Duragesic (Fentanyl) Pain Patch More Info About It ..........

Discussion in 'Fibromyalgia Main Forum' started by JLH, Mar 30, 2006.

  1. JLH

    JLH New Member

    If you are thinking about asking your doctor about the Duragesic Pain Patch, or if you already use them, you may want to read the following information on them.

    If you don't read the entire post, just make sure to read the last paragraph if you use these patches!!

    Also, if you use them, do you have any hints on how to keep them on?

    --------

    The DURAGESIC® (fentanyl transdermal system) patch is a strong medication for moderate-to-severe chronic pain, available only by prescription, that can provide long-lasting relief from persistent pain.

    Through its unique patch technology, DURAGESIC delivers fentanyl, an opioid pain medication, slowly into the body through the skin where it works to relieve pain for up to 3 days (72 hours).

    DURAGESIC is strong medicine for serious pain. The DURAGESIC patch should only be used when other less potent medicines have not been effective and when pain needs to be controlled around the clock.

    DURAGESIC® is indicated for management of persistent, moderate to severe chronic pain that:

    *requires continuous, around-the-clock opioid administration for an extended period of time, and

    *cannot be managed by other means such as non-steroidal analgesics, opioid combination products, or immediate-release opioids.

    DURAGESIC® contains a high concentration of a potent Schedule II opioid agonist, fentanyl. Schedule II opioid substances which include fentanyl, hydromorphone, methadone, morphine, oxycodone, and oxymorphone have the highest potential for abuse and associated risk of fatal overdose due to respiratory depression. Fentanyl can be abused and is subject to criminal diversion. The high content of fentanyl in the patches (DURAGESIC®) may be a particular target for abuse and diversion.

    DURAGESIC® should ONLY be used in patients who are already receiving opioid therapy and who have demonstrated opioid tolerance. Patients who are considered opioid-tolerant are those who have been taking, for a week or longer, at least 60 mg of morphine daily, or at least 30 mg of oral oxycodone daily, or at least 8 mg of oral hydromorphone daily or an equianalgesic dose of another opioid.

    Because serious or life-threatening hypoventilation could occur, DURAGESIC® (fentanyl transdermal system) is contraindicated:
    *in patients who are not opioid-tolerant
    *in the management of acute pain or in patients who require opioid analgesia for a short period of time
    *in the management of post-operative pain, including use after out-patient or day surgeries (e.g., tonsillectomies)
    *in the management of mild pain
    *in the management of intermittent pain [e.g., use on an as needed basis (prn)]

    Since the peak fentanyl levels occur between 24 and 72 hours of treatment, prescribers should be aware that serious or life threatening hypoventilation may occur, even in opioid- tolerant patients, during the initial application period.

    The concomitant use of DURAGESIC® with potent cytochrome P450 3A4 inhibitors (ritonavir, ketoconazole, itraconazole, troleandomycin, clarithromycin, nelfinavir, and nefazodone) may result in an increase in fentanyl plasma concentrations, which could increase or prolong adverse drug effects and may cause potentially fatal respiratory depression. Patients receiving DURAGESIC® and potent CYP3A4 inhibitors should be carefully monitored for an extended period of time and dosage adjustments should be made if warranted.

    The safety of DURAGESIC® has not been established in children under 2 years of age. DURAGESIC® should be administered to children only if they are opioid-tolerant and 2 years of age or older (see PRECAUTIONS - Pediatric Use).

    DURAGESIC® is ONLY for use in patients who are already tolerant to opioid therapy of comparable potency. Use in non-opioid tolerant patients may lead to fatal respiratory depression. Over-estimating the DURAGESIC® dose when converting patients from another opioid medication can result in fatal overdose with the first dose. Due to the mean elimination half-life of 17 hours of DURAGESIC®, patients who are thought to have had a serious adverse event, including overdose, will require monitoring and treatment for at least 24 hours.

    DURAGESIC® can be abused in a manner similar to other opioid agonists, legal, or illicit. This risk should be considered when administering, prescribing, or dispensing DURAGESIC ® in situations where the healthcare professional is concerned about increased risk of misuse, abuse, or diversion.

    Persons at increased risk for opioid abuse include those with a personal or family history of substance abuse (including drug or alcohol abuse or addiction) or mental illness (e.g., major depression). Patients should be assessed for their clinical risks for opioid abuse or addiction prior to being prescribed opioids. All patients receiving opioids should be routinely monitored for signs of misuse, abuse and addiction. Patients at increased risk of opioid abuse may still be appropriately treated with modified-release opioid formulations; however, these patients will require intensive monitoring for signs of misuse, abuse, or addiction.

    DURAGESIC® patches are intended for transdermal use (on intact skin) only. Using damaged or cut DURAGESIC® patches can lead to the rapid release of the contents of the DURAGESIC® patch and absorption of a potentially fatal dose of fentanyl.

    IMPORTANT:
    Keep the patch in a safe place away from children. Accidental use by a child IS A MEDICAL EMERGENCY AND CAN RESULT IN DEATH!!!!!!!!!!!!!!

    IMPORTANT:
    Some meds may cause serious or life-threatening side efects when used with the Duragesic patch. Talk to your doctors about all of the meds you are taking.

    Talk with your doctors ESPECIALLY IF YOU HAVE:
    -lung problems, asthma
    -brain problems
    -bradycardia (heart)
    -liver or kidney problems
    -seizures
    -gall bladder problems
    -low thyroid
    -low blood pressure
    -major depression
    -adrenal gland problems
    -alcohol/drug problems, past or present
    -pregnant and/or breast-feeding

    IMPORTANT:
    Do NOT USE A HEATING PAD, ELECTRIC BLANKET, HEAT LAMPS, SAUNAS, HOT TUBS, HEATED WATER BEDS, TAKE LONG HOT SHOWERS, OR SUN BATHE with the patch on. Elevating your body's temperature will cause the patch to release more medicine which may cause an overdose.


    ____________
    Source: www.duragesic.com


    Hugs,
    Janet

  2. cinnveet

    cinnveet New Member

    I am going to bump up my post for you.

    Thanks!
    Cindy
  3. rosemarie

    rosemarie Member

    I was using the patch for about 3 months . Not really very long, I liked how it worked.

    But I had the worst reaction to the small band of adhesive that it has around it. The patch is in a a square unit. I would break out in a horriable rash, mind you the adhesive part is just abouat 1/8 of a inch in width and I would break out in a rash that had bumps that would come to have a water like head on it and they would break and oose, And it itched like crazy.

    So even as well as it was working for me I had to stop usuing it. You could tell where I had placed each patch as this rash would leave a dark line around the edge of the patch.
    I like it but I could not stand to have this nasty rash and it would burn , itch and finally I had to stop usuing it. And it has been over a year now and you still can see some of the sites where I had placed the patch. They are a darker skin tone than the rest of my body. You really need to make sure that you are not sensitve to any adhesives, in cluding bandaides.

    I didn't know that I needed to tell any one that I would get a rash from a bandaide, and it would itch for a day or two and then would be gone. But this was so severe that I could not cope with how much it itched all the time.

    So if your doctor suggests the patch to you make sure that you don't have any sensitvities to adhesives. Don't go threw what I did. It was so bad and the sites are still some what sensitve and will itch when I get hot.
    So Please watch out and tell your doctor about any history you have with adhesives.

    Rosemarie
  4. JLH

    JLH New Member

    I found a phone number to call about covers for the Duragestic.

    What exactly are these covers? Like adhesive covers to get them to stay on?

    Thanks for telling me about them!


    Hugs,
    Janet
  5. cinnveet

    cinnveet New Member

    FENTANYL PATCH "use it lose it" 03/29/06 08:57 AM

    I have been on the Fentanyl patch for a couple of months now. About a week ago I lost my patch. I looked all over the house and never found it. I was due to change the patch as it was on for almost 3 days. I told my husband and my 2 boys to keep an eye out for it as it can be dangerous to our dogs if they get a hold of it.

    Well, last night my husband gets out of the shower, gets dressed and I noticed something on the calve of his leg.
    It was the darn Fentanyl Patch!!! When I went to pull that little bugger off it was glued to his hair on his leg. He yelled when I pulled it off and took some of his hair with it.

    I asked him if he had any side effects from the patch and he said no. But he was not happy that he now has a patch of hair removed on his leg. My sister was here when it happened and we were ROFLAO!

    Thank God he didnt get any side effects or we would have not been laughing. And after were stopped laughing we talked about how dangerous it could have been if the dogs got a hold of it.

    I cant believe that the patch stuck to him like crazy glue, because it would always fall off of me. Last week I called Fentanyl company and they advise me to use the 3M Transpore tape and put the tape around the patch like you are framing a picture.

    I want to let others know that since I have been using the transpore tape the patch stays secure the entire time I need to wear them and I no longer "use it and lose it"

    And for the question on the rash, I also get a rash as well. When I take the patch off Spray Benidryl, after it drys I use A&D medicated ointment. This combo helps with the itching and healing quicker.

    Thanks!
    Cindy

    [This Message was Edited on 04/02/2006]
  6. NyroFan

    NyroFan New Member

    Janet:
    I asked my doc to let me try the Duragesic patch. He was against it and said 'Once you are on it you will never be off of it'. Anyway: he let me try it and I could not keep the darn thing on. It kept falling off. I called him and it was back to pills. Just my experience. I figure there are pills just as strong and when I need them he will give them to me.

    n.f.
  7. ilovepink4

    ilovepink4 Member

    the pro's are that you don't send the med through your liver....you don;t have the rollercoaster affect that you have with waiting for pills to kick into effect, get some relief, have to wait until you can take another while the pill is wearing off....you have continuous pain relief...

    also, i don't get the covers from the company...i have used 'Tagaderm' dressings to cover the patch and it extends out further than the edges of the patch....you buy them at the drug store...i have to ask for them...they are behind the counter..,,i get size 4 inches by 4 inches....they are about $2 each...some insurance may cover the cost if your doc writes an rx....i have heard some say that it is not okay to cover the patch to hold it on...my doc said it is fine...my pharmasist said it is fine....i have done it for about 6 months now...i had lots of trouble with keeping thepatches on before the tagaderms....it is a shame that people will miss out on the convenience and safety of the patch because of that....also, i change the patch every 2 days...some can make it 3 days...it just wears off on me after the 2nd day...changing the patch every 2 days also helps with the irritation that i would get waiting for the third day....maybe this will help someone...bye! pink
  8. Bambi

    Bambi New Member

    boxes of sample surgical tape. She uses that tape and never has to use the attached tape. She says it works great.
  9. Dara

    Dara New Member

    The last time I had them filled I got the generic, can't remember the name, but the patch is smaller and stays on a lot better than the name brand.

    Also, one thing to be careful with, if you are sick and running a temperature there is a warning about contacting your doctor. I believe it's because the heat from your fever can also cause it to release too much of the medication.

    Dara