I need to find a generic duragesic patch( fentanyl)

[kaya420]

Hi, I take the 50 mcg (or whatever it is) duragesic patch.  I was on the watson brand fenanyl patches for a couple of months and started having an alergic reaction to the adhesive.  My skin broke out really bad around and under the patch.  I got some of the name brand duragesics but my insurance will only cover part of it so its super expensive.  I was hoping someone could tell me about a generic that they think works will that I can try next time.  I dont care if its gel filled or just the plastic, I havent noticed a big differance as far as that goes.  If you have any input on the gel filled or just the plain plastic I would be interested in that to.  So yeah if anyone knows of generics besides watson that would be much appreciated.
Thankz

[Tuckamore]

Hi Kaya,

Welcome to the Pain Mangement Forum. I am so glad that you found us and took the time to post. I can relate to your reaction the the adhesive on the Fentanyl Patch.

My physician prescribed the Patch for me about a year ago. The first few seemed to be okay. However with the fourth application I developed a hive like rash around the patch. When I changed it the area under the Patch was very red. So as I always did when I changed the Patch I applied the next one in another location and went to bed shortly after the change.

Within 12 hours the skin under the Patch was on fire and I was itching. I had placed it on my upper (back) shoulder. I asked my husband to check my back and he immediately got a mirror. My skin was not only full of raised, fire red hives but the area under and immediately surrounding the Patch had blistered. Initially I thought I was allergic to the medication. I called my physician and she got me right in. I was reacting to the adhesive. She gave me a high dose steroid cream and told me to apply it where I would place the next Patch, let it dry well and than place the next Patch in the area I had treated. I did as instructed and I had the same results.

My physician personally researched other brands and spoke with several pharmacists. They all agreed that the adhesives were very similar and that if I reacted to one I would react to them all. Undaunted we tried another brand because I had better pain control with Fentanyl. I used the same procedure and unfortunately I had the same reaction. I simply cannot tolerate the adhesives on the Patches.

Now I hope that you will have better results than I did. Maybe your reaction was not as severe as mine and a bit if change in the adhesive will make a difference. I am so allergic to so many things and possibly you are not as sensitive as I am.

I would try the Mylan Patch, maybe you will not react to it. Discuss using a steroid cream with your physician before application. It may be effective for you.

Please let us know the results of your search and how you or if you react to another brand. I will be very interested to learn what works for you. I wish you the very best and will look forward to hearing from you in the near future.

Take Care & Good Luck,
~Tuck  .

[JadedSweetheart]

I had/have a skin allergy to the adhesive they use in patches.  Some of the patches I used also permanently discolored my skin. (I'm pretty sure that's what it was because I got some dark blotches on my side while using the patch.)  I used the tape and band-aids but I live in Florida and like Jaybay said, they can absorb too much in warm weather, then there's nothing left on days 2 and 3.  I could have gone to the 2 day patch and I liked it, but my ins. wouldn't cover it at the time.
I hope you find one that works!

[Jaybay]

Sandoz is another company that makes generic gel-filled patches.  Call around to different pharmacies to see what brands they carry.  I've found grocery store pharmacies to be the best in my area about special ordering for their customers if an item isn't in regular stock.  The employees also don't play DEA cop like most of the national chain pharmacies do.

Before you change pharmacies, make sure that won't be a problem with your doctor.  Many pain docs make it a strict policy in the pain contract that the patient use one, and only one pharmacy.  If you signed a contract with your pain doc, let them know what the problem is before you make the change.

Like others, I prefer the Mylan generic.  For me, they stay put better, don't irritate my skin beyond a little redness, and actually last the full 3 days.  I had real problems going into minor withdrawal with the gel patches by any manufacturer.  Part of the problem is that I like to be outside as much as possible, and in the summer months, the gel patches dispense faster which means they lose effectiveness faster.  Some people have not had that problem, but I know I'm not alone in that issue.

If you continue to have allergic reactions, ask your doctor for a prescription for flonase or nasonex.  Those are steroid-based nasal sprays.  Some people report that using the nasal spray and allowing it to dry before placing the patch prevents the adhesive rash.  Worth a try anyway.

Don't forget to always place the patch in a different place each time.  I've heard horror stories from people who put it on the same place every time and seriously damaged their skin.  Their docs never thought to mention it, and most people rarely read the patient information from the pharmacy so they end up with a royal mess of blistered and burned skin.

I think the biggest complaints I've heard about the patches are that they don't stay on.  As others mentioned, you can use any kind of medical tape to help keep the patch on.  My preference is Nexcare bandaids made with Tegaderm.  The tegaderm is waterproof, yet allows for oxygen exchange so your skin can still breathe.  If it still doesn't stay put, Nexcare also makes a sports bandaid that works extremely well.  Nothing - and I mean nothing! - will get that thing off until you decide it comes off.  Those are a good choice if you like to swim a lot or tend to sweat off patches easily.  People with more oily skin have a terrible time with patches falling off.  I've found my trunk area works best for me.  You also want to avoid areas with a lot of hair.  Very hairy men for example may have to shave an area before applying the patch.

If the patches work well for your pain, I hope you can find a way around the skin allergy.  I can't imagine how disappointing it would be to find a medication that works and then not be able to use it.

[namnam46]

Good Evening Kaya,

First let me welcome you to the Pain Management Forum and tell you how happy we are that you have found us. We also hope that you will be an active member that will share all of your experiences and knowledge of pain and how you deal with it with all of our members.

I'm so very sorry that you are having to deal with being allergic to the adhesive on the patches. It must be absolutely devastating to you as I'm assuming that the patches work really great on controlling your pain.

As Sara said, Mylan makes a different type of patch. I use the Mylan Brand Fentanyl Patch 62 mcg. I just added the 12mcg to my 50mcg 2 days ago. They are the smaller ones and don't have the gel filling. They're the only ones that I have used and I love them as there is VERY little chance that you can get too much in your system at one time, unlike the gel filled which people have had many problems with.

Did your Dr. give you any ideas about what to do for the allergic reaction that you were having from the adhesive? I know that some have used some sort of an antihistamine spray on there skin and let it dry and then applied the patch. Where do you put the patch on your body? I put mine on my upper back.

I'm sure at some point tomorrow there will be more people on that can give you some other ideas to help you. Do you have an allergy to Latex?

Molly had a great suggestion about applying the paper tape on the patches so they don't have achance of coming off and you losing some of the potency. I had never thought of doing that and I'm going to try it also.  Thanks Molly!! :)

Also don't forget what Sara said about checking with you Pharmacist as they are an Encyclopedia of Information for you on things such as this.

Good luck and we will be looking for to you updating us on how it goes....Sherry

[Mollyrae]

The Mylan brand it about the best for adhesive issues. The patch is very small and not gel filled. You can use paper tape in addition to the patch for added protection on it coming off. Once the patch is removed from the skin and you re-apply it, some of the effectivness is lost because of the dead skin that comes up.

I have tried many types of patches and have issues myself with breaking out. The Mylan brand is the way to go.

I hope this helps.

My best,
Mollyrae

[Sarajmt]

Mylan makes one that people seem to like.  Your pharmacist would be a good source of information of this.

Others will be on later who do have personal experience with this matter .  I did use the Mylan brand but it was several years ago.  Fentanyl wasn't a good choice of medications for me.  But check back.  Someone else with better information will be here later.