Frustrated with fentanyl patch!

[GreyScale]

Ever since the second of this month, I have been using duragestic patch (fentanyl patch, mylan brand) and am having tons of trouble with it coming off or sweat blisters forming underneth, and itching.

My doctor tells me to NOT cover it, even with tegaderm dressing... and to only put it on my upper arm or back... I sweat there a lot. I find I have better luck if i stick it to my side where the rib cage is. Better luck with it staying, that is. I am slightly overweight (10-15lbs) so the patch will bend or wrinkle in other places and that doesn't help it stick. I also live in a humid environment and chase after a toddler outdoors a lot...

I don't know. Am I wearing it wrong? I have tried the ivory soap suggestion, the rubbing alcohol suggestion, showering prior applying, blow-drying the location (prior putting patch on, not after.)

The only thing that keeps it on is the flexible tape by johnson johnson... applied around the edge. But I am allergic to it! The first 10 days, I basically had to apply a new patch until I got some tricks under my belt (johnson johnson) but now I'm itching and turning red at the site... I am so frustrated! I have to go to my appointment tomorrow, I hope the doctor won't blow a fuse at me for going through so many patches and having so many fall off. I truly was trying to make this work.

I have my last patch on right now and am so fearful of it falling off.

Another thing is, my son will pick at it if he sees it on my arm or upper back... so I feel uneasy with it uncovered. It's warm so I wear tank tops a lot.


I'm not sure what I am expecting from this post. Lol.

But I feel as if it helps with pain as long as it sticks or is in contact with my skin.

[Sprices]

Question here??? If the patches are supposed to release the same mcg per hour of fentanyl then why does it matter if u have to put a new one on every 48hours or 72hours? You would still be getting the same amount per hour the only thing I can see is it being a waste of money.

[Pusscat71]

I myself had the same problem, the only thing I found to help me was to clean area with alcohol & wait 15 mins, I put mine on the top part of my breast, rotating side to side then I warm the area with a hair dryer & place patch on that way the glue adheres better to my body cause the glue is warm & sticks..this is the only way I can keep one stuck on me cause I to am a sweater..I hope this was helpful :)

[lazydaisyg]

My Fentanyl patch fell of all the time, I tried bandaids, (all types), ace bandages, cloth tape, sports tape, all of them.  And then I thought...hmmm..what about the tape they use after they put an IV in?  The clear thin square that peels off on the outside and then placed on and it's good.  So I asked my doctor and he said, that would probably work.  I got some and it's perfect!!!  Even in humid weather. The problem is that I forgot the link to be able to order it.  If anyone knows the link I would love to get it asap, as the cloth bandaids are driving me nuts.

[shinty]

Another old post!!! 2010  REALLY?? Why r these showing up on my watchlist?  It's getting ridiculous.

[shinty]

I also had trouble with the patches staying on, especially during the summer months. although it's an excellent medication, I ultimately gave up on them and went to a different medicine altogether. I did continue to use the lolipops for breakthtough pain. If not for the lolipops, I don't think I would have realized the full effect of fentanyl, as the patches were constantly a problem. I recommend getting off the patches and using something else for your pain control. It's a shame thatthey can't make this drug in an extended release tablet like alot of the other pain medications. I think they don't because of the abuse potential. The "powers that be" don't realize that people can and do abuse the patches. They are eaten, smoked, etc.. Where thers a will there is a way! Oh well,sorry for the long-winded post. Take care,  
                                    Sean

[railroaded]

I am with you, I never got relief with the Fentanyl, and I was prescribed 4-100 mg. patches every 3 days. I DID get bloody, blistering rashes after the first month. It was only when I needed a colonostopy in the hospital, and they saw me with my gown on, they gasped and slapped a Fentanyl ALLERGY wristband on. The next day, I went in to the Pain Management Dr. that I had been complaining to, (they didn't work, I had abdomen pain, headache...well, every adverse reaction WITHOUT the relif! He saw the wristband, which I purposely left on, and I was taken off it that day. 4 Months and all I have to say is I took photos of all the scars on my thighs and arms. I don't know why they say it is so much stronger than morphine, MAYBE for some, but I was on a heck of a lot, and NADA! So, on to the next try....! Thanks for posting, it seemed everyone was saying the Fentanyl was SO DARN strong. And the falling off?! My Dr. wanted me to put a 6 inch by 6 inch tegaderm over every patch, even if I hadn't have had the reaction, it would have costed me, because I did it for awhile, over 200.00 a month for those huge tegaderm!

[Outtapain]

Hi, i have been on the same patches and like the rest of you have struggled with itch at the site, however i told my dr. Abt. It and he prescribed me steroid nasal spray that i spray on the area and let dry before applying the patch. You would be amazed how much it helps.

[skmedlin27703]

Posted a comment on the other post. Check it out.

[lett123]

You know when I first started using the patches it was the gel based, when I went back, they gave me a different brand, it looks like a sandy looking patch and they are smaller. Long story short, I started having anxiety, then I started getting SUPER deppressed, then withdrawl symptoms, then I felt numbness on my hands, then I just ended up in the hospital. It was the worst day of my life and now I'm scared out of my mind to get off all meds!!!
I have two daughters and they were in the room when I was uncontrolable and the ambulance had to come get me. Can you imagine... all this just scares me now. So my doctor put me back on percocet 10mg 325 and they really don't do anything. I have to take four of them alone in the morning to get out of bed because I'm in such pain. I can't sleep at night and my 17 yr old daughter said my left leg twitches a lot. I told her I get a lot of muscle spasms and that may be it.
I just can't seem to find the right meds, I would love to just find something I could take three times a day and be done. When my doctor once prescribed Roxycodone 15mg and would let me take two at a time, that would help, but I didn't want to take 10 pills daily, then again, he didn't want to give me the Roxycodone 30mg. I know that if he was to give me those one every four hours, I'd be good. I refuse to take Oxycontin cause when I take them my teeth quinge, I feel too medicated and I don't like to feel that way. What should I do... Percocet is not enough and Oxycontin, well I don't like the stories you hear from it, and the patch, NO!!! not ever again, it scared me. In all reality, I don't want to take anything, I want to get off all the pills and find something that I could put on my back and not be codependent on anything. Any suggestions....
Oh, what do you think about Suboxon (is that how you spell it), have you guys heard anything about it... I thought if maybe I get cleaned up and stick with the pain to see if I could do it, then start over and take meds but maybe one every other day... I don't know anymore, I'm just scared of all this now

[MadMart78]

Unfortunatly i cannot tell if there is any medication left in the patch or not because they are the one's that dont contain any gel they just look like a bit of see thru tape or a see thru plaster. I have not seen a gel based patch for about  nearly 2 years. Boots the chemist i use said i would have to get my doctor to print tilofyl instead of fentanyl to obtain them. I collected a differnt brand yesterday called matrifen but these one are exactly the same in apperance as the durogesic dtrans patches but are about 1/3 smaller and only contain 8.4mg intead of the 12.6 in the durogesic patches. I so far have noticed no difference. I am wondering about what you said about them working off your body temp as i think i do have a slightly lower body temp compared to others as people always say they cant beleive how cold my hands are even in summer. I will ask my doctor about that one. many thanks to you for your reply :) Take care x

[JadedSweetheart]

I have often wondered that same thing about my meds because sometimes they work and sometimes they don't.  The thing about the patch is that it really goes off your body temp.  If you have medicine left in the patch, save it to bring to the doctor and show them.  Then they can suggest something for you to do differently.  Sometimes they will put you on a 2 day change instead of 3.  
I hope you get it worked out!

[MadMart78]

Dam things sure im withdrawing now but dunno if its the fents or the 200mg msts i buy i gotta go see what new brand they have got in for me hope its tilofyl or eqilivent generic and not matrifen but then even they gotta be better than the durogesic if they not got enough fentanyl in them. (if any! im wondering if there putting placebo batches out now and then to see if any one complains)

[MadMart78]

hello everone i agree the adhesive is a problem on these patches as im having problems with these matrix type patches, im on the uk durogesic 75mcg ones and find the adhesive irritates my skin plus i think they are faulty at the moment because either there is not enough of the drug in the patch its ment to be 12.6mg's in the 75's here  (which seems very excessive to me when the patches are so much weeaker than doctors say they are)  or the release rate is wrong and after 3days when you are ment to take it off and throw it away i think maybe about 70% of the fentanyl must still be left in the patch! I have done the maths at 75mcg an hour our uk patches in theroy contain enough of the drug to last 160 hours !!! anyway ive told my pharmacist to get me a differnt brand which im going up to collect soon today. I just hope they are the gel based patches !!! ;) also fentanyl in my opinion is not as strong as doctors say it is and its effectivness as a strong painkiller is inferior to morphine and especially dipipanone (stronger than oxycodone) and diamorphine. What it is fentanyl is about 80times more concentrated than morphine not 80 times stronger !!! ie 100mcg of iv fentanyl is equal to about 7 or 8mg of i v morphine !!!! MadMart

[lett123]

First I want to say hello to everyone...

Then I would like to say to Sarajmt that what I meant was just how my little one likes to play with anything she sees on me and if she was to see it she would want to peel it off. Just relating to the person that asked about the placement of the patch :)

When I said, it makes me peranoid, JayBay got that one too, right on the nose. My mind starts going crazy, especially when you hear death stories and knowing I take it too.
Yes, I am soooo careful to where I keep my meds, in the reach or the eyes of no one. OMG... you guys are just so amazing and imformative and I love it.

By the way, were you able to find a better spot for the patch, and how are you feeling... is  everything better...

P.S. Jaybay, do you mind if I contact you. I wanted to ask you a couple questions if you don't mind...

Lett

[Jaybay]

Yes, fentanyl is much stronger than morphine, and that's why it is dispensed in MICROgrams rather than MILLIgrams.  That's a tremendous difference.  Because fentanyl is used in such tiny physical amounts, it can be difficult even for doctors to measure effectiveness against other opiate-based medications.  To put it in perspective, I've found that 8 to 10 norco tables in a 24-hour period (10 mg hydrocodone with 325 mg of tylenol) equates in effectiveness to the daily dose dispensed by one 25 microgram fentanyl patch.

Over the past few years, people have heard about fentanyl overdose deaths and refused to even try the patch when their doctors recommended it.  Bad press as a result of irresponsible patients, drug addicts and journalists prevented many people from obtaining the pain relief they desperately need.  

After Michael Jackson's doctor inappropriately and criminally administered the anesthetic propofol as a sleep aid, colonoscopy and endoscopy patients refused the procedure when they learned propofol would be used.  All they heard in the news was the words "propofol" and "death" and that was the end of that.  Propofol, like fentanyl, is completely safe provided it is used as intended.

Any opiate can cause accidental harm or even death in a person who is opiate naive - meaning a person who has not built up a physical tolerance to a narcotic pain medication.  That's why the fentanyl patch is not to be slapped on a post-op patient or any other patient who hasn't been on some form of narcotic therapy long enough to build tolerance to less powerful narcotics.  

Matter of fact, ANY medication can kill if you take more than prescribed and that includes over-the-counter medications.  Those recommended dosages are on the packages for a reason.  Take too much tylenol long enough and your liver is gone.  Eat too much aspirin or advil and your stomach lining is gone.  In those cases, death comes slowly and seemingly for a reason other than misuse of medication, so we don't see the danger.  It's the spectacularly fast deaths from intentional or accidental narcotic overdoses grab our attention - and the headlines.

The fentanyl patch is no more dangerous than any other narcotic when used properly.  Like all medications, it should be kept well away from curious pets, children, and anyone else for that matter.  Extra caution needs to be taken in disposal of the patch.  After being in place for the usual 3 days, there is still enough medication left in the patch to cause trouble for an opiate-naive person or even pet.  Many people flush the used patches down the toilet.  That's certainly safe and effective, but if you have a septic system that may not be possible.  If you have a temperamental sewer system, over time the patches may stick together in a pipe and cause a clog.  (Yep, that happened to me!)  If you throw the patches in a trash can, simply wrap them in a wad of toilet paper or kleenex and employ self-closing trash cans in your home.

As Sherry mentioned, the gel patches seem to cause more trouble for patients than the Mylan generic in which the medication is embedded in the adhesive.  My personal experience was that the adhesive in the gel patch caused burned and blistered skin.  It also dispensed too quickly leaving me dizzy and out of it the first day, fine on the second day and beginning withdrawal on the third day.  There is also more potential for abuse with the gel patch (which I won't enumerate here).

Prolonged raised body temperature can cause the patch to dispense too quickly.  Taking a normal bath or shower isn't a problem, but lounging in a hot jacuzzi tub for an hour or more IS a problem.  While using the gel patch, I was outside for a couple hours in 100-degree heat.  I got very nauseated and dizzy and finally figured out it was an overdose of fentanyl.  I didn't want to remove the patch (we all know early refills are very much frowned upon) so I placed an ice bag on it for 30 minutes and the effects slowly disappeared.

(Sorry about the diarrhea of the keyboard.)    :-)  While fentanyl can be a godsend for many people, for others it just doesn't fit individual circumstances or lifestyle.  I would hate for any pain patient to be scared away from the patch by reading misleading news headlines or hearing only about problems from its improper use.  Again, as Sherry said, common sense can help us avoid trouble from the patch - or any other medication for that matter.

[namnam46]

Hi lett:

The Fentanyl Patches are approximately 80 times stronger than Morphine. If your Sweet Little Girl should get hold of one of the Patches and puts it on like Mommy OR puts it in her mouth like Little Ones will do with so many different things it could very well kill her. You have to be very careful with your Patches as I'm sure that you are aware, just like you are with ANY of your meds. But in this case be DOUBLY careful. Be sure that they are put where she can NEVER  get hold of them. The Fentanyl Patch when not used properly has killed Pain Patients that haven't been careful with them OR in the case of the Gel Filled patches where the Gel has leaked and they got more of the med than they were supposed to get. Just be sure that you are careful.

If you use the Patch made by Mylan (it's the one that I use) you won't have the problem with the Gel because it's the one that has the Fenatnyl med in the adhesive and is much safer than the Gel Filled for us Patients. However for the Little Ones in our lives it is just as dangerous because it can still kill them.

If you use your common sense, which I know that you do because you have been protecting your little ones already from your pain meds, then you have nothing to worry about. You've already trained them NOT to touch Mommy's Patches. Plus you are wearing them where they can't get to them. Excellent idea.

Just continue using your common and everything will be fine. If you have any other questions, just ask and we'll all be happy to help you.  :)

Good Luck.....Sherry

[Sarajmt]

Hi!  Just a question  When you said "Oh and by the way, How can it kill you cause now I just got peranoid about that too, as I too have a little one that if she sees it, she wants to pull on it ( I just don't let her) "  Are you just commenting on how your little one wants to peel it off and how you realize the dangers? (I had to laugh.  My daughter used to pick at a small mole just below my neck when she was little.  Drove me crazy!  I'd hardly even noticed it before she started that!)

Or are you asking if it can be lethal?  Because yes, it definitely can be.

[lett123]

OMG as I have the same problem, being alergic to the glue and the tapes... you should see what my rib cage looks like :) What I do is place it on my rib cage cause that's where it sticks better and doesn't peel off. My doctor said I could place it where ever I want... As for the itching and red brocken bumpy skin, I put neosporin. I take turns switching it from side to side. I just find that I get such releif from the patch that I rather deal with the itching.
Plus, everything these ladies have posted.... well, I took notes myself :)

Oh and by the way, How can it kill you cause now I just got peranoid about that too, as I too have a little one that if she sees it, she wants to pull on it ( I just don't let her)

Well, good luck and curious to know what your doctor has to say and the outcome of your posting :)
Good Luck

[namnam46]

Hi,

I'm sorry that you are having the problems that you are with the Patch. I hope that your Dr. can help you. I know that the back (where I wear mine) or the arm are the normal places to wear them, however I know that many people wear them in different places. I'm thinking that your Dr. may be concerned that you will REALLY get overheated on the patch if you wore it where you want to. You have to be SOOO careful about that. It can kill you! PLEASE be careful.

Please figure out some way to keep your son AWAY from it as it could kill him if he gets it and you don't know about it.  If you need to switch to wearing a short-sleeved T-Shirt instead of your tank tops. It's not worth taking that type of a chance with the safety of your son.

Jaybay and Sara gave you excellent suggestions for keeping the patch on. Please don't hesitate to call your Pharmacist for ideas they are a WONDERFUL source of knowledge for EVERYTHING concerning your meds!!

Good luck and please keep us updated...Sherry

[Sarajmt]

I agree with Jaybay.  You might want to try paper tape on the sides of the patch.  I am allergic to latex and the adhesive but the paper tape worked for me.  Except in the shower and the pool.  Your doctor needs to address this problem with a workable solution for you.

[Jaybay]

It sounds like you're allergic to the adhesive.  That's not an uncommon problem, and unfortunately it will probably only get worse.  Some people have luck applying benadryl gel to the area first.  Let it dry and then apply the patch.  Another technique is to use a cortisone-based nasal spray on the area such as flonase or nasacort.  It sounds like the fentanyl patch isn't going to be a good fit for you.

I can't understand why your doctor is so vehement about not using a cover (like tegaderm or other medical tape).  I also can't understand his objection to placing the patch on the ribcage - that's the one location that has worked for me.

I'm glad you have an appointment with your doctor tomorrow.  All you can do is honestly describe the troubles you're having with the patch and see what he says.  See if you can get a decent answer as to his reasoning for not covering the patch or using different body locations for placement.  It makes no sense at all to me.