day for the last month, closer to 40 mg for the first 4 months.

    I guess you wanted him to put me on oxy and watch me vomit for a week just to satisfy the pamphlet? I think I fall right in that range of "tolerant."

  • MetalneckMetalneck Island of Misfit toysPosts: 1,378
    Pain free and safe ... That being said ... from another source ... cant post the link but here's the text ...

    "Before using fentanyl
    Do not use fentanyl unless you are already being treated with a similar opioid pain medicine and your body is tolerant to it. Opioid medicines include morphine (Kadian, MS Contin, Oramorph, and others), oxycodone (Oxycontin), and hydromorphone (Dilaudid). Talk with your doctor if you are not sure you are opioid-tolerant."

    When/If in doubt ... contact your doctor ... Please??


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  • MetalneckMetalneck Island of Misfit toysPosts: 1,378
    In my experience ... and I have a little bit by now ... Is not a large dosage .... but the duration may make up for it.

    Shoot ... I'd question your doc ... I am a little surprised he made this change so close to knowing that you were going under additional sedation soon ... but then little suprises me anymore.

    A phone call to your doc doesn't cost much. Peace of mind is priceless. If you were my own family I would be on the phone on your behalf.

    Call me paranoid ... don't want you hurling or anything bad to happen.

    With concern,

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  • I called the doc who is sedating me, waiting for a call back.

    Trust me, hydrocodone is an opiate ;) It is just a bit weaker than oxycodone. I think I've read that 10mg of hydrocodone is equivalent to about 7.5mg of oxycodone. So, no, not a huge dose. But I don't believe huge doses are needed to make the fentanyl patch safe, just tolerance, or opiate receptors that are not "naive" to opiates.

    They even allow this dosage in pediatric patients!
  • Hello all,
    I've been on the patch for 10 months now with very good results.At first they did kinda make me sick to my stomach though.
    Before starting them I was taking 40 mg of hydro a day.I still have to take it for breakthrough pain but not everyday.
    The patch isn't as effective now though as it was when I first started using it,but I really hate having my dosage increased but I may have to discuss this with my dr.
    Happy I think you'll do fine with it,just be careful.
    Peace everyone
  • Those using it, how long did you have to take it before it started being effective?
  • As well as I can remember it didn't take too long.I could tell a big difference even with my first dose.And once it was in my system good it was amazing how much better my pain was controlled.
    Good luck with how it works for you.And goodluck with the other procedures you have coming up.
  • Any advice for taking care of the itchies?
  • Can't help you there,my nose itches to no end....sorry
  • I took benedryl when my skin itched horribly, but it was on my own. I really should have checked with my PM before taking it. I use the Watson brand of patches. Was on 25mcg/hr, two weeks ago, I was upped to 50mcg/hr cause I wasn't getting good steady 72 hour coverage. Now, I've had better pain management, but the side effects have increased. I've got a call into my PM's office this morning to discuss with them. I feel all out of whack, obsessive, moody, etc. I've still have some itchies, but not just continuously like before. Not sure if they've went away over time or what.

    The best thing would be to call in to your doctor and ask him/her what you could take or do for the itchiness. I know at the time, I was going nuts scratching my nose, then my back, then my arm, and the next spot and all back around again. I had made some small scratch sores in some spots I was itching so bad. I've had the same ordeal when I was given morphine at the hospital. Too...the benedryl didn't take care of the itchies, just lessened it some.

    Good luck. I know how you feel. :)
  • I could be wrong but I believe that all patches are now administered through the adhesive. There are no more reservoirs.
  • MetalneckMetalneck Island of Misfit toysPosts: 1,378
    Still make the reservoir based delivery method .. Sandoz - Duragesic - etc. I was given the Mylan brand that is adhesive based and it was not even 1/2 as effective as the original delivery methodology.

    This can be a real problem for some people ... it caused me 15 days of severe pain and prompted a complaint to the FDA about it.

    There are MANY internet postings about this problem with the "new improved" adhesive based delivery method.

    Be careful, be informed, research and consult with your doctor about what you experience. Pharmacies make switches and decisions based on insurance formularies and profit margins. Not solely on what has the most efficacy for the indvidual patient.

    Pursue a pain free day,

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  • It's working pretty well, but I've had problems with the adhesives on 2 so far, and it seems if I have to tape it on I don't get as much effectiveness. I should call and find out what the other pharmacies get.

    FYI, I did call my doctor about the endoscopy, and the response was that it was fine because due to the meds I was on he was having an anesthesiologist in for full anesthesia rather than nurse anesthesia. So I was put under with the good stuff and they were fully aware.

    Side effects are not really more severe than just the Norco, although effects of the patch AND norco when I have B/T pain are pretty extreme! I can only do that when I'm ready to take a nap.

  • I just got the same patch yesterday...after reading the pamphlet ...I felt like I was getting ready to stick an atomic bomb on myself!!! Har Har Toooo funny!

    I got sleepy an hour later too. It was wonderful. I've had insomnia since February. Only slept half an hour though. =(

    I put the patch on yesterday at 1pm and didn't start feeling any pain relief until this morning at 6:30. Have been awake since 4am.

    I'm wondering about my shower - because I like them really hot. Couldn't believe it when I read that I have to give up my electric blanket and heating pads. This patch better be good stuff cause I want my heat...as of 45 minutes ago, I can feel relief but still quite a bit of...nope, that's not there anymore either. Maybe this will work!

    Just wanted to laugh at you and with you!! I hope this works for us!!

  • It's been one hour now...and I realize now that I didn't truly realize how much pain I was actually IN...until it was gone. (Except the headache... which I'll take.)

    I'm going to take a warm shower and go back to bed for what might be the best sleep I've had in years.

  • Jasro,

    I can't speak for the electric blanket but as far as the heating pad, I still use mine. I wear my patch on my stomach and use the heating pad on my back so they don't come in contact with each other.

    It took a while (about a week) but the drowsiness wore off.) I was amazed at the difference in my pain levels. Just recently I was due to change mine. I took it off one that evening and jumped in the shower. Forgot to put the new one on and went to bed. Woke up in intense pain. For the life of me couldn't figure out what I had done to cause such a flare up. Then I remembered I had forgotten to replace the patch. I was quickly reminded how well they work.

    Here's hoping it gives you some relief and much needed sleep.

  • I put my first fentanyl 25mg on for the first time on Tuesday. I'm due to replace it Friday. I'm not sure what brand I got....I didn't pay attention to that...especially after I read the insert. AND my doctor explained to me that she didn't want to overdose me and kill me.......Wha?????

    Anyways, I'm opiate tolerant...was taking 40mg oxycontin with 10 mg oxycodone for breakthrough...so 50mg per day.

    The 25mg patch doesn't seem to be doing much so the dr. said to put two on my body on Friday and use oxycodone 5mg for breakthrough. I'm really scared to do so.......if you don't hear from me again, you know why.

    SO, depending on your tolerance will depend on your level of relief.....maybe this microgram of patch isn't strong enough for me. IDK? But, IDK much about the patch.

    I truly want off of all this stuff and get fused....we'll see where the road takes me.

    A pain free day to all!
  • You do have to wait a while for full effect, it's not soon enough if you haven't even changed it yet. The half life on fentanyl is pretty long (as my doctor explained to me) so it's slowly building up in your sytem- it's not like the pills where you take it and feel an effect.

    I am interested hearing that others were less sleepy after a couple of weeks. I took it off Saturday morning after I was so sleepy I couldn't wake up. It turned out I was getting sick, nothing to do with the patch at all, and I haven't put it on again since (I also was freaked out by the pamphlet!!).

    I was also having a really hard time keeping it on.
  • Thanks for this posting HBmom. I learned a lot...without having to hit the archives again.

    Thanks Frog.

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