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Appt w/ PM, Butrans patch anyone?

Trisha68TTrisha68 Posts: 32
edited 06/11/2012 - 8:57 AM in Chronic Pain
Hey everyone!
I had an appt with PM a few days ago and had a complete meltdown in the office. I'm not a cryer but let me tell you I did a great job of it! LOL! I am just so tired of hurting all the time. I was taking Norco and it stopped working. I also take Lyrica, Naproxen, Flexeril. The Dr put me on a pain patch called Butran or Butrans. I don't have it yet because the pharmacy had to order it. He told me that he understands that I'm in pain because my body creates a lot of scar tissue at a fast rate. He told me he knows how I feel about another surgery but eventually I'll have to see nuero again. I'm not sure I'd be a candidtate for another laminectomy because they've already taken so much bone to allow for scar tissue that it's caused an unstable spine. Anyway, I'm picking up the patches Monday and was just wondering if anyone else has used them and how they worked for them.


  • P.S. I will still take Norco for breakthrough pain.
  • I've been on butrans for about 6 months I am on the 10mcg/hr patch. You put one on every 7 days and alternate the site. I have not had any side effects. I am also on Lortab for breakthrough. I still have constant pain but the Butrans has brought it to a manageable level. The worst part about the patch is the skin reaction at the sight. Make sure you put it on tight and that there are no bubbles. A couple of times there was an air bubble and it cause localized pain at the site. I get a slight rash which takes a couple of weeks to heal.
    The sites that work best for me are on upper back and on upper arms. Also on upper chest but I have a lot of chest hair and I have to shave a couple of days before and end up with ingrown chest hair.
    Good luck, hope it provides you some relief.
    laminectomy c4/c5 2008, ACDF c4-c7 Jan 20 2014 sched
  • Thanks for the info! I wish something would take it all away as I'm sure everyone else does.
  • I hope the Butrans patch works for you though it can work as an antagonist against the Lortab from working for breakthrough pain but you can ask the Pharmacist about that if you like. I have no experience with the patch but hope it helps you. Take care. Sara
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • It knocks you about for the first two weeks. Feeling very spaced out. Not nice unless you like the feeling.

    I started on 5. I had extreme vertigo, sickness, hot flushs, night terrors. Yet that stopped completly.

    I went up to 10.

    I could not move without them, no under estimtion.

    Only trouble is that for me they last 6 days only, so I have had permission to chnge ever 6 days.

    If you can cope with temporary side effects, please do.

    I recently added another 5 to make it 15 but I felt drugged up and thus just took the extra 5 off within 2 hours.

    It dont touch nerve pain, yet mucle/scar issue, wonderful

    I hope you find this too


  • Thank you Charry and Millie. Millie, I have a question. I have an obligation in a town about an hour from me 6 days after I start using the patch. It's a huge product party for my business and I have to be there, no ifs or buts. Do you think I'll be able to drive to it? I might have to get someone to drive me there. I hope I will be able to do the presentation. Like you, I have to do something because even with Norco it's taking me several hours to get out of bed in the mornings. I have my meds and a bottled water beside my bed.

  • I am very able to communicate in day to day tasks, yet whereas I used to be very on the ball with a pressured job,I wouldnt be able to on the medicine cocktail I am on.I dont believe Butrans affects one like this after the 'getting used to it' period.

    I am not able to drive anymore sadly as I have great troule sitting upright. I think you are wise to get a lift,just incase.

    There are 3 reasons I would delay wearing the patch until after your big day: It may be wort you starting it a week late.

    1. The pain relief wears off a lot by day 6 and the agony is rather awful.I feel this is because we tend to do a little more movement when the dosages are at the highest leels, for me days 2 -4.

    This is why with my GP's permission I change every 6th day.

    2. It takes about 10 times longer before information seems to reach the mind and absorb the information, so presenting to others is rather difficult, rather feels like one is tipsy after some wine.This lasts for 2 - 3 weeks.

    3. The first few weeks you may feel very sick and/or drop off to sleep at a moments notice.

    It sounds awful as I write this, but its only short term.Those horrid tooth-pain type aches we get are dampened a lot by the patch. Ok nausea is awful, yet ladies get pregnant and feel nausea and are ok.You may wish to ask your pharmasist if anti-nausea tablets are allowed if you feel troubled by this.

    4. Please be careful where you place the patch. I put it on my un-fattest part of my arm and I lay on it alot. This caused the patch to heat a lot and the dosage I got was higher when I slept.It was not nice. Also they develop an ugly black glue around them (fibres stiking to the edges of the patch I think) so place where it can be covered if planning on wearing a summer type top.

    Sorry for the essay, I thought I'd cover the basis for you,no one old me about these and I felt very alone.

  • Millie, thank you so much for all the great information. My husband and I both are really excited about the patch because we've been reading alot of people say that it has helped them so much. With a huge smile on my face I asked him, "can you imagine a whole week without me being in bad pain?" I'm so glad you said "tooth pain that we all feel". I describe it just like that. Like a bad tooth x's a hundred. LOL. I think maybe I'll try it and if it looks like I'm going to be impaired too much I'll take it off 24 hours before I have to go. I just want this pain to stop so bad that I'm not sure I want to wait. I'm like a kid waiting to open a gift. :)
  • Millie, thank you so much for all the great information. My husband and I both are really excited about the patch because we've been reading alot of people say that it has helped them so much. With a huge smile on my face I asked him, "can you imagine a whole week without me being in bad pain?" I'm so glad you said "tooth pain that we all feel". I describe it just like that. Like a bad tooth x's a hundred. LOL. I think maybe I'll try it and if it looks like I'm going to be impaired too much I'll take it off 24 hours before I have to go. I just want this pain to stop so bad that I'm not sure I want to wait. I'm like a kid waiting to open a gift. :)
  • hi Trisha

    Is no a good idea to take the patch off, you could be in ultra agony. Plus it dosnt just stop us feeling awful, it can make us feel worse. I am sure by day the initial awfuless will hve worn down, just be prepared for pin.

    It wot take the nerve pain away sadly. I not you tried Lyrica, all this did was mke me feel stoned.Butrans certainly does not do this.

    I wonder, do you ever have muscle spasm (I have a spinal cord injury so not sure if spasm would affct you).If so these produce its own awful pain. If you do have these and would like any further help with these do let me know :-)

    For nerve pain, I use Lidocaine patches (lidocaine is what they use to inject us when having dental surgery). Your dr may not offer you them as they are expensive.I find Aitriptylin at night and then Duloxetine in the mornings help.

    I personally would say stick on the Brutans patch right away.Feel free to pm me.

    Best wishes

  • Trish,I was on Butrans for 6months,they worked at first but my pain was too strong nerve scarring l-4-5 root.i did not have hangovers with it,but last dr put me back on Fentynyl patch 25mcg every 3 days it helps but i still take perocets 3 x day Rick in pa
  • It didn't work for me at all. The pharmacist also said it made the Lortab for breakthru pain not work, which made sense cuz I was dying... I understand it either works or it doesn't so hopefully you will have better success. My pain is more nerve pain tho, and maybe it doesn't work so well on that. Of course not a whole lot does. Take care and good luck
  • Ugh it's not doing anything at all! I might as well have a sugar patch on my arm. I was so excited. My husband just asked if I could tell any difference. I hated to tell him not really and the Butrans stopping the lortab from working makes sense! Crapola.
  • Hiya.
    Although I may not be feeling your exact pain, I know what it is like to be in such agony. sometimes i say enough is enough and end up being down because the pain is constant. drugs that i have been on have been tramadol, co-codamol, naproxen and the list goes on.
    Recently i was put on 10mg of Bu-Trans patches and i have now been given 20mg.
    Davrunner has cited some of the side effects of the patch but there are a couple others like nausea, lightheadedness, drowsy (will feel like sleeping beauty). the other thing is that they do scar and the best places to place the patch is indeed upper arms, thighs, basically somewhere where you have thick skin.
    I have been scarred by the patch and it has taken it ages to sort itself out as it was rectanglar brown patches.
    However give the patches a go and see for yourself. It works pain wise and it delivers pain relief over a certain amount of time a day and a week. you will/should have seven days of freedom from immense pain.
    Spinal pain really aint no joke and its absolutely debilitating. however, try the patch and please say how it worked for you and i hope it really does.
    take care. be strong.
  • This is my 10th week using the Butrans patch. The first month I started off on 10 mcgs. That didn't really help and I was having to take a Norco every evening (the main reason my dr. put me on the patch was to get me off the Norco), so I went up to the 20mcg patch. I've been wearing that for the past 6 weeks. I can't say that it takes away my pain because I'm still in pain 24/7, but I haven't felt so much pain that I needed to go back to taking Norco. I just started a new PT routine, though, so the past 2 weeks have been really rough. I have resisted the urgent take Norco because I don't want to be on that again, but I don't think the Butrans is helping all that much. The Patch irritates my skin a little bit...not too bad. I wear it either on my upper arm or chest, switching sides each week. As I said, it does not eliminate the pain, but I have yet to find anything that comes close to doing that. Snce it hasn't been working as well theseast couple weeks, my doctor is saying that maybe I should start weaning off it. That requires 2 weeks of 10mcg patches plus 2 more weeks of 5 mcg patches. That's fine, except he hasn't told me how I am supposed to deal with the pain during that time period. So, as usual, I am self-advocating and trying to find some answers on my own. Thinking about trying another ESI. I. The past they habvent worked, but I've never had one at L4-L5, so it might be worth a "shot"! Ha, ha! Anyway...has anyone been on the Butrans and gotten an ESI? My doc says I may have to wean off it before the injection. Any thoughts would be appreciated.
  • Hey Trisha,
    Just thought I'd share my experience with the Butrans patch which will hopefully give you some relief. I saw that you said after applying the patch that it did not help you at all. I asked my doctor several questions before starting this patch, I was prescribed 10 mg of Vicodin every 4-6 hrs and he really wanted to get me off of the pills since they can be extremely habit forming. He did mention to me that it would take 3-4 days for the patch to actually get into my system. He started me off on the 5 mcg and unfortunately I experienced the same thing you did, although I did feel a tiny bit of relief. I called my doctor after completing the month supply of the patches and asked him to bump me up to the 10 mcg patch. That worked wonders for me. As I said before I had been taking Vicodin and I'm not going to lie, I did take it more often then I should've because I seem to have been getting "used" to the pills and they just weren't working like they did before. I can honestly say that I'm very thankful for my doctor putting me on these patches. I was tired of the pills and was starting to worry about what they were doing to my body. I think the most important thing to know is that if they do not seem to be helping you out (after the 3-4 day body adjustment period) then maybe you should consult your doctor and ask to be bumped up to the next dosage amount. I've since been bumped up myself to the 20 mcg. I will admit, along with what all the others have said, that the patch does itch like crazy and when I remove it I have a very bad rash that at times scabs up because I itch the application spot of the patch while the patch is on my skin. But if a little itching and skin redness are the only side affects I have then I consider myself very lucky. The best thing about these patches are that they are transdermol and do not affect your liver. And go through your blood instead of your liver, kidneys and other organs the way the pills can. I will also say that I have read in a bunch of other articles, and have also experienced this myself, I noticed that if I took one of my vicodin it seemed to almost "void" out the patch. I know they say that you can use a narcotic for breakthrough pain, but I think this is one of the reasons some people are unsuccessful with the patch. I googled that very question and I noticed a lot of the people had said the same thing about it "voiding" out the patch. I really hope you find relief with the patch, I think its wonderful and now I no longer have that "drugged" up feeling and the wonderful withdrawal that comes with narcotic pain killers. You might want to keep that in mind as well, if you were taking narcotic pain meds before the patch, you might be experiencing some withdrawal from switching to the patch. Just give it time and if it still doesn't seem to work after a couple weeks, then consult your doctor and ask him to bump you up to the next dosage amount. Everyone's body reacts differently, some of us have a high tolerance for pain meds and some of us get that drugged up feeling from the patch, but I noticed that I felt the opposite, I felt alive and energetic again! I hope you find the same relief and I wish you the best of luck with it!! Sorry about the novel I wrote here, but I'm so pleased with the patch and I know my doctor is very proud of me for not taking the Vicodin anymore!! Just remember that your body needs to adjust, especially if you've taken pain meds for a while before starting the patch. Also if this helps I any way I read that the 10 mcg patch is the equivalent of taking 1 percocet every 4 hours. But that was just something I googled, not too sure how factual that is. Good luck my dear and if you have any other questions we're all here for you!! :)

    Ps. Has anyone experienced their patch "bubbling" up after they take a shower. That has been a concern of mine lately, I'm worried that if its bubbling up then maybe the medicine will not get into my system. I only noticed this recently since I just started on the 20 mcg patch since its much bigger than the others. Its almost like a huge band aid and it feel like the actual part that contains the medicine has detached from my skin. Any recommendations would be much appreciated!! Thank you!

    Good luck Trisha!! :)
  • Hi Bethy30,
    My patch has bubbled also. Like yours, it happened with the 20 mcg not the 10. It doesn't happen all the time, though. I think it depends on where it is adhered and how wet/soapy it gets. It has not happened when I have the patch on my upper arm, but has happened when it is on my chest. I agree with you that if the middle part where the meds are is not touching the skin, how can the meds be completely going into the bloodstream? I am very careful when I put it on to adhere a little bit at a time, making sure there aren't any gaps at that point. And in the shower I do my best to avoid getting any soap on it. This seems to help.
  • I've been using the Butrans patch before my last fusion surgery and since it. I am now on a higher dose than I was before surgery, which is disappointing. I'm taking 30mgs/hour and, after many months, we finally have the knack of putting it on.

    Make sure your skin is completely dry. Firstly, put the skinny strip of adhesive plaster onto your skin and as you peel it back, rub it smoothly/firmly with your finger/thumb - all along until the foil backing has come off. If a crease occurs at this point, just quickly peel it back and then rub it away. Then, it is important to rub (hard) along all the edges of the patch a few times before pressing your whole hand, firmly, onto it for at least 30 seconds (the heat makes the adhesive react more effectively). It is a bit troublesome, but providing there are no creases, then it should stick securely.

    The only patches I can really apply myself with ease are on my chest (as there is a large 20mgs AND a 10mgs patch that I use and they take up so much room). My hubby helps me when they need to go, in rotation, on my arms and upper back. Don't put them anywhere lower than your heart if possible. I also have problems with extreme itching after a day of applying - I just HAVE to itch, I can't help it. Also, although they don't eradicate all my back pain (especially the last day or two), I would be loath to stop them as I don't want to find out what the pain would be like without them. I often get a 'funny' head, but this could also be due to other medication I'm currently taking. I also think the Butrans patch causes problems with constipation (well, for me anyway) which makes my back pain even worse! It just means I have to take even more stuff to counteract the stymptoms.

    You'll be able to have showers without worrying about the patch, just press it hard with a towel afterwards. I was never confident about swimming with them (although it says this would be fine). I have a prescription of Tagederm transparent films that I can apply over the top which are 100 per cent waterproof.

    If you feel that the Butrans dose is not helping you, have a word with your doctor to see if the strength can be increased a little at a time over a safe period.

    Unfortunately I am now waiting for my FOURTH back surgery (on 22 December) - I only found out this week and all my best plans for Christmas have just gone out of the window. Still, if the surgery does the trick then I'll be a very happy bunny. Fingers crossed.

    I hope you don't think I'm trying to tell you what to do with the patches, I'm just passing on these tips as it's taken me a long time to achieve 'adhesive success'. I really hope they work well for you and you get the desired relief.
    2 x Microdiscectomy 2005 / PLIFusion 2-level 2010 / revision surgery 2011 / NEVRO Senza spinal cord stimulator implanted February 2013. I WILL NOT GIVE IN / UP !!
  • I just posted about this patch with questions, I am on my 4th day. I put it on Wed afternoon and it is now Sat night. I come from a family with high tolorences so I am not getting the 'drugged' feeling some of you are getting. I have noticed that it really helps with my raynards nerve pain in my extremities, but not terribly with my back pain. I am on the 10mg. Is day 4 too soon to ask my Dr to up the dose to 20mg? I was on Lortab for 3 years and I went to a PM Dr and he put me on this with no questions asked. I don't want him to think that I am drug seeking. I still have some lortab left but I am trying not to take it. My goal is to stop taking it. I been having some ulcer problems and I they don't work very well anyway. I am courious about what has been said about if you take the lortab that it will 'void' the patch. What does that mean? So if I take the lortab.. it won't work or.. I'm sorry, I don't understand. Can someone explain this to me?
    So far the last 2 days I have had the best sleep of my life, not pain wise but i have panic issues in the middle of the night and when I wake and I can only assosiate this with the patch. I also don't have a large intestines (my small intestines is connected to my rectum) so I have diarreah all night - since this patch or at least the last 2 nights - I have been able to sleep better with out waking 15 times a night.
    If someone can explain the 'voiding' of the lortab or patch I would sure appreciate it. Thanks so much.
  • My dr started me on butrans patch 10/hours. Only tramadol besides. The only good that came from it was pain relief. After 3 days I was completely out of pain. But on the 4th day I felt horrible. Couldn't breathe, headache since day 1, tired, couldn't walk from house to car without stopping to rest, and no bowel movements since I put it on. Also starting to feel angry and ready to fight. 5th day similar and patch came off. Pain starts coming back slowly and first bowel movement 2 days later.
  • I am new so 'Hello'

    I use suboxone 1mg twice a day but will ask doctor if three times will be ok

    The patch was too little in dose. I was at one time on massive amounts of percocet's (oxycodone)and went on a clinical trial of suboxone for chronic pain. I was 'leveled' out at 16mg in 2008 and slowly weaned off to zero in 2010 ( I was in no rush and this way I had no withdrawal symptoms which haunted me in the past)

    So a few months ago my pain got worse so I was put on the patch-it worked a little but the pill is much better and more potent. Suboxone is mostly used to wean one off opioids but can and in my case, is used for pain. I suppose buprenorphrine itself would do the trick but the suboxone is much cheaper and the naloxone that is in it has no effect unless abused by IV/IM use.

    My pain is low back from an auto induced spondylolethesis and failed surgery

  • @ Dixiechick- I asked a friend who is a nurse at a pm clinic about the butrans cancelling out the opiate meds. The butrans by itself doesn't. Its when the butrans has another drug in it. That combination is used to wean ppl off opiates. The other drug is what "voids" out opiates ie Lortab, norco, etc. Hope this helps!!
  • I have taken Butrans for about 6 weeks. I have insurance, but the dr. gave me a discount coupon. It costs 15 bucks now. The coupon will run out after 6 months I think I read. Do any of you know what it costs after the discount coupon expires?
    Becky Blackwood
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