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Fentanyl patch
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Fentanyl patch

Ok, so the last time I saw my doctor about 2 months ago, she decided to put me on MS Contin 15 mg 3x day. I was already taking 2  5/325 percocets 3 x  a day, but I went in because it wasn't enough. It never has been enough. She always gave me muscle relaxers for the nights, because she didn't want to give me anymore percocets, but I still wake up in pain. They don't work at all. So I finally went in and she put me on the MS Contins. Well it worked well for the pain, most of the time, but I was still having breakthrough pain at least once during the night and once during the day. Well she only gave me 60 percocets for the month, taking 2 at a time only gave me enough for once. I also hated hated hated the way I was so tired from the MS Contin. So I went in again, told her I hated the MS Contin and she decided to put me on the Fentanyl patch. Unfortunately I she wasn't going to have the Rx for me till the next day which was a time I was unable to pick it up. Long story short, I couldn't get it and being Christmas the clinic has been closed for the next 4 days. So I couldn't take the Fentanyl patch. So my question is, before I take it, Is the fentanyl patch more like morphine which I hate, or oxycodone, which I am happy with and doesn't make me want to sleep all the time. I already told my doc all my worries about the patch and that I am uncomfortable taking it because the higher risk of dependency and how it's harder to taper off of. But I'm not sure if I should talk to my doc again before getting it filled because I really don't want to keep wasting money and time on meds that I can't stand being on and constantly switching.
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1524811_tn?1333244901
The Fentanyl patch is 80 TIMES STRONGER THEN MORPHINE ! If you aren't liking the way you feel on the MS Contins, which are essentially morphine, then you won't like the Fentanyl. I went from the Ms Contins to Fentanyl a few years ago & honestly it was the BIGGEST mistake I've EVER made!!! You build up a tolerance to the Fentanyl quickly, it's 80x's stronger then morphine, 50x's stronger then heroin, & can be quite dangerous.  PLEASE DO YOUR RESEARCH BEFORE TAKING IT!!!!! Dr's don't tell you everything you will need to know & neither do the pharmacists.  Coming off Fentanyl is VERY difficult & takes longer then most other opiate meds as it has it's own long list of complex WD symptoms.  The longer you are on Fentanyl the worse the WD's will be, but even being on it short term can cause symptoms that last anywhere from a few weeks to 6 MONTHS!!!!

If you want more info feel free to inbox message me.  I've had a lot of experience with Fentanyl including the WD's, increasing & decreasing the levels as well as a few of the side effects.

LOTS OF RESEARCH IS THE KEY & I can try to send you the links to some of the info I've found regarding it recently.

Melissa
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Avatar_n_tn
I will NEVER go on Fentynal again. The withdrawals are will you make you feel like you want to crawl out of your skin. I did not feel the head feelings with them like I did with Norco, so I did not think they were doing anything, but when I tried to wean off them. OMG I would of rather died. Think seriously before going on them. I have been diagnosed with Chronic pain and the best thing I ever did was go to the pain management center and start getting steroid injections. Hope this helps.
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Avatar_f_tn
Hi Jenny,

Well, I've had just the OPPOSITE experience with the Patches.  I've been on them for a year and I just had surgery for my 3rd Hip Implant on the same hip {first one was almost 40 years ago} and they raised my patch from 62 mcg up to 125 after the surgery and I've been tapering back down now and I'm having NO PROBLEMS at all with the taper.  I've been going down by 12 mcg's every 3 or 4 weeks and I've had NO w/d's at all.  My Doctor told me at the beginning that IF you TRULY need this strong of a medication then you WON'T have any problems when you taper back.  IF you DON'T really need it then you will have problems.  Now, MY Doctor is tapering me off by 12 mcg's at a time and THAT'S the way that you NEED to taper so that you will have the VERY minimal problems with tapering.  As I stated - I've had NO trouble and I've gone from 125 mcg"s down to 88 mcg's and I'll be tapering down another 12 the first of January.  I'm hoping to  be able to get down to 50 mcg's OR MAYBE even 37 mcg's and hold there for my pain relief.  It's MY choice to taper and I told my Doctor my wishes BEFORE my surgery. He's letting me do it at my OWN pace.  I'm 64 years old and I want to be as low as possible as I want this med to last me for the rest of my life.   I've NEVER had ANYTHING that worked so well for my DDD.  I'm thrilled to have it and I don't EVER want to lose it.  I was SO under-treated before I found my PM Doctor and I feel VERY fortunate to have found him.  :)

The patch has taken care of ALMOST ALL of my pain.  I have VERY severe DDD and I have had 6 RFA's done on my lower spine and BETWEEN the Patch and the RFA's as I said I'm almost COMPLETELY Pain Free.  I've NEVER been so happy with ANY med that I've had.

Now, I will tell you that I'm a little surprised that your Doctor is offering you the patch as you are so young.  As far as I know there is NOTHING stronger that they can give you than the Fentanyl Patch.  IF you choose the patch be SURE that you ask him for the Mylan Brand that had the medicine IN the adhesive.  This brand is ALSO the one that sticks the best.

BEFORE you start the patch JUST be SURE that it's what you REALLY want.  If you have ANY more questions about it feel free to PM me OR ask on here.  :)

Jenny, would you mind sharing exactly what your diagnosis is?  That has a LOT of bearing as to whether the patch is the correct choice for you.  It works on SOME things but DOES NOT work on others. Thanks.

Best wishes and I HOPE that you are able to get the relief that YOU deserve.
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1524811_tn?1333244901
namnam46

Are you implying that I don't need the patches then as I've had problems with trying to taper down?  I've been on them for 3 years & have tried a few times to wean down but the 1st time my dr was dropping the dosage by 25mcg every 6 days!!! the next time it was dropping 25mcg every 10 days.... & this last time it was 50mcg in 1 day !!!! Either you or your doctor need to watch how things are worded & posted.  I've been in chronic pain for more then a decade but only on pain meds for 7 years.  I didnt start with Fentanyl, but it's where I've ended up AND after doing my research & talking with DOZENS of patients, doctors & specialists WHO ALL STATE YOU WILL HAVE WITHDRAWALS !!!!!!  as for her being so young & you being surprised it's being offered to her I was started on them at 25 years old & have met patients as young as 18 on them.  

Just because ppl suffer ill effects trying to come off such a strong medication DOES NOT mean that we don't need or deserve them.


Jenny

Please be VERY careful with them ! No matter what brand you chose they all are basically the same except certain ones stick better then others.  If I could I'm stop using them because they truly scare me.  As Spartan said when you suffer from the WD's it feels like your skin is crawling, so much in fact that ppl tend to scratch at it until it bleeds. I wanted to tear every inch of it off, had horrible electric shock like pains down my spine, vomiting, unable to eat, couldn't sit still, horrible headaches, & extreme fatigue... those are just a few of them & like I said before everyone has different reactions. You may be 1 of the lucky ones that doesnt have issues with them, but make sure IF ou decide to use them that you are TRULY educated on ALL possible side effects, the pros & cons of using them, and then make an informed choice about what is best for you.

I'm here if you want to talk or if you want to see some of the info I've gathered while doing my research.  Just inbox me :-)

Melissa
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Avatar_n_tn
Read the 'drug insert' nott only the patient paper. Read the info that comes with the drug from the manufacturer. Ask your pharmacist for it. Don't stay in the sun or be on a heating pat or get a blow dryer near it. Heat causes the drug to come out of the patch at dangerous levels. I tried it...got a sick dizzy feelingl...not high...like alcohol but weird. I got scared. I read the litature and pulled it off...first I went online and got support and confidence to get off of it. Oxycodone is one of the better pain killers that doesn't give you the down weird feelings and I've never been 'toleraant' of it. It works the same on me every time for always. But as you might know it is hard to get. They will give the patch in a heartbweat because it's harder to abuse. I wish oxyc0odone came in a patch!!! Then I could get it and be pain free! But alas. SO....in the meantime be careful. Do what you need to do but follow directions to the T. Listen to advise from here and other foreums. Some have trouble, some don't. Withdrawal should be done EVER SO SLOWLY and with alot of prayer! Seriously take it SLOW. Try the 12.5 like I did if you can get that to start. That way if it drives you insane like it did me you can stop it after 3-5 days. You might get edgy, have a headache...things like that but soon your mind will again be sharp as a tack...or at least as sharp as it was in the beginning before you took the patch! lol

I doubt I can get mscotin...morphine makes me sick anyway but I'm getting desperate and thinking of a pain pump. I'm a senior citizen but that doesn't matter...I want to llive many more years as well. We all need to think straight. I want to be rid of pain so I can get back to work! I need a clear mind. Well everyone reacts differently to drugs so just be careful and go on very slowly so you can back off if you need to. Wondering if mscotin made you sick to your stomach being morphine. mmmm Well anyway back to you. My best to you. Hopefully you can get relief and heal. I wish the same for you all...and for me. I can't give up hope.
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Avatar_f_tn
Hi Melissa,

No melissa - not at all.  I'm VERY sorry if it sounded like that. All I did was to state to Jenny what MY Doctor had told me. I can't change what he told me and I'm TRULY sorry that you took it that way.  My Doctor told me that IF you taper SLOWLY at 12 mcg's you won't have any problems.  That's JUST his opinion and so far it has worked out that way for me.  I was ONLY stating what MY Doctor told me.  The results that I'm having tapering down, I realize is ENTIRELY different than the one that you are having.  I'm VERY sorry that you are having such difficulty with the patch!!  I wish that you were able to wean off of it as effortlessly as I am.  

Why did your Doctor taper you off so fast??  That is WAY too fast to taper off of the Fentanyl patch.  It's no wonder that you are having such a difficult time with it. Any one - even me - would have trouble with that type of a taper.  I would be in SEVERE w/d's if my Doctor tried to do it that quickly.  I'm not even sure that it's safe to taper that quickly off of the patch. IF you had been tapered slowly then I don't believe that you would have had the w/d's that you are experiencing.  

My Dear, I'm VERY sorry that you have had to go through this type of w/d's.  I hope that you can slow it down to a much more normal type of w'd.  :)

I wish you the best and hope it gets better for you........Sherry

I'm TRULY sorry if it came out wrong as I would NEVER purposely imply that about you in ANY way at all.  Please forgive me.  

I realize that there are MANY patients that ARE young BUT usually the Doctor's DON'T put you on them when you are young BECAUSE there is NO WHERE to go after the Fentanyl as they are the strongest.  That is why SO many young people come on here and they CAN'T get ANY help from there Doctor's at all BECAUSE of there age.  If you go back through the archives here you will find story after story of the young patients ALL the way up to 38 years old that CAN'T get ANY type of help from their Doctor's BECAUSE of their ages.  It's REALLY sad BUT I can understand WHY they DON'T want to give the patches at the younger ages.  And I'm assuming that you WISH that your Doctor hadn't done that to you. When you have CP  that will be with you for the rest of your life then you have no place to go after you've had the strongest meds that are out there.

I'm REALLY sorry that you have had the experience that you had with the patch as many of us on here are having EXCELLENT results and are ALMOST pain free because of the patches.  Sometimes the Doctor's give them out TOO freely and that can cause some bad results.  

Melissa, if I may ask what was your diagnosis that caused your Doctor to put you on the patch at such a young age?
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Avatar_f_tn
Hi Jenny,

No the Fentanyl patch is NOTHING like morphine.  It's an entirely different medicine.  I'm HIGHLY allergic to Morphine as I was given it for a surgery about 20 years ago and had a TERRIBLE reaction to it and was told to NEVER take it again.  That is one reason that my PM Doctor gave me the patch.  Morphine makes me throw-up VIOLENTLY.  So it's on ALL my charts that I should NEVER be given Morphine.  Yes - it IS 80 to 100 times STRONGER than Morphine but IS NOTHING LIKE MORPHINE.  It doesn't give you a high feeling or in my case didn't make me groggy or anything.  

IF your Doctor starts you off the CORRECT way then he will start you SLOWLY at a low dosage and build it up monthly INSTEAD of starting you out at a high dosage.  This will allow your body to see if it is going to be able to handle the Fentanyl.  

What dosage is your Doctor starting you out on?  IF you have ANY type of misgivings about the patch then you need to discuss it with your Doctor.  

There is ONE patch that you DON'T want and that is the one that has the Fentanyl in a reservoir and NOT in the adhesive.  IF it's in the reservoir then it can leak and there have been several deaths that THIS type of Fentanyl patch has caused.  That is why I suggested that you ask for the Mylan brand.  It CAN'T leak out accidentally.  ANY of the patches CAN be abused - i.e. chewed instead of putting them on properly.  You MUST be sure that you don't get overheated - such as a HOT SHOWER or a heating pad etc.  IF you read the insert then you should be OK.  ALSO, if you will check with your Pharmacist they are an UNENDING wealth of knowledge when it comes to ANY of our meds.  They OFTEN know MORE about the meds than the Doctor's themselves as they get ALL of the comments and feed back from the Pharmaceutical Companies as well as ALL of the problems as well as the GOOD feed back from the patients themselves.

I wish you the best and I hope that you are able to get the pain free results that you are hoping for - no matter WHAT decision that you make.

Please keep us informed as to how you are doing.......Sherry :)
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1412606_tn?1282885729
Thank you everyone for your responses. It has been a great help to hear everyone's personal experiences, and my main question has been answered. Although the patch is not like the morphine I have decided against it. Simply because I really don't think I need that much medication. I am 33 by the way and have a separation in my spine and a herniated disc. The reason I don't think I need that much medication is because my pain is managed well with 10 mg of oxycodone. My insurance won't pay for the oxy contin, I hate MS contin, and my Dr. doesn't want me on too many fast acting meds. So the only other option she could think of was the patch. I spoke to her today and explained I am really uncomfortable with trying the patch. So she talked to some kind of other medication program that may be able to help me with the oxy contin with no cost to me. I am hoping it works out. For now I have to continue on the morphine. So I will just take naps constantly through out the next week until I can get the oxy's. One other thing though. No matter what med I am on, I still have breakthrough pain at least twice a day. My doctor only will give me enough for breakthrough once a day as she say's it is not normal for me to have it so often. All I can say is..... Well, I do. So is this really abnormal for me. I asked her what we will do if when I go on the oxycontin, I still have breakthrough pain. She keeps saying raise the dose of the long acting meds. It's her answer for everything. I don't know if this is right. I feel like my pain is managed well with this dose until the breakthrough kicks in, so will I be getting a higher dose of un needed meds with a higher dose of the long acting med?
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Avatar_f_tn
Hi Jenny,

I'm so glad that you discussed it with your Doctor.  If you are getting that much help with the oxycodone then that is what I was talking about - that sometimes you just don't need that strong of a medication.  It's used when nothing else will work.

I wish you the very best as I know the pain that you are going through and will continue to go through.  I HOPE that this program that your Doctor is talking about will help you get the ENTIRE pain relief that you deserve.  

I'm so glad that EVERYONE on here could shed some light on your decision. That's what MH is all about with the differing opinions so that you can hopefully make an informed decision or at least HELP you go in that direction.  :)

PLEASE keep us informed and let us know how you are doing.  I ALSO, hope that you will continue to be a contributing member on here as you will be able to help so many others on here that suffer as you are.

Again, I'm SO glad that you were able to find a solution.......Sherry
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82861_tn?1333457511
I think one reason doctors like to try the fentanyl patch is that you get 24-hour coverage.  You also won't have to constantly chase pain spikes the way sometimes happens with oral meds.  

A few words regarding the potency of fentanyl.  Yes, it's a very potent synthetic opiate and much more potent than morphine on a milligram-to-milligram comparison basis.  BUT, that is why it is dosed out in MICROgrams instead of MILLIgrams.  That is a tremendous difference.  To help put that into perspective, one microgram equals .001 milligram.  Most opiates are dispensed and dosed in milligrams.  

For further comparison, one microgram is one MILLIONTH of a gram.  The recommended top dosage of tylenol is 4 grams (or 3 if new suggested FDA guidelines get adopted).  The amount of fentanyl dispensed through the patch is millions of times less than all the tylenol many people ingest with vicodin and percocet on a daily basis.  Tylenol is more likely to do physical harm than the fentanyl patch.  It's thousands of times less than the amount of morphine or oxycodone ingested by pain patients.  

As a pain management tool, fentanyl is no better or worse than any other opiate if used correctly.  There are pros and cons to it just as there are with any other medication.  None of us knows how we will react to any medication until we try it.  Maybe it will be the right one for you and maybe it won't.  At some point we have to trust our doctors and make an informed decision based on solid science and medical advice.

Like any other opiate, you will experience withdrawal if you suddenly stop using the fentanyl patch cold turkey.  Experiencing withdrawal does not mean you are an addict. It means you are physically dependent and that is a normal part of opiate therapy.  I do wish PM docs did a better job of explaining that to new patients, but it seems that most don't bother.  Some pain docs do a better job of managing taper schedules than others too.  Full and honest communication is the only way to deal with it if tapering is on the table - as it is for any medical concern.  Best of luck to you in your search for relief.  :-)
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Avatar_f_tn
Thanks for your explanation about the patch jay, I have been on it for almost 2 weeks and I had few questions after reading the posts by previous posters BUT I am relieved now and not scared.

I started at 75 mcg every 72 hours and now am on 100 mcg/72 hours. I see my dr on the 5th and we'll see if we up the dose. I did a switch from ms contin to the fentanyl patch and I like the way fentanyl works on my pain, it's better and fewer side effects for me.
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82861_tn?1333457511
I'm so glad you've found something that helps your pain.  Hopefully, you won't need to increase your dose of the fentanyl patch.  You're on a pretty stout dose already and you'll need some maneuvering room in the future.  If you're able to function pretty well on your current dose, try sticking with it for at least another month.  Remember: pain management is about "management" - not "cure."  If your goal is improvement in your life rather than a complete return to your pre-pain life, then you're less likely to get frustrated, scared and anxious about your pain.  All those things only make your pain worse.  Best of luck to you!  :-)
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Avatar_m_tn
Unless you truly plan on staying on them forever stay the hell away from fentanyl. I have been on 150mcg patches for 5 plus years and got sick of it so now I am coming off. I went down to 25 percent for a few days but the pain was just as bad as cold turkey. Withdrawal is something you will never forget. Im on 72 hours clean and think I may not throw up again but the pain goes from manageable to unbearable.
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Avatar_f_tn
Are you coming off the patch with medical supervision?  Twenty-five percent is a BIG drop.  The key to coming off Fentanyl, as mentioned, is to do it slowly.  Fentanyl was not a good fit for me personally and I came off it with very little problem.  This is also a rather old post, so if you post a new question, you'll get better responses.  (Often when we taper or go off our meds, pain gets much worse initially then settles back to "real" pain, which may still be unmanageable without meds.)  I hope you find something for your pain, and your withdrawals ease.  Really important to stay hydrated, which is a big problem for me once I start throwing.
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Avatar_f_tn
Ive been on fentenal patch for 10yrs my current dr retired.does anyone no a good pain dr that perscribes this helps my pain,i live in washington.any help will do i got stuck w no dr&some pain drs after i get referal&make a apt and wait for apt to have the pain dr say he cant go that high. Please help
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Avatar_f_tn
Hi ssassyangelique - I want to welcome you to the PM (Pain Management) Forum.

I must let you know that this is a very old post but as far as your question goes we tend to shy away from recommending Dr.'s as one that is good for me might not be good for you. Sometimes though someone will know somebody and might give you a name.

One option is to go back to your PCP (or whichever Dr.) sent you to the PM Dr. that just retired and ask them for another referral to a different PM Dr. Hopefully, they can help you once more.  :)

If that doesn't work then I would recommend that you "google" PM Dr.'s (in your area) on the internet and I bet you will come up with many to choose from.

I wish you the very best and hope that this has been of some help to you.

Good luck with your search and I will look forward to an update from you letting us know that you were successful!!.........Sherry  :)
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Avatar_f_tn
Ive been on fentenal patch for 10yrs my current dr retired.does anyone no a good pain dr that perscribes this helps my pain,i live in washington.any help will do i got stuck w no dr&some pain drs after i get referal&make a apt and wait for apt to have the pain dr say he cant go that high. Please helpif anyone nos of a pain dr.i am on 100mg every too days.i was a abandon patient when my dr retired i went with new primary care dr that took over for him.i saw him a month and he up&quit 2days before my refil apt, no notice,no 30days worth,i get referals but they waist time if the dr doesnt help me,and you dont no till after referal&waiting for apt&youve waisted time on drs that cant help,&longer wait not noing were your going to get your perscribed meds,do i go fom100mcg to nothing when it helps me with daily living&keeps me out of hospital,can you go there if it comes down to being really stuck,please help any help will do
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Avatar_f_tn
Ive been on fentenal patch for 10yrs my current dr retired.does anyone no a good pain dr that perscribes this helps my pain,i live in washington.any help will do i got stuck w no dr&some pain drs after i get referal&make a apt and wait for apt to have the pain dr say he cant go that high. Please helpif anyone nos of a pain dr.i am on 100mg every too days.i was a abandon patient when my dr retired i went with new primary care dr that took over for him.i saw him a month and he up&quit 2days before my refil apt, no notice,no 30days worth,i get referals but they waist time if the dr doesnt help me,and you dont no till after referal&waiting for apt&youve waisted time on drs that cant help,&longer wait not noing were your going to get your perscribed meds,do i go fom100mcg to nothing when it helps me with daily living&keeps me out of hospital,can you go there if it comes down to being really stuck,please help any help will do
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Avatar_f_tn
Your best bet is to re-post this on your own thread as this post is form 2010. Most people won't look at this post.

Go up to the top of the page and click on the orange button, Post a Question and start your own thread.  That way you will be much more likely to be able to find someone that might be able to help you.  :)

Sherry  :)
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Avatar_m_tn
Hi Jenny I have been on the patch for about a yr n a half maybe two yrs cant remember but it wks good but u do grow a tolerants to it I need to go back to my pain Dr. For stronger dose I had two lower back surgerys that didn't go like wanted then my insurance dropped me like a hot Patato so I am having to pick up the tab my self on a disability fixed income but that my dear is another story lol
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