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fentanyl patch-help!

kathyykkathyy Posts: 585
edited 06/11/2012 - 8:58 AM in Pain Medications
My doc has prescribed me fentanyl patch in the lowest dose and has told me not to discontinue hydrocodone (10mgX4). I picked up the prescription and it has SO many warnings, especially about taking a hot bath or becoming overheated while using the patch. I'm scared to death. I'm dying from pain just using hydrocodone (I have 2 major herniated disks above my fusion site) but I don't want to kill myself with this patch.

Any advice, anyone?????


  • kathyy - I understand your concerns but don't loose sleep over it. I am on Fentanyl too, 50mcg every 48 hours. If you look at the possible side effects on the information sheet an there are actually less side effects than many other narcotic pain meds if used as directed. One thing that you said is correct. You cannot get in a hot bath with the patch on, first of all it would likely fall off or loose its adhesion, and second is that when the patch gets hot (I'm not quite sure what the exact temp is) it dumps more than the regular dose into your system. This can cause over dose and if it is a high enough dose even death. I assume you are on the 25 mcg patch? That is a very low dose so I wouldn't be too concerned, but none the less still avoid high temperatures. This is the main downfall of the patch, I have a hot tub and am not able to use it due to being on the patch. As for the pain relief, it has helped me better than any other extended release meds there are, and I've basically been on ALL of them. One thing about the fentanyl transdermal system is that your body gets used to it rather quickly, In my case I do not receive the same relief that I used to from it but do not want to go up in dosage do to worst withdrawals. Having knowledge of the patch is key to your safety and success and relief. They are a great medicine if you use them as directed, they have helped me a lot in gaining more range of motion and being able to do more activities. There is no drug out there that will take all of your chronic pain away but for me fent has worked better than anything else. I am looking for an alternative though so I can take hot tubs and do aquatic therapy, I think both of them would help aid my recovery. I do NOT want to take Methadone though and the new Oxy contin OP is junk, I do not think they should even be able to call it Oxy contin because it is just not. Another thing with fentanyl is there is a HUGE difference in the different generic brands. There are two types of the patch, Matrix style (like a piece of tape) and gel reservoir. Not all brands are the same like most generic pills are, for instance, they are all made with different ingredients and adhesives that can have different effects than others. I am actually allergic to the Mallinkrodt brand. I have had the best luck with they Mylan and Sandoz matrix patches, and as for the gel reservoir, the Watson brand has worked okay for me. My advise is to take baths in between changing the patches. They say you can shower with them on although there may be some dumping effect with that, and second they will not stay on unless you cover them. I usually just wait in between patches but if you have to take a shower a good way to cover it is with a Tagederm cover but they are outrageously expensive so a good alternative is to cut a square piece of a plastic bag and tape it over the patch with water-proof tape. I wish they worked better but like I said there is nothing that will totally take my pain away and I still take 30-40 mg of oxycodone a day for breakthrough pain and Gabapentin at night for nerve inflammation. Sorry for the long post, Hopefully they work well for you and let you get good pain relief from them. Let me know if you have any more questions I have thoroughly researched this drug and have months of experiences taking it. Good luck and God bless. - Thomas
  • Common sense applies when using the fentanyl patches, using a heating pad, hot tubs, hot baths, etc are all things that are strongly recommended against doing, but a hot shower for a few minutes isn't going to cause a dumping of all of the fentanyl in your patch.
    Tegaderm can be bought in large lots online in the auction sites on the net and I have gotten large quantities of them for a few dollars. They come in different sizes so you can find them for the size of the patch that you are using and save a lot of waste from happening.
    I have found with the matrix version of the fentanyl patches that I have had no problems with them sticking, even without the tegaderm. For the gel matrix patches though, I always covered them to make sure they wouldn't fall off.
    Fentanyl is a good pain reliever, and while I was on it, I didn't need a dose adjustment once we had the correct dose for my pain levels. I was on the patches for three years.
    Good luck with them, and just remember to use common sense- stay away from things that cause your body's core temperature to rise. That is what causes the dumping of the fentanyl .
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  • I used the patch breifly, it didn't solve my pain issues at double your dose, and showered just fine. Just use common sense, no hot tubs or long hot baths, and monitor your heart rate and body temp if you are exercising. I promise a 10 minute hot shower not kill you, and it will probably help you relax a little too. I was scared at first as well, but I am still here, so you'll be just fine. Most of the warnings are for people who do not have a narcotic tolerance built up in their system, but if you have been on narcotics for a while and have a tolerance you'll be just fine!
    Sarah D
  • SavageSavage United StatesPosts: 7,385
    ...the covering of the patch ..on the package info anyway... seems to describe what kind of covering you can use.

    I think above post right..but I would double check reading the insert to be sure you cover patch correctly. I think wrong cover can cause it to be warmed up and too much at one time into your system.

    But I would also express concern to doc. Let him know and let him reassure you, too. And/ or the pharmacist. Never too much double checking if you have an uneasy feeling.

    Take care and hope pain get more tolerable!
    Honorary Spine-Health Moderator
    Please read my medical history at: Medical History

  • How's it going? Are you able to use the patch alright? Just wondering if you're getting some relief? You can get some Tagaderm covers from the pharmacy or there's places you can buy it online. I would be concerned about using it because I get hot flashes all the time. I hope you can find a good medication that works for you. 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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  • You may not have heated car seats, but that was the one time I got into trouble with my Fentanyl patch....didn't even think of it, turned on the heat and slept for four hours on a road trip. My hubby had a hard time waking me up, which gave him a very good scare, and we both learned a valuable lesson.

    I myself didn't get relief from the patches, but I know I've had the injections after surgeries and they have been very helpful.

    Hope it works for you!

  • And getting pretty good relief. My patch is like a tiny piece of tape and it sticks quite well. Am experimenting with placement of the patch. I have done a good bit of research with regards to all the "warnings" and have put 2 and 2 together to come up with the conclusion that everything depends on the placement of the patch. I am, in fact, continueing to take baths. Now hold on everyone...... the warning is focused on the patch being in contact with the heat source. I am wearing the patch above the water line AND I don't take a steaming hot bath. Nor do I soak for any time unless I am between patches. I have used tagaderm but I have experimented with a waterproof bandage with a plain gauze center so that I can remove the waterproof covering after being in the tub. I only use it to make sure no water is splashed on patch. I have a backwarmer in my auto seat but since the heat doesn't come in contact with the patch, I don't notice any issues. My P.A. told me to place it on my chest or upper back. Even on my upper abdomen (above belly button).

    The negative - it makes me drowsy. The positive - it has leveled out my pain peaks and valleys so that they are more manageable.

    Overall, I have been happy with it and in fact, have been able to reduce my hydrocodone by at least 25%.

    The very best thing is that I don't have the screaming, crying, clinging to the bed sheets begging my husband to kill me or take me to the er for something to help me deal with the pain that I have been experiencing. This patch has really kept a level amount of pain killer in my system. In the meantime, I continue to get doc opinions - have 2 so far...1 from a department head of a very well-known university ortheopedic department....that say I need a 2nd fusion to help deal with my 2 severe herniations above my current fusion site. (I have developed scoliosis and worsening ddd as well as the herniations with nerve impingements.) I have a 3rd appointment early in March by a neuro in another state who is one of the top in the country and I will be making a decision then. Damn, I just hate facing anothe major surgery. Why won't they just give me a SCS? Oh well. At least this time around I am getting plenty of very well respected doc's opinions.

    Happy New Year. I wish healing and hope for you all.
  • SavageSavage United StatesPosts: 7,385
    ...patch is working for you!

    I learned a lot from your thread here.

    And very best of luck with upcomming surgery!
    Honorary Spine-Health Moderator
    Please read my medical history at: Medical History

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