Fentanyl Patch Questions?

[kikibaugh]

Hello all. I am new here. I am looking for some advice with pain management. I just went to my second visit at pain clinic. On first visit, they changed me from Norco 10/325 one every six hours, prescribed by my PCP to fentanyl patch 12mcg. I have severe tmj (have had 4 surgeries) and am waiting for a jaw replacement surgery. I am 31 years old. Today I saw a different doc at PM clinic who prescribed 50mcg patch. I thought the Norco was working well and didn't really want to switch, but they insist I try it. To make a long story short, the patch makes me feel like crap and I am not having relief. Any suggestions on how to proceed? Do I stay with the patches? Or try to move to something else?

[Jinx_777]

I have been on the 50 mcg fentanyl patch for about 4 months now.  I take up to 4 percocets a day for break through pain.  I would say that as far as pain goes-- the patch has helped a lot.  there is not the up and downs that go along with just oral meds alone.  The problem I am having with the patch is EXTREME fatigue.  I have hardly been out of bed in 2 months.  I think I would rather be in pain then be bed riddden

[philnoir]

It takes 4-5 days for serum fentanyl levels to reach steady state in a new patient, so give it a week if your side effects aren't life threatening. If it doesn't work for you, call your doctor and tell them.

The patch comes in 12.5, 25, and 50 microgram strength. If the 50 is too strong, then perhaps you'd do better on a lower dose. When you change from one opiate pain medication to another, it usually takes a few weeks to titrate the new dose to an effective level with minimum side effects. Try to be patient, but communicate with your doctor.

Long acting opiate pain medication is better in the long run than using PRN oral opiates like Norco for a number of reasons.

There's also a new formulation of hydrocodone in a long acting pill, called Zohydro. If the patch doesn't work out, you might suggest it to your doc.