A question for BuTrans users

Just started this for my chronic back and leg pain. I started on the 10 mcg patch as I had been on 200mg of Tramadol and 5 mg Oxycodone for bt pain.

First patch went on Tuesday afternoon (7/30) and by Wednesday night it was helping. By Friday, I was feeling "normal", a place I had not been for almost a year. What a difference a new pm doc makes! The new doc also added 50 mg 2 x a day of Lyrica to help with the nerve pain, I waited until Friday to start that, just to make sure I knew what drug was doing what if I had any side-effects. So far, so good. The first two days, I was using my normal 3-4 x a day 5mg oxy, by the third day, I was down to 1-1/2 to 2 x a day.

So, my question relates to patch adhesion and time of effectiveness. I applied my first patch to my upper left arm area, above the breast. I think I stretched the skin a bit before applying. Small vertical ripples developed in the active area of the patch over the next day - so I think these areas are not in contact with the skin and I'm thinking I'm not getting the proper dose. I did shower as the directions said you could but by Friday, after a shower and going out, the area was getting itchy and when I rubbed it, a small amount of water came out and was absorbed by my shirt. If the shirt had not been a dark color, I probably would not have noticed but it was pretty evident water had gotten behind the patch. Saturday was a very good day, only 7.5 mg of oxy spread out over the day. I was pretty active, it felt great to have some energy again.

Early Sunday morning (2 am) I awoke with LOTS of left side nerve pain in the leg. It got me up and I took a full 5mg oxy and finally got some sleep at about 4am to 7 am. When I got up, I felt like my legs had run a marathon, total lead like, heavy and very sore (I used to run in my earlier years so, yeah, I know what it feels like for real). This pain was similar to but perhaps a bit less than what I had been living with for the last 6 months or so. I took another 5mg oxy and my Lyrica - and I while I now feel better and my pain is manageable, I'm having more pain in the back and legs - much more so than I had Friday or Saturday.

Given the adhesion and water issues, is it reasonable to think the patch is losing it's effectiveness? I'm thinking I can certainly manage until tomorrow by going back to my older daily oxycodone levels - but do you think it would be a good idea to call the doc and see if I can swap patches a day early?

Also, looking for any and all suggestions for where to stick these suckers and what is the best way you've found to get them to stick and keep them dry. Thanks for reading and being here!

PS: Found HW by way of a Google search doing my research on BuTrans. Gotta love Google!

Cogito, thank you! I'm very happy to have found this forum. I've found similar places for my other interests in life but it never occurred to me that there might be one for my physical situation! It's like the old saying, you never know what's under a rock until you turn it over.

I googled tegaderm and see that I can get the "windowed" type which appear to have adhesive only around the edges. They (3M) also make it in roll form which is sticky all over. Not sure if one would be better than the other for keeping it dry and in place. I'm leaning towards the over all adhesive so if I stay on the patch, I will be sure and try it. I will certainly share my experiences if I try the tegaderm. I'm very hopeful the patches work for me as I had a couple very good days and it makes me only want more, I'm just so tired of the ups and downs. It was really the first time in months that I've been clear headed and felt, well... normal.

The five day limit that you encountered sure sounds like what I'm going through. Things have gotten much worse tonight, getting difficult to walk with the pain so I'm parked in front of the 'pooter for a spell. My first call tomorrow will be to the pm doc to get his okay to swap patches early.

I was on it for 4 months and then only the 5's.The 1st month I liked it and like you said felt normal.They seemed to run out at about 4 1/2 days on me.That's when my stomach would start hurting.I knew there was no way I could get through a month on them.

That was just my regular Doctor.I'm in Pain Management now and take 150mil of Nucynta every 12 hours.

Good luck to you with whatever meds you settle on.

Litespeed97'

Welcome.I'm new here also.It's a great Forum for people with actual medical problems that are looking for solutions.I love it because I'm interested in everyone's experiences with their Doctors.I'm really just starting on this journey,or just hitting my stride.
I found a lot of Forums where people were asking what was the best way to break down every pill there is.From what I read there seams to be a great number of young people sticking pills up their rear ends.They call it "plugging". Shakes head...

My point being this is a really good site with really good people.

eta:"hey all sync to the same account so you can enter data on any device and it shows up on all of them. It also lets you send an email link to your doctor (you can set how long it lasts before it expires) to share your pain data. And it's free."

Do they read this or does it go into your computer-stores medical records?I'm really curious.

Have a pain-free day,
Rick

I suffer from Fibromyalgia and a bad case of Postherpatic Neuralgia from an awful case of Shingles I had in 2010. For the past year I've been seen by a physician every 28 days who specializes in comprehensive pain management - she is someone I trust implicitly with my care. I take Vicodin 3/500 3-4 times a day, Topamax and an anti-inflamatory called Voltaren. I've been on the Butrans patch for 7 weeks now - the first month was the 5mcg patch for 2 weeks, then 2 weeks with 2-5mcg patches and the past 3 weeks have been on the 10mcg patch. I was doing very well on the 2-5 mcg patches - only needed to take a Vicodin every 12-14 hours! YAY!!! But, not well at all on the 10mcg patch. Prior to using the 10mcg patch I experienced no side effects. Now my stomach and back are in constant pain - almost like someone has punched me in the stomach or hit me in the kidneys. Went to the doctor yesterday and she agreed that it is possible that the delivery of the medication in one big patch as opposed to 2 patches in separate areas of my body could be making me ill. So - she's put me back on 2-5mcg patches. I also asked her about the efficacy of the patch wearing off around day 6 and she said that is the most common complaint she receives from her patients - "they tell me Day 6 is like hell for them" - so not that I'm happy that other people experience pain, but it validated what I was experiencing on Day 6. We determined Day 6 would be a day where I would take Vicodin more frequently for the breakthrough pain. I hope this patch correction works because having pain taken care of on a more even keel would be bliss... Oh, and yes, sometimes the patch gets itchy - but I'll tolerate that if it works - and I've had no issues with it coming off in the shower. Best of luck everyone!

Thank you all for the feedback. I did get the ok to swap out the patch a day early. I also found my local independent pharmacy had a good selection of tegraderm covers so the second patch is stuck well and now waterproof to boot!

I think I was pretty much without the help of the butrans all day Sunday most of Monday but now 48 hours after a new patch, my pain relief is not even close to what I had last Friday or Saturday, I really have no idea why. I'm back to pain that is only semi-controlled for an hour or two with each oxycodone taken. I'm trying hard to stay positive that this is going to work.