Fentanyl Patch Question

[bex57]

Hello Pain Management Readers,

I am a new user of the fentanyl patch. It is working really well for my back and neck pain, but I have the problem with the patches falling off. I've tried using medical tape to tape the edges down, and that has caused skin irritation so I have been looking for another alternative. I read online people have called the manufacturer of the patch (mine is by Mylan) so I did call them, but the adhesive that they have for customers is out of stock. They recommend using the Bioclusive transparent dressing, but I can't find them at a medical supply store near me. I have found other brands of transparent film dressing, but I am wondering if anyone has had any experience using these brands other than the Bioclusive. I believe these transparent dressings the company recommends and the ones I have found are similar- both are transparent, waterproof and breathable. I guess my question is to you all is, have you had experience using these other brands, and if so, do they work just as well?

Thanks in advance!

[sykespiate]

im glad it's working, im curious to know if it's ok to put the fentanyl patch under my pecs, on the rib cage area?

[namnam46]

That makes a lot of sense about your emotions. Because that's the BIG think about the patch and NOT having the euphoria that ''OTHER" strong Opiates do.  It DEFINITELY makes sense that you would FEEL happy and elated to have the relief from the pain plus your other emotional issues.

I'm so grateful that you are also getting this WONDERFUL help from the Patch!!

CONGRATULATIONS....Sherry

[Jaybay]

Give the Nexcare Sport bandages a try.  You'll probably have to go to a pharmacy to get those, and they come in different sizes.  Seriously, they will not come off!  Also try using your ribcage area and see if that does any better.  Anywhere that clothing won't rub it off is fine.  The chest area tends to be more oily in most people, and if you sweat a lot it runs from your face right down to your chest.

I WISH there was a way to reply here to individual posters like you can on Facebook, but so far that capability doesn't exist at Med Help.  They've made a ton of improvements over the years and no doubt that functionality is on a to-do list somewhere, but when?  Who knows.  :-)

[bex57]

I wish mine stayed on like  it seems to do for you. I've been putting it on my chest, and just wearing shirts that cover it when I am out in public. It seems that that is the least sweaty place for me. It must be that my skin just isn't receptive to the adhesive then.

Glad to know you are using a different brand than recommended. Sounds like tagaderm is the same as the adhesive that I am using now.

Oops, I just looked at my other posts a few minutes ago. Seems I got some of the information confused to mellie and jaybay. I've got to get used to this format. Is there a way to directly reply underneath the comment you are trying to reply to as opposed to the box at the bottom? That would make it much easier for me!

Anyway, its interesting that many of you have to replace the patch after 48 hours. Tomorrow afternoon will conclude day 2 of the patch for me so I will see how day 3 goes. Hopefully my body works with the 72 hour format, but we shall see!

[bex57]

The Flector patch is an anti-inflammatory patch. It says its a 1.3% diclofenac epolamine topical patch (yeah, whatever that means :) I put up to two patches on at a time on the areas of my back or neck that really hurt and the patches are replaced every 12 hours. It is a NSAID patch, but I would much rather use a topical patch than take ibuprofin because of past stomach issues. I'm not sure how well these are working on me because I'm on so many different medicines, but I figure I'll try it and it can't hurt, ya know.

Yes, my doctor did give me the drill about the patch. I called him crying because I was so worried he was going to get upset at me after one fell off in the shower. Of course he didn't, but with my anxiety I was so darn worried!

I'm glad to hear you like using the patch as well. Its nice to finally have some relief for more than an hour or so and to  not get the feeling that the other medicines give me.

[bex57]

Thanks for letting me know more about BT medicine and how that works. I think since I am just starting out and the PMP is adjusting the dosages of the patch still, that's why I haven't been prescribed any yet. The 25 mcg/hr just worked for the first 2 days, and now I'm on the 50 mcg/hr since yesterday so things are still being figured out.

I spoke with my PMP and my psych today and they think my feelings of being overly happy are probably just my emotions. I've struggled with a lot of emotional issues through the last few months because of the amount of pain I've been in. They think it's a combination of the medicine giving me some pain relief and me being so grateful that I can actually get out of bed and live my life!

[Jaybay]

I have the 50 mcg Mylan patch and it's worked great for me.  It usually sticks well unless I'm outside and sweat a lot, or hop in the pool.  I use Nexcare brand bandages as covers in the summer.  The elbow size more than covers the 50 or 75 mcg patches.  They're made of Tegaderm, which is waterproof yet allows the skin to breathe.  If that still doesn't work, Nexcare makes a sports bandage that absolutely will not come off until you decide it comes off.  The Nexcare brand is available at any pharmacy and many grocery pharmacies if it's one of the larger national chain stores.

Hopefully your doctor already gave you the drill about placing the patch on clean, dry skin that isn't very hairy and somewhere that you don't sweat too much.  Some people like the upper arm, but I don't want it on display for the public so I use my rib cage.  If you have very oily skin, prep the area with rubbing alcohol first and let it air dry before applying the patch.  And never use the same exact place over and over again to avoid a nasty skin rash.

Every med has its own pros and cons, and adhesive troubles seem to be the biggest complaint with the patches.  You just have to try a few things and see what works best for you.  I'm glad to hear that's the only difficulty you're having with it.   :-)

[mellie4]

Bex, what's a Flector patch?  I've never heard of it.  I wonder if it's similar to the Lidoderm patch.  

I started at 75 mcg/hour but before that I had been on oxycontin with oxycodone as the BT med.  It wasn't working great and the NP didn't want to up the oxycontin; so she thought I should try the Fentanyl patch.  Actually, we had discussed the long-acting medicines before I went on the oxycontin.  I said absolutely not to methadone.  Other choices were a long-acting morphine, the Fentanyl patch, and the oxycontin.  I was afraid to try the Fentanyl patch.

I had read some people on here had good results (like Sherry) with the patch so when it came up again, I was more open to it.  I started at changing it every 72 hours but that didn't work so well with me; so she changed it to every 48.  This seems to be a good fit.  I do seem to need BT meds often.  Maybe it's because I'm still in a long-term flare-up or maybe it's just the way I am.  I have never felt any euphoria with the patch at all.  No real side effects from it (and I've had side effects with some others.)

[namnam46]

I understand that you hope that you won't have to use OTHER meds also, however, that is unrealistic and should ALWAYS have something on had for the BT (Break Through) Pain.

I'm on  62mcg's of the Patch (1-50mcg and 1- 12 mcg) and I don't have to take very many BT at all. That's a very realistic objective. Just don't EVER expect to NEVER have to tak something or you will be VERY disappointed!! Plus, you will be in REAL trouble when the BT Pain occurs and you have NOTHING for it;. Then the pain will be so severe that you won't be able to catch up with the BT Pain.

Some people need to change their patches every 48 hours instead of every 72 hours. I'm one of those. There are a LOT of [atients that have to do that as our bodies metabolize the medication too quickly. This is something that you will need to figure out as time goes by.

I'm VERY surprised that you are having a feeling of euphoria!! I've NEVER heard of that happening with the patch. That's one of the things about the patch, that is DOESN'T give a person that feeling. I'm VERY surprised by that.

I'm glad that you are getting the pain relief and I hope that you continue to get it. :)

Please keep us updated on how it works for you....Sherry

[bex57]

I just started using the fentanyl patch 8 days ago. I started on the 25mcg/hr and had amazing results for the first few days, and then my pain came back and the doctor had me take percocet. However, the point of me going on the patch was so I wouldn't have to take oral pain medication any longer, so my PMP modified my dosage yesterday to 50 mcg/hr. At this point I'm just getting used to the 50mcg dosage and its taken my pain down to about a 2 or a 3 on the pain scale. The first two days my pain was down to a 1, but I think my body just got used to the medicine too quickly. My doctor increased the patch instead of using BT medicines. I've been reading some of the other posts on here, and I'm surprised to see that so many people have contracts with their PMP. Mine didn't talk about that at all with me. My PCP had me taking percocet for the last 6 months though and she decided it was time for someone else to take care of my pain and sent me to this PMP. The first thing he suggested me taking was the patch along with using the Flector patches for the inflammation.

I'm glad to hear you both like the results of the patch. It seems to be working overall pretty well for me. I just have one side effect- I get overly happy and hyper. I can live with that though! I can definitely tell the difference today being on he higher dosage though.

I went on the patch because of a car accident in January of 2010. A driver merged into my lane on the freeway, causing my car to spin, hit her car and another car hit me and caused the car to flip and the car landed on the roof. I luckily escaped with no "major damage" and was very lucky in that respect. I have post concussive syndrome now which causes migranes, along with back and neck pain. My back pain and neck pain seems to be muscular and there is a lot of inflammation and tightness as well. I do PT, massage, chiro and am on many medications to help all of my symptoms.

[mellie4]

Just wanted to say welcome and you've found a great place for all sorts of things surrounding chronic pain.

I'm on the Fentanyl patch, too.  I just started it a couple of weeks ago.  I haven't had any problems with it falling off, so I can't help you there.  I'm 48 (today!!) and I'm on it for severe osteoarthritis.  I'm not quite where Sherry is with her arthritis, but it's probably where I'm headed.  (My mom had it in every bone and joint in her body and suffered terribly for years.  Not a lot of options in her day.)  Right now I have it in my hands, back, hip and knee.

Both my hands are very bad, but I had a joint replacement on my thumb joint three years ago.  The implant was a bust (in everyone, not just me) and since then things have gone from bad to worse.  I've had a total of 8 surgeries with one more to go and I developed RSD.

Like a lot of people here, I've tried a lot of different combinations of medications and a ton of different procedures.  Right now I'm on a 75 mcg Fentanyl patch, 15 to 30 mg. morphine for breakthrough pain.  I'm having some side effects from the morphine, though, and we may change that this week.  I also take 60 mg. twice a day of Cymbalta for nerve pain, Ativan 1 mg. as needed, 10 mg. Ambien as needed, and a compounding gel as well as a Lidoderm patch and 800 mg. every 6 hours.  I've found some decent relief from the compounding gel as well as the Lidoderm patch.  I also do stellate ganglion blocks from time-to-time which usually helps a bit but not for very long.

Wondering, if you feel comfortable sharing it, what pain you have that brings you to the Fentanyl patch?  

Finding this forum, though, has been great medicine for me.  I've learned so much from here.  I've found that emotionally I'm in a better place since finding this forum.

Hope to see more of you here.  Let me know what you think of the patch.  I know Sherry loves it.  I still am getting used to it, but so far I think it has worked the best out of everything I've tried.

[namnam46]

I ABSOLUTELY  LOVE the Patch. I've only been on it since January. I've had CP (Chronic Pain) since I've been about 27 years old. (I'll be 64 in about 2 weeks.) I had never had a PM Dr. until I moved to AZ last summer and I was so fortunate to find the BEST PC  that got me intouch with ALL of the right specialists. My Rheumatologist is the one that sent me directly to a PM Dr. and he is GREAT!! He gave me the option of EVERY "Big Dog" medication that there is and I chose the Patch because of all the pills that I take for my Heart, Blood Pressure, Blood Thinners, etc. I just wanted to be able to have something that WASN'T a pill and would give me the relief that I needed so badly.

I suffer from SEVERE DDD as well as Osteoarthritis in EVERY joint in my body and I'm also having problems with my 2nd Artificial hip (left) the First hip implant lasted 26 years and this replacement hip was put in incorrectly and the ENTIRE implant is loose. The pain is UNBELIEVABLE with EVERY step that I take. My Dr.'s are amazed that I can even walk. It was VERY difficult (I was using a walker) before the Fentanyl Patch. Now, I'm back to using my cane and sometimes I don't  even have to use it if I'm in the house.

I hope that  you will get the same outstanding relief that I have had.

Please keep us updated on how it is going with you and I hope that you will contribute to the Forum with the experiences that you have.

I'm so glad that you have a covering that works!! Just keep checking back and I'm sure that others will post on here also. It's been a little slow on here today but just keep checking back!!

How long have you been on the patch and how do you like it? I use Percocets for the BT (Break Through) Pain. What are you using and are you getting the relief that you need?

I'm excited that you have found an answer for keeping your patch on.

I look forward to hearing more from you.....Sherry

[bex57]

Hi Sherry,

Thanks for responding to my message and the warm welcome. The brand is INVACARE.

I took your advice and called the pharmacist, and she said that since it has the same properties, that it should be interchangeable. I listened to her advice and went ahead and put the INVACARE transparent dressing on, but I would still like to hear from anyone that has any advice or experience with this issue.

Sherry, I would love to hear about your experiences with the patch. How long have you been using the patch and do you like it? If you don't mind me asking, what type of pain are you using your patch for?

[namnam46]

Hi Bex,

Welcome to the Pain Management Forum. We want to tell you how glad we are that you have found. us. Please understand that we are NOT Doctor's ONLY CP (Chronic Pain) Patients that use our expertise in our areas of Pain to help each other.

I'm sorry that you are having problems with your patches. This is a common problem that some people have with the patches. I, also, use the Mylan brand but I don't have any problems with the tape, Thank Heavens!!

I would imagine that the brand that you found IS OK to use but to be safe I would ask your Pharmacist as they would know whether it is interchangeable or not.  As I said it sounds as if it would be interchangeable since it has all of  the properties that the other covering has.

Please check back in and let us know what your Pharmacist says as we will be anxiously waiting for your update.

ALSO, there will be others along later that may have more knowledge of the type of covering that you have found. Would you mind telling us the Name of the covering that you are talking about as that will help us help you sooner.  :)

Best of luck and look forward to hearing from you soon.....Sherry