Pain Medications
April 25, 2011 - 10:14pm
Butrans pain patch---anyone?
After being on Lortab 10/500 for nearly 15 months, recent microdiscectomy surgery in late February, pain is still persistent. My doctor suggested, and at my request to get off the lortab, I've been put on Butrans patch 10 mg. It is working wonders when I am somewhat inactive during the day, but with activity (at work, doing chores around the house etc), it's not helping with my pain whatsoever!! I've also been prescribed tramadol 50 mg for BT pain. I'm also having a heck of a time keeping these patches stuck to my skin!! Even have tried waterproof tape, around the edges of the patch with no luck?!
Dr said if the 10 mg wasn't working he'd switch me to the 20 mg, so I may call him this week to discuss. But I wanted to ask if any of you here have experience with this patch, any advice would be greatly appreciated!! I've looked online and through alot of the forums here with no luck...
Thank you!
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I haven't tried the patch (it's not available where I live, unfortunately) but I have been on the immediate-release version of the same medication (buprenorphine) for many years in the form of sublingual tablets. They are called Temgesic and come in 0.2mg and 0.4mg strengths. I usually need at least 0.8mg in the morning, sometimes up to 1.2mg. Personally I find they work better than the other meds I've tried (tramadol, dihydrocodeine, oxycodone, etc.), but like you, I find they only help up to a point.
These tiny tablets that dissolve under the tongue often work wonders on the pain if I am fairly inactive or not doing anything too strenuous, but with activity (such as walking too long, lifting or carrying things, etc.) the pain quickly gets worse. I find that they work better combined with muscle relaxants and a neuropathic pain medication (mine is Neurontin).
One thing I have noticed is that sometimes increasing the dose just a little bit (say, from 0.8mg to 1mg) can make a lot of difference in terms of pain relief. You may find that you need to try a slightly different strength. Obviously your situation is a bit different to mine, as you are taking the extended-release version while I'm on the immediate-release form. I hope it works out for you and you get some better pain relief.
Lumbar: Severe degenerative spondylosis, central and foraminal stenosis, facet arthropathy, multiple herniated and bulging discs, collapse at L4-5 and L5-S1 with retrolisthesis. Cervical: severe degenerative spondylosis, stenosis, cervical spondylotic myelopathy. Also, polyneuropathy due to protracted nerve compression and injury.
Decompressive laminectomy (L5-S1) in 1995. Currently in pain management.
wondering if anyone has had side-effects from the Butrans patch, especially nausea. My pain management doctor prescribed the 5 mcg patch and after 24 hours I discontinued it due to nausea.
I read in the prescribing information that nausea is a fairly common side effect.
Anyone have problems with nausea and any suggestions?
Thanks.
L4-S1 360-degree fusion + instrumentation, laminectomy 10/2008 and 01/2009. XLIF L3-L4 10/2010. History of chronic low back pain following auto accident 1999. ESI L5-S1 6/2008 (no help). Bilateral SI joint injection 4-2010 (no change). Norco 10-325 one half twice daily. Physical therapy 4 years. Returned to work for two months starting March 2011 but am back out due to bad flare-up.
Nausea is a common side effect with most opioids, especially the stronger ones, and especially when you first start taking them - it usually subsides as you become used to the medicine, within a week or two. This is a common effect of many drugs, actually. I remember when I first started on Neurontin it made me feel really strange, but now I'm completely used to it. Good luck with the Butrans!
Lumbar: Severe degenerative spondylosis, central and foraminal stenosis, facet arthropathy, multiple herniated and bulging discs, collapse at L4-5 and L5-S1 with retrolisthesis. Cervical: severe degenerative spondylosis, stenosis, cervical spondylotic myelopathy. Also, polyneuropathy due to protracted nerve compression and injury.
Decompressive laminectomy (L5-S1) in 1995. Currently in pain management.
Giving it another try. So far, so good, but I'm only about five hours into the new patch. My pain doctor recommended taking an antihistamine in case I get nausea again. We'll see.
Thanks for the comments!
L4-S1 360-degree fusion + instrumentation, laminectomy 10/2008 and 01/2009. XLIF L3-L4 10/2010. History of chronic low back pain following auto accident 1999. ESI L5-S1 6/2008 (no help). Bilateral SI joint injection 4-2010 (no change). Norco 10-325 one half twice daily. Physical therapy 4 years. Returned to work for two months starting March 2011 but am back out due to bad flare-up.
I started the patch. The first month was on 5mcg/hr with 7.5 lortab for breakthrough. Dr shifted me to 10mcg and have decreased breakthrough pills by half.
I also take amrix which seems to counter the constipation side effects (even though it is listed for amrix as well)
The patch stay on seem to pull pretty hard to get it off. Good luck with your second try.
laminectomy c4/5 6/2008 diagnosed crushed discs L3/L4, L4/L5, L5/S1 2010. MRI 2/2011 shows extruded disc C5/C6, bulging disc c4/c5, c6/c7.
recovering from right partial knee replacement 1-18-11
I know everyone's different, so not to be discouraging - the Butrans patch (from 5mg to 10mg) only seemed to help over the first three months. Placebo effect? Had trouble keeping them on and if they didn't fall off, I'd itch like I'd rolled in poison ivy. Looked like poison ivy reaction too.
I, too, was prescribed lower doses of hydrocodone in an attempt to replace those opioids with the patch (antagonist). No pain control ultimately. I was doubling up on the pain meds and wondering why neither it nor the same dosage of hydrocodone was working anymore.
Been on opioids of this low dose (anywhere from 7.5mg/325mg to 10mg/325mg) for about, oh, 7 years. Finally had the spinal cord stimulator implanted (again after a botched attempt by diff providers last year... they implanted a left a sponge in there, too.)
Just not too sure about the Butrans patch as a pain management therapy. Maybe a replacement therapy... if you are NOT in pain. Just taking Butrans now and ... I don't notice a damn thing. Just notice same old irretractible pain with a patch-sized spot of red, blistering itching.
L3 - S1 laminectomy/discectomy '97; L3-S1 fusion '05; medtronics spinal cord stim '10 w/ removal in '11. Boston Sci scs '11. Nerve damage, not sure of dx. Was failed back, but getting different opinions from current neurosurgeon. fusion looks fine to him. It's nerve damage and scar tissue at nerve roots and in spinal column he believes is the culprit, it seems.
(Oh, PS to all the non-legit pain sufferers out there who acquire and sell pain killers illegally, not that any are reading this, - thanks for making pain managaement with pain medication near impossible in the United States. Our legislatures have made it criminal to prescribe medication that could help and are helping electronics companies make billions off these spinal cord stimulators. I don't think I have room in my dural space for this damn thing. I feel worse today than I felt last month.)
I started it 4 days ago (10mg) patch and suffer from back issues as well as fibromyalgia and raynards - which effect your extremities. Today, I have notice a drastic improvement with my extremities, my hands, feet and calves do feel a bit better. It's noticeable, however, I am not so sure that my back is feeling better at all, as a matter of fact, I know it is hurting much worse. I think it from the stimulator that the Dr gave me. It is supposed to send off electronic pulses to interrupt pain signals, which it feels "ok" when I use it but with out it, dear gosh. I can't wear it forever, afterawhile it starts to hurt me.
I have been on Lortab for 3 years now and hate it, hate it hate it. First, it's not effective, secondly I hate to take pills all day long, I can't tell I'm taking it anymore but when I try to stop taking it I get very jittery and I know it's a form of withdrawl. I really had high hopes for this medication. I have only been on 10 mg and put it on Wed afternoon - it's now Sat. Should I call my Dr and request a higher dose? My biggest fear is that someone won't take me seriously. I have my MRI report stating the degenerative disk disease in L4-L5 and am set up for a nerve block appointment, but like the last post said, thanks to 'junkies' I feel like I am scared my Dr will think I am just trying to get more pain medicine since it has been only 4 days. I just keep thinking that, if it takes 3 days to get in to your system, I am looking at another few days of pain.
FYI, as you can see - I am sensitive to what others think of me, I got it from overly aggressive parents....
Can anyone give me any advice? I like the way this doesn't sedate me though, again, it is so much better than traditional meds like loratab. I too, have a sense of 'normal' Please advise.
Just getting through the day the best way I can. Mother of a 3 yr old, struggling with pain
I started on a 5mcg patch and was told that for the first time, it takes 2 to 3 days to reach a steady state in your system where it is dispensing the drug evenly. I was told that if after 48 hours it was not helping enough that I could put on a second patch which I did (actually after 72). At first, after the 2nd patch I felt so much more normal and more "me". Now, having just started patch 3, I hurt pretty badly. I don't know if it's from increased activity because it was feeling better or if my body just adjusted. The doctor said that if needed I can add back in Tramadol for extra pain management but because I reported that my head was "spinny" (yeah, pain meds and a consistent 4 to 5 hours of sleep are not really a good combo), he opted to not up the dose to 20. In the meantime, I am temporarily off my large Celebrex dose and am not allowed to take the Tramadol until after a test on Monday. Sigh.
So many things wrong...Seeking answers to make it all right! Just had five vertebrae fused T10 to L2 mid-March. Had almost every possible thing wrong!
I was on the Butrans patch from August until about one week ago. I was on the 5 mcg dose and just loved this medication. About a week ago, I became severely dizzy and lightheaded. I felt that maybe the patch was over-delivering but I wasn't sure. I also noticed that I was urinating a ton and perhaps my sodium got low and accounted for the symptoms. But anyway, I quit the patch and have been avoiding withdrawal by using a bit of Percocet. I did have to take a bit of anti-nausea medication with the patch at times. I found the most effective by far to be Zofrain. The patch also gave me great pain relief. Better than other meds including Percocet and Oxycotin. I hope to resume it in the future, however, I need to talk with my dr. first and find out what in the heck happened.
Lacansada, Thank you so very much for the reply. I have noticed that every now and then I will get a nausea feeling - its not the common but it can be aggravating. I am so far very impressed with it --I am still in pain but I am on the 10 mg and doubleing it seems kind of scary. I have had the best sleep of my life since, and its only been 5 days.
Don't take this the wrong way , but I hope you just had a bug and maybe you can get back on it. I have been suffereing for 8 years and have been on every thing from Lyrica on. Those drugged me so much I couldn't function. Did you notice feeling drugged with the patch. I don't, it is amazing. also, the ups and downs that come with pills, along with constant ulcers aren't there - or at least my stomach has only had mild discomfort since, but again, it hasn't been that long.
Again, Thank you for repling. It is hard to be stuck at home with a 3 yr old, that already makes me feel so very alone during this. 3yr olds don't care if mommy hurts and I try not to influence his childhood with moans and groans.
Just getting through the day the best way I can. Mother of a 3 yr old, struggling with pain
Dixie chick, you're most welcome. I also slept great on the patch and felt more normal in the head than I had with any other drug. It was amazing. I have a dr. appt in one week and I might ask about about the oral or sublingual form of the drug. I hate to give it up. It seemed to have an antidepressant effect on me and I was reading that this is common with this medication. Until I had the dizzy spell (it did last 3-4 days) I felt great. I hope it works as well for you!
I've been on the 5mcg/hour for maybe 6 months now. It was amazing how good I started feeling with my first patch. I'd say I feel normal on a regular basis. Previous to the butrans patch I was taking up to 6 500mg metaxalone (muscle relaxer) thru the day and 2 flexeril at night. I was only taking pain medication on a irregular basis b/c it was so inconvenient to go to the DR every month to get a refill. I have tramadol for my bad days. I don't like the tramadol at all. It makes me wiry and jittery - like I've had to much caffeine or I'm on allergy meds or something. If I don't take the tramadol before lunch - I just skip it regardless of how I feel - otherwise I'm awake all night. My days are motstly good.. Bad days are usually the result of sitting too much - ie being at a conference or riding in the car for a long time. I've also found that avoiding pushing really heavy grocery carts has helped too. A trip to Sams without help can throw me into a tailspin. I have found that it is a good idea to NOT drink alcohol while one the medication. I can have one drink or so in a social setting but I've found my tolerance to alcohol is way down. I don't mind this at all.
For those that have a rash with the patch, I've only experienced a mild rash when the patch was exposed to sun. Apparently, the new machines at the airport also can pick up the patch. I wish it could be worn in more locations. After another round of physical therapy and 3 or 4 steriod epidural injections - my lower back, leg, sciatic pain is almost nonexistent. My neck and shoulder continue to flare up.
I've been on the 5mcg/hour for maybe 6 months now. It was amazing how good I started feeling with my first patch. I'd say I feel normal on a regular basis. Previous to the butrans patch I was taking up to 6 500mg metaxalone (muscle relaxer) thru the day and 2 flexeril at night. I was only taking pain medication on a irregular basis b/c it was so inconvenient to go to the DR every month to get a refill. I have tramadol for my bad days. I don't like the tramadol at all. It makes me wiry and jittery - like I've had to much caffeine or I'm on allergy meds or something. If I don't take the tramadol before lunch - I just skip it regardless of how I feel - otherwise I'm awake all night. My days are motstly good.. Bad days are usually the result of sitting too much - ie being at a conference or riding in the car for a long time. I've also found that avoiding pushing really heavy grocery carts has helped too. A trip to Sams without help can throw me into a tailspin. I have found that it is a good idea to NOT drink alcohol while one the medication. I can have one drink or so in a social setting but I've found my tolerance to alcohol is way down. I don't mind this at all.
For those that have a rash with the patch, I've only experienced a mild rash when the patch was exposed to sun. Apparently, the new machines at the airport also can pick up the patch. I wish it could be worn in more locations. After another round of physical therapy and 3 or 4 steriod epidural injections - my lower back, leg, sciatic pain is almost nonexistent. My neck and shoulder continue to flare up.
That's good to know that these can be detected at the airport. Between that and my new fusion hardware, I'll be setting off the machine left and right. LOL. Anyway, I've been on the patch for months and months now. I have a 10mcg and 5 mcg patch though I might change to a single 20 just to save money. I find it very effective for about 5 to 5 and a half days. I get a rash almost every time and it takes over a week to go away. That's one of the worst things because it itches like crazy. I had fusion surgery (thoracic) about 6 weeks ago and this is helpful for more constant pain relief that can be supplemented as needed.
So many things wrong...Seeking answers to make it all right! Just had five vertebrae fused T10 to L2 mid-March. Had almost every possible thing wrong!