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3039221 tn?1340461200

Dare I use 2 Fentanyl 100 mcg Patches at once?

Obviously, I should wait until next week to see my MD, but if I have tolerated 1 so perfectly well, I just wonder how great a risk it would be to increase it to 2.  I could always remove it.  I have read here that some people use as many as 4 at a time and are fine. Darn.  I have never increased any medicaion without discussing it first with the doctor.  My better judgement advises against it but I am easily tempted by the prospect of less pain.  I'm being stupid, right?
17 Responses
1331804 tn?1336867358
Hi Lauriel,

I am so glad you didn't try to add another 100 mcg/hr fentanyl patch.  These patches are extremely potent and the strength of them sneaks up on you.  Like I said on another post, the medication continues to gain strength over a period of several days (~ after 6 days is when it is safe to titrate - increase the dose, which should always be initiated by your physician).  The 30 mg oxycodone tabs I believe added to the strength of the patch and together they caused respiratory depression.  So it is important to be aware of how the medications are affecting you especially when taking a strong breakthrough med while the patch is gaining strength.  I know BT meds are needed consistently while the fentanyl is still building up as the pain during that time can be too much to bear but once the patch fully starts working...WATCH OUT! Drop the dose of the BT meds immediately when you feel the fentanyl strength building.  When this happens, I typically start spliting my BT meds in half and then if I still need the other half, I will go back and take it.  I hope you are doing well today and please post how things are going now.

To ALL:  

I had my monthly PM appointment on Monday and he increased my oxycodone IR from 5 mg tabs to 10 mg tabs and that has helped with the breakthrough pain some.  He is hesitating on increasing the Fentanyl patch to 75 mcg/hr because when I was started on the 50 mcg/hr patch I turned into a straight up ZOMBIE for about two weeks so I understand his concerns.  His said he will titrate to the 75 mcg/hr patch next month if I am still struggling with the pain and I am.  I am about to switch patches...I so love when this time comes as the 2nd day wearing the patch is R-O-U-G-H!  I couldn't imagine having to wait until the 3rd day to change a patch...I would be on the floor.

Anyways, the oral steroid burst pack worked and I am up and walking again but still dealing with widespread pain.  However, I am very GRATEFUL to be able to walk again!

I hope all of you are having a relatively low pain day!  Take care.

femmy  :)
Avatar universal
My personal opinion would be to ask your dr first. It's going to take a lot longer to get that med out of your system then a regular pain pill because of the time it initally took to switch over from pills to patch. I would not advise doing it without consulting your dr.
Best of luck to you!
Ginger
3039221 tn?1340461200
Thanks Ginger - I know you're right.  Like I said, it's just so tempting to try to ease the pain NOW!  It's hard to be patient sometimes.  I will wait because I really don't have much experience with the patch yet.  Now's no time to start acting impetuously.  Thanks for your post!

Lauriel
317787 tn?1473358451
Hi Lauriel, I agree with what you and Ginger have said.  The patch is not like taking an additional pill.  Perhaps you could try an over the counter pain pill to supplement until you can talk to your doctor.
I hope you can reach your doctor tomorrow
Good luck
Dee
3039221 tn?1340461200
Thanks, Dee.  I can tough it out - just stop being a baby about it!  I know that I will be just fine. Tell you what, having "friends" here that really understand the nature of the pain and limitations of the medications does make a difference.  It makes it easier to deal with.  Thanks so much.

Lauriel
Avatar universal
Good luck with everything and if you need to vent I'm here:) pain suc*s and if you don't have chronic pain it's hard for others to understand. I'm having a procedure done tomorrow morning but am around anytime you would like to chat!
Best wishes
Ginger
3039221 tn?1340461200
Ginger - that's so nice of you.  You're right, this chronic pain is frustrating and whole other world to itself.  I need to become much better educated about this complex world if I am to manage my pain effectively.  This site, and you have been a godsend.  

What are you having done tomorrow?  You don't have to say if it's private and if that's the case - Good, Good Luck!

Lauriel
Avatar universal
I just read your post. i shouldn't be giving ant advice, because i am not your Dr, but my pain management Started me on 4 100mg. patches, at once, to beggin with! The pharmacist was slightly alarmed, and told me to run it by ny Regular back Dr, which I did, and HE told me to start with 2 and the next day add one and see how it went, etc. That was last week, and I am currently on 4 100 mg. patches as I write this. I got a headache about 24 hrs. after I put on the 2 patches, but the headaches are subsiding, and actually, i think i am getting the same amount of pain control that i got from the oxycontin i had been taking for over 10 years! And I was on a LOT! I still have had to take oxycodone for breakthrough pain, but this was mainly because it took so long for the Fentanyl to kick in...I am assuming.. So I don't feel any adverse side affects, I was tired initially, the second day, but now feel about the same as being on the oxycontin, which I never felt, I mean, side effect wise.I did not have very high hopes for the Fentanyl patches, since i tried them years ago, and stopped, but can't remember why, it has been so long. The one drawback is the patches start to come off within a few hours of placement, and i have tried different ares. I am going to get Tegaderm, but they are out at the drugstore, and the Nexcare brand tape is a joke! I used to have THOUSANDS of packages of 8x8in. patches to cover my sons central line Broviac, so I will look for some kicking around the house, they are so expensive, I had no idea! My next fight will be with the pain management Dr. (from the insurance Co.) he wants to give me epidurals inmy neck,and i don't feel too comfortable after his last lidocaine injection in my neck, missed the spot entirely and numbed my face for over 24 hrs! And he wouldn't admit he missed the spot the next day! He will be a little too close to my spinal column for comfort!, and I know I am in for an argument!, HE doesn't MAKE mistakes, don't you know!p.s., they had 6 100 mg. Fentanyl patches on my 6 yr. old son at once, AND a morphine pack! It all depends on the amount of pain, AND if your tolerant to opiates, and for how long. I WAS concerned, but nothing happened (YET! kidding)
3039221 tn?1340461200
Right, I remember reading some of what you wrote earlier about the patches. Last I read you were using 2, which is what I would like to try.  My question was really how many Oxys do you still have to take for bt pain?  I mean, wouldn't it be great if I could stop the Oxys altogether?  It is unbelievable that they put 6 patches on a child!  Also, I just bought a box of 50 Tegraderm patches for $34. on Amazon.

Thanks so much!
1331804 tn?1336867358
I have my monthly PM appt. tomorrow and I am struggling with the pain.  I am on the 50 mcg/hr patch and lately it hasn't been doing its job.  This crap always seems to happen to me.  Everything is great for a month or two until the bleep hits fan!  It isn't hell on Earth but I remember when the pain relief was a lot better.  Last month I whined, he put me on oral steroids which definitely took the pain down a notch but not without a price.  Those oral steroids make me so sick and good luck trying to get some sleep while taking them.

Soooo we will see what tomorrow will bring.  I usually take 1-3 5 mg oxycodones a day for breakthrough pain but I had to take 4 or 5 today.  I have been complaining over the strength of the oxy for a couple of months now.  So it is either an increase in strength of the oxys or the patch.  Initially he wanted me to put two 50 mcg/hr patches on and I refused and it seems he slid that offer off the table but I plan to fight with a vengance tomorrow as there is too much around the house that needs to be done that requires ME!

To keep the patches from falling off, I wash the area well (3 times) with a rag that has been rinsed with clear water only.  I let it dry and then I apply the patch and press well around the edges and then cover it up with my hand for about 1 minute.  Next I apply Nexcare First Aid tape only around the edges.  I have to cut the strips in half because they are so thick.  I have not lost a patch yet.  I apply them on my upper abdomen and I switch sides every two days.

femmy :)
82861 tn?1333453911
Don't even think about doubling your fentanyl patches.  That's a really good way to overdose and die of respiratory failure.  The patches aren't meant to be used for immediate pain relief.  Because the dose builds up slowly over many hours after you place the patch, it's very easy not to notice that you're overmedicated until it's too late.  Even after removing the patch, there is still medication in the tissues that will keep releasing into your bloodstream.  With that and the fact that fentanyl has a pretty long half-life of about 17 hours, it can take a while for your body to metabolize the excess.  If you have breakthrough pain, you need to speak to your doctor about adding an immediate release medication.  Best of luck to you for pain-free days.  :-)
Avatar universal
Yeah, they put everything but the kitchen sink on my son, (In fact they one time taped a HUGE syringe of MORPHINE under his shirt that I was supposed to inject into his central line whenever he neeeded it! The nurses idea, and his shirt was covering it!. I was on high alert for YEARS and he was fine but really, the bone pain must have been killing him, it WAS!. At the end, he had the Fentanyl patches and the morphine pack HE could push every 90 seconds!.  He only looked slightly drugged once, when he wanted SO much to see my sister, and the pain was so bad, he must have been pushing it like crazy. I never worried about overdosing him, he was living on will alone. Now, I have been on the 4 patches since Wednesday, and I really don't feel the drug, I mean, I MUST, but my foot and leg pain has returned on several occasions, and I have 30mg. oxycodones for breakthrough pain. To be perfectly honest ,I don't seem to feel anymore relief AFTER the Oxycodones!, and I can take 2 at once. I am really afraid that the nerve pain I have had for so long is just...well..THERE...forever! I don't EVER feel pain-free...EVER!, and never have, since my last surgery in 1996, but try to live with it...and what a drag! I MAKE myself do things, but it is will power, and I don't have much, but I try! One thing I try to remember, there is nothing as bad as MENTAL problems, and I am serious. When I have been anxious,and have had panic attacks, I am so incapable of doing anything, and the fear of..am not even aware of what...is worse than ANY physical pain. I have had both, and I will take physical anyday. Whoever has had this knows what I mean. Well, I haven't had much luck with the Nexcare tape, but since I moved the site, it has stayed! I was on such a high dose of opiates, that I guess the fear isn't there as much. (I am NOT relying on my doctors advice, he barely knows me!, I mean the Pain Management one.) So, I have QUITE a bit coursing through my body, my foot is still completely numb, my calf is still spasming, so I guess it lessens my fear that my respiration will be my problem. I needed so much medication, and yet it still didn't work, so have resigned myself to lying on my side every chance I get! I am alive, and breathing normally, my leg and back are killingg me still so...it's business as usual!
1855076 tn?1337115303
First, I just want to comment that no one should ever recommend whether someone should take an extra pill, patch, etc.  People have different health conditions, body make-ups, etc., and what is fine for one could cause death in another, especially with Fentanyl.

I have been on most medications and at large doses and the truth is for a lot of people narcotics just don't work well on nerve pain.  It is very difficult to treat.  Also, some people wind up with hyperalgesia, which is when the narcotic actually increase your pain.  There are other medications to try that give some people good results and also procedures, prescription gels,creams,etc.

I understand exactly how bad nerve pain can be.  I couldn't even complete a thought.  But I chose to taper off my meds because I felt the side effects were not worth the slight help I got.  Being on long-term narcotics at such high doses made me isolate and hurt my short-term memory.
Avatar universal
Oh brother, the funniest(?) thing happenedat the pharmacy a couple of days ago. I live in a small town,and was still trying to find the tegaderm, and had ONE more pharmacy to try. Well, it seemed someone had opened up the packages of Tegaderm..(they only had 2 boxes of the correct size left, and right before I brought them to the counter, THOUGHT they seemed "TOO LIGHTWEIGHT" Someone had opened up both boxes and stole the entire boxes, just leaving the instructions. Anyway, they had ONE package, a little too small, but I was willing to try to make it work, and I am telling the cashier how someone had stole the contents of the 2 boxes, and when I get home, I open MINE, and ssomeone had crammed in 3 boxes worth! So instead of getting 8, I got 24! It's a good thing the girl didn't check MY box at the counter, or it would have seemed like I WAS THE THIEF! They actually fit perfectly, but I could have been in the slammer..and all because I TOLD her about the stealing!So now i have my wonderful tegaderm, it really does help with the peeling problem. have been getting drowsy at weird times, and it's kind of scary, because i never did with the Oxycontin, and also still have a residual, dull headache, which is a total drag.My pain relief is NOT as good as it was with just the Oxycontin, and FINALLY had found the right amount to live with, take care of my grandson, without any drowsiness, and NOW, I am trying again to find the rihjt combo. I am supposed to be able to take 2 30mg. oxycodones for breakthrough pain, but very rarely have, they don't seem to help at all so I don't bother.The new doctor is planning on giving me a lumbar epidural, but I am passing on that! Been there enough, and it NEVER worked...and he numbed my face accidentally at the last appt, so am not too comfortable with the accuracy (although HE SURE IS!)now he will be near my spine, and he DOESN'T make mistakes! (anybody who thinks that is over-confident!) Will let you know if I run into an argument on July 11th!
3039221 tn?1340461200
I just want to thank all of you for your informative and extremely helpful posts.  And to others who wrote not to heed any advice given here.  I was not looking for a physician's advice here, but rather personal experience from user-end patients, which is what I think this forum is all about.

In the end, I did not add another patch, but rather waited for an appointment with my prescribing neuro.  But the understanding offered by these many individuals made the wait more tolerable and actually an enjoyable experience all around.  Many thanks to you all!

Lauriel
Avatar universal
I am living with my husband abusing his fentanyl patches every month. He is prescribed 125 (1 100mcg and one 25 mcg every three days). He has been abusing them for months and steals my pain medication from me and when I have no more he buys medication off the street.

I am at my wits end. We are not able to pay our bills because of the extra spending and I cannot argue with him any more about this. I do not know what to do. I am about ready to end my marriage over this. I have a 16 year old at home and she is having major problems with his attitude when he is drug seeking. I have 4 children and the older three are addicts and one is done with treatment and 2 are still doing a methadone clinic.

I do not understand what caused them to be like this. I argue with my husband because he believes that they are drug addicts and he is in REAL pain and because it was prescribed to him he has a legit reason to use what he does.

I have tried to reason with him because I have done so much research about drug abuse but it goes in one ear and out the other. I just need some advise.
Avatar universal
I never heard anyone being on more than 200 who's your doctor and what city
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