How long does it take for Duragesic Pain Patch to work?

[yobo626]

Does anyone know how long it takes to feel the effect of the pain patch? Thank you

[toolmaker]

It will probally take 8 to 12 hrs on the 1st dose before its fully in your system.

[Tuckamore]

Hi Again Yobo,

The fentanyl patch can take up to 8 hours before the full release of the medication is reached in your system. As I said in my earlier post it took my mother only 5 hours before she had failyy good pain relief. However in eightnhours her pain went from a 10+ on a scale of 1-10. At the end of five hours she was at a 4 and in three more hours she was at a 2-3.

So hopefully you will soon notice reduction of your pain level if you took this recently.

Good luck to you, Tuck

[Mollyrae]

The comments above are correct....8-12 hrs. for the full effect. When you wake up in the morning, you will feel the difference :-)

[stnick_77]

Hi, I was on the fentanyl patch for quite a while. And i guess it depends on the person, but usually it takes about 24hrs in order to get the full dose of the fentanyl in your blood stream...If you are in serious pain and can't wait hours for it to kick in you can put a heating pad on the fentanyl patch, the heat releases the fentanyl from the patch alot quicker, there for reducing the waiting period substantialy. Also..normally you will change the patch every 72 hrs, but at the end of 48 hrs you can put another patch on, and remove the old patch as directed, usually after 72 hrs. This will keep a continous level of fentanyl in your system, and according to my experience and my Dr. it is safe to do. Hope I could help!

-Nick-

[yobo626]

I only have a little relief. Is it possible this dose is not working? Thank you everyone for your help.

Amy

[yobo626]

I have been on the 25mcg for 6 hrs with only a little relief. Is it possible to get more relief?
Thanks,

Amy

[Mollyrae]

Yes it is. Be patient. Like others have said, everyone is different.
Hang in there. I sent you a personal message.........

[Jaybay]

FYI - it's a real bad idea to put on a new patch sooner than the usual 72 hours unless your doctor writes that explicitly on the prescription.  If you run out too soon, you'll have a whole lot of explaining to do, and most pain docs will not be happy that you used this powerful of a medication inappropriately.  Taking more than prescribed of any pain medication can get you fired as a patient in some practices.

[Tuckamore]

Jaybay is so right. I know you are trying to be helpful. But please understand that at MedHelp we only take medications as our individual physician prescribes them. What your physician may prescribe for you, may not be right for Yobo.

It is never OK to change your patch early, increase your dose or take medications any other way than how they are prescribed. And as far as applying heat, it is not recommended in the packet instructions and therefore unless directed by her physician Yobo should not follow your well intended suggestion.

Take care, Tuck

[stnick_77]

Yobo asked how she could get more relief from her patch...I was not telling her to do anything illegal. I'm guessing you have never been on the fentanyl patch. Putting a new patch on at the end of 48 hrs is safe to do, and is recommended to do it that way by the majority of PM doctors. Because at the end of the 72 hr period when you remove the old patch, and apply a new one, it will once again take approx. 24 hrs for the new patch you jst put on to reach it's theraputic syrum levels of fentanyl in your blood stream, and people who really suffer from sever chronic pain that 24 hr waiting period is miserable. Also when you put a new patch on at the end of 48 hrs and leave the old patch on and then remove it at the end of 72 hrs. you are not double dosing, or getting more of the medication than you should beings that it takes approx 24 hrs for the fent. to get into your blood stream anyways. So by the time you take off the old patch at the end of 72 hrs, the new patch that you put on at the end of 48 hrs will just begin to start releasing the fentanyl into your system, therefore it does not increase the fentanyl serum levels at all. So...not to sound rude but before you try criticizing someone for giving advice that was asked for, you might want to make sure you know exactly what you are talking about, and get your facts straight.
-Nick-

[stnick_77]

....Also, by putting a new patch on at the end of 48 hrs. is NOT using more fent. than prescribed, beings that it takes 24 hrs for the release of the fentanyl in the blood, and nor is it using more of the medication than prescribed!  If you put the new patch on at the end of 48hrs and keep the old patch on, you will still be getting the dose of fent. prescribed from the first patch you applied, b/c the second patch is not releasing fentanyl yet, and will not release it for approx 24 hrs, the exact same time that you should remove the old patch at the 72hr mark! Therefore it is NOT over medicating nor is it abusing it in any way, shape, or form. I hope that you guys understand the concept of how the fentanyl patch actually works now.
-Nick-

[sandee1818]

Hi stnick_77,
    I believe the point that was trying to be made is that you should never take it upon yourself or from advice from someone else to alter your pain medication regime in any way shape or form from that in which the Dr has ordered.
I have asked someone who knows about the patch to stop by and clear up any misconceptions so I look forward to her input.
Thanks,
Sandy

[Mollyrae]

OK, Here's my two cents worth.

Putting a heating pad on the Patch is EXTREMELY DANGEROUS. And to tell a first timer using the patch is just wrong.......There are warnings 10x over in the leaflets that come with the box of patches that you should never use a heating pad over the patch.

I came across a story of a woman that used a heating pad over the patch to increase the effect and speed up the process....Well, she went to bed and never woke up....

So don't tell someone to use a heating pad...That's foolishness

[Jaybay]

I am not saying that changing a patch in 48 hours is unsafe.  Not at all.  What I AM saying is that your doctor must write the prescription that way.  My doctor writes mine to be changed every 72 hours.  If I change it every 48 hours, I will come up short at the end of the month.  If I used the patch in any way other than as prescribed, I would be in violation of my contract and discharged as a patient.  Some doctors are very unwilling to write this prescription for anything less than the 72 hours recommended by the manufacturer.  It's just a personal choice for the doctor.

And yes, I have used the patch for well over 3 years now and I do know whereof I speak.

Mollyrae is also right: putting a heating pad on a patch is very dangerous.  Heat causes the fentanyl to dispense too quickly, risking an overdose - particularly in new users.  It also results in the patch losing its effectiveness too soon beause so much of the medicine has already been dispensed.    

Some patients have a great deal of trouble with the heat issue if they go outside and sweat, have hot flashes, run a fever, or do anything that increases body temperature.  My personal experience is that any of the gel-filled patches dispense too quickly and run out too soon.  For me, the flat Mylan generic does a much better job of dispensing fentanyl at a regular rate over the entire 3 days.  The adhesive also works better for me.

The point I really want to make here is that no pain patient who is prescribed narcotics should do anything different with that medication other than prescribed.  If the treatment isn't working, you should talk to your doctor.  The last thing you want to do is take anyone's advice on the internet without first running it by your doctor.

[stnick_77]

I understand what you are saying, I'm not a Dr. and I have made that clear, I was simply stating what my Dr. had told me....and i dont really appreciate being criticized over a post that i left when all that I was doing is giving information that my PM dr. gave me...thats it, period. All i did was share a comment that was told to me by my doctor. When someone posts something on this website people SHOULD KNOW thats all that it is a comment, espcecially when i specifically said that that is what MY dr. told ME, and thats what  MH is all about, sharing your experiences. So if I all of you still think that I am wrong for sharing information that a physician told me, especially when I made that 100% CLEAR, than i am sorry.

-Nick-

[Jaybay]

Nick, nobody is criticizing you.  Tuck and I merely tried to point out to present and future readers that any change in medication use should be first approved by one's doctor.  My own doctor would never in a million years tell a patient to heat up a patch.  So I guess we'll have to agree to disagree on that issue.

[Mollyrae]

Nobody here is being critical...The information you gave to yobo was dangerous and I just can't believe the Doctor told you to use a heating pad when the warnings clearly state that you should avoid heat.....Especially heating pads....That Doctor is just plain wrong and I would question his practice.....I the future, when posting, please don't give dangerous information out. Be sure that what your suggesting is safe. I know you were trying to give helpful advise but please be careful when giving it.
Thank's, Mollyrae

Patches can be changed every 48hrs. Mine are prescribed that way because of my tolorance......

[sandee1818]

http://www.nytimes.com/2005/07/16/health/16patch.html


I had debated om whether to leave the post up about the heating of the patch and decided its better to leave it and make others aware of the dangers of heating these patches.
I have included a link on this from the New York Times about the FDA investigating 120 reports of death from misuse.
please read the article.

[stnick_77]

Sorry for the comments that I made. It obviously started a large controversy.....so in closing...I guess that all PM Dr. are trained diff. and prescribe and change instructions depending to the patient and severity of the pain. I never mean for anyone to try any or the examples that had have given, until you of course talk to your Dr. First, If you didnt talk to ur Dr. first that would jst be insane...I really hope i could clear this up....fell free to leave me comments.

-Nick-

[Jaybay]

Nick, you make a great point in that doctors are individuals just like we are, and not all of them follow the manufacturer's prescribing guidelines.  Once a medication goes to market with FDA approval, it's open season to be prescribed in any manner an MD sees fit.  In medspeak, that's called "off label use."  

I don't entirely trust any doctor or pharmacist's opinion alone, and take the time to look up the drug information myself.  Case in point being a steroid inhaler I was prescribed for allergies.  I got worse, and looked up the "words" on the medication and learned it was contraindicated for people with asthma due to allergies.  Using that thing for three days actually caused a whopping case of bronchitis and the doc was a tiny bit po'd with me for pointing out the problem.

[worried878]

scary stuff...fentanyl patches are...i had a patient once who took it off and chewed it up!  DEAD in a heartbeat and I had to all a code...it was my patient and i placed the patch on him...i had no way with my workload i could be in there 24/7 to check if he would chew his patch up and never dreamed he would have done this!  he died and i felt bad for some reason for a long time after...  so to me any type of quick release method on a patch spells DANGER to me after finding out just how strong those jokers are...young guy...years ago but i am guessing 28 years old at the time...i remember his b-day was nov 6th cos we talked alot...same as my sons.....awful experience...dont mess with patches.....and this is an addiction forum....not sure if this is ur area of need

[worried878]

yikes...i thought i was on the addiction forum!  LOL...u r in the right place...the pain forum....call me crazy but i am used to being on the other forum and saw this post...be safe and ask ur doctor anything u need to know...no one on here can heklp u like someone who knows u and sees u/knows ur history etc....no one should attempt ot give out medical advice to anyone on these forums as far as doses and usage of narcotics...perhaps a medhelp MD but still a good history would also be needed...please be safe with the patch...God bless

[downnout]

the 72 hours that the patch is supposed to be on takes into consideration those level that remain in your blood stream.at the end of 72 hours there is enough in your system to keep your levels in a comfort zone.that is why you put them on every 72 hours....and yes i put a 100 on every 3 days,and there is never a problem and that is why it is prescibed for every 3 days.after 48 hours is not the way it is to be done.the makers of the drug and the dr. prescibing it know what they are talking about and if they thought the levels would be to low to get a good "jumpstart" on your next patch they would have you change ity evry 2 days instead of 3.your body is not a diesel engine that has to be primed if it runs out of fent....there is plenty in you after 3 days to let the new patch start working so any suggestion that it is ok to put it on after 2 days to keep your level up is hogwash and the only thing that you gety is a good buzz for that double day that amounts to patch stacking.hope i didnt **** in anyones wheaties but thats the way it is......i know.

[sandee1818]

Jaybay,
  I totally understand your comment about the Dr being po'ed about your pointing put he made a mistake. This really gets me that some Dr's feel they are gods and do not make mistakes, they are human!
I had a Dr give me a prescription for Valium instead of the phenergan suppositories for my daughter. I was so mad because he insist to the pharmacist that he did no such thing and I even too the script which I copied for proof that he did and he still insisted that I altered it! I mean come on he gave me one script and it was for Valium in HIS handwriting!
I would have simply overlooked it had he admitted he made a mistake but I felt his obvious god complex needed an adjustment so I filed a complaint with the hospital and he was fired.
Doctors are human too and they can and will make mistakes, I tell people all the time YOU have to be YOUR OWN advocate and do not ever take one Drs word unless you trust that Dr.
I have caught mistakes by Dr's and pharmacist and thats because I am my own advocate and my children's. When I first started taking Oxycontin I had a prescription for 20 mg and the script said 20 mg but the pharmacist filled the 40 mg and when I started having adverse side effects I went to the Dr and he was like this should not be happening with this dose as I had a tolerance already from short acting opiates. He asked to see my script I filled and he was so irate when he realized I been taking double the amount he prescribed because of a pharmacist mistake. I did not know as it was my first time filling the script for this med.
You have to be knowledgeable and willing to ask questions and look out for yourself as people do make mistakes all the time.

[Wondering198]

I think everyone is being to hard on you. This Forum the last time I looked was AN ABUSE Forum. I don't feel at all you were tell this lady hey look get a bigger buzz heat the pad. I just don't understand why people just jumped all over you. If she wasn't abusing and wanted to stick to just what the dr ordered she should have went to another forum. This is just my opion.

[sandee1818]

Wondering198
This is the pain management forum.  

No one was jumping on Nick and he realizes this, using this patch in any way other than it is intended WILL lead to death so thats why we wanted to make sure that others reading this knew that and knew the consequences of their actions had they followed the advice to heat the patch.
Nick's Dr had apparently told him to do this and it is NOT recommended as it will cause death. There have been numerous cases where death has occurred from doing this. I have provided links to this fact if you want to check them out.

[sandee1818]

I also want to add that everyones opinions matters here and we certainly welcome your too. We only want to make sure that any misinformation is pointed out so we can keep someone from doing anything that is unsafe.

[Mollyrae]

You comment is pretty irrational....Some people require the patch be changed every 48 hrs. My Doctor has even stated that everyones metabolizm is different. Some absorb the medication faster than others. For you to say that it is for the high is ludicrus....and it makes me mad.....

[Mollyrae]

Sandee is correct...Nobody was abusing Nick. He did give advise that could be danderous......especally for a new timer to Fentanyl...

[sandee1818]

Hi downout,
I do respect your opinion however I must ask you to be respectful to the other members here also.
Mollyrae is a valued member here just as you are and we want to help everyone we can and being disrespectful to each other really isn't going to accomplish that.
So I appreciate your understanding regarding this matter and expect everyone here to be on their best behavior to one another. We are all adults here and being respectful to others opinions can only help everyone:)

[downnout]

Im sorry that my opinion was hurtful and will refrain from responding anymore.

regards,

dwnout

[dgmcloud]

Just a note of caution, everyone tolerates meds differently. My first 3day patch was my last. I don't remember those three days. I was in bed the entrie time with my two children worried about me. Doctor said leave it on, you will adjust. I never took the second patch. I just could not tolerate them. It worked within a few hours. Hope you have better results.

[Wondering198]

Sandy,
Im sorry I have to disagree with you about down disrepecting someone. I think he was just stating a fact. Some people do get thier feathers ruffled when they are called out or someone disagree's with them. I don't think down was being disrepectful at all. I think there are more problems here than to worry about hurting someone's feeling? dont you?This forum is all about someone opinion and if we can't voice that opinon then whats the point on being on here

[SHELLBELL79]

Wow long post! When I started the Duragesic Patch years ago, the pharmacist and doctor said about 12 hours or so. I had also had a Famous Pain Management doctor tell me it can take up to the 72hours to work its full potential and then you have to change. I had also read that after I had detoxed off the horrrible Duragesic/Fentanyl patch!
Good luck!

[Mollyrae]

I don't think you fully understand the nature of some of the comments made. Some of the text used by a couple of members was either dangerous advise or telling them their just "out for a high"......The pain forum is not about ridicule or mis-leading info or getting someones feelings hurt.
I think Sandee was right in telling down that he should respect others...We should all respect each other. If you think the pain forum has bigger worries then you should address them......

[btrfly6499]

I'm very new to this group and I sought it out because of my chronic pain...been on Morphone (controled and extended release) for about 1yr but now seem to be building tolerance to it and/or pain worsening...
...point is that this topic is seeming to get off track...yes its important to respect each other and give appropriate/safe advice...but maybe others can voice their personal experiences in starting out on the patch...
I for one am scared to!!!!!!  I am starting tomorrow AM (to give time to have some morphone out of system before starting)...all the warnings scare the **** out of me!!!  I'm worried about the pain factor (that it wont work) but also scared about the whole "stopping breathing thing!" :/
So...again, new here, but maybe the topic can focus on yobo's original post...about how long took to kick in, and maybe I can ask that others add on how they felt, things they did to reduce side effects (Yobo, how is it going with it since been on a bit now?)
:)

[extrmeski]

I'm sorry I don't think I understood what you were saying, are you saying that you are starting on the patch??

[sandee1818]

Hi btrfly6499,

       This community is for everyone and I have to say that yes everyones opinion matters here. I also have to repeat that we really like to make sure the advice given is safe and when one heats up this patch they are no longer safe and that is not something I want nor does anyone here.

I am wondering how your doing and have you started the patch? Mollyrae has been on these for some time and can and will help you all she can. I will make sure she knows your asking for advice. Also Jaybay is very familiar with the patch and will help all she can.
We only want to make sure everyone is safe and stays that way. I am sorry if anyone was offended.

Thanks,
Sandy

[btrfly6499]

hi, sorry if was confusing, i'm stressed lately ;(
I started 50mcg patch saturday AM...had to stop MS Contin (was on 300mg/day) to start it so i've been miiiiiiiiiiiiiiiserable, so much pain...the patch dosage seems low, and my pain doc has me adding 25mcg patch to the 50mcg patch for now to see if doing 75mcg will help or not (he did it this way because didnt want to give me 3 different rxs, so had me start the 50mcg with option of adding the 25mcg patch if needed...ONLY adding it now AFTER confering with him and confirming to start it).
Has anyone else done this? where do you put the other patch? oy.

[Jaybay]

Yes, I eased on to a therapeutic patch dose in the same manner as you.  Place both patches on at the same time, and keep them close together.  Everyone is different as far as how well the adhesive works (or doesn't work) so try different parts of your body.  You'll want a spot that doesn't sweat a great deal and that skin oil isn't a problem.  I've settled in to placing patches anywhere on my rib cage, and just alternate the sides.  

To keep track of when you put on the patches, just write down the date on them before application.  You don't want to use the same spot over and over again because your skin can get very irritated.

I'm not at all surprised that 50 mcg wasn't enough for you after being on MS contin.  As with any change in medication, it can take some time to figure out individual equivalents.  It sounds like your doctor is a good one though, so you should quickly get to the right dose for you.  :-)

[btrfly6499]

Thank you so much for the suggestions.  It makes me feel somewhat better to know that the 50mcg not working isnt a sign that i'm just doomed (cause, honestly, after being on so many meds you kinda feel like that)...the ms contin WAS working but just over the last year i had to keep increasing it every few months because of increasing tolerance, so in last 3 weeks, my pain intensity was just worse.  I started the 25mcgt patch last night, so i have both on now...will change them so both start together come thursday night...fingers crossed about the 75mcg.  I am so glad i found this site...i have been in this pain for over 3.5yrs (which i know to some is nothing!) but I just feel like i'm at my breaking point right now...i have been in tears since end of last week...moreso last few days because of pain worsening (and crying is the stupidest thing to do bc it makes it worse!).  So thank you for advice/suggestions...i did make sure to put dates/dosing on the patches and will try different spots (i sweat...a lot...its disgusting, lol...so i'm trying my mid/lower back b/c less change of that there...will try ribs when change on thursday).
Thank you again :)

[mbell67]

hi new  this site - I was wondering about typical side effects of the patch   - im on a 25 plus 12mcg for about 6mo and am beginning to feel very tired (more than normal )  emotions not in a good way - confused and having hard time thinking straight.  I know i need to go to my dr - I was so confused i mixed up my days and missed my appt this week - only saw me long enough to give me more scripts -- ANY ADVICE --plz i fee like a freak!!

[btrfly6499]

hey mbell67, not sure if you are up to it, or mentioned it in another post, but what is your pain related to...does it stem from an illness, accident...or just random? where is it? (i ask because sometimes if you have an illness that the pain stems from, it could be that illness flaring...like MS for example...you can start out with pain, or have pain consistently/chronicly, but then have flare ups that cause other problems...not that you have MS, i'm not dx'ing or anything like that, just using as example). regardless i hope u feel better!!!!!!!

[mbell67]

hi there!, my pain is odd.  over 15years ago both femurs broken in MVA.- didn't think I was going to live;  rods with pins were placed inside (i was very late teens) healed up great!  had no pain whatsoever; however, of course the pins had to be removed for me to walk.  Therapy, therapy......... Then!!  several years later in another very strange head on collision (in which my seat belt not being worn) my body, knees first slammed against the dash.  The rods inside my legs, at this point, not too much holding them in place , other than bone, shot up the femur shaft, and blew off the top of the "femoral caps"? (if that's what theyre called). I have also seen at some point bone fragments floating about above my 'greater trocaner'? This has resulted in extreme pain.  Upon seeing x-rays, the rods are not where they are supposed to be but several millimeters, if not 1/2 inch out of my femur.  This may not sound painful to some but there are lots of nerves and muscles that are in that area that are incredibly inflamed and i can feel it.  It feels like walking on red hot pokers, which you HAVE to bear weight on to walk..  This is consistent, non-stop pain Ive been dealing with for about 8 years now

[mbell67]

how are you doing with the patches - I hope well.  I was for years on percocets, vicodin etc.  this has been the best for me, different side affects though.  Id rather have these i think than the ones before - I was worried in the beginning too.  My dr.  said she has heard many complaing about the third day there not being much of an effect  - so she agreed to my changing patches every 2 days - hope ur doing better too

[mutuals]

I am new to this forum also and would like to add that I am on 125 mcg Fentanyl. I use the tape from the Dr.`s office, the cloth like tape and cover the patches, it works great!! Last week though I had a patch fold in half before I could get it on, then couldn`t unfold it. That was not good lol. But I love the patches they have been wonderful for me. Thank you for your time.

Take care everyone
Mutuals