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Questions about DURAGESIC (Fentanyl Patches)

drewsicle3210ddrewsicle3210 Posts: 1
edited 07/23/2015 - 10:25 AM in Lower Back Pain
I was an Airborne Infantryman and a Combat Medic. Jumping out of airplanes brought me to this point.

I had bilateral open hip surgeries in late 2012 while I was in the military.
I got out on a medical retirement after almost 10 years of service in OCT 2014. I have been struggling with pain management since the surgeries in 2012.
I took Tramadol back in 2012-2013, but those turned out to be very bad for me. I loved to take them, they made me feel good, I got addicted, and I had issues coming off.
No other narcotic/opioid has ever done that to me.


I was on 100 mg hydrocodone daily, with no pain relief after 6 months.
The next move was morphine sulphate extended release, 60mg BID, with 6 tabs of the 10mg hydrocodone. The morphine made me crazy as [edit], I mean insane. I thought my wife was cheating on me, and that everyone was out to get me. I don't know, so don't ask. And I developed some crazy acne/rash all over my body.
We quickly stopped the Morphine, and my wife asked my provider to taper me off of pain meds. The provider came up with some ridiculous taper that lasted only two weeks, and she didn't prescribe any additional medications to help with withdrawals. The first step was 9 tabs of 10mg Hydrocodone for three days. I was withdrawing for those three days something fierce. The next move was 6 tabs a day (you see where this is going?) for three days. NO BUENO.
I just showed up at her office and let her know that I am not doing it. I have severe hip and back pain, and I am not going to go through withdrawals just to see where my pain lands. On day 4 of this, I was already unable to walk down the 4 steps at my house.

So, she prescribed the 25mcg/h duragesic (fentanyl patch) and up to 6 hydrocodones a day.
Now, I need those hydrocodones for the pain relief, but I only took them for the first couple of days. I wanted to give the patch a chance to see where I am at. And my pain is still about a 7-8/10, so I have requested a bump in the patch dosage. I think 50mcg/h will knock the pain down to at least a 5/10, which is good enough for me. And if that is the case, then I can just keep the hydrocodone for when it gets too bad. I don't want to keep slamming that Tylenol through my liver.

They gave me a home Narcan kit, and having been a medic I have no problem figuring out how to use it.

How long does it take for tolerance to build?
What happens when I have nowhere else to move up to as far as pain meds?
How will I know that the patch has leaked too much and I need to rip it off or use the Narcan? (they made me paranoid by giving me that kit)
Is alcohol ok?
Can I take it off when I go to sleep and put it back on?
Can I stretch them out to 4 days, so I can have a few extra in case something happens with my refills? (the VA mails the [edit] to me)

I would also like to hear any anecdotal evidence to their effectiveness and/or harmfulness.


Nobody on the forum is medically qualified or permitted to give advice any responses will be based on members personal experiences only

US Army Disabled Veteran


  • LizLiz Posts: 8,835
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  • MarleysmamaMMarleysmama Posts: 1
    edited 07/31/2015 - 2:46 AM
    If someone has never been on a fentanyl patch before, doctors will usually start at the lowest dose. After being assaulted, l ended up in excruciating back pain. It hurt to move and l cried every time l had to sit in a chair. The patch saved me from that awful dark pit that comes with being in chronic pain. It took some time to get the dosage corrected, but once we got it right l rarely needed breakthrough medications. Fentanyl is such a powerful med that many doctors are afraid to prescribe it. I'm an RN who has heard of people dying trying to get all of the medication in the patch at once. I was on it for a total of 3 years (during that time l had several surgeries for breast cancer) so my PM doc agreed not to try to wean me off until after that was completed. I would strongly suggest that you get the Mylan brand patches. They are more expensive, but in my opinion they stay on better & are more effective. I would try to hold off taking any of your breakthrough meds until the patch begins to work. After the first 6 months, l could definitely notice more pain on the 3rd day of wearing the patch, then after a year l noticed that day 3 was not effective at all. After speaking to the pharmacist, she recommended going to 48* & that many patients need to change patch every 2 days when they have been on it. My PM did a very safe, slow wean and l felt no side effects or withdrawals that l feared. I hope this helps!

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  • SavageSavage United StatesPosts: 7,385
    Please know that what works for one may not for another.

    My experience is that alternate about every year or year and half, from fentanyl patch 75 mcg/ hr, then off that and onto OxyContin one twice a day, year or so , back to the patch.

    This has been many years now and both medications have remained effective for me.
    I have never been given a narcan kit.

    The point of the patch is to keep it on always. Not to remove at night.
    The medication continues to work and to run out of medication requiring new patch on third day.
    I took med as prescribed and never tried to get fourth day from it.
    If the medication ever becomes ineffective for me, doctor has plans B,C, etc....but I'm in no hurry to change.

    I rarely take breakthrough medication. I choose to eliminate many activities. I want that med to remain effective, also.

    The only trouble I had with patch was that it would, by itself, start to peel off too early.
    I called the manufacturer and they sent me large supply of Tegaderm, clear tape like covering, to keep patch in place.
    Sent free of charge since I was on their product!

    Other precautions I can think of, would be to stay away from hot baths, steams, etc.... They tend to release too much medication into your system at one time. Besides absorbing too much, the patch will dry out and run out early, before the three days. Doctor would want to know why patches are not lasting the prescribed usage amount.

    I did not and do not drink. I would read information accompanying med or ask doctor before drinking. There may be a limit if allowed.

    I have never had to be weened off a med or had a taper nor any withdrawal.

    I wish you the very best with your pain management.
    Honorary Spine-Health Moderator
    Please read my medical history at: Medical History

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