NeuroTalk Support Groups - Catapres-TTS-1 Patch

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Catapres-TTS-1 Patch

Hi,
My Dr has put me on Clonidine or the Catapres-TTS-1 patch for pain I am experiencing from RSD. I placed it on Sunday afternoon and about 24 hours later I started feeling very worn out and drowsy. Today I am starting to feel a little better. It has only been 4 days so I've not noticed any difference in the pain so far.
Are there any other side effects that anyone has experienced from the medications short term or long term...?
The patch is starting to come loose around the edges and I have a problem with adhesive tape. Does anyone have any idea's that may help me keep it adhered without having to use the adhesive patch that they provide with the medication patch.
The pharmacist also told me to place the patch in the area where I have the most pain which is my right arm. Is this true or can I place it on the shoulder area with the same results?
Also, can I sit in the jacuzzi with the patch on?
Thanks
Dawn ;)

I'll try to address some of your questions.

1) all patches are not suited to heat conditions. Hot showers, sitting in the sun
or heating pads...cause the drug to be released faster than intended.

2) Catapres (clonidine) is basically a blood pressure medication. It has been around for a long time. Since its introduction, it has been used for addiction management, ADHD/Tourette's, pain syndromes, and even hot flashes during menopause.

3) It does cause sedation, but that side effect usually goes away. In rare instances it can lead to mania/insomnia/agitation..but that is in the 1-2% range of patients.

4) It is used topically in transdermal gels for pain and RSD, often in combination with ketamine/gabapentin/ketoprofen/lidocaine etc in many combinations.

You may have to use the cover patch if the adhesive is peeling up. It is my impression that it is placed between the problem area and the spinal cord, as close as possible to the painful area.
If this is not working for you... you need to consult your doctor. I'd give it a full month however (one box) to see if you get used to the side effects and
start to benefit from any pain reduction. It does not work for everyone the same way. If you have any sudden faint feelings standing up, this may mean your blood pressure is too low for you. If you have a blood pressure cuff, it would help to measure your pressure now and then. You can buy a manual one for about $20.

The sedation Catapres causes will be additive with other sedating drugs.

Thank you for all the information...
I sit in the spa because it helps with my TOS and Spine Problems. Would you suggest that I talk to my Dr about this or would you have any suggestions from your point of view as a pharmacist as to what I could do so that I would be able to sit in the spa while wearing the Catapres Patch.
Once again :Thanx:
Dawn

err on the side of caution...

Here is a link with a long argument consisting of the manufacturer of Catapres TTS patches disputing Mylan's attempt to make a generic form.

It is long but if you read it you will see they refer to a "rate limiting" membrane on their product.

Further down however, there is a study showing increased rates of absorption during hot/humid conditions.

Quote:

Hull cites other studies finding that application of heat resulting in subcutaneous
temperature increases caused a threefold, four to sixfold, and even a ten to twelvefold
increase in skin blood flow, respectively. Id. Enhanced cutaneous blood flow during heat
exposure dramatically alters the pharmacokinetics of many transdennally administered
drugs. The results of these studies indicate that external heating is significant for
transdermal as well as subcutaneous drug absorption, resulting in increased plasma drug
concentrations.

The claim is that the parent company has this rate limiting membrane that is supposed to minimize alterations in drug delivery. Given that Clonidine is a
narrow window of safety drug, it boils down to who do you believe.

The majority of patches I see are used in nursing homes and hospitals, and
in the general public by children. These patches are not common in the general public, so I don't expect medical personel to know details of them without looking those details up.

Quote:

It is thus apparent that clonidine at inappropriate levels can be dangerous to
patients.
Ii
is also apparent that, for other potent transdermal drugs, like fentanyl,
experience with heat, etc., has produced toxicity associated with overdose. Catapres-TTS,
on the other hand, has had a remarkable safety record, when the patch has been used in
accordance with its labeling, during the 20-year historical patient experience with the
product.5 We believe, therefore, that the rate-controlling membrane of Catapres-TTS
serves the purpose of controlling the delivery of clonidine and thus avoids what could be
significant safety risks with a patch that lacks the patient-protection features of Catapres-
TTS. Generic versions lacking such a membrane differ significantly in their inactive
ingredients, a difference that raises safety issues. As the ANDA applicants, the burden is,
of course, on Mylan and Elan to demonstrate that their different release mechanisms do
not in fact pose these risks. If they cannot, approval under an ANDA is prohibited.

Given that accidents with patches continually come up as "new"information, I would not speculate on the total believeablilty of the Catapres system. But I tend to be cautious. This argument in this paper is targeting allowing Mylan to market a generic version. As you read, you see the difficulties presented by both sides of that argument.

So I would caution you not to expose the skin or body areas to heat, just in case.

Thank you.. Mrs D.

The information makes the saftey concerns very clear... I will not use a patch in the spa or any other area that would be heat related.
Thank you again..
Dawn ;)