Fentanyl (Durasegic) Patch, anyone on it?

Discussion in 'Fibromyalgia Main Forum' started by fibrohugslife, Apr 4, 2006.

  1. fibrohugslife

    fibrohugslife New Member

    I just started on the patch recently and wow my pain has been lowered and I take one Vicodin for breakthrough pain. However I seem to experience all of the side effects like itching, no rashes just the itching and I take my Aveeno Oatmeal baths to help with that. Then I find myself at times very very sleepy like I would just fall asleep standing up or something. I just ate too, so that makes the fatigue worse. It could also be my going out and doing errands and housework could be causing the additional fatigue.

    I also have hot flashes or just times when I get really hot and start sweating and I know I am WAAAY too young for those, but I just getting really hot and I know that is a side effect of the patch or Vicodin, and end up walking around in a t-shirt and shorts and I drink lots of water and that calms things down.

    I am thinking that my body just needs to get used to it. I have read previous past posts about the patch and I hate that the most dangerous things I need causes the best relief for me and I also fear going off the patch too.

    I was in the ER two weeks ago due to a pain injection my doctor gave me, and I felt like I had some serious chest pains but after the EKG turned out to be severe muscle pain, so I learned no more pain injections for me, and she also prescribed me the pain that same day but was able to get my prescription last Friday.

    So I was wondering if any of you are currently on the patch and how is it helping you? If I am able to continue to feel well, there is a possibility that I could go back to work on a part time basis after finishing my bachelor's degree.

    Many hugs,
    Nicole
  2. fibrohugslife

    fibrohugslife New Member

  3. starmom

    starmom New Member

    but I wish I was. so far my doc is not willing to give me meds strong enough to handle my pain.

    In addition to Aveeno Baths, have you tried benadryl, claritin, or singulair for the itching? The itching is a common side effect of any pain med (other than NSAIDS). I find that taking benadryl or singulair really helps me. Singulair is prescription. It was first for asthma, but is now being used for allergies. It is a tablet, and is easy to take (not a huge pill).

    Aveeno Bath is expensive. If you are cheap (I am SOOO cheap!) you can either grind oatmeal really fine in the blender or food processor or put oatmeal in an old sock or part of pantyhose. Tie the end and toss it in. It is squishy, but does the same thing. I have lots of old socks, so I just toss them. The old fashioned (5 min) oatmeal and hte quick cooking work equally well. Just don't use the kind in the little packets,esp the flavored kind!

    Susie
  4. TXFMmom

    TXFMmom New Member

    Do be very, very careful about taking oral pain meds and a fentanyl patch.

    I know, because I was a Certified Registerd Nurse Anesthetist and used these patches on my patients.

    I would put them on patients long enough before they had to wake up for them to be in effect and it greatly reduced any need, in most cases for pain meds.

    However, do be CAREFUL, VERY CAREFUL IN TAKING OTHER NARCOTICS WITH THESE PATCHES. START ON THE VERY LOWEST DOSE.

    Also, discuss it with your doctor.

    Additionally, I think they have had some problems with the patches being obsorbed FASTER IN HOT ENVIRONMENTS. I do not know if they have gotten that resolved.

    I am glad you are getting something to take care of your pain, but be careful.
  5. JLH

    JLH New Member

    Nicole, my doctor just started me on a "baby" dose of the patch - a 12.5.

    So far, no problems, other than being sleepy all day!! I have so many health problems which cause pain and is has me practically housebound now, that he thought this might give me a better quality of life. I don't think I could take it stronger.

    They have never corrected the problem with heat with them -- you can't use a heating pad, stay long in hot showers, be out in hot environments, etc. If you body temp rises, it will cause the patch to release more medication which might result in an overdose!

    here is more info on it:

    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
  6. fibrohugslife

    fibrohugslife New Member

    Thanks Janet I read that in the previous post research that I did. There are always risks with any medication that one uses. I was just trying to get some others' personal experience with it because really in the end I am my own doctor with these illnesses. I have a doctor which I am lucky to have to prescribe these things and I don't even have health insurance.

    I am just trying to gather a glimpse of hope here. My doc said it was fine to use the Vicodin with it for help with breakthrough pain, so I do use it on occasion but prefer to just rely on the patch for relief. Expensive items they are even without health insurance.

    I hate taking meds with a passion but I have no choice at this point, besides eating healthy and exercising, I still have to find more ways to relieve my pain.

    Many hugs,
    Nicole
  7. Lolalee

    Lolalee New Member

    I never realize how much the patch helps until it wears off. My memory is so bad and I sometimes forget to change the patch . Then my pain gets really bad and I realize that I've been wearing the same patch for 5 days.

    The patch really helps the pain, but I sometimes need something else for breakthrough pain.

    I agree with the advice to start on the lowest dose. Read all the directions carefully.

    Unfortunately, I have found that with the patch as well as other pain med, the body develops a tolerance and then the dosage needs to be increased.

    Good Luck,

    Lolalee
  8. mom4three

    mom4three New Member

    I to take pain medication po and was a nurse as well. There are no cause for concerns in my opinion nor in my doctors opinion. We are not receiving the same dose nor are we receiving it intraveniosly.

    So you should not worry.
    How are you feeling? What does are you on?
    I use azmacort and spray it on the area like 4 or 5 sprays where I am going to stick it and it stays really well without falling off. Infact I have to pull hard to get it off....
  9. slwolf

    slwolf New Member

    I am on the patch and it has made my life liveable. The hot flashes are nothing compared to the pain I was having. Noboby likes to be on a drug, but when all else fails, and a narcotic can return you to society, I suggest you take advantage of the medicine.
    [This Message was Edited on 04/13/2006]
  10. freggy

    freggy New Member

    I tried a low-dose patch, but it kept falling off. Where do you put the patches, and how do you keep them on?
  11. mom4three

    mom4three New Member

    use water proof bandaise or use the tapes in the first aid area that helps. I spray azmacort around the area and it makes it stick like glue. Silly but it works. But before that I bought nexcare waterproof bandaids and stuck them over the patch after I help soft pressure for 40 seconds.