Hello all... long time since I have posted. Things have been in a bit of a mess here.

I have RSD in my right foot, left shoulder and my upper back and some in my right shoulder. Now it's moving down my arm and into my hand.

During the summer I broke my left foot - but thought the pain was the RSD moving, as I don't remember injuring the foot. Dr. finally convinced me to get an MRI of the foot, and it showed two fractures. So, now I have one of those big boots on my good foot, and my RSD foot is really complaining since it has to take the weight etc. Well, at least they didn't insist on crutches. I have been in the boot for about 2 months, and no sign of healing yet. I am to go back in 2 more months to check on it.

Then, I fell off a ladder last weekend -well more like a big step stool. It is a very safe ladder, but I was being incredibly stupid - leaning out to far to put the topper on the Christmas tree. I fell down between a kitchen cupboard and the refrigerator. What part hit the floor first? Of course, my RSD shoulder.

So I have not been a happy camper.

I have vicoden and ultram that I can take as needed, but rarely use because it has never done much. Recently I had a terrible cold/sinus infection/bronchitus and the pain from coughing was tearing me up. I began taking the vicoden regularly - but then went to the asthma doctor and he said if you have asthma you should not be taking vicoden. Something about supressing my breathing He said fentanyl would be ok. So, I used some old Duragesic patches that I had on hand from trying them last year. They didn't do much last year, but perhaps since I am taking namenda now, the patches worked well. Namenda can help some pain meds work better. I had several days of very little pain - what a relief!

I have really missed being able to use my bedwarmer though. Afraid it will make the meds release to fast. Bummer. I love my bed warmer!

When I saw my family doctor last week, I asked about going on the patches full time. She is my main RSD doctor, and is the one who prescribes my pain meds. She had no problem with going on it full time. I knew from my experience last year that I am allergic to the Mylan patch adheisive and I could not find a pharmacy that carried the Sandoze... so she wrote for the brand name. I was shocked when I went to get script filled -- my copay was almost $150. I have never had a co-pay for more than $30. I called my insurance company when I got home, and found out that they will cover "generic" but only made by "Activis". They said that they can send Activis Fentanyl in 90 day mail order. When I saw my doc said she can only write for 30 days -- but the mail-in pharmacist said my state, Ohio, allows for 90 day mail in. I will have to ask Dr. about that. Hoping she can do the 90 day!

Anyway, I did find one local pharmacy that will be able to order the Activis brand generic in case she cannot do the 90 day mail in. They will cost me $10 a month. If I can do the 90 day mail in, the Activis patches will be $20 for 3 months.

Has anyone used this "brand" of generic? The prescribing info says that the inert ingredients are the same as Duragesic, so hoping that they have the same adhiesive - which I am not allergic to - and the delivery system looks the same. Patches look the same.

I have been covering the Duragesic with Tegraderm and have called to get the 50 "covers" from Janssen. Yesterday, I went to a medical supply and got a couple Medline Suresite Transparent film dressings to try as covers. They sure work better than the tegraderm. Pharmacist said they were comparable to the covers Janssen sends.

Does- anyone use this Activis generic? I cannot find much about them on the web.

Thanks a lot for any advice or replies!
Jules

Here is a list from the FDA orange book... for FDA rated generics: fentanyl

http://www.accessdata.fda.gov/script...ocs/tempai.cfm

last updated Dec 7 07.

You sure about the spelling of that company?

I found it under Abrika pharmaceuticals:
http://www.actavis.us/en/products/pr...t/fentanyl.htm

This is a reservoir system, and is unlike the Mylan matrix form.
Manufactured by Corium International
Grand Rapids Mich.

Very new as of Aug 07.

mrsd
The first link you provided comes up with an error page for me.

The second link is the one I went to and read up about how the patch was made, and the inert ingredients. I was trying different spellings to see if I could get something to come up online about it. I found lots of info from Euopean countries, but not here.

The spelling may be wrong. It was how it was given to me by my insurance company.

Thanks for trying to help. Evidently no one has tried this patch out yet. For $130 difference per month, I will be trying it. Hope I am not allergic to the adhesive like I was with Mylan. I wish I could find somewhere to get the Sandoze. Not sure if those are covered for the same price as the Activis ones our not with my coverage.

Thanks for trying to help.
Jules

http://www.fda.gov/cder/ob/

When it loads, do a search for fentanyl.
Sometimes internal links with searches don't give valid addresses.

There is a trick to minimizing patch reactions. Some people use an asthma inhaler like Azmacort, and spray the area first, let dry, and then apply the patch. The steroid powder then minimizes reactions.
You need to rotate your patch site also, which I hope you are doing.

There is a topical spray also called Kenalog. But it is hard to find sometimes.
creams and ointments will affect adhesion and don't work.