Fear of starting the Fentanyl patch and how does it work?

Discussion in 'Fibromyalgia Main Forum' started by shelby319, Nov 3, 2006.

  1. shelby319

    shelby319 New Member

    Hi and a good day to all~~

    I recently had cervical spine surgery and the Dr's had me on Oxycontin 20 mgs twice a day and Oxy IR 5 mgs three times a day for breakthrough pain meds. I seemed to be doing pretty good with those two drugs, but recently I went into a flare with the Fibro and also got shingles the other day.

    Now because of not only still recovering from the surgery, and going into the flare up, but also with shingles, my Dr. has put me on the Fentanyl patch 50 mcg/h. But I haven't started it yet out of fear of this powerful medication. Does anyone have any suggestions or info on how it works and how long it takes for it to work in your system without those funny feelings of waves of the medicaton and pain in between, and also how many of you still take breakthrough meds while on this patch??/!!!

    Does it interfer also with any other medications or vitamins you take or anything I should stay away from for vitamins while I'm on the patch? I'm so confused on when to start taking this medication and also I've asked the Dr. so many questions along with the pharmacy, that I think they feel I'm nuts or something for asking all these questions. So, I just wanted any input from someone that already uses the patch and what or how you feel it works for you. Also do you need breakthrough meds with it, like I do while taking the Oxycontin.

    I would greatly appreciate any feedback you can give me so I can start taking this medication tonight or tomorrow morning. I am so afraid of this patch and I'm sure its only because I know nothing about it, and I just don't like taking anything new that I'm not familiar with!!!!

    I hope someone can help me with some answers that would make me feel more comfortable taking it, as I know there are many here that also use the patch and take breakthrough meds...I greatly need any help I can get!!!

    Thank you to all,
    Gentle hugs,
    Shelby
  2. shelby319

    shelby319 New Member

    I really appreciate all your help with this dilemma I'm having over these patches!!! I have the name Fentanyl on the package, so is that the brand name or not? I'm just so afraid of taking them, but I do understand they work great for many, so I will give them a try!! I was just afraid I might have some kind of reaction to them for some reason!! But if I have been on the oxycontin, I guess their basically the same thing, right?

    If you have a chance though, could you tell me if you also have to take breakthrough meds while on the patch or do you feel the patch works so good you don't need breakthrough meds?

    I really appreciate you answering my question though..you are a sweetheart for doing so and I thank you so much for the information!!!!
    Hugs,
    Shelby
  3. dolfenn43

    dolfenn43 New Member

    I am on the fantanyl patch 75mg. And Kadian 60 mg. 3 X's a day. For break through pain.

    I think the patch works wounderful! I feel no side effects of any kind. If I dont need the Kadian I dont take it. Al though that doesnt happen much. I dont want to start a flare.

    The only thing thats a bother is it staying on. I also use $ kind of flexible tape for around the edges.

    Dolfenn
    Kadian is morphine [This Message was Edited on 11/03/2006]
  4. and was given Norco 7.5's 4x's a day for breakthrough...but I quit the Norco, because, 1.) the nurses* at the pain clinic seem to have MASSIVE ISSUES with doing their job-1 mth script lasted me 3 months, I called them to request refill--NOTHING. 4wks later!.

    Also 2.) It actually doesn't help my pain a bit anyways, so, no point. Tear my gut up too. So far, I haven't been able to take Dilaudid,(2mgx's 4), MSContin 45mg twice a day, with MSIR 15mg twice and then 3 times a day for breakthrough pain--severe*** constipation, stomach pain, and lost ANY effectiveness whatsoever, VERY fast. Seems like EVERYTHING does for me.

    My patches have not helped ONE BIT for at least 2 months now (started to flare, too then..) but, I've tried so many meds--it seems like- that I'm afraid to bring up the fact these do NOT HELP ONE BIT to my pain doc, for fear of not being believed, eventually-

    Even though she is kind, treats other symptoms that she really doesn't even have to, and is an ansthesiologist trained in pain management, and I know I can't be the only one with a naturally high tolerence for meds..that she's dealt with (not exactly natural--everything* lost a LOT of effectiveness after I had GB removed. I cannot* figure out why, but same thing happened to my mother..)

    I believe, the only meds left? Well, unless she *doubles* my patch dose (generic by the way. I swear these have NO medicine in them! "Sandoz" fentanyl patches,. I THINK-the name brand is Duragesic Fentanyl patches..?) I was told Sandoz was just as effective.....I don't think so.

    Also, It appears in the past couple of weeks, I've become much more severely allergic to the adhesive. (I'm allergic to a lot of tapes, tegaderm, steri-strips, etc if they have to stay on for more than cpl hrs.)

    They DO like to come off, at least partially, I never called for the overlay (whoopee a patch to go on top of your patch so it stays on. GRR!) I just use paper tape, that's *supposed* to be hypo-allergenic, a couple of weeks ago, either the patch(I think so, by the size) or the tape, RIPPED MY SKIN off WITH patch. My arm still hasn't healed. I have several little 'speckled' areas, from scabs where the same happened on my chest, even longer ago, still hasn't healed.

    I'm not healing from *any* little scratch right now, though.

    I hope the patch works for you, as you can see---looks like everyone who's responded so far, takes something for breakthrough pain.

    I take several vitamins & supplements too, btw. Always read on the net though, about what YOU specifically take, to make sure there's no interaction/reaction/contraindication, etc.


    Good luck, don't be afraid of the patch--you may not (I never did--was on brand name 25mcg years ago too, for less than a month) have any side effects at all.

    Take care,

    Laura

  5. TXFMmom

    TXFMmom New Member

    There were some problems associated with the fentanyl patch about a year ago. Some people had not followed directions, on occasions and had worn TWO at one time and overdosed.

    Then, due to the manufacture, if the individuals became really warm, the absorption was sped up and some experienced overdosage.

    One needs to follow the directions, as the manufacturing problems, supposedly, have been corrected.

    Do not use other medications without the doctor's okay. If you become confused, take notes, or even record their instructions so you can know what can be taken, at what interval, etc.

    Then, do NOT PUT ON TWO IF PAIN BREAKS THROUGH. Contact the doctor and have them adjust it.

    Patches come in different dosages, so discuss that with the doctor.

    Patches can be a danger, if not used properly, but so can any med, and with the pain meds you and many of us take, many bad things can happen, as well.

    Ask plenty of questions, get the directions outlined correctly, then follow the directions, and they should be as safe as anything.

    One good thing with Fentanyl is that there is no euphoria with it, so one is far less likely to become physically or mentally dependent upon it once pain receeds or ceases, so that can be a distinct advantage.

    Fentanyl is very potent, so the dosage may sound small, but it packs a big wollop. Miligram for miligram, it is 150 times as potent as morphine, and is a synthetic. It is used, primarily in anesthesia, as when given intravenously, it takes effect very quickly, but the effect is relatively short lived. It was and is a fantastic narcotic for sedation and general anesthesia. I was a Certified Registered Nurse Anesthetist for many years before becoming disabled, so I know, as I prescribed and administered it every day.

    Used in the patch, the absorption is very slow, sustained, consistent, and once the level is achieved, it should be very useful for intense pain, without getting the mental blurriness and euphoria, so, as I said, addiction is far less likely. JUST USE IT ONLY AS DIRECTED AND DON'T TAKE OTHER DRUGS IF YOU HAVE BREAKTHROUGHS WITHOUT GETTING THEM CLEARED BY YOUR DOCTOR AS TO DOSAGE, OR OVERDISAGE CAN OCCUR. Additionally, when any drug is given via patches, once the level is achieved, then one does not get valleys and peaks, meaning that one does not see the pain level intensity and a dose be an hour away.

    For many people, use of the patch provides them with relief, they keep mental clarity, and can proceed with things with a clear head.
  6. TKE

    TKE New Member

    You said:

    >>Fentanyl is very potent, so the dosage may sound small, but it packs a big wollop. Miligram for miligram, it is 150 times as potent as morphine, and is a synthetic. It is used, primarily in anesthesia, as when given intravenously, it takes effect very quickly, but the effect is relatively short lived. It was and is a fantastic narcotic for sedation and general anesthesia<<

    Is this med by any chance egg based? I'm allergic to eggs.
    My doc is thinking of having me try this because most meds rip my stomach up.

    Thanks,
    Toy
  7. barbaradh

    barbaradh New Member

    I have been on Fentanyl patches for about three years now. I started out on 25 mcg., but was only on that dose for about six months and then raised to 50 mcg., which I am still on to this day. I originally was on Duragesic (brand), but when the generics came out I was switched to them and have noticed no difference.

    It's true that Fentanyl is a strong drug, but I have never felt euphoric or drugged on it, or for that matter anything else but "normal" (or as close to it as you can feel with FMS). I do have OxyIR and I take 15 mg. of that for breakthru pain as needed, but I don't need it very often (maybe once or twice a week - more often if I'm in a flare).

    I was tried on a lot of other pain medications before finally being prescribed the patch - I had problems with all the other meds, but have never had any problems with Fentanyl.

    As far as whether it interferes with other medications or vitamins, only your doctor and/or pharmacist can answer that question, because they are the only ones who know what all you are taking.

    As far as when to start taking it - I change mine in the evenings, after taking my bath. That is when it is most convenient for me, and when I am best able to remember to do it. The time of the day doesn't really matter - it matters more that you pick a time that will be convenient for you and that you will best remember to change it when it is time to do that. I write the day I change it on the patch itself and also mark it on my calendar - that way I can more easily see when it is time to change it again, and ensure that I change it on the correct day.

    I use Tegaderm tape over my patch to ensure that it will stay on for the full three days (it's the same clear tape that is used in hospitals to hold IV's in place). The patches have a tendency to come off (brand and generic alike) when you have bathed or showered a couple days in a row, and when that happens you can't put it back on - you have to put a new one on. If this happens, you can run into trouble in that you won't have enough patches to last you all month, and by law they WILL NOT replace patches that fall off. So, I really recommend that you use some kind of tape to hold your patch on.

    I understand your fear in taking a new medication that you are not familiar with, but just remember that if you have any problems, you can call your doctor and the patch just peels right off if you really run into trouble. I do hope you'll try it though - it has been a wonder drug for me, and everyone I know that uses the patch has been extremely pleased with it and none of my friends have ever had any problems with it.

    I wish you luck with it Shelby, and will keep you in my thoughts and prayers!

    With best wishes and gentle hugs,
    Barbara
  8. PVLady

    PVLady New Member

    My mom was using a patch called Duragesic, also Lidoderm. When she was given the Fentanyl, it was kind of too much for her - but everyone is different.

    If you try it once and you don't like it, or feel it is too strong you might ask if there are less potent patches - I believe the Lidoderm patches are not as strong.

    Did the doctor think maybe you need your Oxycontin dosage increased? I will say, my mom said the patches helped more than anything for pain and it sounds like you are really having a problem, with shingles added now. You poor thing!!!

  9. LouiseK

    LouiseK New Member

    You poor thing! I just had a bout of shingles which never really left me and it is unbearable on top of the FMS and the CFS pain of everyday. I cannot imagine it along with surgery!!

    My doctor wants me to use this patch and I am also afraid to do it so your posting was welcome and the responses interesting. The warnings that come with the darn thing are enough to scare one to death.

    Would appreciate you keeping us posted of your progress and how the patch does work for you if you brave it.

    Feel better soon.

    Louise
  10. homesheba

    homesheba New Member

    just got it yesterday
    tho just at 25 mgs..
    and i have hot flashes!!
    will that cause a trouble?
    thank you
    and thank you for this post
    and answers cause
    i am nervous also...
  11. TXFMmom

    TXFMmom New Member

    Fentanyl is made synthetically, but codeine, at least some of it, morphine, and heroin are made from poppies.

    Fentanyl was created, synthetically, in the lab, by recreating a basic molecule shape similar to morphine, codeine, etc., and the molecule is ahaped to merge into pain receptor sites on the spinal cord, thus blocking pain from being sent up the spinal cord. The molecule does not have the branch which produces euphoria in the natural drugs, so it doesn't give you a buzz.

    It can be a potent respiratory depressanat, in large doses, or rapid IV doses, and someone was making the stuff and mixing it with heroin and people were dropping like flies from respiratory arrest.

    In patches, it is unlikely UNLESS YOU DO NOT FOLLOW THE RULES, to develop respiratory depression, unless you pile on other pain meds which can cause respiratory depression, as well.

    I would not hesitate to use a Fentanyl patch, myself, and would, actually find it far superior to oral meds, in many ways.

    I may end up on the patch shortly, myself.

    Listen to your doc, take as prescribed, don't add other analgesics, except for tylenol, etc., with it, ESPECIALLY NARCOTICS, and it is as safe as anything else.

    IN ALL THOSE YEARS I NEVER, EVER HAD ANYONE HAVE AN ALLERGIC REACTION TO FENTANYL, AND IT WASN'T EVEN MENTIONED IN THE LITERATURE. I HAVE ALLERGIES OUT THE YAHOO AND HAD THE DRUG FIVE OR SIX TIMES, MYSELF, WITHOUT ANY DIFFICULTIES, WHEN I HAD OPERATIONS.

    It is just like other drugs, USE AS DIRECTED, ASK QUESTIONS, READ THE STUFF THEY GIVE WITH YOU AND ASK QUESTION AND KEEP THE ANSWERS IN WRITING.
  12. shelby319

    shelby319 New Member

    I'm so overwhelmed with emotions of how many wonderful people here took the time out of their daily lives to help me with this question!! Priceless!!!

    I wanted to thank all of you by name, but that might cause too much reading for anyone with problems with Fibro/Chronic fatigue!!LOL!! So, maybe I better keep it short.

    It also took me a couple of days to actually get back on here to read all of your responses after trying to get a hold of these shingles and still recovering from surgery, which isn't an easy task when you do have this terrible desease that never seems to let up. But hopefully with the surgery over with, and getting better with the shingles, it will get better with time, patience and alot of determination!!!!

    After much consideration and looking up as much information about the patch as I could, along when all of your wonderful info about it, I did finally give in and put the patch on last night for the very first time!! It is called Duragesic 50 mcg, which I quess is the brand name? Some of you said I should also put some kind of tape over it, Nexcare tape? I quess I should use something to make sure it stays on...which seems so silly when you already have a patch on, but yet to maintain it sticking...you have to use another tape to keep it in place!!!?/!!! So silly isn't it?

    Seeing its only been on for about 12 hrs now, I don't really feel anything from it yet, so I've had to take some breakthrough meds. This part I don't like one bit!! I really don't want to add anything extra in my system, but I guess it takes awhile for it to actually work in your body and for you to get full relief? Someone mentioned it might take a total of a couple of days for myself to get the full relief of the patch, is that true?

    Well, I didn't mean for this to get as long of a post as it did....but with so many answering my questions, I had to respond as much as I could and to also give my input, which isn't as much as you gave me though. But I did want to let you know how grateful I was for all your help through this difficult time and explaining how this medication works for all of you. Now it seems I've joined the group of the "patch club"!!LOL!!

    I do wish everyone a sparkling pain free day and I thank you for all your help!
    Gentle hugs,
    Shelby