Fentanyl Patch Wearing Out

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Jessica Says:
via mobile

Hello. I am on the fentanyl patch, 125mcg every 72 hours. And ever since starting the patch I have been able to once again be more active. I exercise for an hour every morning and walk in the evening. My dr said the patch will last me 72 hours but by 48 and sometimes less, my pain begins to return and I start feeling withdrawl symptoms I use to feel on oxy or percs. I've tried telling my dr that I need to change every 2 days but he insists that this does not happen to anyone else. Does anyone here have the same issues? And are you feeling better results from different brands of the patch?



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1
Verwon Says:

Hello, Jessica! How are you?

Your morning exercising may be causing the problem. There are actually warnings with the Fentanyl patch that tell you that anything you get hot, sweaty or overheated, it causes it to release more of the medication, which in some cases has resulted in overdose. Thus, you may be absorbing more then, until your body cools back down, so it is unable to last you for the full 3 days.

The FDA classifies this medication as a narcotic analgesic, so it has the potential to be habit forming and may cause side effects, such as nausea, dizziness, drowsiness, dry mouth and constipation.

You may want to speak to your doctor and ask him to research it.

Is there anything else I can help with?

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2
Zumaraga Says:
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Hi Jessica. I was having the exact problem you are, where the patch worked well for two days but then I started having pain. Incidentally I have two crushed vertebrae in my lower back. Also crushed my pelvis and the sciatic and femoral nerve. But back to the story. When I told the Pain Clinic doctor what was happening he said almost 25 percent of the population have this issue and immediately changed me to a patch every two days. Proven much more successful. Good luck!

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3
TommyC Says:

Unfortunately most Doctors have not been on the medications they prescribe and are clueless as to the issues because they prefer to listen to the drug reps rather than their patients. The fentanyl patch does not last for three days as prescribed. I know several people on the patch and hear the same complaint from each of them. This reminds me of when Teva started producing and distributing OxyContin. The formula was so seak many people including me went I to opiate withdrawal. We have two big issues to deal with regarding drugs. The first is as I previously stated is the Doctor's lack of real knowledge on how these drugs affect patients as the Doctors have not taken them. Secondly, the drug reps over sell the benefits of the drug they are selling for a commission and rarely adequately explain the adverse affects and withdrawals. Your Doctor is not a God so you should let him know he is uninformed.

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Bettyboob Says:
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Hi Jessica, I had the same problem the patch never worked 72 hours for me either, my doctor changed it to every 48 hours. It allowed me to be able to function again. If your doctor won't change it ask him to try you on a different time release medication. I hope that helps you.

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Cyndee Says:
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I agree with you totally. I am on 100 mcg every 48 hours I convinced my Dr since I've been on the patch 7 years it wasn't working as well. Thank God I have a Dr that listens to me. Do you wear 2 patches? I thought 100 mcg was the highest. Good Luck

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Hop63 Says:

Jessica, I have used Fentanyl duragesic 75 mcg for several years. A few years ago I noticed that at 48-60 hours the patch was no longer effective. I spoke to my pain management doctor and he said that I had probably developed a tolerance for the medication. I began applying a patch every 48 hours (I try to hold out up to 60 hours) with Vicodin for breakthrough pain. My doctor's solution has kept me from increasing the dosage which would have been the alternative. Talk to your doctor. If you have insurance he/she can prescribe 15 rather than 10 per month. Honestly I am not as physically active as you are but in the hot weather I know the medication is absorbed more quickly than during cooler seasons. Hope this information is helpful. Good luck.

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Lanie Says:
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Yes and your doctor knows. I always changed every 48 hrs because I couldn't keep it on longer, it would fall off. Also After 2 days I would start to get a rash. You can try using either or both to see if Dr. will change it to 48 hours.

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Hop63 Says:

Jessica, I was told 100 mcg/hr was strongest. I try to keep two on until the "older" one should be removed. Often I rash or sweat it off before the 72 hours. I don't know how long it takes for a "new" patch to start being absorbed so the doctor said it was safe to wear the two for the remaining time. I have heard of patients wearing a 100 mcg patch in addition to a 25 mcg patch for severe pain. Maybe that's what the other person means.

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9
Jeff Says:
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I've been on the butrans patch for years and my doc let me take every 5 instead of 7 days wouldn't work for 7. Now I'm on the fentanyl and find it only lasts 2 days I thought I was the only one.

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10
Jeff Says:
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I'm not sure if I'm using this forum right but 48 hours is all I get as well

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Jessica Says:
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Thank you for everyone's info. I went to the dr last Tuesday and what he decided to do was take me down to 100 mcg and chNge every 48 hours. So I went through a day of minor withdrawls but I'm having to use breakthrough pain meds every day now when before on my first 2 days of 125mcg I didn't need any. I go back on Thursday and I'm going to have to tell him that it's not working. 125mcg is a perfect dose for me. I hope I can convince him to allow me to take the same dosage again. My dr is one of those who is so by the book, follows all the AMA guidelines and is completely paranoid about prescribing opiates. Which is hard to believe because he is a "pain management specialist". I know that they are really cracking down on prescriptions and auditing many doctors who hand them out like candy. I also know that it is only masking my real issues. My dr was really working hard on helping me with my Addison's, celiac, hypothyroidism, premenopausal issues. But it seems like he has given up. It is so hard to find a good integrated doctor who is willing to really dive in and get to the root of things. I found a practice not too far from me but because it is integrated medicine, you have to pay out of pocket. And it's expensive. I hope my dr will allow me to get back on my original dosage of 125mcg for 2 days. Just long enough for me to find a dr who is willing to work on difficult cases.

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12
Hop63 Says:

Jessica, I go to 4 different doctors. Two are covered by my insurance and two I pay out of pocket. I understand your frustration. My pain management doctor is an orthopedic doctor but he claims that he is watched very closely when prescribing medications that are controlled substances. He was understanding when I explained the patch did not work or stay on for the full 72 hours and that's when he suggested applying a new one every 48 hours. I hope you can find a doctor that listens to you and addresses your various health issues.

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13
phil Says:

Hi, i am a 52yr old male with arthritis in neck. I had exactly the same problems as you with these patches. I found that as soon as i got warm after only moderate exercise, the sweats became unbearable. The patches kept falling off. I was feeling withdrawal symptoms between changes. I came off patches from 90mg, dropping 30mg at time, used oramorph to help. I took the last 30 mg patch off 7 days ago. I had no more oramorph. It's been rough week but only have upset tummy at moment, so feel it's nearly over. I won't be using fentanyl or morphine again. I hope you find something better than these patches, because i felt they were inadequate. Good luck, Phil.

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14
Hop63 Says:

Phil, I am not familiar with the pain medication you were using. However, this past summer with the hot, humid weather in NY made it impossible to keep the fentanyl patches in place for even 48 hrs. I tried using tegaderm patches ( 3 of them ) to keep one 75 mcg/hr Par brand patch in place. My skin got burned and cut from the adhesive. Would like to get off the fentanyl. Can you provide any additional info. About the medication mentioned in your post? Would it be an alternative to fentanyl?

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phil Says:
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Hi, the oramorph is liquid morphine. 5ml spoon =10mg of morphine. I used this to ease the withdrawal symptoms. Only using as much as i needed. Coping with some of the withdrawal symptoms. Been off everything for over a week now and only have slight tummy upset. My worst symptoms have been back and stomach pain. Also restless at night. I hope this info helps.

Phil.

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IrishColin Says:
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My doc prescribes it for every 48 hrs. No big deal to him. I am opiod tolerant AND a large person. (Big guy). Sooo... maybe your doc is just one of those skittish ones who do not like prescribing drugs that are very, very poten


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Jessica Says:
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My dr is extremely paranoid. He compromised with me and allowed me to change my patch every 48 hours but I had to go down to 100 mcg. So I've been doing so for the past almost 4 weeks. It's been really bad. Usually I only have to take oxy on the 3rd day being on 125 mcg because it completely wears off. I have severe pain and withdrawal like symptoms. But now I'm taking oxy every day because I have constant break thru pain. I go back on Tuesday. I'm going to tell my dr that I would rather go back on 125 for 72 hours. It's better to have 2 good days and oxy on the 3rd day than to have constant bad days. I hate taking oxy. I feel like a slave to the pills. But I have to tread lightly with my dr. I don't wNt him to tank my patches completely. Idk what I would do if I had to go back to living the life of severe agonizing and debilitating pain I did once before. I couldn't live through that again. I wish he would just give me a break. I know 125mcg is the perfect dose for me. I even showed him this website and how many others change their patches every 48 hours. He says those Drs should lose their license. Unbelievable. If it wasn't for my ortho surgeon who knows my pain because of the state of my shoulders (two torn rotator cuffs and much more) and my neck (collapsed discs and large bone spurs) and already having 3 surgeries and waiting on the next, I don't know what would of happened to me. He's the only one that has made sure I don't suffer any more or longer than I have too. And my dr thinks that I should not have any other surgeries. "People walk around with torn rotator cuffs all the time, it's not that bad, it's mostly phycological", is all he has to tell me. But no other Drs will work with me. I'm not a difficult patient what so ever. My case is just difficult.

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Milo Says:

Hi, I have had the same problem from the day I began Fentanyl. I ALSO have found activity and LIFE again with Fentanyl... Also the bonus is not having to stop every 3-6 hours to take pain meds, and having meds in me 24/7 allows me to be more mobile in the morning as I am not waiting on drugs to kick in.

I am a hot person, I sweat a lot and am ALWAYS hot. I also am very active. I had a problem with patches either falling off or loosing effectiveness after 2 days as well. So what I did, was ask my doctor to write my rx differently. I took 50 mcg at the time. So she wrote the rx for "25 mcg patch dispense 20, use 1-2 patches every 2-4 days" This allowed me to wear one patch for a day or so then add a second should i need it. And it made her feel better knowing i was trying to use the lesser dose and by writing it to use every 2-4 instead of a flat 3 day rate. The 4 day allowance made my doctor more comfortable with it.

What I suggest is ask the dr to wrote your rx for " 75mcg patch dispense 10 use 1 patch every 2-4 days" AND ALSO write a second rx "50mcg patch dispense 10 use 1 patch every 2-4 days". This will allow you better control over your dosing as well. I found that if I was not active and had no plans I could do just fine with one patch, but if I planned on lots of work or travel I would apply the second patch. I also liked that it allowed me to accumulate a reserve supply of patches. Because the ONE MAIN PROBLEM with the patch is adhesion. I have had patches fall off after only 5 hours use.. and they NEVER re stick. And if ONE patch falls off you become one patch short at end of the month. In the USA I found myself saving the fallen off patches to take to the doctor to PROVE it did fall off. I hated that. Now I live in Canada, and the doctors here are more trusting than that. I recommend ANYONE living in the USA on Fentanyl call the drug company that makes your patch and complain that you LIKE using the patch and PREFER it but feel you will HAVE to change meds due to adhesion issues, and ask can they help. I did this and Jansen would send me a box of 100 patch covers called TEGADERM, every 2-3 months, I just had to call and say I was running low and they would send out a new box. These patch covers are a god send It is the same material the hospitals use to keep an IV stuck on to a person. The patch covers Jansen used to send me were rather large, about 3x6 inches. A patch cover that size is QUITE expensive. I can buy a box of 8 SMALL 2x3inch tegaderm in the drugstore for $8 Canadian. But, in the hospital pharmacy I can get them for 35 cents each... the 3x6 patch are STILL $1.30 or so Canadian EACH!!! So the free supply from the drug company is a true blessing. (They dont give these free in Canada, but DO still in the USA) If you do not need the covers, I say STILL get them free, I had stopped Fentanyl for a while and had a full box of covers remaining. I discovered 101 uses for these things over the years, I used them for photo covers, phone covers, the list could go on and on.

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19
Hop Says:

Jessica, I don't feel any of my doctors provide an integrated approach. I have fibromyalgia and rhematoid arthritis. I see a pain management doctor, rheumatologist, osteopath, and a psychiatrist. Each strictly adheres to the meds that their "specialty" allows them to prescribe. Two of the doctors do not accept my insurance. I don't think any one has spoken to one of the others about the best treatment plan for me, their patient. An integrated approach would be great, time saving and probably money saving with better results.

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stephendvd Says:
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Jessica tell ur doc to give u opana er 15 to take night before ur third day .. I did this till I had my doc change me to every 2 days ... im off all meds now exploring other Av of pain management .. acupuncture massage therapy and hot I mean hot hydro therapy

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