Pain Management Community
Change in Meds / Fentanyl Patch
About This Community:

This patient support community is for discussions relating to pain management, chronic pain, arthritis, back pain, cancer, headaches, movement disorders pain, and muscle pain.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
Blank Blank

Change in Meds / Fentanyl Patch

I have impacted nerves in my neck which cause pain and numbness that radiates down both arms.  I have had three epidural steroid injections with no improvement and have started physical therapy.  All things seem to have actually caused the frequency of the pain to increase.  I was taking Percocet to manage the pain, 2 pills 2 X per day and Flexeril as needed to sleep at night.  I have recently been switched off of the Percocet to a 25mcg Fentanyl Patch.

Its been almost 1 week and I have not had good results with the patch.  I'm supposed to change the patch every 72 hours, however, after about 48, the skin becomes irritated and itches severely.  I realize the Fentanyl would take time to build up in my system but after 5 days I have not had any relief.  I intend to call my doctor tomorrow but was looking for any feedback or comments.
Related Discussions
19 Comments Post a Comment
Blank
547368_tn?1332173665
Hi Sam,

Sorry, I had the same reaction to the Fentanyl Patch. With each application the red raised hive like rash became worse and in short time spread to my entire back where I was applying them. My physician said I was allergic to the adhesive on the patch, not the Fentanyl. She tried a potent cortisone cream to help the reaction but that too failed. I cannot take Fentanyl because of the severe adhesive allergic reaction.

Give your physician a call and maybe he/she can try the cream and it may work for you. Best of luck. I will watch with interest for your updates.

Take Care,
Tuck
Blank
535089_tn?1400677119
Hi Fatsam:

What are you using to keep the Patch in place? Any form of tape? I wear the Patch on my upper outer arm which is the least sensitive spot on the body. I have had great results. Often the Doctor does not prescribe the correct dosage when the patch is involved. The strengh is calculated by a number of things like your weight, amount of previous prescription and your current pain status. All of these combined can either make the initial patch too weak or too strong. In my case, it was too strong in the beginning and took some time to get used to. I feel that in your case, your dose may be too little and it may need re-adjusting. Talk to your Doctor right away. You will know after a week or by the third or fourth patch if it is going to work or not.

25mcg is a pretty low dose so don't be afraid to tell your Doctor that it isn't right for you. As for the itching...Like I said, try it in different areas. I am sensitive in most places except for the upper arm. Please take care and good luck,
Mollyrae
Blank
Avatar_m_tn
Thanks for the comment.  I've had mixed results with it sticking on its own.  When it starts to come up, I use medical tape around the outside.  The redness and itching is generally focused in the center.  I've tried a few different locations thinking about the sensitivity.  

Its funny because the patch was prescribed by my primary care dr.  The pain management clinic thought it was a big jump from the amount of percocet I was taking.  All I know is what I feel.  I'm about 250 lbs so typically it takes a bit more to be affective than the typical person.  I'm calling both places Monday morning.
Blank
Avatar_m_tn
HMM, I just got switched from Hydrocodone to the patch. I was on 25MCg and it was to strong for me to mentally deal with. So, he dropped the dose by half and supplements for breakthru pain with the pills. I sure do feel like it has helped keep the pain to a lower constant more acceptable level then the YO YO  I was dealing with on the pills. I to put it on my upper outer arm where there is no hair and I can keep it out of the bath.
I agree, talk to your DR for the best approach. Although this forum has really helped me get thru.
Feel better.
Blank
535089_tn?1400677119
Your Doctor nees to take into consideration your weight. I feel that you might benefit from an increase to 50mcg. I strongly feel that you need to discuss the possibility of this with your Doctor. You may find that it makes all the difference in the world.

Molly
Blank
Avatar_m_tn
My doctor agreed that the higher dose would probably be more effective.  We are going to try the name brand rather than the generic in hopes that I will deal better with the adhesive.
Blank
775302_tn?1253104105
Also, you might need to change patch every 48 hours rather then 72, perhaps the 3 days in one spot is causing the irritaion and you may beneifit from changing the location more frequently. Best of Luck

XO
Babs
Blank
Avatar_m_tn
Update:

I increased to the 50mcg patch and have had much better results.  My pain is reduced significantly.  I'm still trying to figure out how its affecting me functioning.  Overall its pretty good.  I also switched to the Duragesic name brand away from the generic.  Its only been 48 hours but so far no itching.  It didn't stick so well either so I am using tape around the outside.

I think how it adheres has a lot to do other factors such as location, movement, and temperature of my skin at the time.  If its humid and I get the least bit sweaty before it gets a good seal its done and will start to peel.

Anyone have any other comments regarding the side effects they've experienced?
Blank
535089_tn?1400677119
I don't think any of them stick very well. My suggestion is to use the "paper tape". It lets the skin breath while providing great comfort. It also sticks very well. I have used this process for over a year now and have absolutely no problems.

Good luck to you friend,
Molly
Blank
767538_tn?1276578920
I'm sorry you have had a problem with the patch but I'm pleased to hear you have had better results with the 50mcg patch.
I am now on the 100mcg patch but my Dr also started me at the 25mcg and had to bump me up over about 2 months to 100mcg. Most Dr's will be conservative when initially prescribing this med due to it's strength, they say in it's pure form it is 80 times stronger than morphine. Past use of other meds needs to be taken into consideration but it doesn't sound like you were on that much percocet.
As for side effects, the only one I have experienced has been profuse sweating, but thankfully not all the time. I can tell you though that now, this patch has given me my life back, enabling me to work 50-60 hours a week again and not be out of it when I get home at night, although some nights I still am. I finally have consistent even pain control without the ups and downs you have when having to take a pill. I've been on many other meds prior to this and the last 'Big Dog' was Methadone which Im now happy to say I'm off of.
As for getting the patches to adhere to your body, well that's another story. Molly has given you some good advice about using paper tape, it does help, but be careful when the patch starts coming away, you will go into W/D rather quickly.
The BEST place I've found to get these things to stick was recommended to me by another member on this forum who unfortunately is not on here any more.
Either side of your midline on your stomach, right underneath the band of your underpants, yes that's right!!! The band helps the patch to stay stuck on you and believe me it works, you have to ensure that you have minimal if any hair down there as I do to get the patch to stick, so you may need to do some yard work...Please pardon the pun!!
Give it a try and see how it works out for you. As for taking the patch every 48 hours instead of 72, I asked my Dr about that. His response was "The insurance company WON'T cover it, and if they do, he would keep having to send them a letter to get them to cover it every 48 hours over the 72 hours stating that I need it every 48 instead of 72 hours". One other downside is the cost of this med. If you don't have insurance it's VERY expensive, I have tried both types of patch, the gel-kind (Sandoz) and the ones that look like a nicotine patch(mylan?) The medicine is in the adhesive and it is paper thin. They both seem to work for me although I thought the gel-filled patches worked better personally, I just get whatever the Costco pharmacy gives me.
I never really started getting decenty pain control until taking about 3 of the 75mcg patches. Not sure how long the 100s will last or what happens when you need more of that? I still have Oxycodone 10/325 for breakthrough pain 1 a day or as needed, but I'm finding now I'm up to 100mcg it doesnt work nearly as well (the oxy). That was my Dr's goal...To get me off the oxycodone altogether.
Sorry for rambling on so much...
Please feel free to send me a PM if you want and I will help you in any way I can.
Take care and hope you further success with the patch.
Brian.
Blank
Avatar_f_tn
I've worked my way up to taking two 75 Fentanyl Patches every  48 hours, 60 mg morphine 3x/day, and percocet & fast acting morphine as Breakthrou medication.  My fibromyalgia is getting worse and the medication is not keeping me from screaming during  rainstorms; so my doctors want me to get a Morphine Pain Pump.

Before when the Patches were working, they never worked 72 hours.  My pharmacy said they don't work for Most People for 72 hours, and advises they're prescribed for every 48 hours.  Even if they last longer for some people, the person still FEEL the medication leaving them or wearing off.  changing every 48 hours stops that feeling of having no medication i you.

I start on the 25  patches for a year, then 50 for 4 months, then 75 for 3 months, then 2 75s as I got extremely sicker this past year.  But before that, they helped.  Although, I never was able to reurn to wrok as Other people have.

as far as the red bumps, my friend gets them more than I do.  But he also scratches at the Patch in his sleep and has delicate skin.  I'm only 5'2 and he's 6'2-- so I think stretching his skin out 1 foot made him a little bit of a dandy.  He needs to put lotion on his skin and wait a week before he can re=put on a patch in the same location.

He also sweat a lot and sweats them off.  so he referred me to these surgical bandages that go over the patches and Re-stick them on when they fall off or keep shower water out of them.  Maybe you allergic to the glue in the patch and if you use the surgical tape to hold it on instead of the Patch's glue, you'd do better.  Just cover up the ends of the Sandoz kind and let the surgical tape or this bandage hold it on for you.

Last, skin is your biggest organ-- so it irritates easily when it doesn't get oxygen.  If you can switch to every 48 hours, that's ONE WHOLE DAY you're skin isn't being vacuum-sealed shut.

Hope that help,
ladydee26

PS: if anybody knows anything about this Morphine Pumps or has one let me know.  I'm small and my doctor said there's a kind that doesn't do in the stomach but is just attached to the back.
Blank
1006065_tn?1251482269
I have to admit my heart sank when I saw that you are on Fentanyl patches.  I'm going to tell you the truth about them.  They are 100 x stronger than morphine and one of the most highly addictive narcotics out there.  I am in the process of weaning off of them and I have had withdrawals like you would not believe.  The patches DO NOT WORK FOR 72 HOURS!  I don't care what the company or doctor claims.  And it won't be long before you will start having withdrawals the last 12 to 24 hours of the patch life.  Here's what you will begin to notice:  you feel a little "antsy" and jittery, a little uncomfortable and cranky, you might start thinking your internal thermostat is broken because one minute you are so hot you can hardly stand it and the next minute you are shivering cold.  There will be bouts of diarrhea and stomach disorders, you will notice your pain is magnified at the end of the patch life, like it's worse than it was before you ever started using the patch.  Those are withdrawals, my friend, and you are hooked if this starts happening.  And it only gets worse.

I was duped into the Fentanyl patch while in the hospital with excruciating pain from back surgery, then an impacted kidney stone, then three kidney surgeries to save my kidney.  I would never, in my right mind, agree to a drug such as this, knowing what I now know.  It was designed for terminally ill cancer patients who will never be coming off the drug, you understand what I mean?  They have made their way into the regular chronic pain management world and that's been one of the biggest mistakes ever.

There are class actions lawsuits for wrongful, accidental deaths caused by Fentanyl.  It's supposed to be designed to release into the body at a steady rate.  BUT, if you get it hot (like standing in a long hot shower, lying against a heating pad, running an unusually high fever, etc.) it will release too much medication and, in many cases, it has been fatal!

Now, once you are dependent on that junk, and you see that you are having more bad days on it than good, you have to decide:  Do I live like this? or Do I bite the bullet and get off them?  I am in the process of doing just that...coming off them.  I'm almost to Day 5 since taking off that last patch and it's been pure #ell on earth.  I'm still not there and I've followed my doctor's advice about getting off this stuff.  Days 3 and 4 are some of the worst wds, but it doesn't stop there.  It can take up to 2 WEEKS to get over the withdrawal symptoms to where you are feeling halfway normal.

I just feel I MUST speak out about this drug.  It has ruined lives of many and cost the lives of others.  It is not designed to be used as it is being used.  I got that straight from two friends:   one is a drug rep who flipped out when she found out I was on it...the other was from a pharmacist, who is a trusted friend.  He said he's never had a patient come off Fentanyl...EVER!  He said they were ALL terminally ill cancer patients who died with their patches on.  I will be his FIRST to come off of Fentanyl and get this demon out of my life forever!  I want people to know the danger and the horrible dependency this drug causes so that they NEVER have to go through what I have and am still going through.  My best to you!

Blessings!

Lissy
Blank
Avatar_f_tn
when i started to us fntanyl a year ago it was stated that it would last three days.  they never did.  Finally a few months ago my doctor told me the had changed it to 48 hours after doing a study.   Now 48 hours is fine.  Also the brand that you use makes a difference.  I only use the mylan brand for two reasons.  #1 i am on a 100 patch.  With the mylan brand it is more the half the size of the other they use to give me.  #2 they stick much better and do not give me a rash like the first one did.  I place them on my upper leg on the front.  I shave both the left and right upper leg once a week and alternate legs.  I have harry legs so it looks a little stupid having a bold spot there but it work best for me.  They seem to not stick as well in other places, plus when i had them on my arm people would ask me what is was and i did not want people knowing my business.  I usually take the old  on off before i shower.  wash really good where the new one will go.  make sure I am totally dry and apply the patch.  works like a charm now.  Before with the other brand it would give a rash and leave a sticky patch where it was that was a ***** to get off and got all over my towels and sheets.  
Blank
Avatar_f_tn
I've been having my does lowered now to 25 patch, I have gone five days without the patch. How long will these feelings of hopelessness go on and hot cold sweats,sweating and freezing at the same time, restless legs. sleepless nights go on for. I still take Flexeral at night and sometimes take oxycodone to get by. I have  had injections into my disc.in my neck that I think are controlling my pain. how long? All that I have read does not give me a clue.
Blank
Avatar_f_tn
My mother who is only 48 years old has been on the fentanyl patch 75mcg for the past 2 years due to having a fusion in her back.  Then her pain doctor who she's been seeing for 5 and a half years keeps putting her on more medications.  She goes in for cortizone shots all the time and he gives her epiderals quite frequently.  About a year ago he started prescribing dilaudid 2 mg along with taking the patch.  She is soooo doped up, I can't even have a conversation with her.  About a month ago, she just had a fusion in her neck, and now her dosage for dilaudid is 4mg every 4-6 hours.  She has fibromyalgia also, but now after these surgeries, she shoud be getting better but because of the medication, her brain is still telling her that she's in tremendous pain, so therefore her pain doctor keeps prescibing!!! She does'nt work, she lays in bed all day, and literally keeps falling because she's all drugged up.  I can't handle seeing her like this.  There's talk about weening her off these meds in a few weeks, I'm just so scared that her stupid pain doctor will keep giving her meds or injections during the withdrawal process because she'll probably be screaming for medication!! She needs her life back, and the medication has taken over her life and her brain. Any suggestions on what my family and I can do to get this pain doctor to be on board and get my mother back to who she should be?????
Blank
Avatar_m_tn
I came off 125 mcg of Fentanyl. It took about 6 days, stomache cramps, symptoms much like the flu. Did not eat much or go anywhere for 3 days of it. After 7 days colors in the world came back, lifted depression. Stayed off for a full month and 1/2, then not being able to take the pain I started again but alternate between 75 and 50 mcg every 72 hrs. I think that amount of time causes such a drop in the meds and thus sleepiness. Push for every 48 hrs if u can even if u need to lower your dose to get doc to agree. Pain still present. Also on 30 mg oxycodone every 4 hours or 6 a day. Stuff makes me lethargic and sleepy. Was on methadone in FL but moved to MD and that doc said u gotta come off Methadone first. I was doing great
on that, actually had a life, the fentanyl does work but u need to go every 48 + a breakthrough and be prepared to lose energy! Gonna see if doc can give me Lollipop fentanyl 160 mcg breakthrough for days I want to do something with my little one or husband.other than that it is real tough to do a whole lot now that methadone is gone and my spine is injured now. Take care out there, it is hard to get fair treatment with all the bad press these days!
Blank
Avatar_f_tn
I found different pharm caring different brands. Example walmarts give me the red rashy itchy but when I get them through the military pharmacy different look and alot less irritation. That might be easier then getting the Dr to do paper work  for an authorization  to get the original. Good luck

Blank
Avatar_f_tn
I been taking dilaudid 4 mg for 4yrs and on 100mcg fentanyl patch and my lower back and siatic (sciatic) nerve pain going thru both leg is getting worse don't know wat to do cant sleep or do any house work wat should I do
Blank
7721494_tn?1415940873
Perhaps your back disease is getting worse. Maybe its time for a new workup, and perhaps a referral to interventional pain management or surgery?
Blank
Post a Comment
To
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
Pain Management Community Resources
RSS Expert Activity
469720_tn?1388149949
Blank
Abdominal Aortic Aneurysm-treatable... Blank
Oct 04 by Lee Kirksey, MDBlank
242532_tn?1269553979
Blank
The 3 Essentials to Ending Emotiona...
Sep 18 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Control Emotional Eating with this ...
Sep 04 by Roger Gould, M.D.Blank
Top Pain Answerers
7721494_tn?1415940873
Blank
philnoir
Four Corners, CO
535089_tn?1400677119
Blank
Mollyrae
WI
8976007_tn?1413334250
Blank
Jinx_777
Avatar_m_tn
Blank
trixy71
1855076_tn?1337118903
Blank
marycarmel
MA
1530171_tn?1362547225
Blank
TheLightSeeker
London, ON