Fentanyl Patches

[Guest guest]

Heidi,

You wrote, " ..to the 48 hour dose period, instead of 72. It's

worked so well for me, and I haven't had to upgrade my dosage.. "

I forgot to address this in my other post about the patches. I found this

peculiar that you wouldn't be able to access the medication in the patch after

the second day. I actually have medication in my patch at 72 hours. It would be

interesting to see if there really is an inconsistent flow of medication.

Based on the theory of changing the patches every 48 hours, the premise would be

that the majority of the medication is released in the initial 24 - 48 hours,

and then slows in the last 24 hours.

I had this conversation with a Janseen rep once, and their take on this is

that there is no way for the Fentanyl to be delivered at alternating or various

rates of flow, when applied properly. Key words: applied properly. [Well, that

can differ off the bell curve.] The reason why the patient senses a decrease

delivery of medication on the third day is usually due to loss of contact with

the skin. When this occurs air pockets can develop, and subsequently dry out

the side of the patch where the medication is delivered. The Fentanyl Patch is

flattened when there is no more medication inside.

I found that even with the use of the bio-occlusive covers that Janseen

provides, when these are applied in a particular way, it can secure the patch

onto

the skin, but it causes the patch to 'buckle and 'pooch' (not pouch, but

pooch). What I do to get every single drop of medicine out of my patches is

apply

them to my shins and the sides of my lower legs. I do not put them on the back

of the calf because there is too much movement in that muscle. When placed on

the shin, it is relatively flat, and they stay for the duration of the three

days. I also always wear moderate to heavy compression knee highs (the medical

kind) and these provide a very nice support to the patches, always keeping

the medication delivery portion next to my skin, with no possibility of lifting

and getting air exposure.

I use three 100 mcg patches at a time, changing them every three days. The

other technique I use is to stagger the change out days, so I am changing one

every day, if that makes sense. There is something nice about a fresh clean

patch.

Karyn E. , RN

Executive Director, PAI

http://www.pancassociation.org

Pancreatitis Association International