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Vicodin vs. Fenental Patch
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Vicodin vs. Fenental Patch

Hi, I was recently given the Fental Patch, not sure if I am spelling correctly...I have not picked up from the pharmacy.  I am nevous aboug starting new medication.I have been on and off Vicodin ES  for the pas year and half. My pain has gotten so much more worse.  And I am becommng to tolerant to thee Vicodin, Any advice on the Patch, side effects, what if any similarity dos it have compared to Vicodin. andy advice at all about this medication would much appreciated...thank you.   My script is for 25 mg and the doc also gave Vicodin for beakthrough pain..
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1301089_tn?1290670171
Hi Sonya:  A lot of people here are on it and really like it.  It didn't work out for me.  We all react to medication differently.  But it is a good medication for many people.  It gives you long lasting relief.  Just be careful bathing so it doesn't come off.  You may want to put some tape over it.  (Mine always came off when I put on or off a bathing suit!)  And do keep it away from heat.  It might release a dangerous level of medication.

Anyway, more people should be here later in the day.  Do check back.  A lot of people are on it and really like it.  You might as well.

This is a good place to come for advice or questions.  There are a lot of knowledgeable and sympathetic people here.  They just aren't around right now.  Do check back.

Sara
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1315260_tn?1275666046
First, Don't be afraid of this medication. Now of course it is without question one of the most potent widely prescribed medications on the market. There are .several reasons why. #1, It has an success rate of controling a broad base ;evel of pain, in an even broader list of pain indicators. #2. If USED CORRECTLY, this medication also by history, requires less BT addems(other pain meds) and bi-linked system medications.Where one must use caution is in bathing. The release of fentanyl is based on temp on the patch, This is the reason, and the sole reson why we must be careful with some areas of recreaton and the hot tubs.
Moreover, trust in your Doctor. seems ro me by reading your post, you are a, straight shooter and your doctor can see that. Most doc's WILL NOT JUMP FROM  ER VICS, STRAIGHT TO FENTANYL.  He sees a reason for the switch.

I have worn the patch 6 years, and it has never ever come off in the bath or pool! When appliying the patch, make sure your skin is dry. period!  I have alays applied them to my left or right upper buttock, right below the belt cover.    Please excuse spelling etc as we have been busy.pmartin
                                                                                                      
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Avatar_f_tn
My pain clinic talked to me about the Fentanyl patch as well.  But I was too scared to go on it.  I'm still not ruling it out, but I just want to know more about it.  I do know it's difficult to get off of, if you ever want to go that route.  The other options given to me at the same time were oxycontin, MS Contin or methadone.  All of them scare me a little bit due to how strong and addictive they are.  But, like you, what I'm on at the moment (which is a lot) isn't doing it.

Sonya, when you say keep it away from heat, what do you mean?  Do you mean like you shouldn't go to the beach or something when it's hot out?  
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547368_tn?1332173665
Hi Sonya,

I understand your concern. First let me tell you that unless you pick up that prescription within 72 hours they have the right to refuse to give it to you at all. I beleive that is the law, at least that is the case in my state. So at least go pick it up from you pharmacy or you won't have the option.

I suggest that you get the type of Fentanyl Patch that does not have the reservoir of medication. There come in two forms. The layered patch is reportedly safer.

I went from Vicodin to the Fentanyl Patch and would have stayed on it had I not had a severe allergy to the adhesive. I encourage you to try it. Any initial side effects should subside in time as your system adjusts to the new medication. Some ppl have very little side effects.

Your physicians beleives this will help or would not has prescribed it. If it does not work well for you than discuss that with your physician. The search for proper pain management is often a trial and error situation.

Best of luck to you. Please keep in touch and let us know how you are doing.

Peace,
~Tuck
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82861_tn?1333457511
I've used the fentanyl patch for a few years and for the most part I'm very happy with it.  It can be difficult to taper down the dosage, but a decent pain doc can help keep withdrawal symptoms to a minimum.  

One more time for folks who don't already know:  Just because a person has withdrawal symptoms from narcotic pain meds does not mean they are addicts.  Addiction is abuse.  People who use meds as prescribed are physically dependent. That is a HUGE difference.

As for the patch coming off and other issues, much depends on how oily and sweaty the patient's skin is.  There are two types of patches available.  One that is like a gel-filled band-aid, and the other is like a piece of tape with no gel pouch.  The fentanyl is delivered through the skin for a 72-hour period.  Delivery CAN increase if you're out in the heat or partying in a hot tub for a long time.

My personal experience is that the gel patches are more prone to heat-related release than the other type of patch.  (I use the ones made by Mylan.)  Living in a sub-tropical region and enjoying my outside time, I've had no problem with overdose symptoms with the Mylan patch.  The gel patches on the other hand - no way.  I'd be sick and dizzy and nearly to the point of passing out if I spent a day by the pool.

I've also had better luck keeping the Mylan patches on than the gel patches.  Again, everyone's skin is different so you have to experiment a bit.  If I'm going to be in a super-hot, sweaty situation, I'll place a cover over the patch.  Nexcare brand bandaids are made with Tegaderm, which is water proof but still allows for oxygen exchange.  If the regular Nexcare bandaids don't work, go to their sports bandaids.  NOTHING but nothing will make those come off until you want them to come off.

Each medication has its pros and cons.  Side effects will disappear as the body gets used to the med (unless the patient has an allergy or develops one).  I like the patch because it gives me 24/7 coverage and I don't have to worry about forgetting pills or carrying them around with me.  Also: WRITE DOWN THE DATE YOU PUT ON THE PATCH!  Either write it on the patch itself or keep track of it on a calendar.  Trust me, if you have a pain spike or some other crisis, it's too easy to forget when you put it on.

If you use the patch and notice it seems to be dispensing faster when you're at the beach, put an ice pack over it to slow it down.  Spend more of your time in the shade rather than the sun and you should be fine.  You mostly just have to be aware of what is happening to your body and adjust accordingly.
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82861_tn?1333457511
Tuck - that's funny!  You and I were typing away at the same time in a race for the Post button.  LOL!

Sorry to hear you're allergic to the adhesive on the fentanyl patch.  Did you ever try spraying your skin with a cortisone-based nasal spray first?  I've spoken to hospital nurses who tell me that usually takes care of it unless the allergy is severe.  Spray on some Flonase or Nasacort; let it dry, then apply the patch.  Their patients reported no difference in absorbtion rates so it may be worth a try for people with adhesive allergies.
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1279189_tn?1275248468
Thank you for all the great advice and responses.  I am just worried how I will feel with the patch. Even though I have read the side effects, I am just so used to the way the Vocodin makes me feel. I can work, drive and still care for my kids.  It was just getting to the point I was having to take more of the Vicodin to keep the pain gone. ***Will the patch make me feel loopy, or dizzy. I still have to be able to function and not feel too sleepy.  Nausea, is another thing I hate and hope I don't experience.  I will pick up today and give them a try...just a little worried
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954005_tn?1304630205
I also was on Fentanyl for a while, and the pain relief is wonderful.  It did not make me feel loopy, dizzy, or nauseous, but it did make me very tired until my body got used to it.  Once my body got used to it, I wasn't so tired anymore, and again, it was an amazing pain reliever.  My problem was keeping them on...and I've since found a medicine that is very effective for me, but I wouldn't rule out fentanyl for me for the future...especially since I have a long life ahead of me with a life-long need for pain control.  And do note that it will take a while for the fentanyl to get in your system, so don't expect any instant results...For the first day, you'll probably use your vicodin for primary pain control, and later in the day and onto the next, you'll switch to using it  only for breakthrough pain, if you even need it at all:)
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1315260_tn?1275666046
Yes, I do so agree with Jaybay in respects to the Mylan brand of Fentanyl. It's super thin, but holds on like a super star!  

Now Sonya. your concern seem to focus on the heat issue with this medication. Simply put, if you wear the patch on a, anyday kind of situation, your going to be just fine, Areas that you will need to keep in check with, are some of the following. ie; Dipping into the 120* degree Hot Tub---Why? well, this will cause your core body temp. to rise, thus signalling your Patch to excrete more Fentanyl onto your skin layer, thus inducing your blood to carry more to your entire body. This is why Jaybay speaks of the "Mylan" brand being better manafactured than lets say the "Sandoz" brand, which is made like a ketcup pack. No where as thick, but sticks to the skin as well, and seems to most all who have worn it, including myself, to be very tempermental about heat variations. In my opinion, they secrete amounts unnecessary due to short temp spikes. Thus, as Jaybay states, that occurance would make him, sick and dizzy, at the point of passing out. It's NOT a nice feeling, or ANYWHERE close to it!!!

You have to realize that much time and research went into developing Fentanyl, as is the case with all FDA approved medications. And these horror stories of death and OD's that we hear of,  occur most frequently with the elderly and those that seek to extract the actual Fentanyl base serum out of the gel and alcohol packs to, "GET HIGH" !!! Now the older folks aren't junkies, they just take those hot baths, forget when they put the last patch on, and sometimes for consecutive days, which leads to respiratory or Cardiac Arrest.  You truly only need to watchout for, long HOT baths, HOT TUBS, LYING OUT FOR HOURS AT END, SUNBATHING, and of course, GOING INTO BURNING BUILDINGS.

Again, your Doctor saw reason to choose this med over the others you listed. Those where, oxycontin, MS Contin or methadone.  HMmmmmm, if addiction is a worry with you, these on the same shelf as Fentanyl. Good PM Clinicians are great with dealing with WD effects and the tapering of meds, if needed.

No doubt you have a choice to make, but as was brought out, with this script, you have 72 hours to pick it up, short of the pharm. playing with the dates, which is a federal offense, I'd pick up the meds, and even should you decide not to use them, at least when you go back to your Dr for something else, you'll have the meds in hand.

Last on the subject, go to:  duragesic.com  and read up on it. After twenty years of pain and some true misery. Along with ingesting about every opiate and receiving most all injections out there, I can truly say, As my main line of pain defense, I choose the, "Fentanyl Patch" to get the job done. I swim, I dip into my hot tub, as I know I can, I go to the beach and I sweat while getting my exercises completed. The only thing I stay away from is, fighting fires... You seem cautious and bright, so use what was given you, make a decision, and make the best of your health circumstances. Take care, Pmartin
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547368_tn?1332173665
Hi Again Mellie,

According to the literate you body temperature has to reach near 104 before it makes a significant difference in the release of the medication from the patch. However that doesn't mean that the sun beating for an extended period of time is a good idea. It sound be avoided as should more than a very few minutes in a sauna or hot tub. In fact the actual time you can spend in either is too short to enjoy or provide any benefit. So best just avoid them.

Most ppl do not have their showers hot enough to cause an issue with the patch. You should not be concerned with showering as long as you avoid the hot water spraying directly on it. Just keep the patch dry.  

I neglected to mention that 25mg is a relatively low dose of Fentanyl. It's a good starting point and should be doable for you. I have also been told that if you have problems keeping the patch in place all you need to do is write to the manufacturer. They will provide you with a clear adhesive patch that can be placed over the Fentanyl Patch which will allow for greater adhesion. The manufacture offers these clear adhesive patches at no cost to you.

And yes Jaybay I did try several barriers to avoid local reaction to the adhesive. Thank you, I appreciate your suggestions. However my reaction was so severe that it actually blister and burned my skin. Where ever I placed the patch (like on the back of my shoulder) the entire area would soon be filled with large itching hives in addition to the blistering under and near the adhesive patch. That occurred even with the barriers that were meant to reduce or stop the allergic reaction.These severe types of reactions to the adhesive is rare.  My body has a mind of it's own. :)

Mellie I encourage you to give it a try. Uncontrolled pain is so disruptive to our lives.

~Tuck
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Thanks for the info on this, Tuck.  I'm trying to decide if this type of pain control is the route I want to go.  My options, according to the NP at the pain clinic, are the Fentanyl Patch, oxycontin, MS Contin, or methadone.  The one I'm most familiar with is the oxycontin.  All of them make me nervous.

One of the things that has me fearful is what happens down the road if you need pain control for something more serious and you're already on so much medication; how do they deal with that?  I'm sure people run into this often and they must have some way to deal with it.

I tend to over-think a lot of things.  I always wonder, "What if," instead of just taking things one step at a time.  It's a huge fault of mine, and no matter what I do to stop it, I always end up going there :)

I'm getting so much good information from this site that I'll feel much better prepared to talk to the Pain Clinic at my next appointment.

I'm wondering on most of these long-acting meds if most people are okay on just those meds or do most people need some kind of breakthrough medication as well?  It would be nice to cut back on what I'm on, which is what the nurse practitioner is thinking; that by going on a long-acting med, I may be able to reduce what I take.
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Avatar_n_tn
Hello all! Does anyone know the safe dose of Hydrocodone 10/325's along with 50 mg of 72 hou r Fentanyl patches? I have break through pain, and have been on a pretty high dose of Hydrocodone fir a couple of years now, and I have worked my way up to 50 mg Fentanyl patches but am scared to continue taking the amount of Hydrocodone I have been taking. How much Hydrocodone is safe with 50 MG Fentanyl patches? Thank you all. :)
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aewyn----2010!!!!  Start anew.  om
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Sorry. This was my first time writing in a chat riom.
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1855076_tn?1337118903
No worries.  It's just you'll get better responses if you start your own post.  I haven't seen that you did post a new question.  I will say that no one here, either another MedHelp member or any doctor here, could ever answer that question.  This is something you need to talk to your doctor and pharmacist about.  Each of us are very different:  we all have different medical histories, genetics, etc., so what works great for one person may not work at all for another.  This forum is a great place to get information and support about chronic pain in general and at times can even help with things more specifically.

I think it is safe to say, however, that if you were put on Fentanyl, you would definitely not want to take the same amount of hydrocodone that you were taking without the Fentanyl.

Most people seem to need some sort of breakthrough medication when taking Fentanyl or any other long-acting medication.  How much and how often varies from person to person.  I would think your doctor would have gone over this with you and if he hasn't, you definitely need to talk to him.  The reason they use the long-acting meds is because people with chronic pain develop a tolerance over time on the medication and rather than taking a ton of pills everyday, by using the long-acting meds, you ideally are able to reduce how many pills you're taking.

You don't mention how long you've been on the Fentanyl.  It does take a day or so to get to a therapeutic level so the first day you may be instructed to take your normal amount of hydrocodone.  If after being on the Fentanyl for a week or so, you should have a good idea of how well it's working for you.  Doctors generally start you off on a lower dose and adjust up if necessary.  They may also adjust your breakthrough medication or even change it to something else.

I hope you'll continue to post and become a part of this community.  

I also think I should mention that when I first joined here my screen name was Mellie4.  There was a glitch with my computer and/or the forum and I was unable to sign in, despite people from MedHelp trying to assist me.  So I started a new profile as Marycarmel.

Additionally, in this thread I was very nervous about starting the Fentanyl, but I did give it a try for a while.  It did have good pain control for me but I didn't like the side effects and unfortunately I was still at a high level of BT meds and other meds to try to get the nerve pain/RSD pain under control.  I've tried various things since then, and am now getting to a place where I'm more comfortable with what I'm on.
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