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Fentanyl Patch
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Fentanyl Patch

I saw my pain doctor today and he put me on Fentanyl patch 25mgs every 72 hours. I have read all the papers on it and searched it on the internet. If there is any info on the patch that you don't read on the paperwork I was wondering if you could share. I put it on about a hour ago. My pharmacy gave me some things to go over the patch so it don't get wet, she said I can also buy them she gave me 2 of them. I was wondering what kind of tape do you guys use that works the best and it is put just on the edges right? She also gave me a thing that that i mark when I put it on and it tells me when to change it. I am also on percocet 5/325 for breakthru pain.
Any info on the patch would be great. So far I have a very bad taste in my mouth and alittle dizzy but not much.
Jamie
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954005_tn?1304630205
Hi! I'm so sorry I missed your post! What i do know about Fentanyl, which you may know by now because this post is from yesterday, is that it takes a while of being on you for the medicine to build up in your system, so you won't get immediate relief.  Did the thing the pharmacist give you work to help keep the patch on? i know that a few members have posted about paper sports tape...I believe it's less expensive than some of the covers you can buy.  The key is to allow the patch to breathe, so make sure you clear whatever tape you find with your pharmacist.  
I did try the Fentanyl patch for a while....it is an AMAZING pain reliever...it just made me sweat constantly, and I was always tired.  I think that side effects like those can go away for some people after a few weeks of being on it.  You MUST stay out of high heat, avoid any heat source near the patch, baths, hot tubs---keep the patch from being submerged....I'm sure most of this is on the leaflet included...
So sorry that no one responded soon enough! As with any medication change, it is great to seek out advice....what to be on the lookout for....
Hopefully some of our other members who are currently taking this medication can respond.... we are here to support each other through our trials and tribulations of pain management after all.... I'm sure that your question will also help others who just browse the forums also... so hopefully we can get some other contributions:)
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Avatar_f_tn
Jamie,

Sorry I don't know much about the Fentanyl patch, but as Alison said, there are plenty of people on the forum that DO know how they work.  Hopefully as Alison said you can get some great advice on how to keep it on, I know you already said that you had it on backwards, did you say?  Or was it upside down?  Anyway, had to chuckle about that, but since I've never been on it I don't know anything about it but that they gave me a fentanyl shot in the hospital and it seemed to work great for pain.  So, I'm sure once you get the fentanyl patch going,  you won't have to take as much percocet either for break through pain, but I know most people that have the patch do have the break through pain meds too.  I'm glad the pain managment doctor is working with you, finally, and that it seems to be working out much better for you.  Be careful as Alison said about temperature, getting wet, I think I've read that a lot on this board.   I hope you have a pain free day!  
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1187071_tn?1279373298
Thanks Alison and Karen!
Karen when I put  on the cover I forgot it was all tape so when I tried to take it off the patch came off with it. Today when I got a shower I put some cotton balls over it and then used bandaides to keep the cotton on. I am so scared of getting it really hot. I don't want to get it wet either. But I know I cant keep trying differnt things for the shower cause I don't want it coming off again.
I did talk to the lady when I got the patchs and she told me to check on another cover that they sell. I read everything in the papers that it came with cause I dont' want to mess up cause it is life or death with this one.
When your starting out with a new med of any kind it is so much better to get advice from others that have been on it, they know more then the dr does cause he hasn't been on it. That is why I asked and thank you Allison for answering me and Karen!
Jamie
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Avatar_f_tn
I used to be on the fentanyl patch and when I was, I used a surgical type tape ONLY around the edges of the patch.  My patches were the gel filled kind, so it was imperative that I not use the tape or anything else on the gel filled portion of the patch itself.  I do know there are different types of patches - some that are gel filled and some that are not.  Since I've only used teh gel filled, I'm not positive, but I've read and heard that the non-gel filled ones you can use a special type of adhesive cover over the entire patch.  HOWEVER, it must be this specific type of adhesive cover - not just any old covering - as these special ones allow the patch to "breathe" so as to not release too much medication at once.

As far as getting the patch wet, I was not told (nor did I read it on the paperwork that came with mine) that I could NOT get it wet, but to definitely avoid using heat on it.  Of course, a shower is going to be warm/hot so you definitely don't want to allow the hot water to run directly on the patch - and you also need to be sure that YOU don't get over heated in the shower or bath because the rise in your body temp can allow the patch to release more medicatioin.  With mine, the reason for possibly not getting the patch wet was because of it possibly coming loose before it was time to change the patch.  However, since I was already using the tape around the edges, I would simply CAREFULLY remove the old tape after I showered and put on fresh tape and I didn't usually have too much of a problem.

It may also take a while for you to find the best place on your body to place the patch where it will stay put the best.  For me, this was on the upper chest area - low enough so that it wasn't seen above the shirt neck line, but high enough that it wasn't actually on breast tissue.  I know some people put them on their upper arms, on their stomachs, on their backs, etc - as with anything, it can work differently for you in an area than it might work in that same area for someone else.

To find the patch covers, you may want to check out the website for whoever the manufacturer of your patches are - they may have some information on there about that -- or at least maybe a phone number where you can call and ask them if there is a specific type that they recommend - or maybe even provide.

As for side effects, you may notice them more for the first couple of weeks that you're on the patch - mainly drowsiness, dizziness, nausea.  As with any new medication - these side effects will usually go away or lessen as your body gets used to the meds - they did for me.

Another thing to remember with the patch is if you get a fever - because the medication in the patch is released by heat, if you get a fever, it could cause the patch to release more medication.  The paperwork on mine said to contact your doctor if you get a fever of over 101 to see what they want you to do about the patch while you have a fever.  I know one time when I had strep throat while I was on the patch, my fever went to 103 and my doctor had me remove the patch and just use my breakthrough meds until my fever had gone down below 100.5.  I only mention this because this wasn't (and probably isn't for others either) somethign I would have thought about - but it certainly makes sense - if external sources of heat can cause the patch to release more meds, then it most definitely makes sense that a fever would do the same thing.

I'm glad your pain doc is giving you something more that will hopefully help your pain better.

Please keep us informed as to how you're doing and if you have any other questions.

How is your son doing?
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Avatar_f_tn
Jamie, I guess you could stop taking showers (ha,ha) but then I think your hubby and everyone at Walmart wouldn't like that too much.  Geminigirl has a lot of information about the patch, about getting a fever, and checking out the website about the best way to keep those patches on.  I know from reading a lot of these posts that the patch coming off seems to be a big thing.  I know after I had my hysterectomy I was given the patch for estradial and it kept falling off in the shower, and then the sticky stuff was stuck all over different parts on my body and I could never remember what day I put the patch on, what day to take it off.  I was absolutely terrible with that type of patch so then I just got the pill to take once a day, seemed a lot easier, and it is.  But I know you will do good with your 25mg and will feel much better once it starts to kick in and do it's job.  I'm proud of you, you stuck around and fought to get the right PM doctor and to get the best treatment for you.  I know you had a struggle and you did not agree with everything that happened and some terrible things went down, but all in all, everything worked out and you found a pain management doctor and you are starting over new!
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1187071_tn?1279373298
My son is doing fine. He is getting a cold right now so his ashtma is all over the place. I am hoping he gets better soon cause he has to start school on Tuesday. Every since his surgery he has been doing so much better with his allergies but his ashtma has seemed to gotten worse.
My patch is the one without the gel it is just clear, my PMP told me to put it on my arms, not sure why he wants me to put it there but that is what he said, some girl I work with she wears it on her lower back. Im more scared of getting the shower water on it cause i don't want for it to get to hot. I never realized how hard it would be to take a shower with this thing on, I am always worried about it getting wet or hot. The cover I got is for cuts, they said to use it when I am getting a shower but I messed up and put it on right over the patch and then freaked out and took it off and the patch came off too.
I remember not long ago someone was saying they got hiccups with their pain meds, I can't remember what med it was but boy I have had the hiccups so bad tonight. I am also getting nausea and itchy but not to bad and I have been sweating. I am sure the side effects will get better, I am so looking forward to this working for me. Like I told Karen on the phone, it is like having a new outlook on life when your pain is being contorled. I will call about the covers and see what they say to use. Thanks alot.
Jamie
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1187071_tn?1279373298
Karen you are 100% right like I tell you all the time lol I had a good feeling about this doctor and I knew once I put my trust in him he would be great for me. He is a good fit. I don't think my husband or co workers would like me not getting a shower LOL I might have to come stay with you for a week Karen while I am getting use to not getting one LOL
I am going to make sure I am always watching what my body is telling me, if I am feeling sick I will start taking my temp all the time. Wonder what would happen like if your on the patch for awhile and then have to stop it because of a fever, wouldn't I have withdrawls? I know I would have my break thru meds but that is scary.
It is like having a new set of eyes and I can see my furture without being in alot of pain all the time. I really like that!
Jamie
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Avatar_f_tn
Jamie,

I think everyone will agree that is so good to have a positive outlook about this patch.  I've heard nothing but great things from Mama Sherry and I think a few others did have pretty good experiences with the patch and keeping the pain away.  Was it Sandee or Sara who were talking about it, I can't remember but I know someone was just recently.  Your attitude has seemed to turn around 100% since you've received this patch, I don't know if it's been because you were in SO much pain before, or that you found something that works, I know you made a comment that it's kind of nice not having to worry about taking pills all the time, so I was happy to hear that.  It does sound like you need to watch what your body is doing, keep an eye on the fever, and stuff, and  of course I have no ideas about the withdrawls, but maybe someone else can answer that question, maybe even our great leader Tuck may have some information on this that she can pass along to make sure you're doing everything perfect.  I know things have been hard for you and sometimes things didn't go perfectly for you but everyone deserves a second chance and forgiveness.  You just seem so much more happier, and I'm so happy for you!
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1187071_tn?1279373298
Thanks karen..
I just hope people still care, I know how much it means to have support when your going thru pain like this.
I do feel so much better with the patch and I am so glad my pain dr gave it to me. I have been on it alittle over 24 hours and I can feel a big differnce in my life already. My father inlaw was over today and he told me I seem more happier which means alot to me. In my kids eyes I want to look happy to them and be in a better mood since my pain is getting better.
I have also sat down with my kids to let them know about the patch and how they can never touch it, I read somewhere that sometimes it comes off and sticks to someone else so I wanted to make sure they knew about it and never to touch it.
I think the patch is my final answer to my pain, I know some stuff will change over time but right now i am very happy with it.
Jamie
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Avatar_f_tn
I, too, was worried about possible w/d symptoms that time my doc had me remove my patch because of my fever.  I'm not sure if it was becuase I was already so sick and feeling horrible, the fact that I was using my breakthrough meds, or if it hadn't been long enough before I was able to put the patch back on (I was off of it less than 24 hours because my fever finally broke and I was able to put a new one on) - but anyway - anything I experienced, I just chocked up to being sick anyway and feeling horirble already, so I didn't have anything additional by having to take the patch off.  At that time I also was on the 25 mcg strength (eventually went up to the 50mcg).  Fortunately, too, the day that the doc had me take the patch off due to the fever was day 3 on it, so I was going to be changing it to a new one the next day anyway, so I didn't "waste" a patch by having to remove it.

It's great that you talked to your kids about not touching the patch if they find it on themselves or anywhere else.  Most kids know not to TAKE any pills that they may find somehwere, but most kids also would not think twice about picking up a patch that may look like a band-aid to them and accidentally get a dose of medication.

I'm sorry to hear your son is having more trouble with his asthma.  I also tend to have more trouble with mine for a while after any surgery I have, so hopefully this bout of increased trouble will be short-lived for him.  Sometimes the airways can get irritated from the intubation and that can make them more sensitive to things for a while, making the asthma worse.  Of course, too, we're beginning (at least here in VA) to get to the fall allergy triggering season (for me ragweed is a BIG one) and that always tend to make my asthma worse.  Do you think it could be that it actually IS allergies causing it inthe form of the asthma (as  opposed to sneezing, etc.) - or has it been more activity/exercise induced?

I'm so glad that the patch already seems to be helping with your pain levels more than they were being controlled before.  I think you'll be happy with the patch in that you won't have the peaks and valleys of pain control that come with oral medication - even the long acting ones.  It's also good that you've already got something on hand for breakthrough pain - hopefully you'll find, over time, that you need less and less of that breakthrough pain med.
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1187071_tn?1279373298
My son isn't doing as much has he was during ball season. So far he has had 5 asthma attacks since ball season and this is the first time he has ever had asthma attacks so I have no clue why it is so much worse now. It has gotten cooler temp wise here so I am hoping that will help him breathe better. I am not sure if he was having allergies last night or not but he was so suffy and he kept sneezing and coughing. I thought it was the start of a cold but he seems ok this morning.
I really like getting up in the morning now and not being in a ton of pain, that helps me look forward to my day. When I was just on the pain meds I would get up and my mornings was always my worse time but now I get up and I am in some pain but not like it was before. My mom said today she was so happy to get my email on friday cause she said I seemed alot more happier about life which I do. I just hope it keeps up. I have to change my patch tomorrow morning I am thinking about taking the old one off then get my shower and then put the new one on so I dont have to worry about it getting wet. I have a thing I use that I put what day I put it on so I will remember and it tells me what day to change it, which is nice cause my memory isn't like it use to be. I also have it put up so no one will mess with it and change the days on it.
I have always told my kids to never take any pills they don't know what they are. I always give my son his meds and he knows what they look like but he isn't aloud to get them his self. My dr told me to make sure my kids knew not to ever touch my patch and they are put up so they won't ever see them. I am going to get a lock box for all my meds. I would feel so much better that way.
Thank you so much for taking time out to let me with the patch. It means alot to me.
Jamie
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1053812_tn?1254006671
I have been wearing the patch for over two years now. It sounds like you have the same kind I do which is the Mylan brand.  I was up to 100mcg/hr, but am down to 50mcg/hr now.  I like the Mylan because it sticks so much better, they are smaller and the ones with the gel seem to make a noise everytime I move and I felt like I was not getting an even dose with the gel pack one.  I also use Tegederm over the patches and they work well, but, like you found out, if you take the Tegederm off, the patch comes off with it.  I wear it on my upper chest and take warm showers all the time and let the water run over it and have not had any problems.  I live in Arizona where it is very hot, I walk for over an hour everyday, get very heated and have not had a problem with it. Sometimes when I'm out walking and I feel I'm getting overheated, I will pour a little water from the water bottle I carry with me on my shirt over the area where the patch is to keep it cool.  As long as the shower water is not steaming hot, it's OK to get it wet.  The Tegederm is very good at keeping the water away from the patch.  We also have a swimming pool and I swim with it on almost everyday and with the Tegederm, it never has come off.  

When you're first using the patch it's good to be cautious and figure out what works for you, but once you get used to it and learn what to do and what not to do, you get to the point where you forget you're wearing it.  The patch has been the best thing I have ever used to relieve pain.
Harplady
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230262_tn?1316649534
had to chime in for one thing- make sure you dispose of the used patches safely. never assume that they are "empty" of all medication. Your kids and pets could still be endangered if they got in contact with a used patch. One time I was in the waiting room at my vets with my dog. They had a dog in there dying because it got into the trash and chewed on someones pain patch that had been discarded. So make sure you throw them away carefully (maybe use some kind of enclosed container like an old baby wipes box or something to put in the trash?) something like that...
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1375159_tn?1311691944
Hi Jamie. I missed your post, and then I was sure that I replied, but now I can't find my reply. Strange. Anyway, I have no experience with the patch, but I just wanted to tell you that I'm happy that you're doing so much better.

Hugs,

Flower
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Avatar_m_tn
Use Tegaderm waterproof woundcovers by 3M.You can get them at Walmart or any drug store.I had a hell of a problem getting multiple types of fantanyl patches gel and non gel to stay stuck on.This info came right out of the Sandoz brand non gel info packet in my prescription and the pharmacist concurred.Dont use any other bandages or covers because the patch will not breathe and give you the relief you need.Hope this helps anyone new to fentanyl patches ive used them on two separate occasions for multiple back surgeries and learned alot of lessons.
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Avatar_m_tn
I am extremely late to the party, but I was using the fentanyl patch.  My doctor took me off of it due to skin irritation, and put me on nucyenta ER. I was supposed to take one every 12 hours.  Not as convenient as the patch, but good pain control.  However, I had a serious allergic reaction to the nucyenta.  We are allowing my body to get over the reaction, before we try something else.  I really think I should return to the fentanyl.  One, it worked very well, and two, it was very convenient.  I was on the gel filled patch, and thanks to everyone's posts, and my own research I am going to ask my pharmacist to change the brand to the mylan brand.  Apparently they stick better, and the are much smaller.  Also, I read some posts that gave me some good ideas for the skin irritation.  So I will talk to my doctor about changing the patch every two days, rather than every three.  Thank you all for your many posts, and ideas.  I have a chronic back and neck condition we have been dealing with for 7 years.  I am 37, and have 3 kids to raise.  I am extremely greatful for my family and husband, who are very helpful.  I have been on hydrocodone for over a year straight, and it just doesn't work anymore.  I am talking to my doctor today, so this information will really help me with that conversation.
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