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Avatar universal

Fentanyl Patch Side Effects

On the 2nd, my new PM doctor put me on Fentanyl patch, the 50mcg kind... It has been helping with my pain so much. I feel so much better except for the fact I am falling asleep left and right! Will this side effect go away? Thats the only negative side effect I am finding... that and the patch peels off especially if I am outside in the sun doing yardwork and sweating. I have had two patches fall off already and I am not sure how to explain this to my doctor. I just brought a waterproof clear patch thing that can go over it. It helps a little bit.


But the exhaustion is just insane. I apologize if theres mispells or grammar errors, I am nodding off here!

Is there any other medications that might provide the same relief but without the tiredness? Like slow-release morphine or oxycotin? I have tried hydrocodone, oxycodone (percodect), darvocet, ultram... most of them work but wear off within 2-3 hours. I tried methadone, but couldnt function and pain relief was slight. This med is providing wonderful pain relief, but I have a 2 yr old to chase after! Will this tiredness go away when I adjust to the med? Or should I try something else??

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547368 tn?1440541785
Hi Vicar,

Welcome to the Pain Management Community. I am glad you found us and took the time to post. No, I haven't experienced what you are describing.

I encourage you to begin a new thread instead of hijacking a very old one. You have interesting thoughts - and others will see a new thread and respond better if you begin a new one (question).

I almost missed it.

Thanks So Much,
~Tuck
Helpful - 0
Avatar universal
Eight months on Fentanyl/Duragesic.  Started at 25/3days, raised to 50/mcg over 2days...the fatique is killing me, sleeping 20 hrs when allowed, and the brain fog interferes with work.  Just diagnosed with Central Sleep Apnea.  

Researching if the fentanyl which works the central nervous system may be causing the CNS to not recognize CO2 levels at night.  Sleep study had be at 73% oxygen blood level!  Still having over 30-50 AHI events on the CPAP mask.

Seeing sleep/pulmonologist with CPAP records this week for 2nd appt.  Wondering if anyone has experienced same relationship.
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547368 tn?1440541785
I've sent you a message.

This is a very old thread. Info may no longer be accurate. Please begin a new post.

Thanks
~Tuck
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Avatar universal
Is there a way to tell when a post is generated by corporate employees
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Avatar universal
I just wanted to add some things to my previous post. I have to use the patch every 48 hours becaus of my matabilism. I tried many methods so my patch won't fall off. Please remember the patches are one of the only types of medication that has SO MANY VARIABLES that effect people in very different ways. Like how long they last, what brand that works best, and how to wear them properly without them falling off. I found that in the hot months I have to use the Jonson&Jonson multi-purpose cloth tape. the kind that is breathable. It has little diamond pin holes, and I only put it around the edges.On some days when it was really hot I had to buy the 4inch x 4.5 inch tagaderm patches,and take a utility knife,so I could cut 2inch x 2.5 inch hole out of the Tagaderm patch so it will breath. Its still goes on the same way ,and works great for me.                                                                                                                                      Now that it is getting cooler out I just use the Jonson&Jonson Mult-Purpose breathable cloth tape AROUND THE EDGES ONLY. In reference to the patch heres what I found to be most important to keep them from falling off. In the morning when I take a shower I had to find a way that when I got in the shower my tape,and patch stayed totally dry!!  Here is how I did it: I took an old (THICK RAIN COAT), and cut my own seperate 5inch by 6inch "rain coat patch", and yes my Dr. knows I have to shave the area. Then I use the thinest duct tape I can find and tape the rain coat patch over top my "taped around the edges fentanyl patch." Now let me make it clear I'M NOT RECOMMENDING YOU USE DUCT TAPE TO STICK THE RAIN COAT PATCH ON OVER TOP THE F-PATCH,  (BUT)? This method has been the ONLY WAY that I can garantee my self a good shower every morning.                                                                                                                               I have used this method for 1 year know ,and I have never had even 1 patch fall off in the shower. When I tell my Dr about this method of showering he just shakes his head,and says why don,t you try the water proof tape to apply your "rain coat patch",and I told him the water proof tape falls off in the shower. So he told me If my skin doesn't get irritated then go ahead if it works?. I told him the worst thing about using duct tape to keep the raincoat over-patch in place is that it hurts like hell when you get out of the shower,and remove it.                                                                                                                                       My Dr. Told me the raincoat over patch was a good idea BUT I will be honest with you. My Dr.,and I do (NOT) recommend using duct tape by any means, BUT, If you want to take a nice shower,and are tired of worring about the F-Patch falling off then try my method of using (RAIN COAT PATCHES) over top the taped around the edges Fentanly -Patch. I really think you will be surprised how it keeps your F- patch dry. (NOW REMEMBER) how you stick it on is totally up to you. ALSO IT IS IMPORTANT that just because you can now take a good shower PLEASE KEEP THE WATER luke warm ,and don't stay in for a long time, or the raincoat patch will CONDENSATE,  and your patch will get moist. I get in and get out .SHeeeeeeoooow I love the pain control but these PATCHES ARE A LOT OF WORK !!!!!!                                                                                                                             I had to come uo with this alternative plan because I can only use the patches with the GEL durigesic kind. I tried the MYLAN little patches I liked the small size,(BUT) one major problem I had with them.  They did not work near as well for me as the GEL type. The Mylan patches would only last 36 hours.THATS IT. I could not wait untill the following month. I went back to the Gel resevore type. They work great for me.                                                                                                                                         Remember,This is just my way. we are all different and what works for me might not work for you, but I do recommending making your own (RAINCOAT OVER PATCH)  they work great in the shower. Best wishes to all,and Take Care, Sincerely
Helpful - 0
Avatar universal
I've just been put on fenytal patches. I have had the complete different
feeling. My pain for the most part gone. The good thing is I have all this
energy. I can't stop moving. When I start to get to warm I sit for a bit.
Then is off to the races as they say. I will say I can tell when my 3 days
are up I start to get a headache and little twinchs of pain in my body.
This has also been good for my wieght loss. So far 22 dowm 38 to go.
I forget to eat. I am not hunger. I make my self take ensure to help
with my nutrion(sp) Thanks for listening
I do love this patch. I've tried everything else this is the only thing that has worked.
Bye Yanni
Helpful - 0
1348302 tn?1286575703
...........  If problems with the patch not sticking persist, cover the patch with Bioclusive or Tegaderm. ...........(Brenndy)

The only, and I mean ONLY thing I could find to keep those buggers on was the Tegaderm.
  I just put it right on top of it and made sure it was pressed down all around.  Every other tape I tried would either fall off, or cause a severe skin reaction which made me nervous that I would absorb too much medications.

Tegederm are those clear film thingies they put over your IV in the hospital. My pain Management P.A. gave me some every few months, I would ask your nurse or Dr. for one to at least try and see if it helps.

:)
Helpful - 0
Avatar universal
Hi there, I'm sorry that you are having difficulties with the patch making you tired. I know this sound strange ,but I noticed when I first started on the patch last year when I drank coffee I would feel really tired for about 2-3 hours. As this kept happening I did some research, and found coffee has a spacific chromium  molecule that when mixed with oxymorphone can make some people sleepy. Please don't take this as carved in stone, because now a year later I don't have any problems with my morning coffee, but thats just me. So its just a question you could ask you Dr. It might be of no truth, but it happened to me the first 1-month, and I did read it in mild interactions, but every ones different, and the last thing I would want to do is concern someone for something that has no merit to them. On the other hand I did find that drinking a couple of caffienated  sodas a day helped me in my first month. Just remember  that the side effects do go away over time, and for me the pain relief that it gives me out weighs any side effects that I have ever experienced.                                                                                                                                                                                                                  You also need to make sure your getting the proper daily vitamines, and good nutrition foods. Remember that your B-complex Vitamines help give energy with a good balance of Protein, and carbohydrates. I do know this to be very important ,because medications have toxins that drain our bodies of our important daily vitamines. These are just some thing to consider, because a little caffiene with a great balanced diet could be the tweek that makes a difference, rather than stopping the medication before one knows its benefits, but also remember these deccissions of changing your medications in my oipinion are very personal, and should ultimately be made between you ,and your Dr.                                                                                                                                                                                                                                                                                                                            I started on the 50mcg 11 months ago, and 10 months ago I was put on the 75mcg. patch every 48 hours. In July, and August I had a rough time  with the medication in the patch absorbing in my body much faster. Now with the cooler weather coming I'm hoping to get that great balance back between the 100mcg. patch, and my IR's that I had last year with the 75patch. Sorry for rambling,  but I just wanted to give you some insight of my situation abit, because from November 15th of last year through the end of June of this year I had the greatest pain relief that I have ever had in my life "HANDS DOWN".                                                                                                                                                                                                               For me the patch has worked so well I am literally both hesitant, and concerned to go off of it for any reason.  My Dr., and I are going to work on a alternate plan for next summer because of the exstream heat. I will use the patch 9 months out of the year, and  the 3 hot summer months use Opana ER three times a day so I can get the same benifit as the patch. This is a great plan for me. The only problem is I don't if my Insurance CO. will pay for it, and Opana's is Expensive. That just my luck when I finally get a "near" perfect plan there seems to be a monkey wrench thrown into my gear box messing up everthing?. Oh well, I will just have to take what ever long acting medication I can afford in the 3 hot months of the year I can't use the patch.  I will just keep optamistic, and think possitive.                                                                                                                   It looks like you have a great group of people with really good ideas on here. I am not a Dr. or in the medical proffesion by any means. So please remember this was just my opinion, and what works for me might not work for you,  but with that said I wish you the very best of Health always. Take care. Sincerely, Paingotago
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Avatar universal
My doctor told me that the sleepiness usually gets better within 1-2 weeks.  For me, it didn't really and I went off of them, but I'm considering going back- they were the best pain control I had ever had.

Helpful - 0
1301089 tn?1290666571
Hi!  Sorry you find yourself in this position.  But the reasons that you cite are the very reasons I got off it. HOWEVER many of the forum members love the patch. I guess it depends on the person.

You will get a lot more responses to this if you start a new post.  Just cut and paste your question into a new question.

Good luck and welcome the Pain Management forum.

Sara
Helpful - 0
Avatar universal
Hello I am so glad that I found this thread! I was recently switched to the patches and I have the PriCara type. I started at 25 but am now up to 100. I have been on meds for years to control pain and I hate oxycontin and finally my dr switched me. However I've suffered from insomnia for 12 yrs (since my daughter was born) and these things make me so darn tired! So I wanted to know if this does subside? Bc I usually get 2-6 hrs of sleep a night now that's how long I'm awake if I'm lucky! Also, I've been having terrible hot flashes and brain fog like I'm hooked up to an IV in the hosp or something? And since I had a total hysterectomy 5 yrs ago and was put through medical menopause yrs before that, I know its not that! So does anyone else have these symptoms as well? And do these side effects in fact subside or should I grin and bear it with the oxycontins? The sooner the better I say... Thank you all for sharing your experiences, its been such a great help!  Thanks again, rachael.
Helpful - 0
Avatar universal
When I first started using the patches ( along w/ oral pain meds too) I was sleeping about 20 some hrs a day!! I had a young child at the time too. Most side effects from meds can take up to 6 weeks to adjust to ur body. *****, but it finally does in most cases & mine did. Now I have trouble FALLING asleep! We can never win!!
   About ur patches falling off, mine did every time I put them on. I was using tape ( which I am allergic too! ) Tagaderms ( I should've bought STOCK in the Company! ) & even got so desperate as to just lay on my side for 2 days straight! I wear mine on my hip/ gluteous area. I finally got a Pain Dr that knew his stuff & he told me to clean the area I was going to put the patches w/ Rubbing Alcohol first. This gets rid of excess oils, dirt & grime that just washing doesn't. Since I've been using this method I haven't had a patch fall off YET!! Good Luck :)
Helpful - 0
1355948 tn?1278881732
i just took that sucker off!  ive been alseep since sunday night.  ive been on the patch for months and the fatigue has only gotten worse.  i feel like im in some kind of brain fog or dream.  i cant wait for the effects to wear off.  altho, im not looking forward to taking the pills again.  they upset my stomach.  im so sick of being in pain!!!  but i can not spend the rest of my life asleep either.  im going to set an appt to talk to my doctor and see what other options there are.  i can not believe people get on this stuff for fun!  its such a pain in the *** to me. BOL.
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Avatar universal
You probably will notice a decrease in the fatigue as your body adjusts to the medication, however, if you're finding that it's not getting better, you may want to ask your doctor about lowering your dose of the fentanyl patch to the 25mcg - at least for a short time - in order for your body to get adjusted to the fentanyl.  Then, if you need to, they can increase it back to the 50.  Most doctors usually start their patients out at 25mcg anyway, so I'm not exactly sure why your doctor started you out at 50mcg.  Perhaps because of the meds you were taking before the patch...

Anyway - another thing to remember - since the fentanyl is released into your system by your body heat, it's very important to not get overheated while wearing it.  Avoid hot showers, soaking in hot tubs, and even being in the sun.  You mentioned about doing yardwork - if you got over heated while doing the yard work, the patch may release more medication than normal, and that definitely can add to the fatigue/drowsiness effect of it.  Also if you ever get a fever from an illness, it's important to notify your doc about it - depending on how high your fever is, they may ask you to remove the patch tmeporarily - for the same reason as avoiding other heat sources - too much medication can be released.    When I was using the patch (I had to stop it due to negative side effects), one time I had a fever of 103.6 from strep throat and my doc had me remove the patch until my fever was below 100 (and use my BT meds during that time).

As for the patch not staying stuck in its spot - there are a couple of things you can try.  The most important is to make sure that wherever you are going to put the patch, make sure it is clean and DRY - no lotions, powders, etc.  Also try not to place the patch in a "hairy" area - rather than putting it say on your arm, put it on your upper back or chest - it'll get much better "holding power" contact on a less hairy area of your body.

I used to use the reservoir type patch (the one that had the medication in a little "bubble" (what I called it) area.  If you are using this type, it's important to NOT use a covering/adhesive that will coverthe entire patch - mainly because there is a very real chance of the area that holds the medication getting alittle tear in it as you're removing the patch, which could possibly release a fatal overdose of medication into your system.  If you need to use something to help the patch stay stuck (I did) - I used clear surgical tape ONLY around teh four edges of the patch, making sure the tape did not touch the area where the medication was.  This technique usually worked pretty well for me - there were some times that I had to change the tape before I had to change the patch, but since I always made sure the tape was not touching the medication "reservoir", it wasn't a problem - simply peel off the old tape (still being very careful to avoid pulling on the patch which might cause a tear) and replacing it with new.

I did have a couple of instances where the patch and tape did fall off because I hadn't kept a close enough eye on how the tape was doing, but I was lucky enough to find the fallen patch quickly and it hadn't gotten damaged/dirty or anything, so after careful inspection to make sure there were no leaks, I was able to place the same patch back on until my scheduled change date.  So even if your patch falls off, so long as you find it relatively quickly and it hasn't been damaged, so long as you're some other way to keep it stuck to you, you can replace it and not have to break open a new patch.  One time I did have a situation where the patch fell off at night and I didn't find it until the next morning and by that time, it was all a crumpled mess that couldn't be salvaged.  So I called my doctor and explained the situation.  She told me to go ahead and put on a new patch (it was only a day earlier than my scheduled time).  She made a note in my medical file to this effect, so that if there had been a problem/question when it came time for me to get my next script filled (fortunately there wasn'), she would be able to provide proof to the pharmacy that she knew about me having to do this and that I wasn't just chaning the patch more often than she had prscribed.  I'm guessing there wasn't any problem at the pharmacy because I had only had to go to a new patch one day before my scheduled time to, so I was only one day early getting my new script filled as opposed to possibly having to be several days early.

I guess I'm rambling, sorry --

I don't know much about the newer patches that are not the type that I used - I've seen wehre other members here use them and they've been able to use an extra adhesive device such as what I believe you're talking about with the waterproof cover.  I believe since those type of patches dont' have the medication in the "reservoir", it's safe enough to use a tape/covering that covers the entire patch as opposed to just the edges wihtout fear of the patch tearing and releasing too much medication.

I'm glad to hear the patch is giving you good pain relief, however, if the side effects are really bothersome or continue, definitely check with your doctor about possibly lowering your dose for a while until your body adjusts to this type of medication.  Or, like you asked, you could ask them about another type of longer acting pain med such as extended release morphine (I had this after my shoulder replacement surgery and it did work quite nicely) or oxycontin.  As with any long acting pain meds, you may still find that you need other meds for breakthrough pain - that's quite common.  Even with the patch, you may need that.

Best of luck and keep us posted on how you're doing.
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1301089 tn?1290666571
Brenndy gave you excellent advice.  I'd like to emphasize one comment she made:

"Lastly, this medication will most definitely cause chronic dry mouth (xerostomia) and therefore recommend oral vigil.  If needed, use a mouthwash for chronic dry mouth; such as Biotene.  If this side-effect is left untreated, it will cause tooth/enamel decay leading to loss of teeth. "

Believe this!!  It's true!!  My dentist is going to get a new wing with my name on it pretty soon.  You will get dental problems if you do not heed her advice.
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Avatar universal
Initially, sleepiness will occur, but your body will adjust.  When it does, so will the amount of pain relief achieved.  You still have room to titrate up and/or switch to a change 'q2d' regiment.  Other medications may be causing this exacerbation as well.

The manufacturer of Duragesic (Brand Name for fentanyl and manufactured for: PriCare, Division of Ortho-McNeil-Janssen) are actually now manufactured by ALZA Corporation,  Vacaville, CA.  This particular brand name achieves far better consistent pain relief response than the generics.

On rare occurrence, will this brand name fall off.  Should this occur, apply first aid tape only to the edges of the patch.  If problems with the patch not sticking persist, cover the patch with Bioclusive or Tegaderm.  These are special see-through adhesive dressings.  Never cover a Duragesic patch with any other bandage or tape.  

Lastly, this medication will most definitely cause chronic dry mouth (xerostomia) and therefore recommend oral vigil.  If needed, use a mouthwash for chronic dry mouth; such as Biotene.  If this side-effect is left untreated, it will cause tooth/enamel decay leading to loss of teeth.

Best wishes to you in your continued recovery.
Helpful - 0
1301089 tn?1290666571
It's nice to know that at least the pain is ebbing.  There are a lot of members of this forum who use it and love it.  That fatigue seemed to dissipate for them.

I've thought about not posting this but decided that you might want this info.  Please keep in mind that all meds affect people differently.  And fentanyl patches have been a godsend for many.  I'm not one of the many.  Because of the extreme fatigue and it quit stopping the pain, I had to get off it.  It was not unusual for me to sleep 14 hours a day. It didn't work out at all for me.  But that in no way implies it won't work for you.  You probably will get over the fatigue.

The patch coming off was a problem for me as well.  You might ask your doctor or pharmacist about the Mylan brand.  It did better than the Duragesic for me as far as staying on goes.

But please reserve judgment until others have weighed in.  There are many who really like it.

Good Luck
Sara
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