Fentanyl patch rx'd for first time?

[Mlmk]

@slimshade. Thank u for checking on me. I didn't realize anyone had posted further on this thread. There is probably some way to receive notification when someone posts on a thread one started. I think if u put the @ sign and the person's name u r responding to, or u use the quote function, then that person gets notified of a response/post.

Do u have insurance? I assume if so u have tried a PM clinic? I only have experience with the one that I go. Never been to another. After over a year of doing everything they told me to do to no avail, they suggested something continuous release. The patch made me too sick. So now back to usual. Doesn't work. I'll see the doc next month.

[chera]

I am in PM. I'm in my 40s, I'm in shape, otherwise healthy. My problem is my back. I have been taking 2 norcos a day for about a year. Tons of ibuprofen ( my stomach hates ibuprofen), and at least 10 injections and nerve ablations. I don't want to do major surgery right now. I know it would set me so far back, I wouldn't be able to exercise, I wouldn't be able to work. I had two shoulder repairs from weightlifting injuries and I swore never again...the rehab is so depressing and long. I'm babbling. Again. They r pretty tight with pain meds and I about fell out of my chair when he suggested a fentanyl patch. I hate norco btw and I hate being dependent on it. So the patch is frightening. I can't function like this anymore tho. I just cannot stand the thought that the rest of my life will hurt like this. Will the fentanyl work? If so how well? Like will I be able to do my 12 hour nursing shift without constant misery? I'm scared but I am so wanting this to work. My. Brother told me it was an awful med, he hated it. Couldn't pee couldn't poop etc. and he likes his drugs lol. If he had it and didn't take it it must really suck lol. Anyway long post. I did search fentanyl on the site. Also a truthful issue and fear is that I like my ambien and occasional (a few times a week) 0.25 Xanax. So I know I have a propensity for liking drugs as well. My PM a legitimate doc knows of my other med use. I also pee in a cup to keep me honest. Anyone who read this really long post is awesome. Any takers for advice? Pro and con welcome. Seems a safe place to be real about these issues. Patch is 12.5 mcg.

I also think actually that there is something wrong with me ( maybe not healthy just look healthy). I'll post that in the correct forum for that question. I appreciate advice and will give return advice if anyone needs or wants it.

I'm VERY SURPRISED your doctor prescribed you the fentanyl patch, given the fact that you've only been prescribed 2 norcos a day for pain. Granted, a 12.5 mcg patch must be the lowest dose available. I honestly thought that 25mcg was the lowest dose patch, but 12.5mcg may very well be offered by a brand other than the one I receive.
Typically though, they are only prescribed to those who have built up quite a tolerance for opoid drugs. In fact, there is an insert inside each box of fentanyl patches that shows the guidlines for prescribing the patch, listing the oral dose conversion guidlines and norcos are not even mentioned. Patch dose conversion is normally reserved for those previously taking oral, im, iv morphine, oral, im, iv oxycodone, oral codeine, oral, iv hydromorphone, im meperdine, oral, im methadone.
If becoming dependent on medication is a concern for you, I personally urge you to please consider another medication for controlling your pain before starting with the patch. You will become dependent on these after only a short period of time.
If you do decide to try the patch, please be very careful using it, especially during the first few weeks of therapy. They will be much stronger than anything you are used to, even though you may not "feel" this for a couple hours after putting it on. Please follow the instructions for use to a T. The patch is a wonderful medication for helping to control severe pain, but also very dangerous to those who aren't opoid tolerant.

[betsky]

@Mlmk glad you didn't stay with the patch. I was put on 50mcg after my last cervical surgury. I couldn't swallow was on thickit for a year. Mmmmm.... i was pretty ignorant about fentanyl at the time, i know you say but your a nurse! !!!!!! I worked mostly peds Sheba in house though. Anyhow i ended up seriously addicted. It really should be a last effort at a pm. My husband was on it for cancer and for him it wasn't working. Hospice switched him to morphine.

[Divinity]

My 89 year old mom was on the 12.5 mcg patch for a while for pain. I believe that is the smallest dosage available. She can't tolerate oral opiates as even the smallest amount make her nauseous and sick to her stomach. She was on the patch for about 6 months and then the doctor took her off it with no tapering. I was worried about that and kept asking if she had any discomfort and she said not really. That did surprise me, considering all I had heard about fent.

Wow...I've never heard of no side effects after being taken off this. Never been on it, just haven't heard that from other people. I am on 4 10/325 Percocet...and have been for 1.25 years. The problem is, I've just moved to a new state (AZ) to a very small town. I know they don't prescribe like that here, so I'm very scared of what I'm about to go through. Maybe it'd be worth a plane ticket back to my home state once a month. Who knows.

[merovingian]

A fentanyl patch? I don't know whether to be envious or terrified for you. I can only imagine that a constant dose of fentanyl is going to lock you into a dependence rather quickly. You must be in some serious pain.

If you experience any side effects, speak to your physician immediately. He/she will either adjust your dosage or prescribe yet another drug to help minimize your problems. Stool softeners are fun!

[WebRocker]

Hi, I have heard that somewhere a Fentanyl Intranasal Spray in a 40-140ug(mcg) dose is being developed for breakout cancer pain and as an abortive for cluster H/A pain! Anyone heard about it yet? I do know that the Germans are testing an Intranasal Morphine Spray in a 23mg dose for aborting the same 2 acute pain syndromes! Its about time somebody was at least acknowledging that some people with cancer can't tolerate chronic multiple injection on their bodies for pain medicine and that cluster H/A pain is often the same as or even worse than breakout cancer pain or being gunshot!!!

Spread the Word and Ask Questions Ya'll!

~WEB

[merovingian]

Hi, I have heard that somewhere a Fentanyl Intranasal Spray in a 40-140ug(mcg) dose is being developed for breakout cancer pain and as an abortive for cluster H/A pain! Anyone heard about it yet? I do know that the Germans are testing an Intranasal Morphine Spray in a 23mg dose for aborting the same 2 acute pain syndromes! Its about time somebody was at least acknowledging that some people with cancer can't tolerate chronic multiple injection on their bodies for pain medicine and that cluster H/A pain is often the same as or even worse than breakout cancer pain or being gunshot!!!

Intranasal opiates? Hmmmm. I think I need to get some of that.

[crwhitlock]

Fentanyl patches have killed alot of people. They are very dangerous and will get you extremely dependant on opiates. The withdrawls from fentanyl patches will be brutal. I would reccommend talking with your doctor about switching to something else. There is no good outcome with long term fentanyl patch use.

[auskick]

to the ts...
my friend recently got prescribed these for a disc problem in his back. his doc said once he had filled the script he had to come in and he would show him how to cut them up into the right sized strips to make them effective with out making him sick or getting him used to too high a dosage to quickly......hopefully you can ask your doc to do the same if you decide to go down the same road.

[crwhitlock]

I would be weary of your friends doctor. Fentanyl patches are inherently dangerous because they contain 3 days worth of a powerful opiate in one patch. If something goes wrong with the patch and you get the entire 3 day dose all at once it will kill you no problem. Cutting the patches or manipulating them in any way is dangerous because you don't want to disturb the release mechanism and get too much medicine at once. I would assume that by cutting the patches up you are automatically releasing the company of any liability of the patch meaning if the patch screws you up or kills you there is no legal recourse. Fentanyl in and of itself is an extremely powerful opiate that is going to get your body extremely dependant. I would personally fight tooth and nail to avoid these things. Google fentanyl patch death, you'll get the phone book.

[613]

you are going from 20 MILLIGRAMS of Hyrdrocodone (not very strong), to something that is so strong they measure it in MICROGRAMS. The only other thing I know in life that is measured in micrograms is LSD.

Fentanyl is for OPIATE TOLERANT patients.....not for people only taking two vicodin a day. Usually its for people when things like Opana or OC are not working anymore (and the elderly who cant stomach it)

[audacity]

@613 12.5 mcg can be used on opioid-naive patients with caution. It says so in the PDR. I think even 25 mcg didn't require a large opioid tolerance. There's a chart of doses, and doses with a asterisk next to it are the ones that are dangerous without a big tolerance.

I used a 25 mcg patch once and opioid-naive. Worked well for the agonizing leg spasms and aches I was having at the time, and didn't OD (just got a bit sleepy) but when I took it off after 3 days, my nose was already running, so it produces dependence pretty fast.

This is just my personal experience with a 25 mcg. Don't take it as a recommendation. The stuff in the PDR I saw for real though.

[bradw]

I think it is a terrible idea to go from 2 norco's a day to a 12.5mcg/hr fentanyl patch. 20 mgs hydrocodone a day isn't even equivalent to half of the opioids you'd be receiving from the fentanyl patch. Perhaps try an extended release formulation of morphine or oxycodone, even hydromorphine, before switching to fentanyl. Fentanyl is basically the last step you can take in pain management, there isn't really anywhere to go up from there (besides increasing the fent dosage), so before you leap onto such a powerful medication, try alternatives.

This is only my opinion, but any doc who would recommend ANY dose of fentanyl for someone taking 2 norco's a day should probably lose their controlled-prescribing license.

[costa1107]

12.5 mcg should be safe to take for low tolerant patient but i am surprised your doctor is not trying some other form of pain relief. When I tried Fentanyl I had a problem with them staying on so I had my doctor switch me back to Extended release meds.

[auskick]

I would be weary of your friends doctor. Fentanyl patches are inherently dangerous because they contain 3 days worth of a powerful opiate in one patch. If something goes wrong with the patch and you get the entire 3 day dose all at once it will kill you no problem. Cutting the patches or manipulating them in any way is dangerous because you don't want to disturb the release mechanism and get too much medicine at once. I would assume that by cutting the patches up you are automatically releasing the company of any liability of the patch meaning if the patch screws you up or kills you there is no legal recourse. Fentanyl in and of itself is an extremely powerful opiate that is going to get your body extremely dependant. I would personally fight tooth and nail to avoid these things. Google fentanyl patch death, you'll get the phone book.

yeah he was dubious about starting to use them due to how strong they are and the addictive properties... but guess living with terrible back pain for years will drive you to try what ever you can... about his doc.... he has been with him for a long time so im assuming the doc wouldnt do anything to put him in danger, infact im sure he said he was cutting them up to start him of slowly so if there was a risk he would OD or something im sure he wouldnt put him in that position. i'll have a chat with him anyways and tell him what you've posted... thanks.

[andyli]

Fentenyl is a very powerful opioid. This drug should be your last resort for pain relief in any situation, just like what the older posts above me say. It astounds me your doctor would prescribe you Fentenyl, when you were only taking two narcos a day. Typically a doctor should increase your medication to oxycodone or oxymophine, but I am no doctor. IMO, you should stick with the narcos for as long as you can and just increase the hydrocodone dosage until you reach maximum dosage for ibuprofen, then move on to percs, and you shouldn't take to much of ibuprofen even if the doctor tells you to. Ibuprofen in large dosages are lethal. I think the maximum dosage of Ibuprofen was 2,000mg, but I believe this number was lowered recently. Honestly though, I don't think anybody should take more than 1,300mg of ibuprofen a day, if your taking it every day.

[PATRICKZ]

I have used fentanyl patches--alas, not legally, but use them I have. As others have noted it takes many hours for the drug to build up a reservoir in the skin before it exerts its effect. My first time I was opiate tolerant, and I had the highest-dose patch made. The patch had me feeling great for a few hours once it kicked in. Six or so hours in I was under my desk projectile-puking in the garbage can. It's an extremely powerful drug.

The knockout gas that the Russian antiterrorist team used on the hostage-takers at the Moscow theater was a gaseous form of fentanyl. Knocked everybody out, killed more than a few. But no terrorist was able to trigger a bomb, so the net was probably many more lives saved, but you wonder why they weren't carrying hypos loaded with Narcan. By weight fentanyl is like 100x the potency of morphine. Which is why fentanyl is prescribed in microgram doses.

The best advice for anyone using the fentanyl patch is DON'T USE A F**KING HEATING PAD OR ELECTRIC BLANKET IF YOU'RE WEARING A PATCH! As another poster noted, the heat greatly increases the release rate of the drug and it can quickly rise to lethal levels. I believe most of the deaths attributed to this patch were the result of use of a heating pad. If you get the patch between yourself and the heating pad, you're dead. Probably a decent way to go, since you just drift away in your sleep, but it's definitely to be avoided if you are not, in fact, planning to shuffle off the mortal coil anytime soon.

[jay13902]

I tried the patch (prescribed the 100mcg) but didn't notice any difference in pain so I slapped on a second one and still no difference, so after wearing two for a day and a half I finally called my doctor and got switched back to oxycontin.

[Chef Groovy]

Bit of a necro-post, but wth, have a few cents to throw in. I've used fent patches (albiet sometimes used ones) for about a year. They have a different "feel" to them, no real buzz like some of the norco can give, but I have to say, of all the times I wake up up not in pain is when have fentanyl in my system, it works great.

One word of caution, like I said sometimes I would use old ones from friends who only wore few days, I clean them off with alchohol and scrap with razor to try and get their skin off (or whatever), but can overdose pretty easier. It builds up so slow.

And OD'ing on them is not fun! I had 3 used 100's on and I guess she didn't wear them long cause, and I swear was seeing like little gnomes or something walking around the house, puking, and everything was all out of whack. and no way to stop the train. Pull em off, but then what? Just sweat and wait it out. Not good at all.

Also, keep in mind the stuff never goes out of the patch, can slice them up and mix in with coffee beans and put in coffee ginder, and have a "special" pot of coffee. Last all day. Even after wearing for 10 days. Gross, but still... Any port in a storm.

[rowanman28]

I took a Fentanyl patch once. I don't know why, but I booked myself into a mental ward for a couple of days. It wasn't that bad, or that good, and it was probably just me, but I didn't feel right. Reminded me a little of lighter gas.