keeping a fentanyl patch on

DH just started with fentanyl patch and we are having trouble keeping it on. I have been taping around the edges but it does not stay attached in the middle where the medicine is. We have tried his upper arm, upper chest, upper back.  I would love any advice on how to keep these things on! I tried using a hair dryer to dry his skin and then warming up the patch with the hairdryer before sticking it on tonight.
His movement just makes it separate from his skin.

[sandee1818]

PLEASE DO NOT HEAT THESE PATCHES! IT CAN AND WILL CAUSE DEATH!
I used all caps to express how very important this is.
Heat makes the medication release faster than it designed to and you get entirely more medication than your suppossed to. Call the pharmaceutical company they make special patches to keep them on and there free if you have a script.

[sandee1818]

I also wanted to give you the number to call to get the special 3m patches that will keep the patch in place but I will have to find it again. Mollyrae a member here uses the patch and she uses a tape that works well I will let her know you need assistance. She can help you much better as she has been using the patch for awhile.
Please do not heat the patch anymore or the skin where your applying it. It is very very dangerous.

[scaredmom330]

have you cleaned the area where you are putting the patch  with alchol before applying? it could be the oil in his skin. do not heat the patch that releases the medicine faster, he will get too much. also have you talk to the pharmacy? they might be able to tell you what tape to get that will help. good luck and keep us posted.

[ngio64]

I just woke him up and he is ok. I won't heat it again though! THANKS for the warning. I went running to make sure I could wake him up.

I cleaned the area with witch hazel because we did not have alcohol.

He works out of town in March and April and we just need these things to stick until he can schedule surgery in May.  They actually are helping him , if only we can keep them on him.  

Thanks for any advice you can give me. (I found the dryer stunt from a google search!) I should have known to come here first!.

[Mollyrae]

Hello ngio:

When I heard that you warmed the patch up I almost fell off my seat. You could kill DH. Haven't yopu read the inserts!!!!! this is very dangerous and will make the medication seep into the skin at an alarming rate. Please read the insert before continuing with the medication. If you still have questions, please ask a pharmacist. They can assist you.

As far as the patch sticking to the skin, I use a paper tape found in your local pharmacy. It will not cause a reaction to the skin as most do and it will stick on the skin for the duration of the patch until next change. You can buy Tegraderm skin patch but they are very expensive. I cut the tape just large enough so that the tape hangs over the patch by about 1/4 of an inch on all sides. This will prevent the patch from coming off.

I can't stress enough to you that you MUST read the insert before using this medication. It is 81x stronger than morphine and is ment to release medication over 72hrs. if you heat it up, DH is getting the blunt of it all at once. Please don't ever do that again.

For now, you have heated the patch so watch DH very carfully over the next 24hrs. DH will be very sleepy...wake DH up frequently....I urge you to do this.

If you have any questions, please contact...."Mollyrae"....leave me a personal message in my profile page. please take care.........

[Mollyrae]

Also, read the warnings section of ther insert. This will tell you what not to do...good luck

[sharonanne]

hi i have been on the patch 25 mg for about 6 months now and fine that it has stoped a lot of my back pain ..but in the last 2 to 3 weeks it is burning my skin quite bad i told mr dr. he gave me a cream to but on after i take the patch off to stop the itching but i find i am swelling up quite a bit when i first put it on whats going on here???? also want to know what the long trem afects of this patch   thank-you  sharon

[ngio64]

We did read the insert, I remember it saying to not cover it with tape,. He is acting fine doing chores around the house. (I will keep him from any power tools!!)
He did get a headache and nausea last night, that was probably when he got a burst of med.  
Thanks for your concern and don't worry I will never heat it again.

[Mollyrae]

Please don't be concerned bout covering the patch with  PAPER tape. This is not dangerous. In fact, my doctor recommended this to me. I am glad that he is doing well. I didn't mean to come off sounding harsh, I was rather worried. Paper tape lets the patch breath. You don't want to cover the patch with a tape that wouldn't let the air through. I guess I should have mentioned that in my first comment. Paper tape is just fine and will let the patch "Breath" which is what it needs. You will find it in the band-aid section of your local drug store and make sure it says paper tape. You can ask the pharmacist, they will get it for you. Believe me, it really keeps the patch on. Please take care.....

[Mollyrae]

Hi Sharonanne:

Sorry to hear of the problems your having with the patch. I will tell you that i have had problems in the last couple of months myself. I have been breaking out in hives. Not alot but enough to make things uncomfortable. I will get the occasional rash as your experiencing and here is what the Doctor has me do.....

I use Benadryl Gel along with benadryl tabs. This keep the itching at it's lowest. Use the cream the Doc gave you along with the benadryl Gel. You can buy generic under the name of " Diphenhydramine Hydrocloride Topical Analgesic 2%"...ask your local Pharmacist. Sometimes they do not have it on the shelves. The Gel will also keep the same area from becoming infected with rash over a period of time.

The long term effects of the patch are numerous. One of which is short term memory problems. This can occure over a long period of use. It is more promonemt in Fentanyl use. The other major long term effect is the Depression. I have found that with the Fentanyl. my depression has doubled. Some of the other long term effects include ( and i might add that these can occure with all narcotics) is the onset of a more rapid aging of the skin, problems with the teeth and gum disease, muscle soreness or weakness, joint problems and thinking ability. The long term effects go on so your best advise is to google..."Long term effects of narcotic use" this will give you a great idea of the problems you might face.

I hope this was helpful. If you have further questions, please don't hesitate to contact me by way of personal message. Just go to my profile page and hit personal message. I would love to help you in any way I can. Take care,

Mollyrae

[ngio64]

We called the pharmacist and she gave us some tips, and the phone number for walgreens home health. They might be able to help us get our insurance to pay for bioclusive overlays, like they use over iv sites. I am going to wax his chest today (he is freaking out!)so it will be healed when we change it again in two days. he is hairy and the sheet said not to shave.

He does have a pounding headache today, so he is probably got too much.

Thank you for all your help and concern, You did not come off as harsh, I just got so scared I ran in the bedroom and yelling his name and woke him up so suddenly, he claimed that almost killed him by giving him a heart attack! LOL
(He claims I am after his insurance;-)

After 26 years of marriage he should be used to my excitability. I wake him up the same way if I see a spider, or hear something outside.

[Mollyrae]

There is also some really helpful advise at MedHelp. Type in Fentanyl in the search box in the right upper hand corner of the screen. The information will tell you all you need to know. I really had to laugh when you told me that you ran into the bedroom calling his name.....that was great. Yes, he definitly got too much medication. Good thing you realized the mistake.

[Mollyrae]

PS- Those overlays are really expensive. If your insurance doesn't cover it, then use the paper tape. :)

[Tuckamore]

Everyone has given you good advice. I just wanted to add NOT to clean the area with alcohol. If you go the goggle and read the insert I beleive the warning can be found on both.

Good Luck. Please keep in touch and let us know how your husband is doing. I am glad you didn't have a heart attack or share him to death.  LOL

Take Care,
Tuck

[melo64]

I also use the tape to keep my patch in place. i usually just tape all the corners and it will be fine for about 2-3 days even if it gets wet. I've called the manufacter of the patches and they do not have anything to help keep the 25mg. patch on but they do have them for a higher dosages. Huh? go figure!

[ngio64]

He still has a killer headache.  but he is not overly dopey or sleepy. Pharmacist was not allarmed by our hairdryer stunt. It did not help by this morning anyway, so we will not even be tempted to try it again.

[ngio64]

we have the edges taped, but there is a big bubble in the middle. will the med absorb with the inside not adhered?We will get wide paper tape tomorrow am.

[Mollyrae]

I would really recommend that you just tape the patch on all four sides. Your not going to hurt anything by doing this. When you do get the proper covers or paper tape, don't worry about covering the whole patch....It's totally safe and your worrys about the patch coming off will be gone. I have done this for 9 mo+ and I'm still here :)

[bev62]

I've been on Duragesic patches for a year.  When I first went on them I had a hard time keeping them on.  The doctor told me to try spraying the area with Arraid Extra Dry antiperspirant before putting on the patch.  I know it sounds crazy, but it works.  Especially in the summer, when you get really sweaty.

[btj]

HI, I AM IN THE UK AND NEED SOME ADVICE DESPERATELY. I HAVE BEEN ON FENTANYL 150MCGH FOR ABOUT 12 YEARS AND ITS EFFICACY HAS GRADUALLY WORN OUT SO I AM HAVING MORE AND MORE PAIN. MY CONSULTANT HAS DECIDED TO PUT ME ON OXYCONTIN INSTEAD AND HAS REDUCED THE PATCHES TO 100MCGH AND 20 OXYCONTIN 2 TIMES PER DAY. HOWEVER I AM SO VERY SLEEPY, HAVE A TERRIBLE HEADACH AND AM SO IRRITABLE THAT I WONDER IS IT WORTH IT ANY MORE. HAVE ONLY BEEN ON THE NEW ROUTINE FOR 6 DAYS BUT HARDLY GET OUT OF BED. MY DOCTOR DOES NOT WANT TO KNOW AND WILL NOT ADVISE. MY WIFE IS MARVELLOUS BUT I AM PUTTING TOO MUCH ON HER. IS THERE ANY LIGHT AT THE END OF THE TUNNEL OR WOULD IT BE BETTER TO JUST END ALL THE SUFFERING

[Lexie321]

I just spoke with Sandoz and was told to only cover the 4 sides with medical tape. Under NO circumstances do you cover the entire patch. She also said that even if your skin is clean - like after a shower, you should just use plain water to get the soap off your body. This way the patch will stick better. She also said not to put the patch in the same place. Move it around 4-5 areas of your body and NEVER below the waist. Hope this helps!

[Jaybay]

If you have a lot of body hair, that makes it nearly impossible to keep a patch stuck on.  Men sometimes have to shave the area before applying the patch.  Also, check different pharmacies and see what brands are available in your area.  Some people have better luck with the gel-pouch patches; others do better with the Mylan generic that looks like a clear piece of tape.  

I personally have better results with Mylan patches with adhesive ability, lack of skin problems and they actually last the full 3 days.  I use the ribcage area to apply them since there's no hair to worry about and the area doesn't move around like the parts of the abdomen not protected by the ribs.  The more the body moves and flexes under the patch, the more likely it will fall off.

[designgyrl0112]

I was told by the pharmacist to put nexcare clear tape on it, it's the kind they put over IV sites.  It seems to work, but they are pretty expensive around 15.00 for 4 patches.  They do stay on though.