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Fentanyl 25 mcg/ hr patch

I just saw a pain management doctor for the first time the other day, and he prescribed 25 mcg Fentanyl patch for my pain. I have been taking percocets 10 mg and hydrocodone/apap 10 mg which only help a little at this point. My pain is a nerve pain which is in my feet, lower legs and left out thigh. I believe the pain is from my spine surgery which as a t12/L1 laminectomy/fusion with instruments done in a posterior lateral (modified TLIF approach) approach. Other doctors believe that the spinal cord may have been inflammed or moved although the doctor and operative report indicates that the cord was not retracted nor touched. In order to get the cage in, the doctor would have to get near the spinal cord, so it is hard to say if it was damaged/bruised. What I do know is that I have new pain since surgery, which started as a burning left foot with throbbing pain. THe burning pain has subsided in my foot but the burning neuropathic pain is still there and it is now in both feet, both calves, and my left outer thigh has pain which was probably never adequately addressed. I also had an L2 L3 left sided hemi-laminectomy the same day of my surgery for T12/L1 which was 6/29/15. Other doctors that have seen my post op MRI and cat scans feel that l2 l3 should have been full laminectomy as there is still compression going on. Also, it was hard to tell from the MRI if there was damage to my cord at t12/l1, although there was a higher mri intensity singal around the cord which could be due to metal artifact. My latest neurosurgeon, and doctor who performed my surgery both say to give it more time. Both agree the area is too soon after surgery to operate. The neurosurgeon wants to see me in 3 months and do another MRI and flex x rays.

The neurosurgeon indicated that going back into t 12 is risky although there are bone spurs there. However, further surgery on l2 l3 may help but would require a good surgeon due to the scar in that area already.

Meanwhile, I am dealing with the pain, and the pain mgmt doctor put me on 25 mcg Fentanyl patch. I have not tried it yet. I have read it is helpful for chronic pain sufferers and will help with nerve pain which is hard pain to treat with medications.

I am also taking percocets 10 mg about 3x per day. I aslo take klonipin for spasticity. Does anyone have any input on the Fentanyl patch? I understand the withdrawals can be tough, but I have to deal with the pain I have at the present moment.



  • used to treat moderate to severe pain. It delivers a constant level of fentanyl into the blood stream and provides more consistent, even pain control.
    Nerve pain doesn't usually respond well to opiates, but there are other medications that do help ease nerve pain more effectively. Gabapentin, lyrica, cymbalta and others usually offer better help with nerve pain.
    The fentanyl patch is worn usually for 72 hours. Some areas are better for it to be placed in than others, upper arms, beneath the collar bone, or the outside or inside of your calves, where the muscles movement is not so constant. When you apply the patch, clean the area, avoid hairy locations, make sure your skin is completely dry and free from lotions, creams or other skin care products. Once you place the patch, hold it firmly in place for about a minute to make sure it is adhered well.

  • CherylCCCherylC Posts: 185
    edited 11/05/2015 - 1:44 AM
    After 2 years of being on Fentanyl with Actiq (Fentanyl) lozenges for breakthrough pain I decided I didn't want to take it anymore and so have just changed from it to Palexia (Tapentadol). As a result, I can offer the following observations based on my experience:

    Fentanyl definitely helps with the pain but, after a while, like all opiates, the body gets used to it and the breakthrough episodes happen a lot more often.

    * On Fentanyl, I tended to feel a bit fuzzy in the head and had trouble dealing with day to day issues and decision making.

    * Withdrawal from Fentanyl is awful. I have just come off it and don't think I would have made it through without the medical support I had to deal with the withdrawal symptoms.

    * I am now on Palexia and my dose is not right. This has allowed me to see just how good the Fentanyl was. I now have severe radiculopathy in both legs, my feet burn and my lumbar often feels like someone is sticking a knife through it. I now realise that, while I ended up with daily breakthrough episodes on the Fentanyl, they were nothing compared to what I am experiencing now so yes - the Fentanyl obviously help with both the spinal pain and the nerve pain and burning in my legs and feet.

    I am going to see my PM doc on Monday so that we can figure something out. I don't know what it will be but I know it won't be Fentanyl. I never want to have to go through that sort of withdrawal again.
  • SavageSavage United StatesPosts: 5,476
    Fentnyl was first med prescribed for me. I found it very effective.
    It not relieve all my pain, but definitely took the edge off. I never expect to be totally pain free, but enough to have function for basic needs.

    My PM doctor told me that he would be switching me after a year to year and a half in the hopes it will remain effective med for me....as I may have decades of having to keep pain under control.

    So, it's been fentnyl, then OxyContin, back to fentnyl and so on. So far, both meds remain effective, although PM doctor has spoke of plans B,C, etc....for possible future situations.
    Treatment for pain can be such trial and try again.

    I have never had withdrawl experiences.
    Spine-Health Moderator
    Please read my medical history at: Medical History

  • And never experienced withdrawal from converting or even reducing the dosage.
    A properly done taper or conversion to another medication should minimize any withdrawal or at least minimize it.
    There are many medication options to treat nerve pain, gabapentin, Lyrica and Cymbalta are three of the most common ones. Because of the dosage ranges of the first two, it can require a few dosage adjustments to reach an effective dose. None of the nerve pain meds should be suddenly stopped, since there can be adverse effects.

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