Fentanyl patch

[Guest guest]

Hi everyone, My GP, who is in charge of my pain management, wants me

to stop taking my MS Contin and put me on a 3 day patch called Fentanyl

(not sure of the spelling). Has anyone used this patch and could I get

some good points and bad points about it? I like the MS Contin and

really find it to be the only med that helps my CP. I am hard pressed

to give it up as I have had CP since 4/2001 and this has been a great

help. I had a flareup 2 weeks ago and spent 3 days in the hospital. My

GP doesn't like the fact that I get nauseous and throw up my meds. He

seems to think that pain management is an exact science and doesn't

like me going thru my meds before the exact date I should. When I

throw them up, they get flushed down the toilet and I try to take them

again when things calm down. So, I end up looking for a refill a few

days early. I hope this note finds us all pain free and healthy...Jim

[Guest guest]

Jim,

I think you'll like the Fentanyl Patch. I'll be he started you on the

25, which gives 25 mcgs of Fentanyl each hour. It's a nice, even

dose, so you don't get the spike like you do with oral meds. The only

downside I've seen with the patch is that I have a dry mouth and

occassional sweating. Did he prescribe something for you to use for

breakthrough pain?

SamT

[Guest guest]

Hi Sam, I have an appt on 5/26 with him. I haven't spoke yet about

breakthru pain but I have to get something. When I eat, the pain goes

thru the roof. I usually take 20 mg of Oxycodone with each meal. I

only eat 2 x a day. I take enough meds now and if I ate 3 x a day I

would need that much more meds. Thanx, Jim

[Guest guest]

Jim-

I'm on the Fentanyl patch too. I started about 5 or 6 weeks ago. They

started me at a 25mcg patch and I've worked my way up to 75mcg. I too

find the patch to work better for me than oral meds. It's really nice

to have the constant relief. I also have sweats now and then, some days

more than others and some nauseau, but not as much as with oral meds. I

take my phenergan every 6 hrs as prescribed. I will be having my

surgery soon so I will find out just how difficult it is too wean off

of the patches. I have vicodin for breakthrough pain, but find I don't

need it very often. I do know how scary it is to have to change meds

when your in pain. That old fear stuff comes sneaking in and grabs you

by the throat. I hope that if that's the method your GP has chosen for

you that it will help you with your pain and that the transition will

be a smooth one.

All my best,

Rhonda

[Guest guest]

Jim,

I've been using the Duragesic patch, (Fentanyl), for well over two years now,

and have been totally satisfied with this type of medication, My pain

management doctor had me try all the other types of pain medications, MS

Contin, Oxycontin IR, Morphine, Percocet, etc., and the patch is the only one

that gave me continuous relief the most effectively. I started on 25 mgs. and

went up to 75 mgs. when experiencing the worst levels of pain. Now I've

been able to drop back to a maintenence level of 50 mgs., and have used

that strength for over a year.

You will need a short acting med for breakthrough pain, which does happen

occasionally for me, it may be more or less for you, as each of us is different.

For that I use Oxycodone, 10 mgs., up to 4 times a day if needed. We didn't

want me taking anything with tylenol, so Percocet, which is what I used in the

very beginning, was nixxed. The Oxycodone works well, too. I did find that

the patch only worked effectively for 48 hours, instead of the 72 hours that

they claim it's effective. Many other patients have had the same complaint,

and my doctor had no problems accepting the 48 hour schedule.

Some patients experience itching at the site where the patch is applied, which

is usually a reaction to the adhesive that's used to keep the patch attached to

the skin. A solution for this is to spray the area first with an antihistimine

spray like Benadryl first. Let the antihistimine dry for a few minutes before

you apply the fentanyl patch, and then apply hard pressure with your hand to

the patch for 60 seconds to help it adhere fully to the skin. Some people had

problems with the patch getting loose or peeling away from the skin before it

was due to be changed, thus rendering it useless. So, the company that

distributes the patch, Janssen labs, also furnish a free adhesive film that

covers over the duragestic patch, called " Bioclusive " . Once the Bioclusive

overlay is applied, there's no way that the medicated patch can fall off in the

shower or when swimming. The toll free number to call Janssen's Customer

Service to ask for the free Bioclusive adhesive patches is on the back of the

box that the duragesic patches come in.

An important word of caution, DO NOT let the doctor write your script for the

patches to accept generic equivalents. Make sure that he writes it for

Duragsic Patches in the dose that he wants to start you on, with " no generic

substitutions " . The generic patches have had a lot of problems and

complaints, and the doctor's have been notified that the generic's aren't

working properly. The patch itself should be worn on a flat surface on the

upper portion of your body, above waist level, to be most effective. I wear

mine on my back, rotating sites each time I change it. This avoids having one

specific area become irritated from repeated postitioning in the same place.

The only side effect that I've experienced on a long term basis that may be

linked to the patch has been excessive sweating, (at night only). The only

initial side effect I had when I started wearing them was some drowsiness

and a little bit of a dopey feeling, both of which went away within the very

first

week. About a month later, the night sweats started up. My doctors aren't

sure whether that's been caused by the patch or by my insulin, as both

medications list sweating as a side effect, and I have had serious problems

with night sweating for the past two years. I started using the duragesic

patch in the beginning of Feb. '03 and didn't notice sweating at the time.

Then in March of '03, I started insulin, and the sweating began. Since other

people have complained of that as a side effect with the patch, we aren't sure

which is causing it. I have to take insulin, so in that I have no choice. And

I'm

not willing to give up the duragesic patches in lieu of any other pain med,

because it works so well for me, so I've just learned to accept it.

If you have any other questions about the patches, please don't hesitate to

ask me for help.

With love, hope and prayers,

Heidi

Heidi H. Griffeth

www.pancassociation.org/anthology#Heidi.html

Bluffton, SC

SC State & SE Regional Representative

Pancreatitis Association, International

www.health.groups.yahoo.com/group/pancreatitis/

Note: All comments or advice are personal opinion only, and should not be

substituted for professional medical consultation.

[Guest guest]

hi Heidi, I will print out your posy and bring it to the Dr on

thursday. I am so glad I found this group. Thanks to all who answered

my query on the patch. Just knowing that other people understand what

I go thru on a daily basis makes me fell a lot less alone. I hope you

are all well...Jim