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Anyone who uses or has use the Duragesic (Fentanyl) Patch

edited 06/11/2012 - 8:44 AM in Pain Medications
I have just found a new doctor who gave me the mcg/h dosage to be changed every 3 days, along with tramadol, which does nothing for me, for breakthrough pain. I don't know if maybe the dosage of the patch is wrong for my body or what, but it isn't working that well. I am VERY opiate tolerant - my body becomes tolerant much too quickly. My questions are:
-If you are using the patch, what dosage did you start out at, and what dosage are you at now?
-What, if any, medication do you take for breakthrough pain?
-What medications and at what dosages were you taking before you were switched to the patch?
Does the patch work well for your pain?
If you stopped using the patch, what was the reason?

Thanks, I am just trying to find out if I should even keep trying to use the patch or not. It seems as if I get a tiny bit of relief on day 2, and then nothing. Thanks so much for your replies in advance!


  • I too became very opioid tolerant.
    The Fentanyl patch is very potent. You must be on something teeny, like the 12mcg?

    At one point I was on the highest dose (100mcg), but found that it was better to stay on a lower dose and change every 48 hrs if needed, because the high dose of 100 created too many pain spikes, when it began to wear off. I've been thru the gammet of pain meds and got SICK of having to remember when to take pills all the time, so that's why the patch was so convenient for me. It keeps a steady stream of meds in your body and I just had to write down the date I put it on and then put a new one on B4 the old one wore off (to avoid withdrawal)....

    But I ended up getting a SCS and it takes away 75% of my pain, so i safely tapered off the patches, from the 100's, to the 75's, 50's, 25's, 12's, done.
    I have Lortab on hand for Breakthru pain.

    The reason I wanted off the hardcore opiates is because, like you say, I became VERY tolerant, I was sick of the hassle I had to go thru every month to get the damn things. Not to mention the negative 'stigma' that goes along with it....
    But ALSO because opioids will deplete your hormones, cause dry mouth, which leads to dental issues.....I could go on forever. They do serve their purpose, but I couldn't continue revolving my entire life around the pharmacy and getting the scripts and feeling like an 'addict', despite the fact that I used all my meds very responsibly.
    So, I ended up costing the healthcare industry $100 thousand to get an SCS implant (which works for me).
    I probably would have spent that much eventually anyway because all my scripts were out of pocket pay.
    Oxy would cost me over $700/month!
    Just SICK of the pharmaceutical BS. They are killing us!!

    Anyway, the patches DO take a while to kick in, so give it a good week or so B4 getting the full benefit.
    Good Luck

    Just be wise with this med. Follow the directions to a T.
  • How long have you been on it? It takes a while to build up in your system. My doctor warned me not to give up too quickly.

    1) I just started, I'm at 25 mcg/hr
    2) Norco (Hydrocodone 10/325, just finished my 2nd patch and only needing it about once a day.
    3) Norco 3x/day + Ultram ER 100 mg, not good pain control at all.
    4) Yes, very well, it's the best pain control I've had since my accident, although the norco + the patch is too much I'm going to ask for something lower for b/t
    5) (you didn't ask but) I also take Topamax 200 mg/day and Cymbalta 90 mg/day.
  • is the location on your body where you place the patch to get the best 'absorbtion' thru your skin tissue.
    Many people have best results in different parts of their body.
    Also, make SURE the patch is securly stuck with NO open creases.....I usually had to apply that medical tape around the edges to keep a firm seal.
    Even the teeniest little open area will dry out the underside of the patch and you won't get good absorbtion.
  • MetalneckMetalneck Island of Misfit toysPosts: 1,371
    Hey Rachael,

    How - Why are you so opiate tolerante?

    I have been on almost every opiate pain managment therapy available... From Oxycontin to Methadone - Percocet - to MScontin. I have also had to go through medical detox do to over use of opiates postsurgically - in the past.

    I recently switched (2 Months ago) to the fentnyl patch. I am 100mcg/hr with Norco 10/325 X 6 per day for breakthrough. I was started at 75 mcg/hr initially based on MScontin 60mg X2 per 24 hours with Norco 10/325 X6

    The current therapy along with other meds (see signature) has provided the best pain relief in over 5 years (before my first failed surgery).

    There is definatively a day three syndrome ... and my personal experience is to avoid the Mylan brand of patch, as it is a completely different delivery system and formulation.

    Good Luck on your pain control journey - Keep in touch!


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  • I was on the 75 but was taken off and now I take Opana ER 15mg 2x day and Opana IR 5mg for breakthrough. This works better for me and I don't have any of the bad pain spikes.
    Live one day at a time and do it with no regrets. I hold my head up high with pride to the fact that i wont let my injury beat me.
    Lumbar surgery 2009
    Cervical fusion C4 to C7 2009
    Neurostimulator 2010
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  • I am on 50mg patches, changing them every other day (have been for 2 years). These patches have changed my life. I am no longer a pill popper and no longer go through withdrawals that I wanted to die from. With that being said, I know that if I was ever forced to go off these patches, that I would have to be put in a rehab facility. My doctor has been EXTREMELY supportive of my using these patches. I place mine on my back in different locations and did find a difference with the brand of patches and now my pharmacy knows to only order the longer patch instead of just the square patch that often feel off. I do not have a problem with the more long rectangular version. I believe the notes from the Pharmacy talk about not placing them near the heart so I don't. I do not and will not ever take a pain pill prescription again. My pain is never gone and I can't sit, stand or walk for even short periods of time but for the short term I've been able to work. My biggest worry is that someday I may not be able to walk and so every day I'm closer and closer to raising the white flag and going out on a permanent disability but the thought of me being denied a permanent PERS disability retirement and having no income scares me. Anybody have any recommendations on working vs. applying for California PERS disability retirement benefits?
  • I am currently on the 50mcg patch with oxycodone 30mg for breakthrough, but that is because I just had fusion surgery. We will be dropping down my breakthrough meds as needed. The patch takes a little while to start working. When I first started using it, honestly it wasn't until about the third patch change that I really started feeling the relief. I change mine every 3 days with no problems. I am on the mylan kind and prefer them to the gel kind. I was getting way bad breakthrough pain with the gel kind on the third day...now it seems to be much better....
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