Fentanyl Patch
 

Has anyone ever tried the fentanyl patch- Just curious how it is and if its worth a try at a low dose

Debbie

Hi Debbie,
I have been on this patch. Even at a low dose they can be very strong.

When I was on them I slept alot.

Some people I have heard get a rash where the patch is applied.

Hugs, Roz

Yes, I'm on the patch. I'm on the 75 - started at the 50, and raised really quick cuz I had too much BTP. I also change it every 2 days instead of every 3 per my doc's orders in the hopes of having "less of the peaks and valleys" of pain. Originally I used ONLY the patch, but when the weather began to change and get colder, we added percocet "as needed" then found that I needed it every 8 hours on top of the patch. That is pretty much my "pain control" - but in addition I take topamax, effexor and other stuff I can't think of right now but it may be in my signature line.

As for getting sleepy...my pain doc believes taht yes, the patch MAY be the reason I was falling asleep during the day, at work, on my ride home, every time I'd sit down, etc. So I also have provigil to take "as needed." usually I take one around 8 a.m. and it works great until abou 4 pm. If I don't take it at 8 a.m., but find I need it later, I don't take it past 1 pm for fear of not being able to sleep at night.

Have you been prescribed the patch? If so...please give it some time. It does take a few days to get into your system, to work effectively.

how long..
 

do you wait to see if the fentanyl works?? i used it once(at a low dose) and all it did was make me vomit and rock back and forth on the couch for an hour then passed out for 2 hrs. woke up with just as much pain.. my friend uses them along with methadone and dalordid(?) she is recovering from diambera(?) and back fussions along with many other ailments(for over 15 yrs now) she goes to a pain clinic in nyc... i have enough problems with vommitting and dizziness...do these effects go away quickly or does it take a long time for the meds to help thru the side-effects?? i know there is no quick fix for this nightmare..13 yrs of my life has been filled with so much pain,doctors and frustration...linda :eek:

I was on the patch, 25 at one point while still on wc. It was bloody hell!!! I was sooooo sick for 2 days and couldn't deal anymore so called doc. I got to fold the patch down so only a bit of it was touching my skin, taped it in place. Every 3 days when I changed it I'd inch it up a bit. It took a month for me to get it opened back up all the way. I've heard it takes awhile to adjust to it and stop being sick.

My biggest problem with the patch was even after I got used to it I'd still feel very nauseous all day long. Then the doc decided to take me off it so did the whole fold down process in reverse to wean off. He wanted to see if my pain was any better after having it on for 3 months. LMAO He was an idiot. After I went off he put me back on vicoden 5mg. Then I settled and when I went back to him thinking it'd be better now that I was paying, it wasn't. He said I have 2 choices, patch or 5mg. I told him I couldn't afford the patch on my own. Found another doc and this one actually cares and is soooo good!

Karen

Were you on any pain meds PRIOR to the patch? Or did your doc just put you on the patch right from the start?

It could be that you were either put on too strong a dose (the lowest, I believe, is 25) or that your system isn't used to pain meds at all, and fentanyl is one of the higher ends. Your doc should have tried vicodin, percocet, etc, prior to trying the fentanyl. The reason for fentanyl is to get more consistent pain relief, not necessarily stronger, but longer.

The patch lasts days whereas, as you know, the oral pain meds must be taken every 6-8 hours. The reason I was put on the fentanyl is because the pain meds I was taking were only lasting about 4-6 hours, generally 4. So I'd take a pill and have 4 semi-good hours, then 4 really bad before I could take another dose...then 4 semi-good, and 4 really bad before another dose. So generally I was only having 12 partly good hours a day. When you take oral pain meds, you become immune to the dose, and it either has to be increased, or it just stops working. Plus, they aren't good for your insides. Rather than increase the dosage, or the number of pills, he put me on a longer lasting fentanyl and gave me percocet for the breakthru that occurs every few hours a few times a day.

The fentanyl did upset my stomach at first but I don't think as badly as yours. BUT...I will say that I made a few mistakes in the beginning which caused too much of the medication to get into my system too quickly, and I had an odd effect because of it (dizziness, nausea, etc). For example - I soaked in the bathtub. Now, generally thats okay, right? Not when you're wearing the patch, and you have the water really, really hot, and you sit in there for an hour soaking in the hot steam! That made too much of the medication release into my system all at once and I'll tell you - I WAS STONED! :yikes:

Then, another time, I slept on the side that I had my patch on...which wouldn't be bad if I did't have a heated matress pad. So again, the patch overheated and released too much of it into my system at once.

Also, I got into the habit of cleaning the area where I was going to put the patch with alcohol first, to help it stick, cuz prior to that I was using the generic which WOULDN'T stick, and that's what I'd have to do with it. And at times, I could TASTE the alcohol in my mouth...so I knew it was getting into my system quickly at that point. At those times, I knew what areas of my body the medication absorbed thru more quickly.

If you want to try the patch again, here are some tips:

* First, your doctor should not have given you JUST the patch for pain control. He/she should have also given you some of your regular pain medication to get you thru at LEAST the first few days, because it takes at least 3 days or so for the fentanyl patch to work it's way thru your system to start working on the pain. If you didn't wear it for at least 3 days, THEN put on a FRESH one and try it for 3 MORE days, then you don't know whether or not it helped with the pain. During those first 3 days, you should have been taking your regular pain medication while the patch was working its way thru your body. After that, try only the patch, and yeah, you may have some breakthru pain, but it's possible you won't need anything in addition to the patch. Then again, you may need something on top of it.

* READ the package insert. Make sure you pay attention to the warnings on where it should be stored, and pay attention to the warnings on HEAT (don't pay attention like I did though :Blush2:). Even if it's warm where you live, if you're out in the sun for an extended period of time, that can overheat the patch and make more get into your system. That will make you ill, and dizzy, almost a "stoned" feeling. I've even found my own body heat can overheat it. If you even stick it on a part of your body that has rsd, the rsd heating up will overheat it.

* Which patch are you using? The brand name or the generic? You can tell the difference because the brand name is like a "pocket" of "gel" and the generic looks almost like a piece of tape with some sticky stuff on it. No gel in the generic. If you got sick on the 25 brand name, see if you can use the generic instead. I started with the generic, and they weren't strong ENOUGH, so we switched to the brand name. If you think the brand name is TOO STRONG, see if you can try the generic instead. It could make all the difference. HOWEVER, the generic does NOT stick well. I suggest covering it with a bandage made by nexcare called "absolute waterproof" (here's a picture: http://www.amazon.com/Nexcare-Absolu.../dp/B000FKGI9M) They are the ONLY thing I found that covers the patch entirely and absolutely does not come off until you take it off.

* Where are you putting the patch? Keep in mind that the THINNER the skin, the QUICKER the medication gets nto your system. If you think it's getting in too quick, so it's making you sick, try putting it on a "fattier" part of your body. My doctor suggests the chest area cuz it's such a 'thin' part of the body. I put it there, and on my wrist, cuz those are two thin spots. I only have one "good" wrist, and only one "good" side of the chest. The other sides are RSD sides, so I can't stick anything there, so I have to alternate. But if it's making you ill, try putting it someplace where the skin is thicker, such as your hip, or buttocks. Perhaps that will slow the medication down, so it doesn't get in so quickly.

* If you get accusomed to it, and it works for you, my doctor has me change mine every 2 days instead of evrey 3. There is still medication left in it on day 3, so what I do is put on my NEW patch, but leave the only one on for 12 more hours. Basically it helps me thru until the medication in the "new" patch starts to work. Then I'll take it off.

I lose my train of thought (and my mind) sometimes, so I think that's all for now. I do think you should try it again, perhaps making some adjustments. Give it a chance. It's much better than taking more and more pills, or upping the quantity, the dosage, etc. A lot of meds take some time getting used to. The only side effect that didn't go away for me was the exhaustion. And I do mean I was EXHAUSTED. I couldn;t keep my eyes open for anything. I brought it to my doctors attention and he gave me provigil for that. Just what I wanted...another pill. But I take it "as needed" and one f the side effects of the provigil is "weight loss" so I don' much mind taking htat one :)

Let me know if I answered your qestions, or if you have any more. Hope I helped.

Fentanyl Patch
 

Very good advice from Lisa! I am on the fentynal patch 75, I started at 50. I did not experience the nauseau perhaps because the first few days on the patch I was so relieved to not have pain. That was short lived. I had no initial side effects and even now they are not too bad. But when that 3rd day comes to change it I am a wreck, typical signs that my body is craving more than the patch is giving. This is my 3rd year on the patch, the only other meds I take are percocet for break through and ambien to sleep and maxalt on occasion for migraines. I am very careful to limit the heat (bad thing for the patch, even long hot showers are not good). I also limit my percocet. I take between 2-3 a day some days none, I have to be really cringing. I am used to pain but sometimes it gets too much, as I am sure you all know. The nauseau I experience is from percocet but a small amount of ice cream helps! Yeah for Ben & Jerry's. As far as the patch, it should be used only after other meds are explored. I have been on so many and so many discarded until the patch was used. I am lucky and do not get a "high" from it. It just helps me get through the day, well some days without pulling my hair out. Some of the drugs I have been through - Neurontin, Lyrica, Cymbalta, Zoloft, Amitryptilan and Nortryptilan, zanaflex, darvocet, serzone, and a bunch of others. Nothing worked for me until the patch but each person is different. Please use the patch with caution, read the pamphlets that come with the drug and search the internet for other info. This is not a drug to use uninformed.

Smiles - Septmystic:icon_biggrin:

Fentanyl
 

I think I will hold off for now-thanks for all your info....

Deb

Deb, can I ask why? Did I scare you?

Like Septmystic, I also experience no "high" from it at all. I feel completely normal. MUCH better than when I was on oral meds all the time, and much better than if i'd have to increase the dosage of oral meds. Also, the only time I get nauseus now is when I take my regular daily meds - so I just take them with milk, and I don't get that nauseous feeling.

Did I say something to scare you away from the patch?

TY
 

No you didnt say anything to scare me...I have sooo many medications that I dont take in my medicine cabinet! I am going for some stalite ganglion blocks- I will see how I do with that first....

Deb

Thanks
 

Thanks for the info and the article! will keep it in mind...

Deb

Hi Debbie,
I was on the fentyl patch for several years - 50 mgs. It made me sleep for up to 20hrs per day and didn't really make me pain free. It was absolutley horrific to withdraw from.

My doctor had put me down to 25 mgs and I was still sleeping all the time so an intern told me to just remove the patch. Well, 2 days later I ended up in full opiate withdrawral - low blood pressure(60/30), stomach pains and nausau. I went to the ER where they had a hard time getting my blood pressure back up and admitted me.

I spent the next 3 days suffering with the most incredible stomach pains. They kept telling me that I had to put the patch back on but I would not. It was a holiday weekend and my doctor was unreachable.

They would not put me on the detox floor and they told me that there was not a protocol for withdrawing from fentyl because it is mostly used on terminal cancer patients. I tried to convince them that I was addicted but they thought that since my doc perscribed the patch that I wasn't an addict. But I was - a physical addiction to opiates. It didn't matter where I got the opiate it was that my body needed it and I wouldn't give it what it needed.

Finally, my doctor showed up and convinced me to put a patch back on. I immediately felt the withdrawral symptoms disappear. It took another 4 months of weaning off to finally get off of narcotics. He used oxycodone pills starting with 8/day for a week, then 7/day the next week then 6/day the next week and so on until I was down to the smallest amount.

Back in 2004, there were many deaths from leaky patches and many from heating pads causing the patch to release too much med too fast. I am very lucky to be alive since I used a heating pad 24/7 with the patch.

That's what happend to me and my fentyl patch usage. I just want you to be aware of what it takes to get off of it once you go on. Something that I was not imformed about before I started.

Peace and hope,
Lisa

The fentnyl patch about 5 years ago. It was one of the first meds I tried and after 6 hours of wearing it I was vomiting. That was at the lowest dosage. I tried several times to wear one and had the same results. They were just too strong for me.

Ada

ok here's a positive,

I was on the patch for awhile, and had a rash, then stopped the patch, then one day in the chatroom of braintalk, an ocupational therapist came in, we were talkin about meds, and I mentioned that the patch was great, but I had the rash, she told me to have the doc give me asmacort spray, it's an inhaler, and a steriod....to apply it to my skin where I was puttin the patch, let it dry for a few mins, then apply the patch,

I am happy to say, I never had a rash again from the patch.

The patch made me sleepy at first, but by the end of the first week I was ok with that. And I did have a pain drop going on. SO I was very pleased with the patch.

Then I got a new nurse at the docs office, who changed everything and put me on a diff med, cause it was cheaper to fill!

SO I was on that med for over three yrs.

Recently I switched entire doc's....and the new doc put me back on the patch with the asmacort spray....and I have been back on there about 4 months or so now...and it's pure heaven.

The pain has decreased, not gone...but less at least...after the second week, the patch no longer made me tired.

I love it! And I'm in heaven again girls!!

Debbie