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Duragesic pain patches
Hi, I was wondering if any one out there has any idea if there are any of the duragesic pain patches that will stick as long as they are suppose to work. i am having a hard time keeping my patches on and the doctors wont replace the patches until it is time for refill and the pharmacies dont seem to care either. I have tried different brands, I have tried different parts of my body, and I have tried the tagaderm bandages on top of the patches and nothing seems to work. Is there a pharmacutical company that actually knows how to make a patch that sticks. or this there a way for them to work if they dont stick?? I am in constant pain with 3 kids to take care of....if anyone has any info, please pass it along!!
thank you
Tina
thank you
Tina
Tina I have been thru the same thing. I have found that if I put the patch on my side where my bra band goes around ( under my arm) it helps to hold it on. Good luck.
Thank you all for your time and information. Especially to peekawho for the article. I will definitely follow these directions to the "T". I have already called the manufacturer and at least they are willing to send me back my copay, but because it is a schedule 2 narcotic, they cannot replace the patch. I have to make another appointment and actually go back to my doctor to see if he will replace them with a new script. Again, thank you all for your time.
Tina
Tina
Hello Goofalot,
Welcome to the Pain Mangement Forum.
Peek found a good site to provide quality information. I find the Skin Prep to be an excellent product for sticking any type of adhesive bandage to your skin. It's my personal favorite. You can purchase it at any large drug store or pharmacy chain. I haven't found it in the large department stores like Wal-mart or K-mart. One little package will do the trick. They come in little packets similar to alcohol prep squares that you tear open.
As the information states, cleaning the skin free of oils is important...but not even required so much with the Skin Preps. If you pharmacy doesn't carry these they will order them for you.
I found that the back of my upper shoulder blade was the best location for the patch. I wasn't forever rubbing against it and the area doesn't seem to get as much motion as other areas.
Hope you'll be able to find something that is successful for you. Our skin types are all different, hence the different things that work for different ppl.
Best of Luck,
~Tuck
Welcome to the Pain Mangement Forum.
Peek found a good site to provide quality information. I find the Skin Prep to be an excellent product for sticking any type of adhesive bandage to your skin. It's my personal favorite. You can purchase it at any large drug store or pharmacy chain. I haven't found it in the large department stores like Wal-mart or K-mart. One little package will do the trick. They come in little packets similar to alcohol prep squares that you tear open.
As the information states, cleaning the skin free of oils is important...but not even required so much with the Skin Preps. If you pharmacy doesn't carry these they will order them for you.
I found that the back of my upper shoulder blade was the best location for the patch. I wasn't forever rubbing against it and the area doesn't seem to get as much motion as other areas.
Hope you'll be able to find something that is successful for you. Our skin types are all different, hence the different things that work for different ppl.
Best of Luck,
~Tuck
Give the Nexcare Sport knee and elbow bandages a try. They still allow for oxygen exchange, but I have never once had one of them come off until I decided it was time for it to come off.
I've had the best luck placing the patches on my ribcage and just switch sides each time. If you place the patch anywhere on the abdomen other than the ribcage, there is too much motion from breathing which makes it more likely for it to fall off.
I also agree with the statement that patches that fall off can be salvaged - as long as it's still flat and not stuck to itself. Place it in the same spot where it was originally and secure tape or whatever you usually use. I realize the manufacturers say to throw them away if they fall off, but there's also real life to consider. Most doctors aren't going to be pleased with patients who consistently need early patch refills for whatever reason. I was appalled when the very first patch I put on came off in the shower. Finally found it stuck to the clear shower curtain liner and secured it back on with tegaderm and it worked just fine.
I've had the best luck placing the patches on my ribcage and just switch sides each time. If you place the patch anywhere on the abdomen other than the ribcage, there is too much motion from breathing which makes it more likely for it to fall off.
I also agree with the statement that patches that fall off can be salvaged - as long as it's still flat and not stuck to itself. Place it in the same spot where it was originally and secure tape or whatever you usually use. I realize the manufacturers say to throw them away if they fall off, but there's also real life to consider. Most doctors aren't going to be pleased with patients who consistently need early patch refills for whatever reason. I was appalled when the very first patch I put on came off in the shower. Finally found it stuck to the clear shower curtain liner and secured it back on with tegaderm and it worked just fine.
I found this, not sure of the accuracy of the whole article, but copied it for you. I've never used the patches, but this seems like very good info. Perhaps someone else can comment on the accuracy.
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The recommended procedure is to clean the area with water and then apply the patch. However, for anyone who has used Fentanyl Generics or Duragesic, we know that's ridiculous. Skin oil, patch location and hair are the 3 biggest adhesion factors for the patch adhesive to contend with.
Having used Duragesic 100mcg patches (x2 on occasion) for 9 years, I know of 4 good ways to keep the patch stuck:
1. If you're using Duragesic, Janssen Pharmaceuticals has long had a program for its Duragesic users who have this problem. They will send out free of charge 300 Bioclusive bandages (clear adhesive bandages) that will fit over the 100mcg patch. I've used them many times and they work well. You need to call them at the 800 number on the box. Only Duragesic users are eligible.
2. Skin Prep - Skin Prep is a product made for Colostomy patients. It applies a thin film to the skin that helps the adhesive bond strongly to the skin. The tricky part is to only apply it to the skin area where the edges of the patch are going to be, since applying it to the transdermal area will block release of the drug. It works fantastic though. Most pharmacies carry it. They make 2 types, a lower cost one that stings, and a non-stinging one for double the cost. It doesn't sting that bad compared to the pain you're already dealing with.
3. Isopropyl Alcohol - all patch literature will tell you not to use Iso to clean the skin and then put the patch on. The reason for this is that Isopropyl leaves a residue on the skin that can interfere with the drug release. However, to get around that issue, clean the area with Iso, then rinse it with water to remove any residue and then dry well before applying. Iso is the only real way to get skin oil off of the skin, which is the primary reason the patch adhesive comes unbonded from the skin. Of course if you have any Grain alcohol, it leaves no residue.
The other reason is that Iso can cause skin irritation if not rinsed prior to the patch being applied.
4. Location, Location, Location - Skin Real Estate is a major factor in how well your patch stays applied. The instructions tell you not to use the patch in the same spot over and over - this is to let the skin breathe between applications. It must be applied on the upper torso - I've always applied mine to my upper biceps, as the area is flat, relatively hairless, and the skin there doesn't flex like it does on the chest or elsewhere. Normally my regular dose is 1 100mcg patch, so I just switch arms every 2 days when I change it out for a new one. However, there have been times where I've needed 2 100mcg patches, and I have used them on both arms simultaneously. In those cases, I've overlapped the application by several hours so that the skin has time to breathe before reapplying. I also will apply it vertically or horizontally so that the same area isn't always completely covered.
If you're having difficulty with the patch staying applied and the area doesn't appear to have any hair, keep in mind that the small micro-hairs that we all have can interfere with the patch adhesive. In those cases, you might try shaving the area to ensure there's nothing to get in the way between the patch and your skin.
I know of terminal cancer patients who have required up to 6 100mcg patches, and in those cases they were applied on the back. The problem with that is you need someone to apply it, and if you're like me, you probably like doing it in private by yourself.
In a pinch, if your patch comes off, don't toss it - it's a misconception that it cannot be reapplied and used, as long as it doesn't stick to itself, in which case you're out of luck. If you're using generics, you can buy Bioclusives yourself, though they aren't cheap - about 100 bucks a box. Alternatively, simple transparent medical tape on the patch edges will keep the patch in place or help you to re-attach it. Make sure you clean the skin before reapplying, and put it in the same place. It takes about an hour, but if there's enough gel left the body heat will start the drug release again.
When applying your patch after you've prepped the area, make sure you hold it between your hands for about a minute (BEFORE you remove the backing...) to warm and soften the adhesive. After you put it on, hold your hand over it for a bit to help the adhesive stick better
One other bit of advice - all doctors are required by Federal Law to only give a month's worth of Schedule 2 opiates to any patient, essentially making us slaves, and making it a real pain if a patch comes off and cannot be reused, especially if it was just applied recently. I learned early on to build up an emergency month supply of meds that will help me in such situations, or in those rare times where you have problems with medical insurance companies or prescription supply interruptions. It takes time, but most Fentanyl patients have breakthrough meds like Percocet. Use that to help you get by and try stretching your dosage in order to bank up extras so you don't fall short if a patch does get screwed up. If you're seeing a doctor that tells you to turn in any extras, get another one. Federal Law prohibits transfer of any narcotic to anyone other than whom it was prescribed for, and I know of no such exception for doctors, even prescribing ones. I have always been up front with my doctor about my emergency supply, and over the years he's been willing to give me a bit more when it's run low.
---------------------------------------------------------------------------------------------------------------
The recommended procedure is to clean the area with water and then apply the patch. However, for anyone who has used Fentanyl Generics or Duragesic, we know that's ridiculous. Skin oil, patch location and hair are the 3 biggest adhesion factors for the patch adhesive to contend with.
Having used Duragesic 100mcg patches (x2 on occasion) for 9 years, I know of 4 good ways to keep the patch stuck:
1. If you're using Duragesic, Janssen Pharmaceuticals has long had a program for its Duragesic users who have this problem. They will send out free of charge 300 Bioclusive bandages (clear adhesive bandages) that will fit over the 100mcg patch. I've used them many times and they work well. You need to call them at the 800 number on the box. Only Duragesic users are eligible.
2. Skin Prep - Skin Prep is a product made for Colostomy patients. It applies a thin film to the skin that helps the adhesive bond strongly to the skin. The tricky part is to only apply it to the skin area where the edges of the patch are going to be, since applying it to the transdermal area will block release of the drug. It works fantastic though. Most pharmacies carry it. They make 2 types, a lower cost one that stings, and a non-stinging one for double the cost. It doesn't sting that bad compared to the pain you're already dealing with.
3. Isopropyl Alcohol - all patch literature will tell you not to use Iso to clean the skin and then put the patch on. The reason for this is that Isopropyl leaves a residue on the skin that can interfere with the drug release. However, to get around that issue, clean the area with Iso, then rinse it with water to remove any residue and then dry well before applying. Iso is the only real way to get skin oil off of the skin, which is the primary reason the patch adhesive comes unbonded from the skin. Of course if you have any Grain alcohol, it leaves no residue.
The other reason is that Iso can cause skin irritation if not rinsed prior to the patch being applied.
4. Location, Location, Location - Skin Real Estate is a major factor in how well your patch stays applied. The instructions tell you not to use the patch in the same spot over and over - this is to let the skin breathe between applications. It must be applied on the upper torso - I've always applied mine to my upper biceps, as the area is flat, relatively hairless, and the skin there doesn't flex like it does on the chest or elsewhere. Normally my regular dose is 1 100mcg patch, so I just switch arms every 2 days when I change it out for a new one. However, there have been times where I've needed 2 100mcg patches, and I have used them on both arms simultaneously. In those cases, I've overlapped the application by several hours so that the skin has time to breathe before reapplying. I also will apply it vertically or horizontally so that the same area isn't always completely covered.
If you're having difficulty with the patch staying applied and the area doesn't appear to have any hair, keep in mind that the small micro-hairs that we all have can interfere with the patch adhesive. In those cases, you might try shaving the area to ensure there's nothing to get in the way between the patch and your skin.
I know of terminal cancer patients who have required up to 6 100mcg patches, and in those cases they were applied on the back. The problem with that is you need someone to apply it, and if you're like me, you probably like doing it in private by yourself.
In a pinch, if your patch comes off, don't toss it - it's a misconception that it cannot be reapplied and used, as long as it doesn't stick to itself, in which case you're out of luck. If you're using generics, you can buy Bioclusives yourself, though they aren't cheap - about 100 bucks a box. Alternatively, simple transparent medical tape on the patch edges will keep the patch in place or help you to re-attach it. Make sure you clean the skin before reapplying, and put it in the same place. It takes about an hour, but if there's enough gel left the body heat will start the drug release again.
When applying your patch after you've prepped the area, make sure you hold it between your hands for about a minute (BEFORE you remove the backing...) to warm and soften the adhesive. After you put it on, hold your hand over it for a bit to help the adhesive stick better
One other bit of advice - all doctors are required by Federal Law to only give a month's worth of Schedule 2 opiates to any patient, essentially making us slaves, and making it a real pain if a patch comes off and cannot be reused, especially if it was just applied recently. I learned early on to build up an emergency month supply of meds that will help me in such situations, or in those rare times where you have problems with medical insurance companies or prescription supply interruptions. It takes time, but most Fentanyl patients have breakthrough meds like Percocet. Use that to help you get by and try stretching your dosage in order to bank up extras so you don't fall short if a patch does get screwed up. If you're seeing a doctor that tells you to turn in any extras, get another one. Federal Law prohibits transfer of any narcotic to anyone other than whom it was prescribed for, and I know of no such exception for doctors, even prescribing ones. I have always been up front with my doctor about my emergency supply, and over the years he's been willing to give me a bit more when it's run low.
Is there maybe a place on your body that you haven't tried sticking them. When I was on them I used to put them on my upper back/shoulder area. Although I had to have someone else put them on my because I can't reach very well.
If they don't work after that, maybe talk to your doctor about switching to something else? I would caution anyone about switching, though, as fentanyl is some of the most effective pain medication there is.
If they don't work after that, maybe talk to your doctor about switching to something else? I would caution anyone about switching, though, as fentanyl is some of the most effective pain medication there is.
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