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Fentanyl Patch

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Posted 2/24/2009 1:38 PM (GMT 0)
Has anyone had much success with Fentanyl patches? I was given the 50 mcgs patch to replace Oxycontin 40mg about 5 days ago. The patch is supposed to last three days and the Dr. says that it can take up to a week before I could notice much of a difference.

My experience so far is that I put the first one on around noon Thursday. My back was about the same until I got up the next morning. Friday morning, I woke up with less pain than I have had in the past year or so. As the day went on and I sat working, my back started to hurt more and more. The last day of my first patch was pretty rough with a lot of back pain. I am currently almost 48 hours into my second patch and my back hurt quite badly this morning when I woke up. I take 10/325 Norco for breakthrough but I have taken this for almost 18 months now and they don't really seem to do anything at all to touch the pain once it sets in the morning.

I am trying to figure out if the initial success I had could be attributed to the patch or if it was just a really good pain day and I really wanted these to work. Overall, since having the first patch on for 16 to 18 hours, my pain has been less so I really have hope that it is helping. It is just that this morning my back feels just like it does when I am unmedicated. Could this patch have something wrong with it?


Skrape
Posted 2/24/2009 2:34 PM (GMT 0)
Skrape,

I have never tried the patch personally, but as a nurse, I can tell you that you have to give the pain meds time, sometimes days, to really work to their full potential. Try to be a little more patient for the next couple of days. I know that is hard when you are in pain and hope you don't clobber me for saying be patient. I would probably clobber you if you said it to me when I was in pain. It's an awful feeling I know. I have back pain too and have had back surgery in the past so I know somewhat of what you are going through. Blessings to you.


Gentle Hugs, my friend.

Lindaloo
Posted 2/24/2009 6:57 PM (GMT 0)
Thank you. I know that I need to wait it out and see if these will make a difference. I am always so optimistic when I am able to try something new, especially when the old has stopped working so well. I truly was amazed after about 24 hours of having one of these on. I am just worried that it might have "been in my head"! LOL if I had a dollar for every time I have heard that one! I think a lot of my frustration is with the medication I have for breakthrough pain. It worked well a year and a half ago when I had first started taking it. I have never had it changed since first hurting my back. It has been the same frequency and the same dosage all along. I told my old doctor a while back that it was helping, just not as much as I would like/hope. His response was to discontinue it all together. This really didn't help too much.

I saw another post on here about being afraid to ask for a change in medication. I know all too well what this is like. I am with a new doctor now (going back to see him a second time Thursday, it has only been about a week) and I do not want to ask for a med change. I know at this point, taking the Norco has little benefit but it does have SOME! I really don't want to ask for something different, I have never had anything different so I don't know what he could give me. I was under the impression that 10mg hydrocodone was a lot. I know not to ask the doctor for anything particular but does anyone know if there would even be a point to asking for a change? Is there really anything that would work better/different than this does? I know it is different for everyone...


Skrape
Posted 2/24/2009 11:28 PM (GMT 0)
What out for the fentynal patches they take away your memory. I was on 100's for ten yrs. and those yrs. are missing from my memory and it hurts to not know what happen in my childrens lives then. I couldn't even remember vacations we went on . But they sure worked for me along with breakthru meds of different sorts. But soon I weaned myself off of them and it was good for a while untill I recienty bot bucked again in the fall from a different horse and fractured 2 more vertabra this time in my thorasic area and im having a flair now so I got to go . will write more later . Im needing an ice pack take care they do work.
Posted 2/25/2009 5:42 AM (GMT 0)
skrape, I have used the 50 fentynal patch for about 11 months.It gives me very good pain control for the first 2 days.The last day is not to great.Other people have posted on here about there use of them and most of them have the same results.I am willing to put up with the last day because I am very bad about taking pills on time and remembering if I had taken one or not.Even with the patch once in a will I will forget on the third day then hurt like h*** on the fourth day.The fentynal is not the reason that I have a hard time remembering to take my medication.I know it doesnt help but there is a lot of reason I have this problem.
Posted 2/25/2009 9:25 PM (GMT 0)
I started my third Fentanyl patch today around noon. I had been having a lot of pain problems within the last 24 hours of my previous (2nd) patch just as I did with the first. When I first put these on, I can wake up with relatively little pain. When I say this I mean maybe a 3 to 4 on the 10 scale they use. If I can achieve a 3 on a scale of 10, I am very happy and I consider this a very tolerable amount of pain. By mid-day today, I was to the point that when it came time to change this patch, I had to lay down for almost 2 and a half hours. Once I woke up from my nap, I was back down to a 4.5 or so again and this probably has just as much to do with laying down as it did with the patch being changed.

I know from reading that a lot of people have problems past the 48 hour mark on these types of medications. I have never had any bad reactions with pain medications (except Ultram, that stuff makes me super nauseous) and I always remember to take them. My back always reminds me that I need to keep up with my medication! ;-) These patches work a lot better than the extended release oxycodone I was on before but with the oxycodone, I think I had a more stable level in my system. This doctor is telling me that the patch maintains a better level than pills do but I really do wonder. I don't want to complain since these are providing me better relief when they do work but I hope that this will not end up being a good two-day and bad third-day type of situation.

I do have another appointment with my doc tomorrow at 4:00pm. I will chat with him regarding the patches and the problems I am having. I have said in other posts that I really like this guy and he has given me a lot of hope. I am looking forward to talking with him tomorrow and seeing what he has to say. I have started a journal and have been trying to keep everything written down so I can keep it straight. Hopefully this will help.


Skrape
Posted 2/25/2009 10:51 PM (GMT 0)
I have been on Fentanyl patches for 8 years. They do take a few days to be optimally effective. I had to go to changing them every 48 hours right at the beginning. My doctors and insurance have no problem prescribing them this way. I started with 25mcg, had to increase to 50 mcg for a few years, then last year decreased to 25 mcg again. I don't believe I had more than a slight memory problem. I use Ultram for break through pain; fortunately, it doesn't make me sick. Keep on the patches for at least a couple of months before you judge them ineffective.
Hugs and I wish you success.
Posted 2/26/2009 2:30 PM (GMT 0)
Skrape be sure to tell your dr about only getting fair 48 hours of relief. Thats happened to so many so the dr prescribes them as a 48 hour patch instead of 72 and Super posted above. I would also tell this new dr you have been on the Norcos for a long time and they seem to have lost their punch in getting the pain down. Just ask if there is anything else available that may work better for your BT pain. That way you are not asking for a particular drug, we know what happens to people that go in asking for a certain drug, they get booted out the door. If you are not honest with your dr then he can't effectively treat you. Good luck and let us know what happens. Susie
Posted 2/27/2009 6:57 AM (GMT 0)
I'm going to see my PCP today and I already dread it. I really like him..he's smart and very through. All of my labs came back fine so there is no way I should feel this bad! I just hope he doesn't think that I'm losing it! You know how they look at you sometimes.....you look relatively fine but you feel like you've been hit by a bus. If someone could just help me!
Nurse2
Posted 2/27/2009 7:05 AM (GMT 0)
Aw Nurse I sure hope your dr can help you out, let us know. I have a bug or something and I feel just awful. I am up & down out of the bed, I ache all over can't get comfortable....Susie
Posted 2/28/2009 1:22 AM (GMT 0)
I have used the fentyl patch for a little over a year now. For me the patch was a life saver. I was having stomach problems from all the years of taking tablets. I started with 25mcg and within two months switched to 50 and then every 48 hours instead of 72 hours. My doctor is very good about listnening to me about my pain levels. I have been in pain management since 1995. I take norco for break through and it seems to work for now.

Chronic pain from too many spinal operations!

Posted 2/28/2009 2:18 AM (GMT 0)
My Dr put me on Fentanyl as nothing else was working very well.

Before the 3rd day, I was in screaming pain. It was like I had taken nothing.

I put on another patch, but it never touched the pain so I went back to him and he switched me back to Methadone and Morphine.

In my mind, Fentanyl is completely worthless *for me*.
Posted 2/28/2009 2:23 AM (GMT 0)
Pain is a very individual disease just like the medications we take. We all have a different metabolism so what may work for one may not work at all for someone else. We are getting lots of questions on here recently about medications and what works best. There is no answer to that simply because we are not all different, people have to remember that. Its kind of like what may hurt me may not hurt someone else. No two are alike....Susie
Posted 2/28/2009 3:16 AM (GMT 0)
I was on fentanyl for about 3 years and it almost destroyed my life but everyone is different. I had alot of sideeffects from it. I lost down to 92 lbs and my mood swings were horrible. I thought that I was going crazy. I was on the 50 every two days. I had several overdoses from them and was constantly going through withdrawls from them. They made me so tired all of the time. I kept telling the doctor that it was the fentanyl and when I lost so much weight he agreed. My mind would race and could not sleep the first night I changed the patch. It was horrible. It is very hard to get off of them because the withdrawls. I have been off of them for 3 months now and have gained back 13 lbs and feel much better. I have never been bothered with neuropathy until when I was coming off of the patch and now the neuropathy is horrible in legs,feet,hands,feet and spine. Does anyone know if the fentanyl could have caused this? I am now on hydrocodone 10/325 but my dr has me taking 12 to 14 of these a day. This seems like alot to me plus lyrica and soma. The patches were not for me and my pain is no worse than when on the patch. yeah
Posted 3/1/2009 9:46 PM (GMT 0)
LBS-
Yes, the increased pain could be (but isn't necessarily) due to the fentanyl withdrawal. I know I get that as a symptom. It is called hyperalgesia & there is some preliminary research to suggest that ultra-short acting narcs like fentanyl are more likely to cause it. You can google it or look it up on the acpa website (theapca.org), but basically it just means that your brain cut back production on natural pain relievers (endorphins & such) once it got used to having the fentanyl in your system. It does get better. If you can handle exercise, yoga or such that's a good way to help increase those chemicals in your brain. Otherwise, it will just take some time (usually 3-6 months, but I have heard some people say it took them up to 2 years) and you will go back to normal.
Maybe you can try a topical NSAID (like Voltaren) to help with the neuropathic pain in the meantime. It's not 100% effective, but maybe it would be just enough to get you through the hyperalgesia.

feel better,
frances
Posted 3/4/2009 7:36 AM (GMT 0)
What is apca? I googled it and tried apca.org with no luck. I am interested in this possible pain phenomenon of fentanyl withdrawal.

Thanks to you all.
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