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Fentanyl Patches

Pain doc switched me from 60 OXY ER per day to 50mcg Fentanyl patch plus 10mg Opana (regular, not ER) for breakthrough). Not working. Also taking 4mg of Zanaflex for myofascial pain. This does not seem like the 50mcg of Fentanyl is as strong as the 60 OXY ER? Shall I taper off the patch and go back to OXY? I think the two work differently.
I have had 4 surgeries and have painful muscle spasms and dare I say, cervical dystonia.


  • Everyone metabolizes drugs differently. If you've given the fentanyl a good try and truly believe it's not working, you need to talk to your doctor and come up with a plan. Fentanyl is more potent than morphine so it wouldn't be for a lack of strength. Why did he/she switch you in the first place? Was there concern over the amount of oxy you were taking?
    2015: Thoracic protrusions C7-T1, T3-4, T6-8
    Dec'13: 360FusionL4-S1 w/bone graft
    2013: 3x2-level disc injections: 12mo surgery postponement
    Dec'12: DiscogramL4-S1
    Sep/Oct'12: Bi-lateral Rhizo AblationsL4- S1
  • My experience with Fentanyl was ugly I felt like doing myself in and that was only 5mg.
    It is sad that you are in so much pain that you have to take those meds.
    I take some too but they don't help. The old routine from a Pain Clinic.
    Through my pain med. trails a lot of really scary reactions and one thing I always
    made sure of is I let my Doc. make those decisions for me.
    Please don't change without a Doc. direction you are way to valuable.
    Take care of yourself
  • sedorsessedorse Posts: 3
    edited 02/16/2014 - 12:11 PM
    I am currently on 100mcg fentanyl patch plus 400mcg of fentora for breakthrough pain. There are some days it doesn't feel like enough to push the pain back, but for the most part I can function pretty well. It's taken me 4 years to get to this point and I absolutely love my nurse practitioner who is willing to work with me and change things around until we get me some relief.
  • sandisandi Posts: 6,342
    edited 02/18/2014 - 9:10 AM
    That is the very first question that has to be answered before we can suggest much........if you are new to the patches and it sounds like you are, the delivery mechanism is much different than with taking oral medications. Fentanyl transdermal patches can take up to a few days to build up to a steady plasma state in your blood stream, which means that you won't be getting it's full benefits until you get toward the end of the 72 hours between patch changes in some people- due to how dry your skin is, how much body fat you have, and how easily your skin allows the medication to transfer through your skin........sometimes, new patients to the patches don't experience the full benefit of the new medication until they change out their first patch and replace it with a new one-------
    If you are new to the patches, it would be wise to give it some time before deciding that it isn't working. Fentanyl is considerably stronger than oxycodone- which is the medication in Oxycontin.
    Read the Step by Step Guide to Chronic Back Pain, especially the part that talks about the medications and giving a new medication a fair trial.
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