[QUOTE=Neurochic;944601]Rare

Hi there! I am new, my name is Angelina & I have Lupus, Fibromyalgia & Raynauds (they go together) and thus, chronic UGLY pain! 👎
I have used Fentanyl patches for many yrs - diff generics and doses, depending on my pain level (last Year I went into remission and went OFF patch for first & only time in 8 + yrs!).
My question is this: I've been having same prob as everyone else on patches and that is break-thru pain! I like the Mallenkt patches because I'm allergic to all adhesives except it & Mylan but it wears off about 12-16 hours early and then I go through the "cycling". My dr (as paranoid as all of them are now - a Rheumatologist- will NOT increase to every 48 hrs & when I ask they say I will have to go to Pain Specialist which I SIMPLY CANNOT do as I'm presently having heart symptoms - Lupus attacking my heart).
So.. I want to cut them in half and use every 48 hrs (at same dose) - I used to do that with Mylan without any probs. I'm unable to find ANYWHERE if anyone has done this successfully as I did it w Mylan for YRS until we moved! Ugh - so frustrated to be this sick and have to argue w physicians when I am a Health-care Provider myself -- at least I WAS before I got very sick (a Pharmacist, believe it or not! A waste bc I cannot use my education but that's life)!!!
Thanks so much!
Angelina

I have used both the reservoir and matrix patches in the 100 mcg/hr strength.

I did not care for the Watson reservoir patches because I felt that the delivery of the Fentanyl was inconsistent and I had a heck of a time making them stick for longer than a few hours. As for the matrix delivery system, I have used Mylan, Sandoz and Mallinckrodt. Of those three, I found the Sandoz to be the most potent and long-lasting. My tolerance is quite high, but even so I can get at least 48 hours of significant pain relief from the Sandoz patch. Not so the other two. The Mallinckrodt are by far the least potent in my humble opinion, with the Mylan coming in 2nd. All three seem to adhere just fine though.

And of course, having found one I prefer, my pharmacist now tells me that he cannot get the Sandoz patches. Go figure. I am currently using the Mallinckrodt and I am not happy, not at all. I imagine that I will be changing pharmacies.

Hope this helps a bit.

Yes, thank you, unclereggie. Very insightful.

Sorry to hear you won't be able to get the Sandoz patches any longer.
Sounds as tho the Mallinckrodt is worthless past the 48-hour mark.
Did you get full-on withdrawal symptoms at this point? I did. And, as we know all too well, it's hard to get on top of the pain again once the medication completely wears off.
I have hydrocodone for breakthru pain and even THAT wouldn't get me back above the pain

I appreciate your input!

Rae

I have used both kinds and prefer the matrix type. They seem to stay on better and I don't have to worry about piercing a gel pac which could lead to overdose. Since I live in South Texas, I was having trouble with the patches staying on even with a tegaderm adhesive over it....I couldn't go outside without sweating it off so my dr. approved a higher dose (150 mcg)...taking it off after 48 hrs so I could go outside for a while without it. This has been working well for me and I don't have to feel like I'm imprisoned in my home!

Sorry for falling off the thread. Yes, I begin experiencing withdrawal symptoms as the patch wears off: cold sweats, body/joint aches, depression, etc. I now have several months experience with the 100 mcg/hr Mylan and Mallinckrodt patches. They both stink, to put it bluntly. Both pretty much expire past the 36 hour point. No help in sight. It would cost me a $1400 co-pay to go to the Duragesic patch - not going to happen.

Rocker Dan here:Back in 2007-2009 i was on the Patches and had the matrix one time and then had to go to a store that only had the Watsons(Gel)Store i wont say(but they are "On the corner of????)So after the gel Watsons i went through a divorce and landed in a different state and have been on Oxycontin,MS Contin and well everything but the patches!Last night i finaly had enough of not getting what i know works and just called my PM Doctor who said to come in as i was seeing his P.A. and that person was refusing Fentanyl as they did not like it(they never had to take it thank G-d!)So i went to my Ma and Pa Great store and low and behold they had Mallinckodt Matrix!!!!!i was very Happy.And i also bought the Tegraderm covering patches by 3m>Something EVERYONE on patch should do as they "breathe"as well as cover any size fentanyl patch! I think you should try the matrix as the brand is made of matrix from the start and its so much better(for me0as they stay on well,are not so visible and with the Tegraderm,well your arm will come of first.I wont worry about removing till hour 71.Good luck and i really do know of what i speak having been on the patches for two years and now again and a couple of people told me they are doing away with the gel since****** abuse them!If you are really a pain patient,you do not abuse anything and should not.Peace, Rocker Dan

Angelina
I can't make any comment around brands - they are different to the brands available in my country.

You can cut the matrix patches but never the reservoir type. However, you are not going to get any approval to do so from any manufacturer or pharmacist because they are not licensed on that basis so no manufacturer or pharmacist will be prepared to take on any potential legal liability by suggesting that it's OK.

I don't understand what you say when you say you will cut them in half and change them every 48 hours at the same dose. Half a patch = half the dose. If you stick half a patch on, you will be receiving half the dose of the original patch. Sorry if I'm misunderstanding.

I'm not clear why you won't go to a pain specialist because of your lupus playing up. These patches can be prescribed on a 48 hour change cycle and it's not a terribly unusual thing for people to be prescribed on a 24 hour cycle. If it gives you the pain management you need, why is the lupus flare up preventing you going to see the pain specialist? I'm just confused.

Hi I have been on them sense my accident, I 2 got the new ones from different manufacture, I tried it and it stuck 6 hrs then had to tape it. I called my Pharmisist and he cannot get Watson anymore, The government had been cracking down on everything. I was on Delaudid and Jan 1st the government made manufactures mimit there amount. Watson is the same, you may find them in Hospitals Pharmacy and there is a difference, They are supposed to work for 3 days and im on my 3rd and I start withdraw the 2nd day and 3rd day its not working at all. But it is not the Pharmacy fault it is the government controlling people that are in need because of people abusing the medicines that work for us. After Delaudid I couldn't get I switched to Mrphine ER its coated so I cannot and do not abuse them or any of my medicine. But drug addicts I guess the ones you see threw they cut open I saw on sites and shoot them up or suck the liquid out of them which is very dangerous due to the glue sticky part that eats liver functions. I called all around and no one has Watson fentyanl anymore and has been trying due to I guess the drug addicts wanting them. I was at mine and had a guy in there and he said he couldn't use the new ones because his doctor said he couldn't. No Doctor would care what brand they or you use all are same they think but they are not. Thye do not stick at all, tape I guess makes them release the medicine more quickly due to the fact they don't work on day 3 at all anymore. Never had to use tape on Watsons, I checked with Watsons website and yes my Pharmacist was right government has reduce there production I guess for hospitals only. I also found out Oct 6th 2014, vicodine and Norcos are going to be schedual 2 also so doctors cannot no longer call them in my doctor didn't know this yet but hes un happy with his other patients now have to go in each month and get a written script, no refills, more work for pain doctors and I don't drive but im on sch 2 meds anyways. Fentyanal and Percocet both sch 2, You see I hope you don't have to tape them I thin that's why they don't work day 2 and 3 nothing.. Its like tin foil and the 3 patch I put on edge bent and stuck together I couldn't unstck the edge, they are a mess, good luck. I wish they could operate on my nec C2 rotated and no surgeon will operate on C2. Im gonna just get pain pump in stomnach and meds will go to my pain area, delaudid, morphine which don't last long for me, don't now why delaudid worked and jan 1st they cut off pharmacies, I hate the abusers and drug addicts who ruin it fo r me and my pain I have to deal with more because of them...

Welcome diehardt06.

I have been on the Patches for about 8 years, prior to that it was the never ending chase of pills. Anything but oxycodone gave me a headache and did nothing for the pain. Morphine was the most useless, giving me no relief, not even via IV.
Then I finally got the patch. Took a few months, but I got the dose right. I put on 2-100 mcg/h patches every 36 hours. Yes, you read that right, I wear 2-100mcg/h patches on my shoulder and change them when they run out in 36 or so hours. When I first used them, they lasted almost 48 hours, but over the years it dropped to 36. Sandoz is the one I prefer as they give 16.8 mg per hour, unlike the other transdermal suppliers, of which there are more than a few- Teva-fentanyl, RAN-fentanyl and Sandoz are the main ones, only the Duragesic, making the old style with the gel inside. You can get the gel ones(Duragesic), but as they are not generic, you have to pay out of pocket. What is great about Canada's coverage is after you cover the deductible, depending on your yearly income, it's free. Average person is about 600.00 for the year. Anyhoo...what I notice between the gel and sticker, is the gel last about 12 hours longer, but I like the stickers better as they are smaller. I tore my shoulder up playing hockey and after 2 failed surgeries and them wanting to do bone grafts and more surgeries, I said no more damage by well intentioned Doctors thank you...I will stay will the meds. But my shoulder is now bone on bone.
So I noticed that other than Sandoz, the others all had a lower per hour dosing, they would be 10.8 or 11, compared to the 16.8 that Sandoz provides. So it is important to find out how much the the patch delivers per hour, as the lower the dose, the less effective the patch. I realize we have different suppliers compared to our brother and sisters South of the border, but that per hour dosage makes a big difference in pain management. I am not sure what the gel patches give per hour, since it has been years since I used them(see coverage). Hope that helps, I apologize for being all over the place, but I type slower than I think...good ole hunt and peck.