Fentanyl Patch Wearing Out (Page 2) (Top voted first)

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Hello. I am on the fentanyl patch, 125mcg every 72 hours. And ever since starting the patch I have been able to once again be more active. I exercise for an hour every morning and walk in the evening. My dr said the patch will last me 72 hours but by 48 and sometimes less, my pain begins to return and I start feeling withdrawl symptoms I use to feel on oxy or percs. I've tried telling my dr that I need to change every 2 days but he insists that this does not happen to anyone else. Does anyone here have the same issues? And are you feeling better results from different brands of the patch?

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18

Hi, I have had the same problem from the day I began Fentanyl. I ALSO have found activity and LIFE again with Fentanyl... Also the bonus is not having to stop every 3-6 hours to take pain meds, and having meds in me 24/7 allows me to be more mobile in the morning as I am not waiting on drugs to kick in.

I am a hot person, I sweat a lot and am ALWAYS hot. I also am very active. I had a problem with patches either falling off or loosing effectiveness after 2 days as well. So what I did, was ask my doctor to write my rx differently. I took 50 mcg at the time. So she wrote the rx for "25 mcg patch dispense 20, use 1-2 patches every 2-4 days" This allowed me to wear one patch for a day or so then add a second should i need it. And it made her feel better knowing i was trying to use the lesser dose and by writing it to use every 2-4 instead of a flat 3 day rate. The 4 day allowance made my doctor more comfortable with it.

What I suggest is ask the dr to wrote your rx for " 75mcg patch dispense 10 use 1 patch every 2-4 days" AND ALSO write a second rx "50mcg patch dispense 10 use 1 patch every 2-4 days". This will allow you better control over your dosing as well. I found that if I was not active and had no plans I could do just fine with one patch, but if I planned on lots of work or travel I would apply the second patch. I also liked that it allowed me to accumulate a reserve supply of patches. Because the ONE MAIN PROBLEM with the patch is adhesion. I have had patches fall off after only 5 hours use.. and they NEVER re stick. And if ONE patch falls off you become one patch short at end of the month. In the USA I found myself saving the fallen off patches to take to the doctor to PROVE it did fall off. I hated that. Now I live in Canada, and the doctors here are more trusting than that. I recommend ANYONE living in the USA on Fentanyl call the drug company that makes your patch and complain that you LIKE using the patch and PREFER it but feel you will HAVE to change meds due to adhesion issues, and ask can they help. I did this and Jansen would send me a box of 100 patch covers called TEGADERM, every 2-3 months, I just had to call and say I was running low and they would send out a new box. These patch covers are a god send It is the same material the hospitals use to keep an IV stuck on to a person. The patch covers Jansen used to send me were rather large, about 3x6 inches. A patch cover that size is QUITE expensive. I can buy a box of 8 SMALL 2x3inch tegaderm in the drugstore for $8 Canadian. But, in the hospital pharmacy I can get them for 35 cents each... the 3x6 patch are STILL $1.30 or so Canadian EACH!!! So the free supply from the drug company is a true blessing. (They dont give these free in Canada, but DO still in the USA) If you do not need the covers, I say STILL get them free, I had stopped Fentanyl for a while and had a full box of covers remaining. I discovered 101 uses for these things over the years, I used them for photo covers, phone covers, the list could go on and on.

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19

Jessica, I don't feel any of my doctors provide an integrated approach. I have fibromyalgia and rhematoid arthritis. I see a pain management doctor, rheumatologist, osteopath, and a psychiatrist. Each strictly adheres to the meds that their "specialty" allows them to prescribe. Two of the doctors do not accept my insurance. I don't think any one has spoken to one of the others about the best treatment plan for me, their patient. An integrated approach would be great, time saving and probably money saving with better results.

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21

Jessica, in the beginning the Fentanyl patch did last for 72 hours if it didn't come off due to sweat. Soon I discovered after 2 to 2 1/2 days I was hit with breakthrough pain. My pain management Doctor decided it would be better for me to change the patch every 48 hours. It increases the amount of medication in your bloodstream but not as much as increasing the dosage. So a one month supply is 15 not 10. It seems very common if you read some of the posts here. Good luck!

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22

Hi Jessica. It sounds like what you need is a physiatrist. Physiatrists specialize in physical medicine and rehabilitation. ThIs is branch of medicine that works to restore functional ability and quality of life to those with physical impairments or disabilities.

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23

Many pain management doctors are physiatrists. Find out what your doctor's specialty is. An orthopedic doctor often is called a pain management Doctor but physiatrists do have better understanding of the meds, side effects, drug interactions, etc.

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24

Hi, I have recently heard of exactly the same thing happening to someone else. I guess this isn't much help but you are definitely not the only one experiencing this. I should push the case a bit more. You could try buprenorphine. Not as strong but apparently lasts stated time.

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25

I was on the patch also and needed to go to 48 hours per my doctors permission then I needed at 24 hours which doctor wouldn't allow. I also developed terrible sweating and I'm well past menopause. My body just kept wanting more. I had to stop using the fentanyl patch

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26

Not to sound rude, but if you dont think your drs are talking to eachother... WHY arent you doing something about it? YOU are the captain of ur healthcare team. Not even your family doctor is the captain, YOU ARE. Your family dr is more like the 2nd in command. Do not ever assume they are thinking about ALL you need. They have hundreds of "yous" to look after. Only YOU can look after YOU the best.

Have a copy of your own medical records. KNOW THEM. Never go to the doctor without reviewing them and preparing ahead of time. make notes to take with you each visit. You would be surprised how much they DO miss and if you get the right doctor like i have been lucky enough to find, you will be able to voice concerns and have them listened t o and acted upon.

When I first came to Canada, I hauled a suitcase FULL of records to EVERY doctor appt. I am sure they thought i was nuts or "malingering" ( making it up) But, over time i became educated enough that they began to listen, and in the end it was ME who diagnosed a problem I have with insulin, which was making me quite sick. When I suggested it may be my insulin problem, I had the medical records right in hand to show my reasoning and I was given the CORRECT diagnosis (for that part of my health any way) Had I NOT been all over my records and researching on my own, i could very easily STILL be producing too much insulin and be very ill by now. I discovered the probable diagnosis at age 35, by then i was already childless, and had high blood pressure, not to mention many other effects of the disease. But, most doctors know little about my illness despite it being one of the most common reasons for infertility. (and EASILY treatable with simple diabetes pills twice a day) My point is do not rely on them to be combing over your records, looking for tests from two yrs ago looking at other doctors notes, lab work etc. MOST read the most recent progress notes and thats about it. So if the LAST doctor you saw says you have "abc disease" the next one will go with that assumption and continue wth that theory. SO if YOU do not look into these things yourself you may find yourself in worse shape than when you started. ( I was being treeated for Multiple Sclerosis before I discovered my TRUE problem... and the drugs for MS are BAD BAD BAD for you especially if you dont actually HAVE MS!!!)

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27

Milo, well said! The patient must advocate for him/herself. I was wrongly diagnosed with MS. I have had a 22 year journey dealing with chronic pain, insomnia, fatigue, migraines, and the list goes on and on. My "team" includes 4 doctors that have probably never spoken to one another about me or my care. It is unfortunate but a patient cannot trust a doctor to look out for his/her best interest or treatment. You seem much more organized than I am but your advice is key. I hope everyone reads your post and follows your words of wisdom. Otherwise you will fall victim to a long list of medications with negative side effects. No one is watching out for the patient. If you are too sick to handle the responsibility, please bring a family member or friend to help.

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28

Hey phil classic case of where if you cant beat it(or em) then join em to a small degree getting ready to go in for big time back surgury and if i can come out of it with long term less pain than what ive been dealing with its time to start wrapping up my episode done it once before but thats good info for me to absorb for rightnow other ideas of course ive been adding on a list to ease my detox that i plan on soon as i have surgury l-3l-4 herniated disks crowded nerve that just makes me cry at night and at work my 2scripts from pain management just hasnt been cutting it lately i wont take this crap the rest of my life though if you know what i mean just stuck in a corner right now with definetely a semi clean way out of it just need to get this surgury done and start weening my way foward only way to do it know were your coming from good luck wish me gonna need some soon
........fenatyl what a relief for now....
.

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30

I have been treated with Durgesic Fentanyl patches. Dr would have Me apply a new patch on day 3 rather than the 4th. That seemed to remedy the problem with the medicine being used.

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31

I feel your pain. For the past 4 yrs I was told I have fibromyalgia. Come to find out I have Lupus and it has gone so advance that it has now damaged my kidneys and liver. I begged my dr to listen saying there's something else wrong with me. Went to a few other Drs, looked at my tests and agreed with my current dr. FINALLY left the county, went 4 hours away from home, found an amazing dr who did all the proper tests and found it. Gave him all my old labs and he showed me how my past labs showed lupus signs. My other Drs just didn't pay attention. Now I'm stuck with permanent damage which could of been avoided all along if someone would just listen. To all new Drs or med student on this website, listen to your patients. Really listen to them. Don't play God, give them a chance. Yes some over exaggerate but others really have a pressing need.

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32

Jessica, I was on the patch for three years and it can be changed every 48 hours, I talked to my doctor and he changed my script so I could change my patch every 48 hours. I have fibromyglia, nerve damage in my legs, was in a car accident, now I have degenerative dics diease in my neck and lower lumber area. If he won't let you change it every 48 hours, ask him to put you on a different time release medication. I wish you well, and I hope your doctor will work with you.

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33

i had the same problem. I take the same dosage 125. my doc changed the script to every 48 hrs so i know it can be done. I am a disabled vet and use the va system for my spinal cord issues but have a civillian pain management doc.and even there ( Keep in mind the va is all about cutting u down to as little as possible. Forget quality of life for which my civillian doc. goes for) and i have seen guys prescribed it every 48 hrs there too.

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35

Jessica, better still ask for Oxymorphone 20mg ER. It's cheaper than Opana... Opana is real expensive... Oxymorphone is a generic and Opana is brand name...but to me Oxymorphone ER works great :-) Good Luck Jessica! :-)

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36

Bettyboo. You need to get tegaderm patches. Poke about 10 holes I. Them then put them over your patch. That will help to keep them on. Mine fall off within hours if I do not use them. Also look through new posts here. Someone else suggested using some kind of nasal spray on your skin before applying to avoid rashes.

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38

Tell your doctor that you need to have the patch changed every 48 hours! Ask your pharmacist to back you up in that MOST patients need to change the patch every 48 hours! I have been using the patch for 15 years now, every single person I have met who is on the patch tells me that they need 15 patches per month.

You pharmacist will call your doctor for you if you ask him too.

ALSO the dosing instructions from the FDA:

"...The majority of patients are adequately maintained with DURAGESIC administered every 72 hours. Some patients may not achieve adequate analgesia using this dosing interval and may require systems to be applied at 48 hours rather than at 72 hours, only if adequate pain control cannot be achieved using a 72-hour regimen. An increase in the DURAGESIC dose should be evaluated before changing dosing intervals in order to maintain patients on a 72-hour regimen. Dosing intervals less than every 72 hours were not studied in children and adolescents and are not recommended..."

Good luck!

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39

Talk to your pharmacist for more backup. They tell me that half of all patients are 48 hour users.

Have the pharmacist call the doctor.

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40

Yes I was on the Fentanyl patch for 3 years started with 25 mcg q 72 hours, but they wore off after about 36-48 hours eventually I was prescribed 100 mcg q 72 hours. Still after 48 hours the patch began to wear of and major pain would come back. I supplemented the patch with Tylenol Arthritis Formula as well as Clove Capsules which act like an opiate but you MUST eat something with them. Understand I am not saying this will work for YOU. I was desperate and did the research. God Bless!

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41

Your doctor is full of s***. Any type of pain meds will last longer for some people than others. Take methadone. Some people can take 40 mg and it will last 2 days while others take over 500mg and they start feeling pain in 12 hours. Talk to a pharmacy as they can tell you more about pain meds than any doctor.

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