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I Am Scared to Take Fentanyl

jennychelejjennychele Posts: 22
edited 06/11/2012 - 8:57 AM in Pain Medications
I have been on some type of narcotic for about 5 years for neck/shoulder/arm pain. Nearly 2 years ago I had a 4 level fusion (C2-3, C3-4, C4-5, & C5-6)
using 4 of the Medtronic PEEK Prevail disks and BMP. So no donor bone or cages. About 6 months after surgery my ortho dr. sends me back to pain mgmt because I am still in pain, although it is different and I wouldn't call the surgery a failure because I still hurt. Well the PM Dr has had me on Morphine
(I think 20mg) 2xday (but they only worked for about 6 hours) then I had Percocet 10/325 up to 4 a day and Soma. I had to quit the Soma because the knocked me out. So he switched me to Zanaflex generic. They are better but not great.
About 3 months ago he took me off the Morphine and gave me Immediate Release Oxycodone 3 times a day and kept me on the Percocet’s for breakthrough and the Zanaflex for muscle relaxers.
My problems are:
1. I sometimes forget to take the IMM Release Oxy and then the pain starts acting up pretty good and I just have to take whatever I missed and wait for it to work before I can get on with what I need to be doing.
2. Even when I take it on time, the relief is not constant and at least once a day gets to me pretty bad. (I have an alarm on my phone that goes off every 4 hours to remind me to take something. Either the Oxy's or the Percocet’s)

SO...I went to the PM Dr Tuesday and explained to him the situation of forgetting and the unrelieved pain that is still hanging around. He at first asked if I would like to try a patch. I said it was whatever he thought would work. We discussed Fentanyl and another new one that you change every 7 days instead of 3. Then I said ok unless there was another pill that I could just take once a day. So he said to try Morphine again but this time 50mg once a day. But when I went to get that filled at the pharmacy it was going to over $130.00! I ask the pharmacist if he could check the prices of the patches the doctor and I had talked about. He said the new one was going to be expensive because it doesn't have a generic yet but the Fentanyl was like $26. So I left the 50mg Morphine there and went home and called the doctor back. He said he would write me for the Fentanyl so I went today and picked you the prescription for it thinking it would be a low dose since I thought it was strong and I was new to that particular drug. But the script I picked up was for 50mcg. I have slight asthma for which I take Symbicort and Albuterol and my PM Dr also put me on Welbutrin (anti-depressant) about 3-6 months ago. I have read and researched Fentanyl on line and I am scared to take it. Am I being silly and should just try it out over the weekend when I will be with family and they can watch me or should I call my PM Dr and try to make another appointment with him for next week?
Sorry this is so long but I figured more information would help.

Thanks for listening,



  • I don't have asthma, or anything like that, but am now on the (3 day) 50mcg Fentanyl patch. I've been on it for like 3 weeks or so (maybe 4?) at the hospital with no problems.

    I heard "nightmares" years ago with the Fentanyl patch, but not so much now a days? I am in a better place with it now. I am still not thrilled with it, but better. You still can't cut them or anything silly like that, but the chance of OD'ing on them is so much lower, I feel bukoo better about them than I did years ago. I know that might sound weird, but I am in a better place concerning "Fentanyl" now and after? Sigh, pain patches....argh! (G) Health wise...yes?

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Jenny,
    Was the other patch Butrans ? If it was I have been taking it for 5 months and it has done wonders for me. I was able to stop taking oxys and break through meds. We are all different and some things work better or worse. Hope that you can find the med for you.
  • Thanks for answering one thing I was/am kind of hoping will be able to trim down in that sort of fashion. I am on Fentanyl, Oxycotin and Dilaudid. I pretty well know I can back off of the Dilaudid similar to the way I did Percocet in the past surgeries. My guess is once I do that, the Oxycotin would be stopped, I would be put back on the Dilaudid to slowly back off from, and then leave the Fentanyl if it is working.

    At least I see someone with 3 levels plus (seeing your prior surgeries) I can compare a bit with. You bumped higher and lower on the levels on the last go - my fear I will end up similar in the future - fingers crossed. :)


    I did a bit more digging on the Internet, and it seems after the problems (big time) like 5 years ago, a lot of safety measures were put in place with Fentanyl. Hopefully you and I are not placing trust in it falsely. I know "so far so good" for me if that helps. Understanding *HUGS* to ya!!

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Thanks so much for responding. It helps so much knowing that someone has had positive responses with the patch. I have just been looking things up online and half I found was people trying to abuse it. That was NOT what I needed. So thank you very much for some legitimate responses.
    Mark that was the name for the other patch but my pharmacy says there isn’t a generic yet so it will be way out of my price range.
    Brenda, I sure all goes well with you being in the hospital and all. Sounds like you've been in there a while, UCK!
    I did call my PM office today and spoke with a nurse who reassured me that I am more opiate tolerant than I think I am so all will be fine. My husband also reminded me that my PM Dr is very calculated and does a very thorough job. Like counting everyone's meds on every visit and drug testing randomly to make sure you are using your meds and not selling them. I do really like him and he has been my Dr. for 5-6 years and has never done me wrong. So I guess I trust him on this too. So pray for me. I plan on getting them filled tomorrow morning and since they take a while to work I may call in tomorrow night from work depending on how I am feeling. Still not sure if I am supposed to quit taking my Oxy IMM rel right before I put on the patch or when. I take them at midnight, 8 am and 4pm and I plan on getting and putting on the patch around 9am. I will ask the pharmacy when I pick it up. Thanks again for helping calm my nerves on this issue. I really appreciate it. :)
  • Jenny,
    Don't worry, you will be fine with the patch. What it does, is replace the short acting pain medications that you are taking. Long Acting medications are what are sometimes called your base pain medication. This "base" pain med is used to treat your chronic pain levels- the ones that you have all day, every day, no matter what you may or may not be doing. The short acting percocet and oxycodone ( which are the same opiate by the way, the only difference is that percocet has tylenol in it, and the oxycodone does not)are used to treat the "breakthrough" pain, or pain that is caused by the sudden increase in activity or a pain spike caused by unknown reasons. The short acting meds are only supposed to be used when those spikes in pain happen, not just because they are dosed as three times a day or whatever the dosing schedule is....otherwise, if you take them regularly, at the same times, every day , then it just becomes another part of your long acting "base" pain med.
    Does that make sense? I hope that I am not confusing you.
    As to what will happen when you put the patch on, it can take up to a few days before you get the total amount of pain relief that you will recieve from the patches, so it is okay, to use a few of your short acting pain meds during this time. With the patches, or any long acting pain medication, it may take some time before your body builds steady blood plasma levels of the medication before you see how the medication will help with pain. Sometimes people find they get relief much sooner and some, sometimes it takes those few days to get it built up in their system.
    Take a calendar and mark it with the day you place the first patch, then three days later when you will change it, so that you know that it is time to change the patch. This will help you from changing it too early or too late.....for example, if you put the first patch on Saturday, you will change it at the same time on Monday.....and so on.
    Good luck with the patches, they really do give the best pain relief that I have ever had.
  • Yeah I understand all that. I guess I just didn't think I was as tolerant as I guess I am. That, plus all the horror stories that I read about it, made me a little (well a lot) nervous about starting out at what I thought was a higher dose than maybe I needed. I spoke with my pharmacist this morning and he counted up the amount of oxycodone in both my long acting med and my med for breakthrough. He looked it up on a chart and it said the same thing, that 50mcg/h is what I should be using with the Fentanyl. So I went home and put one on about 9:30 this morning and went to bed around 11:00 (I work 3rd shift). I woke up (praise God) and so far all is good. I didn't take a dose of the break through med at my regular time (normally at noon and 8pm) because I wanted to see how long it was going to be before I needed it. I came to work and was doing some physical activity (moving some 14+ Lb boxes around) and started aching so I finally took one then (around 11pm). Besides that I am doing well on it. I don't feel real groggy or loopy and my pain level is good. So I think this is going to work out just fine.
    I do have one question though. I am supposed to change the patch every 72 hours. So, make sure I am thinking about this correctly, if I put one on at 9:30am on Friday I should change it at 9:30am Monday, right? Because 9:30am Friday to 9:30am Sat is 24hrs, then to Sunday at 9:30am will be 48 hours, so 9:30am Monday will be 72 hours? Right?

    Thanks so much to all you guys for responding and being here not just for me but everyone y'all help. I don't post much on here but I do read a lot of the posts that are on here and get a lot just from that. And the times I have posted I have always gotten a very helpful response.
    God Bless all of you and I hope everyone has a great and less painful weekend.

  • Yeppers! For instance, I had a new patch put on at 0600 Thursday, so in 2 hours (72 hours later - Saturday morning) I switch to a new one.

    Like Sandi said (and I am seeing it now), I am not 'needing' my break through meds near what I was. My new script says "every 4 hours as needed for pain. Meaning I can nibble down if I feel good - which I am. I haven't had any break through for like 14 hours, and feel fine if that helps.

    I am on Fentanyl 50mcg/hr as well as Oxycotin 20mg every 12 hours along with my break through. If I can get my Dilaudid (4mg) down, then we can hopefully stop the Oxycotin, and wean once again on the break through such that the Fentanyl will work for a while. Would love to get off all of it, but not sure if that will happen yet. Fingers crossed for us both!! :)

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Sorry for not responding sooner- I lost power for a few days here because of that giant storm.
    Yes, if you put it on Saturday at 9:30, then change it on Monday @ 9:30.
    I hope that both you and Brenda find that it works really well for you .
    It did for me and I miss it...and don't worry about those horror stories. Those occurred when the matrix was different in the patches. There was a problem with the patches leaking too much medication at one time but they have since changed the delivery method- it's now in the adhesives, rather than the gel matrix they were in.......so those problems aren't there any more.
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