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Fentanyl patch - I forgot to ask my doctor...

QuiltinouslyQQuiltinously Posts: 152
edited 06/11/2012 - 7:48 AM in Pain Medications
Hi all,

With Oxycontin generic no longer an option, I am focusing on what I will switch to. Subutex doesn't sound very good the more I research it. That leads me to one of the other options my doctor gave me, the Fentanyl patch.

I forgot to ask my doctor how a person transitions from Oxycontin to Fentanyl. Do any of you know? Will I be able to just take my last dose of Oxycontin and than put a patch on the next day and manage to be without extra pain or withdrawls? I'll ask my doctor too in a few weeks. I just wanted to get a feel for what's coming if I go this route.



  • In my experience, there was always an 18 hour ramp-up. I needed BT meds in order to get through the times when it did not work.

    Each of us, is different, so give it a try and see how you react to it.
  • Keep me posted on this as I'm switching to Fentanyl from Oxycontin after November 17 when I see the PM Dr. Thanks. Charry
    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
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  • I switched from morphine to fentanyl, but to a lower dose. I had W/D but they only lasted a few days.
  • For those of you who asked, the transition from oxycontin or similar medications to the fentanyl patch usually goes rather smoothly. The doctor simply converts the oral dosage of your current medication to the fentanyl patch which is dosed in micrograms instead of milligrams, and you place the patch on at least 8 hours from your last dose of your current med, but your PM doctors will advise you of the time frame to place the new patch on after your last dose of your current meds.
    The new matrix is in the adhesive in most of the brands of fentanyl patches now, so do be careful when you come in contact with the adhesive. Make sure to hold your hand over the patch for at least a count of 60, and do not use rubbing alcohol or lotions or similar products prior to applying the new patch. It does take a bit of time for the medication to be absorbed through the skin so they may offer you an interim medication or tell you to use the breakthrough meds for the first 18 hours or so until you build up a blood level for the fentanyl.
  • Thanks for the input so far. I hope that the withdrawal stuff isn't too bad.

    I'm pretty nervous about this route. Is my pain bad enough? How does one know? I wouldn't be switching if affordable Oxycontin generic was still here. Maybe I should just take one of the other options of more MS Contin than before...

    Charry, You may end up starting this before me if I even do it. My doctor told me he's going to be gone over Thanksgiving so I'm not sure how that will impact any of this.

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  • If you haven't started the fentanyl patches yet, I suggest calling the doctor's office and asking his/her nurse, or ask for him to call you and speak to you for a minute and ask him about it.

    Don't know how your doctor is, but the office and the pain management doctor I see are great folks who will gladly take a question and get back to me. Sometimes the doctor calls himself if it's something very specific.

    I may be following you on this path for a slightly different reason. The new OP oxycontin 30mg pills (as opposed to the previous OC version) just flat don't work for me.

    I never had an issue between generic oxycontin and "real" oxycontin, they both worked for me, but the new tamper-proof OP version is like taking nothing at all. I've been totally dependent on stretching out the few breakthrough Lortabs he prescribes me to get alive to my appointment tomorrow, Nov 12.

    I've been looking at what other folks take for time released pain meds that aren't oxycontin, and the fentanyl patches sound promising and is one that I want to discuss with him tomorrow.

    I'm broken hearted over this because oxycontin has worked great for me for 2.5 years until the recent formula change to help prevent tampering. The new OP pills are like little rocks and my suspicion is that not much of it dissolves while passing through my innards. The only effect I've ever gotten from oxycontin has been lessening of my pain, no side effects whatsoever, which has allowed me to keep working as an engineer.

    Now I'm scared to change to something else, but I must have a new time released pain med to be able to function. My lower back and left leg have been giving me so much agony except for the little help the Lortab he gave me for breakthrough pain has given me.

    Please come back and let us know how the patches work for you. Good luck.
  • I just switched today to the patch....I wear it for 72, yes, 72 hours and then put on a new one.My doc said the 1st patch may not feel like much but the 2nd one should kick in very well.It is 50 mcg/hr

    So far nothing but my breakthrough meds changed also.I now take percocet 7.5. but only 1 every 8 hrs.

    I was on Kadian (morphine) 30 mg once a day and roxycodone 15 mg one every 6 hrs.I had a bowel obstruction and of course my meds got blamed.I knew something had to change and I am being asked to try the Morphone pump too.The pump bypasses the stomach so it is a little better than swallowing a pill, hench the patch now.

    BEsides,my pain was becoming uncontrollable again.I will give this the 72 plus 24 hours for judgement on how the patch works....
    ANY info is appreciated, these are new meds for me.Thanks and gentle hugs
  • Hi Guys,

    Thanks for the doctor advice, Mastersja. My doctor is pretty easy to talk with, it's that I've asked him a lot lately with the change from Oxycontin and I didn't want to call him on this. I will talk with him in person soon though.

    I've read on here other people who are saying the new Oxycontin doesn't work well at all. That stinks, doesn't it?!!!

    Mia, I sure hope it's going well for you! With stomach issues, I'm guessing the less pills for you the better. Now if the patch will just work. Do tell us how it works for you.
  • Mia,
    You have to give the patches more than 24 hours to see how they are going to help you. In fact, with most medication changes /starts/stops, a patient should give new meds at least two weeks, and at least one increase/decrease in dosage to see how their pain levels are controlled before making that determination .
    With the patches, you should give them at least a box of patches which is 5 changes to see how well your pain levels are controlled.
    It takes a few changes to build a serum plasma level of fentanyl in your system ( ie around 3 patch changes)before your body begins to build a good level and you can see how it is going to work for you.
    You will start to feel the pain relieving effects in about 12-18 hours, and it will improve from there.
    Just watch for over sedation and how taking your breakthrough meds works in addition to the steady fentanyl levels.
    Best of luck to you,
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