How to keep the duragesic patch on

[Guest guest]

This is for M.

I noticed your on the patch, I was on that too and it worked great but I

couldn't figure out how to keep it on and take a shower. I too can drive with my

pain medicine. with out my pain medicine heck no though, but my husband is

afraid of me driving and scared of me getting pulled over but I have a clean

record.

any tips of how to keep the patch on for me would be great cause I am tempted to

go back to that pain doctor cause he would give me the patch but I don't know

how to keep it on during the summer.

Thank you for all the advice in the world.

in Az age 32

--- M. wrote:

>

> I am on Duragesic (3 100mg/hr patches every 48hrs; delivering 450mcg/hr)

[Guest guest]

My doctor gave me a constant supply of boxes that are filled with this material

you put over bandages and etc. to keep them on. These things are so thin its

like really fine fine plastic that is sticky. I can't remember the name. I

can't get out of bed right now but I will post the name later. The doc also gave

me an inhaler pump with steroids to spray straight onto my skin before I put the

patch on so that the patch wouldn't eat up me skin

> wrote:

> any tips of how to keep the patch on for me would be great cause I am

tempted to go back to that pain doctor cause he would give me the patch but I

don't know how to keep it on during the summer.

[Guest guest]

TegaDerm or Askina Derm clear dressings (large versions of what they

put over an IV in the hospital) work WONDERS.

Most insurance will cover them. I get them delivered (for free) by

National Rehab (nationalrehab dot com). One of the many reasons that I

like them is because they work with almost every insurance company in

the country.

Sorry that it took so long for my to reply, my health has been VERY

bad lately. Plus, I got kicked out of my pain management doctor's

office for missing an appointment because my father in law (who was

supposed to drive me there) fell a few hours before and ended up in

the ER.

Steve M in PA

> wrote:

> any tips of how to keep the patch on for me would be great

[Guest guest]

where do you put your patch?

that sucks that you got kicked outta your pain doctor. I have yet to get my

blood and drug testing done plus see my primary care doctor again for a new pain

doctor, damn me!! I can be so damn lazy and I guess it's just much easier to

stay in bed in the cold. well my husband wants me to find a pain doctor that

will give the methadone to me considering he said it's the only medicine that

will make me do anything and he is probably right, i have a bad habit of

forgetting stuff, he don't forget much.

so if I was to go back to the patch, that's what works for you, where to you put

your patch on??

Thanks

in Az

> M. wrote:

> TegaDerm or Askina Derm clear dressings (large versions of what they

> put over an IV in the hospital) work WONDERS.

[Guest guest]

rub some rubbing Alcohol let it dry then put it on

> wrote:

> any tips of how to keep the patch on for me would be great

[Guest guest]

and i forgot i would put it on my left or right side of my chest

> wrote:

> any tips of how to keep the patch on for me would be great

[Guest guest]

Try using ace bandage to keep in place. I use it to hold ice pack in place.

Works well on knee and leg.

    Viv in C.T.

> wrote:

> any tips of how to keep the patch on for me would be great

[Guest guest]

There are several approved locations, but I find that the best location (for me

and for my wife) is on the upper arm, but sometimes I will put it on my lower

arm when the skin on my upper arms needs a break. My wife used to put it on her

upper back, but her shoulder blades cause too much motion which cause too many

issues with patch adhesion.

The MOST IMPORTANT factor in patch placement is how much that skin moves. Loose

skin causes issues.

Methadone is nice because it is cheap and affects the kappa opioid

receptors as well as the mu-opioid receptors. The only reason it isn't my

primary pain medication is that it has to be taken 3-4 times per day when used

for pain. It has a very long half-life, but pain relief wears off after 6-12

hours (for most people). The other problem with methadone is that there is no

extended release form.

Also, the largest pill is 10mg, so if you take 100mg/day, that's ten pills and

some people take more than 100mg PER DOSE (up to 40 pills per day). Methadone

also requires an EKG before starting it and another every 6 months to monitor

for prolonged QT syndrome. Some doctors will also want regular blood tests.

Duragesic is nice because it needs changed only once every 2-3 days. Most

insurance makes you start out with once every 72 hour dosing. Once my dose was

increased from 12mcg/hr to 25mcg/hr I could feel a drastic reduction in pain

relief and withdrawal symptoms 12 hours before each patch change, which

continued until roughly 12 hours after each patch change (the medication goes

from the patch to SubQ fat to blood, which take 12 hours).

When I told my doctor about it wearing off 12 hours before each patch change,

she wanted my to change it every 60 hours (2.5 days), until I reminded her that

it takes twelve hours for a patch to kick in and then she switched me to 48 hour

dosing. If you and your doctor decide that Duragesic is for you, you may want to

keep an eye out for this, and if you have problems, immediately report them to

your doctor. I have talked to (both verbally and online) dozens of people who

have used Duragesic as well as a dozen or so doctors and pharmacists and not one

of them has EVER even so much as heard of a patient doing well on 72 hour

dosing, they all required 48 hour dosing.

When you start Duragesic, you need to be opioid tolerant (taking at least

30mg/day oxycodone, 60mg/day morphine, or equivalent) for the 25mcg/hr patches

(or stronger). They came out with 12mcg/hr patches (which deliver 12.5 mcg/hr of

fentanyl). My doctor had me on 30mg/day oxycodone and switched me to 12mcg/hr

fentanyl, which caused me to go into withdrawal.

Duragesic has worked well for me, but it is not for everyone. Both

methadone and fentanyl can have life threatening side effects if doses are

increased too rapidly.

If you end up on Duragesic, I recommend that you go on the generic Mylan pacthes

as they are matrix based (no reservoir) and slightly safer than the reservoir

based Actavis patches. I have no experience with the new Sandoz patches, but

they are matrix based. Sandoz patches are authorized generics, meaning they are

manufactured by and identical to the name brand Duragesic patches (except they

say fentanyl instead of Duragesic).

Mylan will also provide Askina Derm free of charge (Sandoz doesn't). They will

mail you a form you have to send back. They'll ask you to mail it, but you can

email or fax it to get them faster and avoid the postage (just ask them for the

email or fax to send it to). If anyone needs the email of the person at Mylan

who handles this, I can look it up in my email.

I like the Tegaderm better, so I order them. Plus, I am on the largest

patches (100mcg/hr), which are too large for the AskinaDerm. They

technically fit, but there isn't enough of a border for them to work.

If you don't like one brand of fentanyl patch, just ask your pharmacist to order

a different one and try it out. Same goes for the overlays.

Steve M in PA

This is not medical advice. Do not change, start, or discontinue any

treatment without first discussing it with your doctor of other qualified

healthcare professional.

> wrote:

> where do you put your patch?

[Guest guest]

An ACE bandage can cause the patch to overheat and deliver too much

medication. I HIGHLY recommend that you do NOT use am ACE bandage over ANY

transdermal patch, but if you device to do so, PLEASE use EXTENDED caution.

An ACE bandage will also cause that skin to sweat, causing the adhesive to

completely release. The adhesive in fentanyl patches is hydrophobic,

meaning water (like sweat or saliva) causes it to release.

That would also cause additional skin irritation.

The monograph for fentanyl patches always says that you should NEVER cover

the patch with anything except clear dressings. There are several reasons

for this, including:

• risk of altered absorption, including overdose

• in the event of overdose, the EMT would not know that you are on it out

what side your on, highly critical information.

You can also use medical tape to create a border, but this doesn't work

nearly as well.

Steve M in PA, age 22

Married with 3 year old daughter

Non-text portions of this message have been removed]

[Guest guest]

Steve m

I thought you had to wear the patches on places with a lot of body fat. Do

they really stick to your arms? I have been wearing them on my belly as I sure

have a lot of fat there!

Becky

[Guest guest]

The amount of body fat is not important. There are small amounts of

body fat everywhere on your body, that's all you need. The patches

actually worked better for me when I had mostly muscle in my arms and

almost no body fat (before I got sick). Additional fat just means that

the patches take longer to work and the skin will move more, which

means that the patches [especially the larger ones] don't stick as

well. The thickness of the skin is far more important than the amount

of subcutaneous fat.

According to page 8 of Mylan's " A Guide to proper Application and

Use " , but the " belly " isn't one of the approved locations. This is the

same with all brands, Mylan is just the first one that came to my

mind.

http://bit.ly/xCJH7O

By the way, aren't the illustrations in this ridiculous? How many

chronic pain patients do you know with that much muscle mass? Are they

trying to make us feel worse? (And, it's not just Mylan, all of them

do it).

Duragesic Instructions (approved places- chest, back, flank, upper arm)

http://bit.ly/AfuIRb

Yes, they do stick on my arms fairly well (better than anywhere else),

but I do use Tegaderm overlays to keep them on (I didn't need the

overlays with the 12, 25, or 50 mcg patches, but I need overlays for

the 75s and 100s).

I hope this information helps.

Steve M in PA

I thought you had to wear the patches on places with a lot of body

fat. Do they really stick to your arms? I have been wearing them on my

belly as I sure have a lot of fat there!

[Guest guest]

Re:

My arms are skinny but I change from one arm to the other every 48

hours. I am on the 100mcg patch and use the Mylan brand as it seems

to stick much better. When I first started using them about years

ago, I changed from each side and under the breast but I was nauseated

which may have been because I was not used to them as I know longer

have that problem.

I had my second lower back surgery with ten years in between. I had

fusion, plates and screws put in just above the previous ones which

they removed.

I had a glorious three weeks of being pain free but all of the pain is

back. Since it has only been three months, I am praying that healing

will still take place.

I do have neuropathy in my feet that started about two years after my

first surgery.

I have had almost anything you could think of to try to find solutions

before deciding on the second surgery.

Wishing the best for everyone.

Lois

> Steve m

> I thought you had to wear the patches on places with a lot of body fat. Do

> they really stick to your arms? I have been wearing them on my belly as I

> sure have a lot of fat there!

>

> Becky

>

>