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fentanyl patch

manicpuzzlemanmmanicpuzzleman Posts: 6
edited 06/11/2012 - 8:52 AM in Chronic Pain
Hello all,
I started using the fentanyl patch on wednesday 4/27 and was told by my doctor that these would last 48 hrs. he also said in the beginning we would probably have to adjust the strength. well I tried the first one and found relief right away but after the first day it started wearing off. I have noticed since wednesday that I'm getting pain in my hips and it feels like it is in my bones. Has anyone else experienced anything like this?
Just a little history I had spinal fusion L4-L5 with disc replacement and rods and screws on 1/26/2011. The pain in my legs was gone after surgery, although the pain in my back was still there and is getting worse. I was on oxycontin 80 mg 3xday but was getting no relief so they switched me to the fentanyl patch.
Any suggestions would be appreciated.


  • metalneck,
    it is 50mcg/hr, Mylan, adhesive matrix. also i take percocet 10/325 1 every 4-6 hrs for breakthrough pain but that wears off long before on the 2nd day.
  • Hi. You had artificial disc replacement and fusion? What level had the fusion and what level did they use the artificial disc if i may ask? When they started me on 50 mc of that patch i was geting stoned from it so i asked them to lower it to the 15mc . Problem is neither 1 realy worked on the leg pain much cause its nerve issue.

    I would give it a few more days if i was you but if its not helping then it might not be the right med for that pain. Or might have to go to the 75 mc but that patch scares me personaly because its heat sensative and it can releise too much too fast from my understanding and few people had issues because of it. Good luck and i hope you find a way to releive the pain. Alex
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    There is a realatively knowed "3rd" day syndrome with the patches. There are typically Rx'd as 1 every three days - but many people comment that they have little (or reduced effects) on day three.

    The package insert would imply that peak serum concentratons are achieved in the 24 to 36 hour day
    or maximum effect during day two.

    I have found that the effect vary greatly as to which brand and strength that has been obtained.

    So, 1: What is the mcg/hour you are Rx'd?
    2: What brand did you receive?
    3: IS it a gel filled pack or adhesive matrix?

    Some doctors will RX #15 and allow for a new patch every two days - but you should speak with your doctor and discuss this issue with him. Also, do you have a short acting med for break through pain as this is not atypical with patch use also. (Norco or Percocet).

    I have found that there is only one brand that works well for me.

    Keep us posted!

    Spine-health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!

  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    I have found the Mylan brand to be the least effective of the Fentynls on the market today.

    I even registered a complaint with the FDA about it.
    When most of the patch makers made the switch to the non-gel based - Mylan didn't raise the base amount of med in the matrix and Sandoz did.

    I am on 100 mcg/hour started at 50 ... then 75 ... then went to 100 .... through this I have been on the Watson Gel filled then Mylan ... and now insist on the Sandoz ONLY .... It is made in the same factory that the name brand Duragesic is made.

    Was on 150 mcg/hr for a bit after a recent accident.

    You may want to check and see if your CVS can get the Sandoz brand for you and discuss this with you doctor. Also do a web search about Mylan vs. Sandoz ... there are a lot of complaints about the Mylan brand not being effective. I don't believe they have their formula right and we suffer because of it.

    I take Norco 10/325 up to 2 - six times a day for break through.

    Hang in there .... do some research, talk with your doctor and get you "blend" adjusted, Do you take an anti-inflamatory and muscle relaxant also? If not these are additional things to consider and speak with your doctor about.

    Hoping for relief for you,

    Spine-health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!

  • I just started with 12mcg,fent after a month iam now at 25mg it helps with walking,standing,i had a l-4-5 fusion in 93 that failed,also failed scs,plus a lot of injections iam full of scar tissue also take 2 percs a day was taking 3-4 Rick
  • i tried the patch after first fusion about 10 years ago and i started with 100 micrograms. it seems you have a small dose. the only problem i had was if i sweated, they would come off. i tried tape but that did not work. they are ok bu toxycontin is best for me. but i use fenatyl lollipops 500 mics for breakthrough and they work fine also
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • Oops i ment i went down from 50mcg to 25 mcg not 15 mcg. I am not sure how many of you use higher dose because the 50mcg was already making me itch like crazy and breathing was slowing down which is 1 of the side affect. The 100mcg would probably put me in a coma. I am suprised they would give anyone something that strong after surgery

    I am just guessing but i would think surgery should fix the problem to some degree to where that strong of a med should not be needed. At least after person leaves the hospital they should of got the pain under control at least to a point where while person is healing they would only be dealing with the surgery pain mostly.

    I am just speaking from my surgeries where i know surgery pain is a walk in the park compaired to the nerve pain issues people develop as i myself have. I understand like in jon case and few others where surgery failed or caused other damage where stronger medications had to be put in place to control it.

    If you just had surgery this year in jan Manic. Hopefuly each day it will get beter once you are able to start pt. Those muscles have to be built back up always after they cut you open as they did and it is sometimes a long recovery. Good luck
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • i was already on high dose of oxy-45 mg 4x's a day plus lollipops for breakthdrough. in fact dr was worried that they would not be able to medicate me due to my high dose. 100mics was no problem. i don't know but i think that is the highest dose they make but i could be wrong. i've always had high doses of meds for back since day one. i also had pain pump after surgery, morphine was the med they used. every 3-5 minutes i could dose myself. they did not put it in the spine so my dose was not as strong as could be but they also upped the dose in the pump
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • Oh ok i understand Jon. Maybe its just me then who has low tolerance to pain meds. I always had trouble with higher dose of every med oraly. It was not bad like during pain pump trial where it goes direct in to spinal fluid.
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • 5/17/11 I've been on this patch for over 5 yrs. now. Mylan does not work at all, doesn't stick to my skin. The patch is so thin, there's really no adhesive. I wear mine for 3 days, but also use VicodenES one every 6 hrs. I had a whiplash in 1989, that resulted in a spinal fusion of C5-7 in 2003, had many cervical injections prior to that. Surgeon stated I have osteoarthritis of someone 25yrs.older than myself. He never saw such a severe case of it in my neck. He lasered the oa. Got 18mos. relief, no meds except nsaids. No pain pills. Arthritis returned, now with peripheral painful neuropathy in both arms, meaning like a hot poker being stuck from your neck down to the fingertips. Duragesic brand is most effective for me. Not avail, too costly, no insurance. Mylan is a very poor product.
  • MetalneckMetalneck Island of Misfit toysPosts: 1,364
    The Sandoz brand is on "Factory Backorder" and they have a recall on their 50mcg/hr. Caused me a world of problems over the past week.

    Watson still has the gel filled patch - but doesn't work for me .... Just switched back to McContin 60 mg 3X a day + up to 6 Oxycodones (percocet) 10/325 for break through .... relief at last !!

    Darn med manufacturers !!!

    Spine-health Moderator
    Welcome to Spine-Health  Please read the linked guidelines!!

  • I use Watson name brand. Started out on 75 mcg every 3 days and quickly had to go to every 48 hrs.

    I use a 4x4 1/2 Tegaderm Film over my patch and can swim or do anything with it on.
    L1 - S2 "gone" useless in 1 way or another. DDD. RA. Bone Spurs. Tons of nerve damage/issues. Stenosis. Both knees replaced. 50 yrs old. I had a great fall (hence my user name) at age 41 and it has been a domino effect every since.
  • I have been using the 50 mcg patch for almost six months, changing it every 72 hours. By Day 3, I don't get much relief from the patch, but the first 2 days have been great and I'm getting the Mylan. No problems with it falling off either. My only issue has been the nausea that I have the first day after putting a new patch on. This happened with the 25 mcg and at 50 and we thought I would adjust but I still have it almost every time I change the patch. My PM suggested that we try to find out if my insurance would cover the name brand to see if that made a difference, but like Metalneck stated, it is not available right now. Wonder what the supply issue is about? My BT relief is Lortab 10/500, but I rarely need it the first day and a half after a new patch.
    Right now I'm recovering from SCS surgery (Tuesday)for the second time and this recovery is going so much better. I wonder if the pain patch has anything to do with it? I am requiring very little pain medication at all right now!
  • I am reading your comment about the disc replacement I too had the flexicore disc in 04, @ the L5 S1 level, immediately after waking up from the surgery i knew something was wrong, longs story short, i have nerve damage in my leg from the surgery, dr tried to tell me it was a "nerve stretch" and so on and so forth, I have had numerous problems, and the trials were supposed to extended until the 8th year, however over the summer i rcvd a letter from the manufacturer stating the trial had ended and the disc would not be approved by the FDA stating that insurance reasons was why the trial was ending.I have point blank asked the drs my problems were caused by the disc and all i get is a flat out no,( now they want me to have a spinal stimulator implanted)after multiple injections and therapies on my lumbar region. in December I was diagnosed with fibromyalgia, which I believe is a result from surgery, I have never met anyone who had had this device implanted so i googled it and came to this site and was wondering if you could relate your story to me. I am so frustrated and if i could turn back time i would have never had this done i was 30 @ the time, and it seems I have been deteriorating ever since I have multi level DDD as well as some tearing im one of my discs, of course MRI's wont show anything below the surgical level because of the implant(scrambles the image) I would love to hear from someone that had the surgery and know that I am not alone, even though I would never wish this on ANYONE, I feel like I am alone and no one understands. Thank you for your time
  • I was on them would not stick,i was on 25mcg,then 50mcg,i quit them i felt like could not drive safetly.was dizzy,now on Butrans patch they stick really well dont come off and your not dizzy,i can drive ok,but i still have back pain,scar tissue percocet work but not very long. Rick
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