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Fentanyl Patches
Andrew Binns





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About MedAu

Last Modified 31/10/98

To add to the choice of opioid analgesics used in palliative care we now have in Australia fentanyl patches. Each patch is worn for 72 hours and has about the same effect as using twice daily oral sustained release(SR) morphine. However from a quality of life point of view there are some advantages in using fentanyl patches for some patients. It is not yet listed on the Pharmaceutical Benefits Scheme and is quite expensive. So what is its present role in palliative care and how is it used?

The main side effects complained of by patients on morphine are nausea, vomiting, constipation and drowsiness all of which can significantly impact on quality of life even though pain relief may be adequate. For total pain management both physical and psychological factors need to be taken into account. According to a study comparing transdermal fentanyl versus sustained release oral morphine the following has been found.20(1)

Pain control

No significant difference was found between fentanyl and SR morphine in regards to pain control. However those on fentanyl did require slightly more breakthrough doses of morphine.

Sedation and sleep

Fentanyl appeared to be less sedating than morphine both in the daytime and night.

Bowel function

Fentanyl treatment was associated with significantly less constipation than morphine.

Nausea

This was significantly lower in the fentanyl group.

Treatment preferences

Significantly more patients indicated that the fentanyl patches had caused less interruption to their daily activities and the activities of family and carers, and had been more convenient to take than morphine tablets.

Side effects

Skin - 3% erythema, 5% mild itching and 2% moderate itching.

Transferring from morphine to fentanyl

Withdrawl from morphine symptoms were common and symptoms such as abdominal pain, agitation or anxiety, sweating and 'flu' like symptoms were reported during the first few days of fentanyl treatment consistent with morphine withdrawl.

A second line drug

It should be emphasised that fentanyl is not suitable for unstable pain or rapid titration. In those situations morphine must first be used preferably on a four hourly basis until adequate pain control is acheived. If there are then indications to use fentanyl then the change is made according to the conversion formula listed below.
24- hour morphineFentanyl Dose
(mgm/day)(mcg/hr)
<135 25
135-22450
225-31475
315-404100
405-494125
495-584150
585-674175
675-764200
765-854225
855-944250
945-1034275
1035-1124300
There are four sizes of patch and more than one patch can be used if a higher dose is needed.The four sizes of patch have a delivery rate of 25,50,75 and 100mcg per hour. Notes (1) Fentanyl is excreted in the urine and the dose may need to be reduced if there is increasing dehydration or renal failure. (2) As regards cost fentanyl is approximately three times as expensive as morphine. (3) Care must be taken to adequately dispose of used patches and it is recommended that sharps containers be used for disposal. Summary Fentanyl is a very good opioid analgesic that is particularly useful for those people who are intolerant of morphine. However it should be considered a second line drug after morphine and is not nearly as flexible as 4 hourly morphine. It is used particularly for those with severe morphine related constipation or nausea, those who have excessive morphine induced sedation, those with poor compliance or inability to swallow and those who have inadequate pain relief with morphine. It is easy to use and well accepted by the patient. It will hopefully soon be listed on the PBS.

Andrew Binns

(1) Reference: Transdermal Fentanyl versus Sustained-Release Oral Morphine in Cancer Pain: Preference, Efficacy and Quality of Life. Journal of Pain and Symptom Management. Vol 13, No.5, May 1997. See also Fentanyl Patches - Update



Discussion
Fentanyl........100mcg
which is better in the long run? Oxycontin or Duragesic?
like to know what orther name is the Duragesic patch called
switching form oxycontin to patch
having hard time adjusting
Getting off fentanyl patches
long term effects
PATCH USED UP BEFORE THE 3 DAYS ARE UP
Duragestic 25mcg patch
withdrawl symptoms and treatment
WITHDRAWL OF DURAGESIC - NEED HELP!
Discontinuing
Severe reactions to Fentanyl Patches
Problems with patches coming off before 72 hours up
Morphine Pump
Duragesic 25
Fentanyl Patches
Fentanyl and the Liver

Marvin, mgates@sunflower.com
Posted 21/7/2001 1:38 AM


What are the effects of Fentanyl on the liver??I have hep-c and suffer with a great amount of pain-Thanks



Fentanyl........100mcg

Stella Blackwell, StellaMB@aol.com
Posted 7/7/2001 8:45 AM


This stuff is horrible. I was not informed of it's withdrawal effects nor do I believe I needed to go from 25 to 100 in 5 days,total abt 9 days.The withdrawal is worse than the osteoporis pain was in my back. The pain is gone and I have not had a patch on in 6 days,however I still have chills,sweats,tremors,weakness and severe shortness of breath(some of which is due to COPD).I would have suffered the pain rather than this condition which is not improving my life at all.It is horrible to have to suffer thus when it was not a life threatening situation.



which is better in the long run? Oxycontin or Duragesic?

Randa, turbosbabe96@yahoo.com
Posted 19/4/2001 5:38 AM


I have been on oxycontin for a yr now. A new doctor in the state i just moved to will not prescribe these as he says 'this area is the drug capital of the world'..as if this is MY FAULT??? anyway, he is talking of putting me on patches. i am not familiar with them. Am I going to have withdrawal from the oxycontin?? Someone please help!



bob, BT5050@att.net
Posted 3/6/2001 5:59 AM


i have been on both oxy-contin and duragesic patch. i started with 25 micros and went to 50. i really didn't like the patch because i would have to use more break thru meds. i have suffered from head aches for 15 years now. i have been on everything a-z. im now on oxy contin 60 mg bid. the oxy works much faster. i no longer need to wait 1-2 days for pain relief. the patches took at least a day to start working. the draw backs on oxy are upset stomach and constipation. i take a mild stool softner at night and all is well. i take an all natural softener called senna plus. works like a charm! im also on tegratol 200 mg 3 x day and o2 15l for 20 min as needed. i have recently had a nurve block on the occipital nurve. they used a steriod and lidociane. i really feel it helped my head aches. the only thing i found worked to abort the h/a is predisone starting at 70-80 mg and tapering off in 5-6 days and seems to help. the draw back on oxys are that they do NOT last the 12 hours. pla



like to know what orther name is the Duragesic patch called

CHRISTOPHER MEKWUYE, cmekwuye@hotmail.com
Posted 3/4/2001 4:29 AM


I like to know what other name the fentanyl patch called. i am on this patch right now and they don't have it in the state i am moveing to so i want to change it but i dont want to be on the morphine, so what kind of patch can i use or what other medical name is the fentanyl patch called. thanks
Chris



switching form oxycontin to patch

Jan Abbinanti, jan0710@aol.com
Posted 27/1/2001 2:28 PM


Have been on oxycontin for several years. My doctor would like to switch me to fentanyl patches. My concern is withdrawl form the oxycontin. Would I have withdrawl symptoms?
Help, I am very frightened and would like to ghave a lot of information to make an informed decision.
Jan



having hard time adjusting

susan, kita@total.net
Posted 30/12/2000 3:59 PM


just started to take the patch it doesnot give me much relief I have been on ms contin oxycontin leritan this was very good off the market i am on 5o 3 days I feel pain after 2 days or less can you take other pain medications with the patches this is from mvh accident I have chronic ostemalyisi staph b infection they were going to amputate thank god they saved my leg god help me i suffer please anyone have an answer to my question can you take other medications with the patch



Lynda, teoandlynda@earthlink.net
Posted 24/5/2001 11:34 AM


I am a migraine suffer, and have tried many medications(Imitrex,maxalt,amerge,naproxen, verapamil,elavil,tylenol with codeine,DHE and kytril for nausea.It's been along battle trying to find the proper med. because I'm allergic to many meds.(penicillin, asprin, compazine and reglan)I get a dytonic reaction.I'm on the fentanyl patch 50mcg and still experience severe pain.My doc seems to not take my pain seriously.These headaches are taking over my life.I don't know what to do anymore and I don't want to give up!If anyone can help me figure out what to do.Thank you, Lynda



Getting off fentanyl patches

Fran, guardia1@crosswinds.net
Posted 17/12/2000 9:32 AM


I have seen so many people request to get off the patches. I myself have taken every pain killer know to man and withdreww from all of them at sometime in my life by myself. I have just gotten off 30mg of my final doses of morphine (Was at 120mg.now at 30mg.)in preparation to also get off the patches this way.

My body can't take severe withdrawel anymore as I am 50 and have several medical problems that are lifelong. I have come up with and idea seemed to be working when I suffered an Addisons crisis and was hosptialized. I have no stress homones to help me battle withdrawel. I had worn my patch for 4 days instead of 3 and got down to the 17 hr half life of the drug before experiencing withdrawel,. I was into the 3rd day of sysmptoms when I collapsed and spent 5 days in the hospital. I would have made it now that I have some medications for nausea and can also use morphine as needed for pain,just for the week of withdrawel. My doctor thinks it will work, I am waiting to try again when I am stronger. Getting off the morphine was fairly easy, but this stuff is 30 times stronger remember! have someone stay with you and if things get out of hand, go to the hospital if nausea gets to severe or dehydration starts.



Tom Woods, wanker@hotmail.com
Posted 11/1/2001 10:55 AM


www.icq.com



Howard, hj@mail.com
Posted 1/2/2001 8:06 AM


I was on all types of pain meds for chronic pain, starting with Talwin,darvocet,vicodin,percocet, then stadol, after using that too much my doctor put me on duragesic patches, they worked great for awhile and one thing happened that never happened before, I lost weight, it was amazing, the best weight loss drug out there, then I started having withdrawl symptoms but still needed pain meds, so finally they put me on oxycontin, I've been on it for a year, my weight all came back and my pain is controlled, so we'll see what happens, but if they could figure out how the fentanyl causes you to lose weight and make that into a non-addictive pain med, they'd make millions, this weight loss never happened on anything else, just duragesic patches.



Holly, kajo@dmv.com
Posted 13/3/2001 3:20 AM


I have been on 80 milligrams of oxycontin 2 times a day and tried to stop this weekend by just taking percocet. Couldn't do it, the withdrawel was so bad, the percocet took the edge off by about an hour. The 80 milligrams of oxycontin was making me so anxious I felt like I was loosing my mind. So I had a 50 milligram patch of Fentynol that I put on and am heading to the Dr. in a few hours. Has anyone been weaned off this and if so how did your dr do it? Please someone respond asap. I threw the oxycontin down the toilet, I just couldn't take one more! The fentynol patch is better but I want off all of it. Please someone give me some feedback! Thanks



Granny, skybluepink333@hotmail.com
Posted 7/6/2001 7:12 AM


I just got my prescription filled today and will start it tomorrow in hopes this will lower my pain level. I too have numerous allergies to many 'pain' meds, and pray this works for me. My doctor gave me some samples of the butterfly tape they use when stitches are removed, and told me they would keep the patch in place. Plus a previous poster gave a toll-free number to call for dressings to make it adhere longer. My doctor also mentioned adding Actiq (in the form of a lollypop) to help with 'breakthrough' pain. You all might want to investigate this medication if you're dealing with chronic pain.
Take Care all.. May God surround you all with His loving arms, and may He direct us all on a path to lessen our pain.



long term effects

John, jwe43460@yahoo.com
Posted 5/11/2000 2:40 AM


can anyone tell me what the long-term effects of fentanyl use are. Or the long-term effects of fentanyl vs/compared to morphine.



PATCH USED UP BEFORE THE 3 DAYS ARE UP

lesley, tippan@iprimus.com.au
Posted 21/10/2000 3:31 AM


what causes your body to absorb a three day patch within 24hours person has been on long term slow release morphine for approx 2years



Rob Young, tassieiscold@hotmail.com
Posted 27/1/2001 3:58 AM


I can't get 72 hours out of a patch.
48 hours and I'm starting to hurt again.
I am on 75s.
I reckon they're great though in other ways.
I used to get up so withdrawn, from having no medication through the night, I looked like Godzilla.
I wake up now, and feel almost human again. It definately takes away the drawn out feeling of waking up dry.

But as for 72 hours, i think there's some hopefull theory going on there.

rob



Duragestic 25mcg patch

buttercup, butercup@tampababy.rr.com
Posted 29/9/2000 10:11 PM


I am curently suffering from back pain associated from injuries I substained from a MVA accident in May 1998. I have bulging disc's at C4-5 and C6-7. A small central disc protusion at the C7-T1. A herniated disc at the L5-S1. Pain shooting down into my right knee. Tingling pins and needles in both arms associated with stiff neck and migraine headaches. The stiffness in the neck and headaches come and go. The lower back pain is worst before, during and just after my periods, do to the imflammation there. I also have chronic Asthma. I've had Chiropractic treatments, massages, cervical and lumbar excercise therapy, Accupuncture, nerve blocks, facet joint injections and radiofrequency lesioning done. I'm still in lot of pain. I am scheduled for surgery in Nov. 2000. I did get some temporary relief from these past treatments, but the pain keeps coming back.

So until I have surgery. I've been given this Duragesic 25mcg patch to try. I have chronic asthma and I'm curently also taking 300mg of Theo-dur 2 X a day, provental (generic Albuterol) inhaler, the same for the nebulizer (for breathing treatments)for my asthma. Celebrex 200mg 2 X a day,Ultram 50mg 2 x a day as needed and Glucosamine Sulfate Complex (300mg-sulfate & 200mg HCI)for healthy joints, all for back muscle and joint pain.

I started the Duragesic 25mcg patch at 6 pm (09-28-00). I woke up from a sound sleep at 3:15 am (09-29-00), wheezing and shortness of breath. So I took a breathing treatment by using my nebulizer. Which helped control my breathing. The patch is still sticking now at 7:00 am.(13 hours hours after applying my first patch). I currently have a headache and stiffness in my upper back up into my neck. My lower back is hurting, but not as bad as it was, but bloated do to not starting my period yet. I feel drowsy and dizzy. Unsteady on my feet, walking. I'm 3 days late on starting my period. (I know I'm not pregnant!!) I am passing alot of gas and a liitle upset to the stomach, but have not vomited yet! But feel like it! My headache seems to be turning into a migraine and can't continue typing. What I need to do now is call my doctor or pharmacist to see if I should coninue with this drug, do to the side affects i am experiencing while typing this. I f they will get worst or decr



buttercup, butercup@tampababy.rr.com
Posted 29/9/2000 10:10 PM


I am curently suffering from back pain associated from injuries I substained from a MVA accident in May 1998. I have bulging disc's at C4-5 and C6-7. A small central disc protusion at the C7-T1. A herniated disc at the L5-S1. Pain shooting down into my right knee. Tingling pins and needles in both arms associated with stiff neck and migraine headaches. The stiffness in the neck and headaches come and go. The lower back pain is worst before, during and just after my periods, do to the imflammation there. I also have chronic Asthma. I've had Chiropractic treatments, massages, cervical and lumbar excercise therapy, Accupuncture, nerve blocks, facet joint injections and radiofrequency lesioning done. I'm still in lot of pain. I am scheduled for surgery in Nov. 2000. I did get some temporary relief from these past treatments, but the pain keeps coming back.

So until I have surgery. I've been given this Duragesic 25mcg patch to try. I have chronic asthma and I'm curently also taking 300mg of Theo-dur 2 X a day, provental (generic Albuterol) inhaler, the same for the nebulizer (for breathing treatments)for my asthma. Celebrex 200mg 2 X a day,Ultram 50mg 2 x a day as needed and Glucosamine Sulfate Complex (300mg-sulfate & 200mg HCI)for healthy joints, all for back muscle and joint pain.

I started the Duragesic 25mcg patch at 6 pm (09-28-00). I woke up from a sound sleep at 3:15 am (09-29-00), wheezing and shortness of breath. So I took a breathing treatment by using my nebulizer. Which helped control my breathing. The patch is still sticking now at 7:00 am.(13 hours hours after applying my first patch). I currently have a headache and stiffness in my upper back up into my neck. My lower back is hurting, but not as bad as it was, but bloated do to not starting my period yet. I feel drowsy and dizzy. Unsteady on my feet, walking. I'm 3 days late on starting my period. (I know I'm not pregnant!!) I am passing alot of gas and a liitle upset to the stomach, but have not vomited yet! But feel like it! My headache seems to be turning into a migraine and can't continue typing. What I need to do now is call my doctor or pharmacist to see if I should coninue with this drug, do to the side affects i am experiencing while typing this. I f they will get worst or decr



shirley, pandalee@webtv.net
Posted 29/10/2000 9:52 PM


I Just started using this patch and I feel great. I was on Wicodin ES before and I wanted off of them so bad. What Ineed to know is...Am I better off doing the patch or the Pills as far as becoming an addict?



withdrawl symptoms and treatment

Posted 1/9/2000 1:10 PM


WOULD LIKE TO KNOW WHAT THE COMMON WITHDRAWL SYMPTOMS ARE AND BEST WAYS TO TREAT AND TOLERATE THEM. THANK YOU FOR YOUR HELP. ALSO WOULD LIKE TO KNOW WHAT DRUGS ARE EASIEST SUBSTITUTED TO FACILITATE A SUCCESSFUL TAPER OFF OF FENTANYL PATCHES. I HAVE TAKEN THESE>2YRS, STARTING @150MCG-NOW AT 25MCG. THANKS AGAIN.



Posted 1/9/2000 1:04 PM


shandy, smehdian@yahoo.com
Posted 25/12/2000 11:38 AM


Please HELP!!!


I need to know how to treat withdrawl symptoms of morphine!! Patient is having delusions and burning sensations. How long will this last, what can loved ones do, ie stay away or comfort?

How long do the symptoms last?

Please, please help fast!!!


Thanks



WITHDRAWL OF DURAGESIC - NEED HELP!

Steve, scrawfrd@aol.com
Posted 27/8/2000 4:46 AM


I have been on 25 mcg of duragesic for almost 3 years now. Over a year ago I wanted to get off them. Could not handle the withdrawl, it was worse than anything I have ever experienced.

I have had numerous surgeries and was always able to withdraw from whatever was given to me. Am also in AA and have not drank for 13 years.

The duragesic gives me energy when a new one starts and after about 36 hours I get so physcially tired that I have to wait until it is time for a new patch.

I just cannot stand to be addicted and controlled by the duragesic, have made so many attemps to withdraw but have never gotten past 5 days.

Please, if anyone has any answers or can direct me to someone who does. My Doctor does not think I should be having these severe withdrawl symptons so his only answer is for me to stay on them.



FAMILY YEPEZ of Ecuador, tathyj@yahoo.com
Posted 27/9/2000 7:29 AM


we need search the fentanyl patches for a sick aunt.
Please, if you help us , write us to: tathyj@yahoo.com



Discontinuing

KLS, ksimp50756@gateway.net
Posted 16/8/2000 8:45 AM


Would like to know if anyone has tapered off of fentanyl patches. Currently using 25mcg q 3 days. Have previously been up to 150mcg's. Have used for 2 years. Thanks for your help.



Severe reactions to Fentanyl Patches

Shane , nightflier@ace-mail.com
Posted 30/6/00 10:47 PM


I had a really bad motorbike accident 4 yrs ago.
Due to this accident i have a bad back and left knee injury. Thankfully to God that i didn't get my left leg amputated.
I have been on about everything out there for pain managment.
Then my specialist recommended me to use the Patches because due to much intake of tablets even methadone i now have a very sensative stomach and can hardly keep food down or any type of tablets to relieve pain.
I had used them for approx 6 months and then tragedy arrose. I got a bad case of allergic reaction that lasted for 1 month.
Non stop vomitting and nausea, even got to the stage i started to vomit my own bodly Fluids.
So the time came to take them off and find the last thing to relieve my pain, and the only medication for pain management that is left for me is IMI of Morphine.
But i must say that i have had to turn to other alternatives cos all medication big or small has damaged me more than i have bargain for, left me much worse than the initial injury and even pain.
I am glad to hear that many people it has helped, but i am interested to hear if anyone has gone through similar reactions.
Keep faith because you will eventually get used to it. I am almost there, patience is such a hard thing to learn, for me, it was anyway.
I wish you all the best



daniel kaminski, kevala@webtv.net
Posted 6/7/2000 2:41 PM


yes ive tried the fentanylpatch

100mcg-switching from 200mg a
day methadone for chronic pain

( the methadone was giving me
anxiety attacks ) the fentanyl was worse, hot flashes-cold
chills, I could not sleep,I
could not eat ( food literaly
tastsed like poison ) I became
increasingly nervous,by the third day my brain felt over-amped.I felt so bad that I
decided to take the patch off
for a couple of hours. (what I
didnt realize was that I was
actually in a state of withdrawal) I fell asleep and
woke up the next morning in a
state of extreme withdrawal.
I was nuaseated sick and in a
state of mental hell. I took
about 60-80mg of percodan and
2hrs later I was even worse.
I decided to try a nearby
hospital er. they made me put
the patch back on and gave me
4 yes 4mg of morphine. eight
hrs later still sick, I threw
up and decided to go home.
when I finally got back to my
pain doc he put me on oxycontin
but I continued to lapse into
withdrawal every 6 hrs. I needed 300-400mg of oxy just
to stay out of withdrawal.
it took me about 3weeks to
stablize. for the next 3months
I woke up every morning chilled
to the bone absolutly freezing

my doctor said it was psychological !! now my doctor
wants to drop my case because
the episode made him look bad!!
and he is being investigated.

somebody please help!!!
I cant belive this is happening

I need to find a pain doctor
that I can trust.

sincerely dk



Kermit, paracon@spacestar.net
Posted 8/7/2000 4:14 AM


Can anyone suggest where I might find some guidelines for changing from a patch back to morphine. I am presently wearing 75ug/hr patch and would like to discontinue them for a short while--It is my hope that switching back and forth every so often will decrease the likelyhood that I will get used to the patches and have to increase the quantity as a result.

Additionally, can anyone suggest a medicine that can be used to minimize the psycholigical discomfort that comes with withdrawl? i.e. would librium or xanax be options?

Thank you and God bless.
Kermit



KLS, ksimp50756@gateway.net
Posted 16/8/2000 8:41 AM


PAULA, ALYSMOM@BWSYS.NET
Posted 3/9/2000 7:43 AM


MY BROTHER WAS EXTREMELY ADDICTED TO PAIN KILLERS LIKE VICODEN AND VICAPROFIN AND WAS SEEN BY A DOCTOR. THE DOCTOR PRESCIBED FENTANYL PATCHES AS AN OUTPATIENT THERAPY FOR PAIN MANAGEMENT. THE DOCTOR PRESCRIBED 10 PATCHES BUT MY BROTHER COULD ONLY PAY FOR FIVE. HE ENDED UP USING ALL FIVE PATCHES AT ONCE AND DIED THAT EVENING. I DON'T THINK THAT HE SHOULD OF EVER BEEN GIVEN THAT MANY PATCHES, KNOWING THAT HE HAD A SEVER ADDICTION TO PAIN KILLERS. I THINK THIS DOCTOR SHOULD BE LIABLE FOR PART OF HIS DEATH. MY MOTHER BEGGED THE HOSPITAL TO ADMIT HIM, BUT HE HAD NO INSURANCE. I JUST FEEL THAT HE HAD NO BUSINESS PRESCRIBING THIS KIND OF TREATMENT. I WOULD APPRECIATE ANY KIND OF RESPONSE AND/OR OPINION ON THIS MATTER. THANK YOU



PAULA, ALYSMOM@BWSYS.NET
Posted 3/9/2000 7:43 AM


MY BROTHER WAS EXTREMELY ADDICTED TO PAIN KILLERS LIKE VICODEN AND VICAPROFIN AND WAS SEEN BY A DOCTOR. THE DOCTOR PRESCIBED FENTANYL PATCHES AS AN OUTPATIENT THERAPY FOR PAIN MANAGEMENT. THE DOCTOR PRESCRIBED 10 PATCHES BUT MY BROTHER COULD ONLY PAY FOR FIVE. HE ENDED UP USING ALL FIVE PATCHES AT ONCE AND DIED THAT EVENING. I DON'T THINK THAT HE SHOULD OF EVER BEEN GIVEN THAT MANY PATCHES, KNOWING THAT HE HAD A SEVER ADDICTION TO PAIN KILLERS. I THINK THIS DOCTOR SHOULD BE LIABLE FOR PART OF HIS DEATH. MY MOTHER BEGGED THE HOSPITAL TO ADMIT HIM, BUT HE HAD NO INSURANCE. I JUST FEEL THAT HE HAD NO BUSINESS PRESCRIBING THIS KIND OF TREATMENT. I WOULD APPRECIATE ANY KIND OF RESPONSE AND/OR OPINION ON THIS MATTER. THANK YOU



John, JFer7631@aol.com
Posted 26/11/2000 1:31 PM


Been up the ladder of pain medications to finally reach the oxycontin level. Doctors are schocked that I take '3' a day for pain relief. Frankly, i could take 5 a day to adequately relieve the pain I feel. Oxycontin ain't no heroin or morphine. Anyway, my doctor was on vacation. My back was completely on fore. The alternate dr. gave me 5 50 mg. patches. They've lasted for about 36 hrs. and then become uncomfortable to wear. But the relief has been phenomenol. Unlike eating gobs of pills and begging from my friends for more, this patch has softened my waking up and allowed me the mobility (within reason) that I've been used to. So, for me, at this point, I'm very peased with the dose of patch I'm on.



Problems with patches coming off before 72 hours up

Tammy Ewing, mtewing@earthlink.net
Posted 10/6/00 10:47 AM


I wanted to post some information I found on the Internet regarding using Duragesic (Fentanyl Transdermal patches. I found that no matter what I tried, I was unable to get the patches to stick to my skin for more than an hour or two. I just started on the patches Monday of this week and on the first day, I ended up ruining two 25 patches because they wouldn't adhere to my skin. Finally, I found a mention on the Internet that you could call the maker of Duragesic (Janssen) and they might have a solution. I found their number in the insert with the patches and called them and they sent me an additional adhesive that you use over top of the patch and this makes the patches stay put. The dressings they sent me work great! I wanted to post this information in case others are having the same problems with the patches not adhering.

I called Janssen at 1-800-JANSSEN (526-7736). I went through their automated answering options and requested to speak to a Customer Service Rep. Once I explained my problem, they federal expressed me a box of Johnson and Johnson Bioclusive transparent dressings to use as an additional adhesive to help secure the Duragesic patches. They sent me a box of 50 at no charge to me for either the dressings or for the shipping. The letter enclosed told me that all I needed to do was call them before I ran out of the dressings and they will send me more dressings as long as I need them.

I just started on Duragesic. I am on 1 to 2 25 patches every 72 hours in response to strong pain from Fibromyalgia and a bulging disc in my lower back. While I don't 'feel' the medication the way I did when I first started taking the oxycontin I was on prior to switching to Duragesic, I believe I'm getting more even relief. On the oxycontin (20 mg 3 times a day), I would wake up feeling pretty bad (sore, aching, headachy). Now, for the first time since being diagnosed with FMS, I wake up feeling almost normal (I still have acute pain in my back, but the FMS pain seems lessened). Overall, I seem to have more energy and less pain and I feel this way most of the day and night now. On Oxycontin, I would feel good starting about an hour after a dose. That relief would last for about 2 - 3 hours and then I would be on a rising scale of pain that would peak about 1-2 hours before my next dose of oxycontin. Then I would start feeling relief an hour after the next dose and the roller co

Thanks and I hope my information helps.



Morphine Pump

Leo, hair@zippnet.net
Posted 20/1/00 6:11 AM


I am scheduled to have one of these put in for intractable cronic pain and would like any and all comments about anyone's experience or concerns regarding the pump. Please E-mail me directly at the address above.

Leo



Duragesic 25

Joseph Pearn, pearn34@aol.com
Posted 17/12/99 3:16 AM


My doctor recently prescribed Duragesic 50 to me for pain - injury. I experienced much nausea with vomiting for days + alot of itching all over my body. I also am constipated, and I cannot stay erect, and I sometimes urinate without knowing (loss of feeling). My doctor then lowered my dosage to 25. He also prescribed Compazine for the nausea. I want to hear any comments you may have to offer.



durtro, durtro@dellnet.com
Posted 31/3/00 4:19 PM


I am a 40 y/o m in the USA. one of the medications that i have been taking for advanced HIV infection has caused a very painful condition called peripheral neuropathy. without going into too much detail, my feet are riddled with cramps, pain, sensations of tingling, numbness...and sleep is difficult, as i often wake up with cramps in my feet/shins shortly after falling asleep.

due to all the medications i take, oral narcotics had especially problematic side-effects. if i had already taken my antiviral meds for the day, and had to take an oxycodone, invariably i would hitch, and gag. sometimes, i would even throwup the antivirals, which is very bad [studies show microdoses of antivirals create drug-resistance sooner in the population of HIV].

plus, oxycodones make me crabby. not so, with the Duragesic patch. i have pain relief, clarity, and i'm not nearly as worried about addiction [i have a history of addiction to multiple substances]. it's not that kind of thing.

i have dealt successfully with addictions to stimulants, mostly, and no longer partake [or even desire them]. the problem is that many physicians wouldn't prescribe me anything, due to my past history of abuse. and i'm here to say that is just plain wrong. i have been managing pain successfully with my physician for two years. i know when i need to back off, and she knows that i am very conscious of addiction and that it's something i don't want.

please, Physicians-pain relief is so important to well-being. sometimes, addiction should even be a secondary consideration.

thank you
-durtro
grateful for the duragesic patch
and compassionate physicians who aren't afraid to be audited



DIANA, DWINN404018@aol.com
Posted 27/4/00 5:47 AM


I WAS DX WITH FIBROMYALGIA 2 YEARS AGO BEEN ON OXYCONTIN 30MG THREE TIMES A DAY WASNT WORKING SO DR STARTED ME ON DURAGESICS 25MG HAVENT STARTED THEM YET CAN ANYONE GIVE ME THERE OPION ON THESE AND HOW YOU FEEL ON THEM I GET USE TO ONE THING AND AFRAID TO TRY SOMETHING DIFFERENT APPRECIATE ANY SUGGESTIONS THANKS



pete, pvp62@aol.com
Posted 26/5/00 3:27 PM


can anybody tell me how duragesic25 makes you feel in there mindset. doesit make you feel good and also stop the pain.I have 2 herneated discs in my lower back.

Thanks PETE.



Jan, Jann4@webtv.net
Posted 15/8/2000 10:54 AM


Hi. Since my surgery to remove three discs and repair stenosis I have been better but am stil expieriancing much pain 24-7. My doc decided today to have me try the patch instead of raising my now dose of 200 mg of Oxycontin plus vicoprofen and Robaxin.I think it will be cool not having to take pills and hopefully I will not have to wake up in serious pain anymore! I would love to receive e-mails from anyone and everyone that will give me their opinions or advise concerning the use of the Duragesic Patch....Sincerely, Jan Woodring



Fentanyl Patches

George Harris, StarPD@worldnet.att.net
Posted 20/5/99 6:50 PM


I have been using 'Duragesic' Fentanyl patches as needed for about a year now. I take them to combat the severe headaches, stiff necks, general mucle pain, and insomnia that is a part of Chronic Fatigue Syndrome.
I take my pain meds on a graduating basis, depending on the severity of the pain, and how much of which I've already had, and when.I've been doing this for 12 years, and am now 60.
Soma w/ Aspirin-Free Extra Strength Excedrin routinely for mild pain. When that's not enough, I take no more than 1 Percocet w/ a Soma 4 hours apart, no more than 2 consecutively, and no more than 2 consecutive days. When the pain is extreme, I stretch that to 3 per day for 3 days, That's absolute max. When the side effects of the Percocet accumulate and make life miserable, I stop them for a few days, then use the 'Duragesic' Fentanyl (25) patch.
While the pain relief is not as great as the Percocet, the side effects are much lower too, plus I can sleep! I'd try the Duragesic '50', but am afraid of the doubling of the '25' dosage. But then, I ration the Duragesic to no more than one every 2 or 3 weeks.
It's a balancing act to try to choose the best medication for the amount of pain I have, and still avoid either physical or pschological addiction, or reduction of the effectiveness of the drugs, which I fear. Unfortunately, too many doctors don't believe in long term use of narcotics for chronic pain control, even with patients they can monitor, and know are not abusing them. So, they refuse to prescribe them to people for whom they arer actually intended
Naturally, I am bitter and resentful of the medical profession, and accordingly, don't trust their knowledge, expertise, or dedication.
But, with proper monitoring, I think Duragesic is the answer to a pain suffer's prayer.



Dania , dsorlmia@aol.com
Posted 30/5/99 3:45 AM


My mother has been prescribed the fentanyl transdermal patches, however, we are having trouble getting the prescription filled. She lives in Miami, Florida. How do you order yours? Did you have trouble getting your prescription filled? Her prescription strength is 25mg. If your insurance does not cover it, do you know the approximate cost? (Just in case we have to go to a pharmacy outside of her group pharmacy coverage).

Thank you!
Dania



Karen Brentnall, karen@tansleyhill.freeserve.co.uk
Posted 12/8/99 12:50 AM


I have been on Fentanyl patches since July 1996. Previous to that I was on a cathater of 3 x 100 ampules of diamorphine per day and oramorph for breakthrough pain. My vetebra snapped when I was 21 getting out of bed. I am now 36. I first had the vertebra fused back to my spine. 7 years later I had it re-fused and also a 'hartmans rectangle' inserted in my back. This effected my scar tissue and was removed 12 months later. I then had 2 cathaters unitl the last one was removed through an abcess. The UK had just started using Durogesic patches & through my pain consultant Dr Kumar, he introduced me to it. I had withdrawl from comming off the morphine, but little things to be able to shower & not have to carry the cathater around have made it worth while. My only complaint is that like all medication, your body gets used to it eventually & I find that is the case. I am on 2 x 100mgs every 48 HOURS (I previously got chronic breakthrough pain at about 52 hours) and I still have bre
I used to get very nausious & terrible constipation on morphine, I certainly am not as sleepy now. I would just like something to take all the pain away as with chronic back pain, it is not just the back that it affected!



Lael Walker, mojowoman2@aol.com
Posted 9/9/99 9:15 AM


I am about to be in a study for the 12.5 mcg patch for chronic TMJ pain and wanted to know the history of the patch. It sounds like a life saver! Anything to get off the Percocet, Oxtcontin roller coaster. (though, I prefer the Oxycontin for its time release capability) I am looking for information on price, availability, long term side effects and any other info pertinent to use of this drug.



MIchael Hall, mhaller@bmr.net.au
Posted 18/9/99 9:14 PM


I wonder if I should try the Fentanyl patches. I am currently taking oxycodone (endone) and codeine/paracetamol tablets at the rate of 8each a day and have been for 10-12 years. I have bad damage to my neck as the result of being assaulted. I don't know how much longer I can go on with the pain. I am only 39 today and have a long time to live yet if my insides can make it after all of this mediciation. Can anyone assist me with their thoughts, Michael



Shafiq ur Rehman, shafiqr@sa.ibm.com
Posted 6/10/99 2:52 AM


Janice, eckerska@wimmera.com.au
Posted 25/10/99 6:26 PM


Great handy for assigments



stewart cowley, stewart.cowley@cableinet.co.uk
Posted 30/11/99 10:33 PM


I have been using this patch in its 50mg state for the past 2 years now and have found it to be a lot better than taking 150mg of SR Morphine a day to keep my pain at a tolerant level without the side effects that taking Morphine involves.I also take Dyhydrocodine which used to be 8 30mg tabs a day now I thake 4-6 a day.This is for leg and back pian caused after an EDB TRANSFER operation in1991.



stewart cowley, stewart.cowley@cableinet.co.uk
Posted 30/11/99 10:29 PM


I have been using this patch in its 50mg state for the past 2 years now and have found it to be a lot better than taking 150mg of SR Morphine a day to keep my pain at a tolerant level without the side effects that taking Morphine involves



chad, rico50@hotmail.com
Posted 20/12/99 10:12 AM


I have been on the Duragesic patches for over
1-week now and previously took (12) Norco 10mg (hydrocodone) tablets per day. I find the Duragesic to work much better and I get a smooth sustained release throughout the whole days instead of the up and down roller-coaster effect of the immediate release medications.

It does not cause me any constipation nor nausea and when I wake up, I do not have hardly any pain (like I used to). I highly recommend it to anyone who has failed on the IR meds and needs around the clock medication.

I am on the 50mcg patch and then I only need approx. 3-4 Norco tabs per 24-hours now instead of the 12-tabs that I was previously taking.





Chris Somers, epicene@student.ecel.uwa.edu.au
Posted 12/1/00 6:31 AM


January 12 - 2000 - 3-15 AM - Australia.

First Happy New Year 2000 and may it be kind to you all.

I have just been placed on the 25 Fentanyl patch.

Prior to this I had a dreadful run of various pain relieving drugs which have given me a dreadful time to put it mildly. I was on 'oxycodone' then 'prolodone' both of which I found intolerable causing great upset, excessive constipation, restlessness and constant nausea as I did with morphine 'MS Contin'. Though all three took the pain away or reduced it, they did so at one hell of a price.

I have actually asked my medics to take me off all three and never to be given them again - in fact I would refuse to take them if given them knowingly or otherwise. I would rather suffer the pain than be in constant fear of other debilitating factors which cause further pain and thereby establish a vicious cycle. This may sound silly but all I want is relief not added problems or substitutes of a nasty sort.

I have been put on other pain relieving drugs inclusive of 'Fortral'(pentazocine) which gives me short term relief, but find that it too causes nausea, sometimes nasty headaches, and I can never sleep and dare not shut my eyes with it. It gives me nightmares so consequently it is not very conducive to relax the system which is always compromised by all the various side effects of this and other medication.

Perhaps I am a hard case to crack concerning pain management and getting adequate relief without all the negative side effects of the medication the world has to offer. I have had pethadine in the past but have too suffered headaches, and taste of petrol like-symptoms and nausea from this too.

I have only been on the 'Fentanyl' patches for a month and though I still get the nausea it is not as bad as before and the constipation seems to have been reduced, though I still find pain breaking through I think I may be able to accommodate it at present, as I do have a high pain threshold for certain types of pain ( interestingly enough I have often wondered whether other people have been able to shut out certain types of pain and not others through force of habit and having to deal with it constantly assuming it does not get too high or peak?).

Pain is a strange phenomena as some of these medications may reduce the pain they seem to lay the foundations for other problems which in the end seem to exacerbate that which one is trying to get rid of. It is difficult no doubt for medical personnel and sufferer to find the combination to alleviate that which is so draining, i.e. the pain that any given individual may be suffering and the fear that some medicos have in prescribing to those who actually suffer pain.

I am hoping at long last that I may have started to get some real help that may lift me over the hurdles... I shall give it a fair chance and see what happens...

All the best to all of you who are trying to find a path to alleviate your suffering and the sharing you offer to others to help them over. Thanks too for the feedback you give to the doctors and others through sites such as this, which I hope, will help them too in their research and understanding.

Oh, I suffer from chronic back pain, which is extremely painful - the result of an old injury sustained from being the victim in a hit and run case - me on a bicycle and a drunk driver of a car slamming into me. Not a good mix.

However life goes on and I wish, as no doubt you do too, to live it as well as I can. Good wishes for the New Year 2000 and more - Chris.

PS My e-mail is not working at present so anyone writing directly to me will not reach me - I can send out but not receive. You can snail mail me at: c/o P.O. Box 1066, Nedlands, W.Australia 6909.






andy, lovemasta13@aol.com
Posted 3/3/00 3:29 PM


please help i'd love to try the patch



shane, finchboy@webtv.net
Posted 3/3/00 4:41 PM


would like to switch to these, tired of the oxycontin addiction. i just want to slap a patch on my arm and not have to pop pills all the time. i have read these comments and i believe they will be better than oxycontin for pain and in the narcotic high you get with it. oxycontin makes me wired like a hyperactive kid almost, with periods of 'nodding' too. i can't take the oxycontin at night because it keeps me awake! Does everyone who uses the fentanyl patches (duragesic) who USED to use oxycontin get to sleep better at night? Please answer. i would appreciate your comments. i suffer from severe TMJ as well as other dental problems for several years. I like the oxy and its pain relief and feeling, but i am tired of the anxiety i get with the oxy. i hear the duragesic/ fentanyl patches are more relaxing but you are still able to function also. I just don't want to vomit alot on them! Oxycontin does NOT make me vomit or make me nauseous. Thanks for any replies on this list!- shan



Maurice Tremblay, tremblay@ntl.sympatico.ca
Posted 13/3/00 12:34 PM


My father had a fall some 4 years ago. Since then he has been in unbearable pain in his sciatic area. After seeing many doctors over this time frame he finally found a doctor that took the time to investigate his problem. this doctor decided that my father had a collapsed muscle running up the cheek of his bum. While inside he discovered that the sciatic nerve had been moved from its original location and was riding on a bone causing some scaring to the nerve. my father is now on 2 x 100 Fentanyle Citrate patches and still has to take morphine, by injection, for breakthrough pain. While at home he was taking Dilaudid 4mg 5 times daily instead of the morphine for breakthrough pain. the doctors in my small town are not that familliar with the patch and seem to be hesitant to increase it. The local pharmacist isn't concerned about increasing it further. He needs more relief as he can't eat due to the pain and has went from 170lbs down to 130lbs. if there is anyone out t



Holly Pivoda, Holly.Pivoda@lockhart.txed.net
Posted 15/4/00 1:39 AM


I have recently been put on a Duragesic patch this week. It seems to be working well for my endometriosis. I still have back pain and my neck continues to ache. I am due to put on a new patch tonight. My question is does anyone have trouble keeping the patch on? Mine started lifting the day after I put it on. Does this mean I am loosing medication? How do I keep it on? I followed directions on the box.

thanks,

holly





James Lewis, jimbob1@ptd.net
Posted 7/6/00 4:34 PM


I've been on 100microgram patches for about 5 months now. I still have terrible problems with pain. I can't lay on my left or right side without having severe pain in my lower back and or my hips. Please help me if anyone can offer any suggestions.
I've got blown discs at L-3 & C-5,C-6.
Torn rotator cuffs in both shoulders.
Plus much more from a bad truck accident back in 1985.
Again I was injured terribly in a fall back in 1997.
To top it all off, I have degeterative disc disease in my whole back & cercical region plus real bad authritus in both knees and both ankles.
I'm not kidding with any one. I keep praying to our GOD to help me. When he knows that I can no longer handle this then he will intervene.
GOD BLESS YOU ALL & MAY YOU ALSO SEEK THE LORD OUR GOD



Marc Fellman, mmfxx@home.com
Posted 7/6/00 5:41 AM


Have been using for a year just broke off two weeks ago tough withdrawel but probably can get by pain iscbeing controlled by predizone right now was using 100mg patches 2 48HRS



Valee, zepolv@aol.com
Posted 1/7/00 12:03 PM


Can anyone offer suggestions on how to safely discontinue the use of fentanyl patches, 50 mcg/3 days, after being on them for five months? Are there any withdrawal symptoms likely to occur?
Thanks.





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