Fentynl patches? has anyone had luck with them?

[Rockieroads]

I got some of these at 15mg and they did nothing for my pain in my lower back. I called my doctor and he upped it to 30. Tried them twice and still nothing, it didn't even take the edge off. He wanted to give me patches that began the a B (can't think of the name) but my insurance company refused to pay for them. The pharmacist said they are very costly. But wondering if anyone had any luck with these patches. My husband didn't either years ago when he got them and neither did a friend of mine. Maybe we are intollerant to them or the pain we have is too harsh for these to ease it up.

[betsky]

I got some of these at 15mg and they did nothing for my pain in my lower back. I called my doctor and he upped it to 30. Tried them twice and still nothing, it didn't even take the edge off. He wanted to give me patches that began the a B (can't think of the name) but my insurance company refused to pay for them. The pharmacist said they are very costly. But wondering if anyone had any luck with these patches. My husband didn't either years ago when he got them and neither did a friend of mine. Maybe we are intollerant to them or the pain we have is too harsh for these to ease it up.

@Rockieroads
i didnt even know the patches started at 15mg. usually they start at 25 than go to 50.
the alternative id probably the new bupronephrine patches which is another way for big pharma to make $ off soboxon or subutex.

[Rockieroads]

Oh great. I can't even keep one on all night. I think I am just going to tell him like it is that they did nothing. I thought I had one day when it seemed ok (the pain) but I have those days without the patches. Well, thanks for the response and feedback.

[photogirl1980]

on a scale from 1-10 what would you say your pain level is? the patches only work well for people with a pain level of like 3-5, or so i have heard. my friend has back pain and complains that they work well on days where he doesnt move around much and his pain is minimal.

[Hugo]

Fentanyl patches are dosed in micrograms (mcg), not milligrams(mg), and are for moderate to severe chronic pain, not mild to moderate pain (i.e. 3-5 on the scale).

[betsky]

@Hugo
actually they are for moderate to severe pain, chronic. I was on them for 3 years b4 i realized how quickly my body tolerated them and it took a detox program using suboxone, then methadone to get off them. they are nothing to fool around with.

[mmille42]

@Hugo, can I ask you how you liked the suboxone? Did it help you and did it give you any side affects? I hear a lot of people talk about it? Thanks..

[betsky]

@mmillie42
actually it was i that went through the sub process, i know some members have been on it for years, same as methadone. unless you are really in a bad situation, please avoid it. there are several threads devoted to both these medications I suggest you read through these threads b4 making any life altering decisions

[alumni]

I got some of these at 15mg and they did nothing for my pain in my lower back. I called my doctor and he upped it to 30. Tried them twice and still nothing, it didn't even take the edge off. He wanted to give me patches that began the a B (can't think of the name) but my insurance company refused to pay for them. The pharmacist said they are very costly. But wondering if anyone had any luck with these patches. My husband didn't either years ago when he got them and neither did a friend of mine. Maybe we are intollerant to them or the pain we have is too harsh for these to ease it up.

Are you sure you're talking about fentanyl patches?
As noted, there is no such thing as a 15mg or 30mg dosage. The dosages go from 12mcg/hr to 100mcg/hr.
The only patch I'm familiar with that starts with a B is the Butrans transdermal buprenorphine which comes in doses from 5mcg/hr to 20mcg/hr. It is fairly new, still on patent and can be pretty expensive for a one month supply. It is also prescribed for severe pain like fentanyl is but is nowhere near as potent.
I'm surprised that anyone would find that fentanyl patches "did nothing" for pain treatment. Although the dosages are time released in microgram amounts, the active narcotic is approximately 100 times stronger than morphine on a comparable comparison.
If an appropriate dosage of fentanyl is having no effect on your or your husband's chronic pain, I guess the next step up the pain ladder might have to be consistent IV administration of an opioid such as morphine. In most cases, that is only done in a hospital setting, hospice or in a home healthcare situation.

[smokinjoe]

@alumni,I respect your postings here,and when I see your postings in know there is a no $hit answer Could not Kadian help in this persons case?

[UGAgal]

Yeah I dont think you were on a fentanyl patch. They are 12.5mg, 25mg, 50mg, 75mg, and 100mg.

I was put on the patch from a PM doc after being sent straight to the ER from the MRI place and I had serious issues on the 25 mg patch because I had not been on ANY opiates at all. No percs, no nothing for a bit. The severe headache and nausea and it was awful. I finally took it off after I realized that I had NO BUSINESS being on this patch and the doctor OVER REACTED BADLY......... and now I have been doing ok. Had surgery and he has me off pain meds to see how my hips reacts to the back surgery which is still in a lot of pain but I am trying.

I would seriously ask what he had you on because I do not think it was either the pain patches listed in this thread. There is no such dose for those.

[alumni]

If they are not experiencing any analgesia from fentanyl transdermal, it's very doubtful that an extended release morphine formulation like Kadian would be any better.
I'm still amazed that this person feels like they could be "intolerant" (assume that means immune) to this drug. The only people I've ever encountered who were not affected at all with using fentanyl were long-time, very heavy opioid drug users or a pain management patient whose physician totally screwed up the painkiller equipotency conversion when substituting the patch for another narcotic like OxyContin.
Fentanyl, when properly dosed, is an excellent choice for treatment of severe chronic pain. Infrequent dosing, less likely to be abused or diverted but expensive and, for some people, not effective for the full 72 hours.

[betsky]

@UGAgal is correct. if a person had been on high doses of other opioids then the fentanyl might be an option. for you@ugagal your dr was a quack. it states ery clearly not to be used for postoperative pain. and if the dr. was aware of your low tolerance than you were very smart to pull the patch. the first side effects when administering the fentanyl are nausea and headache. had you been on opioids recently i would have suggested to give it 20 more min. for the antiemesis effects to go away and the pain receptors in tne brain to start using the pk.
but the packaging papers specifically state not to use post op, mainly because the patches do take approximately12-14 hours to "kick"in and a different med would be necessary in the interim.
the only reason i was released from the hospital on 25mcg patches was
#1-I was on dilaudid for 6 days in hospital.
#2- i had taken lortab pryer the the fusion.
#3- i could not tolerate anything oral at this point. I was "fed" parentally and had no gag reflex after c-2 to c-7 were fused.



@Rockieroads, may i ask what other means of relieving the pain had been used prior to the patches?

[Hugo]

@Hugo
actually they are for moderate to severe pain, chronic.

Yep, that's what I said in my earlier post, and it's why I was surprised that someone suggested they were only useful for mild-moderate pain. When it comes to chronic pain relief, they are about as strong as you can get, outside of parenteral opioids in a hospital setting.

[betsky]

@Rockieroads
@Rockieroads
i just saw one advetised for $90 each at 1600 mcg. um do you think this is for real?

[UGAgal]

@UGAgal is correct. if a person had been on high doses of other opioids then the fentanyl might be an option. for you@ugagal your dr was a quack. it states ery clearly not to be used for postoperative pain. and if the dr. was aware of your low tolerance than you were very smart to pull the patch. the first side effects when administering the fentanyl are nausea and headache. had you been on opioids recently i would have suggested to give it 20 more min. for the antiemesis effects to go away and the pain receptors in tne brain to start using the pk.
but the packaging papers specifically state not to use post op, mainly because the patches do take approximately12-14 hours to "kick"in and a different med would be necessary in the interim.
the only reason i was released from the hospital on 25mcg patches was
#1-I was on dilaudid for 6 days in hospital.
#2- i had taken lortab pryer the the fusion.
#3- i could not tolerate anything oral at this point. I was "fed" parentally and had no gag reflex after c-2 to c-7 were fused.



@Rockieroads, may i ask what other means of relieving the pain had been used prior to the patches?

I was not given the patch for POST OP - I was given the patch WELL BEFORE my surgery - after being sent to the ER in such severe pain during an MRI. My doctor overreacted with how to treat me and freaked out because I was in so much pain. I came off the patch and onto opiates and we got a good balance. I have SINCE had sugery and I am doing better but still have bad hip pain and that surgery is next.

The doc that put me on the patch was a new PM I was going to see and he just freaked because my pain was so severe. He admitted it and I also admit it. But he is a good doctor that has had compassion on me. He just over reacted to a situation that was pretty bad at the time. Anyways, it is a long story that happened back in december. He and I have talked about it and over it all together.

I really start back to see him again soon to treat me until hip sugery. I get released next week from back surgeon.

[alumni]

Yeah I dont think you were on a fentanyl patch. They are 12.5mg, 25mg, 50mg, 75mg, and 100mg.
I would seriously ask what he had you on because I do not think it was either the pain patches listed in this thread. There is no such dose for those.

Just a clarification. The fentanyl patch doses are referred to in micrograms per hour (mcg/hr) not milligrams (mg).
A microgram is 1/1000 of a milligram.
Big ass difference.

[UGAgal]

Just a clarification. The fentanyl patch doses are referred to in micrograms per hour (mcg/hr) not milligrams (mg).
A microgram is 1/1000 of a milligram.
Big ass difference.

Thanks - I did not realize that.... yes BIG difference

[betsky]

oops edited out a stupid remark

[alumni]

For one thing, it's supposed to be used as a breakthrough pain med in only the most serious pain situations and for only patients who are up to their eyeballs with opioid tolerance.
Personally, I've only seen the 200mcg and 400mcg doses used and they were in an in-patient setting.
There's a whole complicated absorption process associated with these "pops" but the bottom line is that approximately 25% of the fentanyl is absorbed immediately into the bloodstream via the buccal mucosa and 25% eventually through the GI by swallowing. 50% is useless for analgesia.
So, a 200mcg dose would deliver 50mcg immediately and another 50mcg over 30-40 minutes.
You can see why the 1600mcg dosage is reserved for extremely acute pain conditions.
I'm surprised you haven't run into Actiq during your nursing career.