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Fentanyl Patch - experiences, particularly for neuropathic pain

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Posted 6/17/2011 4:37 AM (GMT 0)
Hi,

I have a severe chronic digestive disease in which peristalsis does not function properly.due i have been developing severe polyneuropathy subsequently to high dose iv.- antibiotics for the treatment of recurrent septicemia and due to chronic use of oral antibiotcs for chronic bladder infections.

The nerve pain is unbearable and increase my pain level once again (have bladder and gut/stomach pain due to CIPO)

I am probably going to try fentanyl patches as the usual drugs don't work. I also have some allergies to the conservative agent many drugs contain.
And, i must Be very careful with pain meds because of my gut issues. It wouldbe Best avoiding oral administration.

So can someone please tell me about his/her experiences with fentanyl patches? Also, what is your experience with weight change on fentanyl? Some folks seem to struggle with weight loss while others gained.
Tanks.
Sarah
Posted 6/17/2011 1:51 PM (GMT 0)
I was on the fentanyl patch for 7 months. I had some problems while on it, which was why I made the decision to discontinue the patches.

The amount of fentanyl in the patch can be released more if your body temperature is increased too much. That was my major problem with the patches, I have previously had chemotherapy and it damaged my sweat glands. So I do not sweat very much, when my body gets overheated, I stay overheated for quite a while as my body has no way of cooling itself down. Because of that, the patch was releasing too much fentanyl at a time and was making me sick a lot of the time.

Also - you must be careful with how you apply it and what types of soap, body lotion, powders, etc you use on your body. I have found that you shouldn't use any body washes or oil of olay soap prior to putting on a patch. Ivory soap, caress, and irish spring were all good soaps to use. If you find that you have any problems with the patches not adhering well to your skin or moving/sliding around, you can get a special bandage called tegaderm to put over the top of the patch. This tegaderm is the clear adhesive bandage that breathes that hospitals put over your skin when they put in IVs. You can get the brand name tegaderm or CVS has one that works exactly the same way but is a little bit cheaper because it is a CVS brand.

Other than the above issues, I did get good pain control from the patch. If I did not have the above issues - especially the first one, I would have been happy to have stayed on the patch.

Hope this helps!
Trudy
Posted 6/17/2011 2:03 PM (GMT 0)
Hi Peltzier...Sorry to hear you are having trouble with your pain and figuring out medicines to help...

Your title of this thread...I just want to say that the Fentanyl Patch is not made specifically for Neuropathic pain...It's just a regular narcotic...It's one of the stronger narcotics out there, and should only be used in opiate tolerant patients....your Dr. and you should be able to decide if that is the next step for you..

Keep in mind that it is measured in MICROgrams...and not MILLIgrams like all other medicines....so it's not like 25mcg of Fentanyl is the same as 25mg of Oxycontin..

So your Dr. will start you on a fairly low dose as it's a different active ingredient (Fentanyl) than what you have taken before...so they want to see how you react and not any severe side effects...So you may have to be a bit patient when starting a new medicine..

So you have gone through all the other long acting medicines like Oxycontin, MSContin or Kadian, Opana ER, or Methadone...and none of those helped? Even with stomach issues...lots of people can use the long acting medicines since they spread out over 8, 12, or 24 hours..

Have you also tried actual nerve pain meds like Lyrica, Neurontin, or Cymbalta? I had great success for awhile with the Cymbalta...and lots of people really have good luck with the first two...

Also...lots of Dr.s will prescribe both a narcotic and a nerve pain medicine that work on different receptors in the brain...

If you've run the gamut of everything...then the Fentanyl patch...as it releases into your skin over the three days....and if needed down the line...some Dr.s will move to have you change the patch every 48 hours....

The good news with the patch since I was on it...is there is now a 12mcg one...so this can be either started on this...or added to the others to slowly increase the dose...

Many people have great success with the medicine...the only downsides are that it sometimes has trouble sticking...depending on the brand....and you need to really watch being out in hot weather for any length of time....no long hot showers or hot tub while wearing it...

I haven't heard any issues with weight loss/gain with the patch...that is usually with other meds...but even then...maintaining healthy eating...doing daily exercises as directed by a Dr....should be able to keep that from happening..

I hope that if you move to this...that your Dr. can also give you a nerve pain med to help you as well...
Posted 6/17/2011 5:10 PM (GMT 0)
Hi Sarah, I was on the Fentanyl and it worked well for pain until the summer months hit, then the bottom fell out. I was outside a lot and when my body temp went up too much Fentanyl was being released and it made me feel awful. So, by day 3, I had little of the drug left and I was in withdrawals and that was no fun. It did little for my neuropathic pain in my feet, as most pain medications do not do much for nerve pain. I was on Lyrica and Cymbalta at different times and did really well. Has your dr tried you on any of the meds that work well for nerve pain?

I am not aware of any weight issues related to the pain patch. Good luck.
Posted 6/17/2011 5:49 PM (GMT 0)
thank you all for responding.

my options are extremely limited due to a severe allergy to a conservative agents many pain drug use, so is the nerve pain meds.
Methadone is also no option for me as it aggravated my bladder spasms.

also, oral pain meds do more harm to my fragile gi system and are not equally absorbed due to malabsorbtion issues.

i was now prescribed norspan patch which is apparently not available in the U.S. I am from Germany,
I thin you use the agent in norspan as a drug for withdrawal symptoms from opioids.
but here i's also used as a pain med for fairly severe pain.
if i don't get relief from it I could try the fentanyl patch but my pain doc wanted me to try the norspan patch before as it's not that heavy.
I know that fentanyl pain is a narcotic with a broad spectrum of indications but as I can't take the actual nerve pain meds I have to switch to opioids. Also, my nerve pain is severe and my pain docs said that severe nerve pain is usually left untouched with the real nerve pain meds, at least when taking alone.
Posted 6/17/2011 7:03 PM (GMT 0)
Thanks for more information....I am a bit confused...are you on the Norspan patch now...or the Fentanyl?

In the US we have the Butrans patch which is exactly the same patch as the Norspan...as you said...just different names in the US or other countries.....so you can ask about that...and yes...it's primarly used for addiction but just like Suboxene and Subutex...it's used for pain treatment with some patients...

I'm not sure what you mean by the Dr.s say that all nerve pain is untouched with nerve pain meds...There are a lot of people on this board that have horrible nerve pain issues and are helped with them...along with narcotics as I mentioned...it's a dual approach...

But I realize you say you have tried everything and have reactions to most medications and can't use them.....

So...it sounds like your options in the US are the Butrans patch, the Fentanyl patch, or possibly getting a pain pump installed...There are some people on here that have the pain pump that can give you more information....

Hopefully you have a very good PM Dr. that is willing to look at those 3 options and if you get to the point of the pain pump, that they are experienced in the medication and the pump...

I wish you luck..
Posted 6/18/2011 4:23 PM (GMT 0)
hi,
thank you very much.
i am going to try the Butrans patch first. if it doesn't help I'll switch to the fentanyl patch.
do you have experiences with the Butrans patch and side effects or know anything other people told here?
Posted 6/19/2011 3:09 AM (GMT 0)
Hi! SOrry you are having such a rough time! I have GI issues so I have an idea of some of what you are going through. I used the frntanyl patch & while I did get good relief from 25 mcg it did slow my breathing down. so that is something that has to be watched for as well!

Good luck & I hope you can find something that works for you!

Sandy
Posted 6/20/2011 3:47 PM (GMT 0)
Hello,

 

Sorry to hear you are having a rough time. I am on the Fentanyl patch. I've used it for over a year now. We started on a very low dose, then worked up. I am not on 75 patch. Everyonce in a while it gets a little itchy. I think I've had trouble getting it to stick twice so far, so not too bad. I did experience the high temps and feeling sick. But it is summer right now, and so far so good. I know that everyone is different, but for me, it has been a great help.

 

Good Luck!

 

-Monica

Posted 6/20/2011 5:11 PM (GMT 0)
TegaDerm is a clear adhesive that is great to use over a Fentanyl patch. Its like the clear adhesive they put over an IV once they have it in your hand. When I was on Fentanyl patches this is the only way i could get one to stay on. The drug stores carry these and if they are out they can be ordered.

I have also heard that some brands of the Fentanly patch will send you covers to put over them if you have trouble getting them to stick. I have no idea which mfgs will do this.

Hopegirl you know when you get warm while outside in the summer you will have more of the medication released which will shorten the life of the patch.
Posted 6/21/2011 5:50 AM (GMT 0)
I am on the Fentanyl patch. They work pretty well for me. I use the Tegaderm to help keep them stuck on. I buy them at Walgreens, but you can order them off of the internet also. I haven't used the Butrans patch, so I don't know how they work. I wish you good luck with finding the right medication for your pain.

hugs
Loretta
Posted 6/21/2011 6:23 AM (GMT 0)
Sarah,

Sorry you are struggling to find the "right" medication for you. 

I've used the fentanyl patch in the past.  While fentanyl is the best pain reliever for me - I can't use it in patch form.  I have very fair skin and body temperature regulation issues - two things that usually don't fare well w/ the patch.  I, too, used the tegaderm to try to hold it in place... and had to change the patch at the 48 hour mark.  But I still had issues.  Anyhow, I'm now on oral fentanyl (Actiq) in addition to my other pain meds.  It works well for the horrendous breakthrough pain I get.

Re: nerve pain - for me, the fentanyl helps my pain in general - but it really does nothing for my nerve pain (I have neuropathy in my hands, arms, feet as well as chronic sciatic nerve pain).  My nerve pain med works best for all that - but I hear you in that you don't seem to be able to use many of those.

Re: the butran patches - I think there are one or two people on here right now that have some experience w/ the butran patch.  You can also go to the search section (upper right hand corner) and put in "butran patches" or "norspan" - and read what others here have said in the patch.  I don't have experience w/ that medication (one of the few I've not been on!).

I really hope that you can find something that works for you!  Take good care -- Tina

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