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fentanyl patch

tristanuttristanu Posts: 10
edited 06/11/2012 - 7:24 AM in Pain Medications
my doc switched me to the fentanyl patch about a month and a half ago, and it had helped me quit a bit. He started me at 100mcg/hr which is a little low, but i would rather stay lower on my meds that wear them out too early because of my young age (26). My conversion was 160mcg hr....anyhow i am quite impressed with its ability to control pain, especially not having to wake in w/d like i did every morning from OxyContin. I have tried both Mylan patch and sandoz patch. I like mylan for its size and comfortability and it seems to work quicker when putting a new patch on (every 48hr). the sandoz gel patch has a little more strength i think, and longer action, but itches and irritates skin. So all in all i havent decided what brand i like yet, other than the fact i dont have to take hundreds of pills a month anymore and my stomache feels better. It has been a great change in meds for my rotation, but i wonder if i will ever be able to rotate back to another med other than fentanyl knowing its strength? Anyone here have much experience with this medication and what results have you had with it? I am still in line for a revision of my fusion i had in feb of this year and fusion of 2 levels above,was supposed to have op on 21 of october but could not afford 2 major ops in one year. Next year will be the one for my next large fusion and to fix the disc material the left on my nerve root during the fusion. Well any comments would be appreciated thanks


  • Sorry to hear about your surgical complication. It's difficult at my age to deal with chronic pain, and I don't know what it's like for you, being so young. Maybe it'll work out for you, your youth and relative good health. I sure hope so.
    I had a a discectomy last year and am recovering from a TLIF/Laminectomy this year. When I started Fentanyl at 25mcg, it took a while for me to feel it working. Then I started having headaches, nausea, vomiting, and dizziness on the 2nd day wearing it. I was miserable. Then I was told to wear it on my stomach, and it was a miracle. All the side effects went away, and the only thing I felt was when the patch was wearing off and the pain would shoot up. Otherwise, I was alert, could drive when necessary, and not sleepy. The only meds that made me drowsy was the Norco, Valium, and Neurontin.
    I was bumped up to 50mcg post fusion, and then put on a 2 day schedule. Again, I felt just fine. I don't get euphoric or altered. I prefer the Watson brand, and use waterproof tape and it stays just fine.
    I hope your next surgery gets you back on the road of recovery. Take care
  • WoW... starting out on 100mcg is alot. I was on the patch started with 25's, then bumped up to 50's prior to surgery. I had ben on alot of by mouth meds and it was tearing my stomach up, and frankly I was tired of taking pills all the time, three times a day for the oxy's etc. Hope things work out of for you. Its one day at a time. Good luck!
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  • I am only allowed Percocet. I think it's because of my age. So I can't offer any help here. My only experience with Fentanyl was having it injected through my IV in the operating room to knock me the heck out before getting put to sleep. Lol.
  • Are you guys afraid of the patch? I would love to try it but Ive been hearing some negative things about it. Tristanu, I also wake up feeling HORRIBLE, all sweaty, I guess it is wd? I wasnt sure what is was but I have to take my oxy lay in bed for 1 hr then get up. I hope this new med works for you.
  • paulag, what i meant by the conversion is what my doc calculated in the office from my oral meds to fentanyl daily conversion, he said it came to around 160mcg/hr and started me at 100mcg/hr, i still have pretty large ammount of pain, but its tolerable compared to what i have dealt with since my last fusion. I do like the med so far, i notice the mylan patch really works good the first day, ok 2nd and when i was on 3day the 1st month it didnt do much on day 3, but i do 48hr now and its ok. Lo, i do agree its probably your age, it took me a lot of suffering and looking and finally my doc in my home town said he would take care of me and put me on the patch because he saw how bad my pain has affected me, him knowing me all my life knew i have changed a lot from it (thepain). I hope that you all find the releif you deserve, and i think i am close to being there. I am greatfull that i receive the meds i do. Its so much better than oxy 3x a day i agree cause that is where i was along with 20mg perc every 6 hours sometimes more for bt pain. thanks all for the comments. :)
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  • Big step but living in pain is torture.

    I feared using the stronger meds but when i gave them a go I was surprised that they did turn the pain down somewhat and it all helps. It also helps when you don't struggle with side effects.

    I don't take fentanyl myself - I use oxycodone. Carefully supervised , titarted and monitored why should you suffer. Mind you, I had walked a long way before they gave it to me (excuse the joke) and then I look back and wonder why did I struggle?

    Good Luck with your revision. You never say what the problem is? It is still early yet so why are they so keen to do a revsion??
  • The reason for my next surgery is that they did not fix all the problem with the first operation. I went into surgery with l3-s1 all blown out with multiple tears, the doc while i was in only fused l5/s1, i was under the impression i would be taken care of, he let me heal somewhat from that fusion and told me my accounted pain was from the other discs needing fused. Had a myleogram and they found a large protion of disc material that was left in my nerve root space at the l5 nerve root. also l4/5 had colapsed now, and l3 is on the verge. All in all i had a surgeon who took me for a fool and wanted more money by doing multiple ops. I found another surgeon, neuro surgeon that i like and is more honest who said it should have been all done in one shot. I agree, but nothing i can do now but wait till i can afford to have the next surgery. The op is covered but i cannot afford the time off work, as he said i would not be going back to work early and pushing myself like i did with this one. I know i hurt myself more, but a lot of my nerve damage is from the surgeon that left the disc material behind during my fusion and is now leaving my left leg numb and painfull, also one of the cages has migrated and bone is only growing on one half of the disc space, if that makes sense. My spine is very bad from cervical to lumbar with multpile herniations on each section. worst being in my lumbar spine. I have spinal stenosis, herniated discs, scheurmermanns kyphosis, degenerative disc disease, facet disease and a lot of other crap...mostly lots of pain and stiffness. all at 26 years old, but i am optimistic and i work nearly every day trying to keep a normal (if there is such a thing) life. I really wish that the young people like me start to get treatment they deserve, i finally found that i can live better, not pain free, but better without having to suffer every day. If there is anything i can ever do for anyone let me know. And the fentanyl is a major step in drug terms i have come to learn from reading, but it has made my mornings much better, no more waking at 4-5 in morn to get meds running in me at a stable level so i can stretch and move to go to work at 8. i now sleep till 6 and watch a little tv and move fairly well in the morning, def not suffering like i used to :) i have bad days, but i think they will get better, and hope to get on a lower dose once i have my next operation to fix my bad fusion and fuse l3-4 all in all l3-s1. It would be nice to not have to rely on such a hefty dose of medicine. sorry i talk so much.
  • I started on fentanyl patch 25 mcg, then increased to 50, then to 75 mcg. The problem is, they are so strong, it is nearly impossible to find an equivolent dose of an oral medication. I came off the patch due to side effects. I developed profuse perspiring at the 75 dose. That caused the patch to not adhere well. So not the best absorption, then they would fal off eary. So now I am on opana ER 40 mg and 10 fast acting for breakthrough pain. They are not the best. Still in pain, but some days can bearly stay awake. Now that is NOT fun. My doc also started me on Namenda. It is a alzheimer's med that he says prevents tolerance. So that I should not need stronger and stronger doses. Has anyone heard of this?
  • BE CAREFUL WITH THE PATCH. I used it 50mcg and then 25mcg due to side effects. Got a letter in the mail one day from the pharmacedutial company to take off my patch immediately.
    Many deaths from leaking patches and patients getting lethal overdoses. Just google duragesic patch class A lawsuits and read for yourself.

    Do you belive a letter, no phone call etc. Anyway, the side eeffects are miserable. My PM doc switched me to MS Contin wwith no withdrawls, and excellent pain management with a side effects at all.
  • Hello....Sorry to hear about your pain.

    I have quite a bit of experience with the patch....And, I have done a lot of research on the product. You're right....It's a great med and is one of the best pain control mechanisms out there, IMO.

    The brand "Duragesic" is the most potent. It is made by Janssen. Janssen also makes the generic Sandoz. Watson also has good feedback. Conversely, patient experience with Mylan has not been good. Many have reported going into WDs.

    IMO, the great differences between brands are due to the generic industry. Generic drugs are regulated by Hatch-Waxman Act of 1999. The legislation permits generic companies to be +/-20% in relation to the brand....Or a 40% total variation possibility. However, very few are stronger than the brand....Because more med equals higher cost. The 20% variance is permitted as a way for generics to keep prices down....Less med equals less cost. The Hatch Waxman Act of 99 essentially created the generic drug industry we have today.

    It's no coincidence that Mylan is the cheapest in the market....In terms of pharmacy cost.

    BTW, this concept isn't just re: pain meds, but all meds. This is why any transplant Doc or cardiologist will almost always demand brands (vs generics).

    Hope this helps with your patch issue.


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