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Fentanyl 100mcg/hI was wondering how these patches actually work, if anyone knows specifically. I know they work by transdermal, thru the skin and into the blood, or under the skin, whatever. But I was wanting to know HOW it actually releases the Fentanyl. I have looked at the patches, but I see nothing obvious to the naked eye. are there microscopic holes in the patch? To make is more specific, how does the narcotic transfer from one side of the plastic to the other? assuming it is plastic or rubber I asked the doctor to raise me to opana, but he kinda thought maybe oxycodone, which i didnt really like b4. So he suggested the Fentanyl patch b/c of the low potential of misuse or overdose, since the patch would only relase my specific dose. He does know that I am opiate tolerant trying dilaudid, oxy and hydro b4 with no real relief, altho the hydrocodone did the trick for a long time. He said I have became opiate-tolerant due to the latge doses of hydro. I have had this patch on since 11AM - which was 11 hours ago, and so far I AM VERY SATSIFIED with it. anyone??? thanks for any help in advance. ( categories: Discussion of Prescription and OTC Meds )
 opana(oxymorphone) has highest critera
Here's the gov't criteria for opana(aka,blues) VHA Pharmacy Benefits Management Strategic Healthcare Group and the Medical Advisory PanelThese criteria were based on the best clinical evidence currently available. The recommendations in this document are dynamic, and will be revised as new clinical information becomes available. This guidance is intended to assist practitioners in providing consistent, high-quality, cost-effective drug therapy. These criteria are not intended to interfere with clinical judgment; the clinician must ultimately decide the course of therapy based on individual patient situations. Criteria for Use Yes No Patient must meet all of the following criteria to use oxymorphone oral tablets. Patient has moderate to severe pain Patient is able to take oral solid medications (intact tablets) Patient has had documented intolerable adverse effects to ALL of the opioids listed below (according to oxymorphone formulation), and the adverse effects persisted despite aggressive measures to alleviate them and prevented upward titration of dosage to achieve a satisfactory level of analgesia. Oxymorphone formulation Prior opioid trials required Immediaterelease tablet Hydrocodone / Acetaminophen Morphine Oxycodone Hydromorphone Extendedrelease tablet Morphine Methadone (see exception*) Oxycodone Fentanyl transdermal Levorphanol (nonformulary) * Methadone should ideally be initiated by or in consultation with a practitioner who has knowledge in titration of this agent. In situations where there is no practitioner or consultant with experience in using methadone for chronic pain, another long-duration opioid may be used until such consultation can be obtained. Also refer to Methadone Dosing Recommendations for Treatment of Chronic Pain available at http://www.pbm.va.gov. Patient is under the care of a pain management specialist. It is recommended that providers ask patients to review and sign an Opioid Agreement. Providers should also advise patients to take oxymorphone tablets consistently on an empty stomach, avoid alcohol consumption during therapy with oxymorphone tablets, and inform their provider if they are unable to adhere to these precautions. Fentanyl patch
hello knitemetal, I did some research on how the patch works and I couldnt fint too much stuff on it. I tried a few sites and gave up. What I did find out that it some how metabolizes thru the skin and releaves pain, it is very interisting to me as to how the "correct" amout is metabolized for 72 hours. There must be some microscopic release system or something. I have heard that they are extremly effective in pain management, you dont get the highs and lows that you get when you take long acting and short acting narcotics. I have heard also that they dont last 72 hours and some doctors prescribe them every 48 hours. Also just wondering what did you dr give you for breakthrough meds. That always interests me because 100mcg Fentanyl patch is the highest you can go in the pain med world. I was just curious. I have also read in maby places that the generic Mylan patches are better or more effective than the durugesic. Kind of like the mallk vs watson vs qualitiest hahahahahahah. All my information is just from resaerch, please do not take it as medical advice. See you MD first....
anthony ok
Ok, thanks on your research, both ANTHONY and WOLVERINE. I will check some places myself today. Well I suffer from seizures and everytime I have one, I seem to fall and break something. I have alot of messed up discs in my neck and back, have fallen face first into concrete and broke jawbone, nose (i know isnt a bone) and some other bones in that area. I tried the usual (or ununual) high doses of hydrocodone, oxycodone, dilaudid, and one other I cant think of right now. The patches that I have are the JANSSEN. While I do not like the MALLIKRODT products, I have to admit that I havent tried any other kind besides the JANSSEN, so I dont really have any idea, but these are working awesome, so i dont really feel the need to change (yet). I do think however that my insurance only pays for the JANSSEN. you said: "I have heard that they are extremly effective in pain management, you dont get the highs and lows that you get when you take long acting and short acting narcotics." --- So far this ALL seems to be very rue, i have NO problem going to sleep or waking up (like I did with the other narcotics). You dont really feel a "high" or "low" it is a continuous PAIN-FREE well-being feeling. Which is just fine for me, since it does KILL-PAIN tremendously - close to 100% if not 100%. And it also makes you feel good, not a "high", just an awesome WELL-BEING feeling. it has only been 21 hours, but it is still working great, will let you know about the 72-hour thing. He did tell me NOT to wait 72 hours though, and told me to change it a couple hours b4 the next patch is applied.
KnightMetal I am not an MD I know by experience only Please do not take advise from anyone, consult YOUR MD 1st What for break thru
Zomg.I used duragesic 25mcg/hr 1 time when I hurt myself bad at a good temp job and could barely walk.That had me working 100% for 3 days then the pain was gone. The pain doctor I used to see when I had private insurance,not for pain but you basically need a pain doctor to treat anxiety with xanax.However I took notes and seen some real high end fast acting stuff for breakthru that cost another fortune im sure(the rep gave him a fire extinguisher with the brand on it). I know fentynal+versed(midazolam)=assisted suicide.Most pain docters probably already have you on xanax 2-4mg/day to potentiate the analgesic.If I was a licensed doctor,even just being a common sense person.I couldn't see adding any additional c-2 agonist to that med(fentynal) most pain docs would probably give you some 10mg percacet's(most likely has a placeabo effect) .since to increase past where you are although doable would not sit well with all patients who have tendancy to over react and accidentally overdose. However for severe breakthru on the most powerful narcotic,there is another class of pain killers.Dissociative analgesics,aka Kedamine.where you would just leave you body for an hour or two.This might be a tough sell but it would be safe. But if you have a doctor that is that good you better wash thier car and send them and thier staff holiday cards,also never visit him/her with less than 2 pounds of butter in order to properly butter them up. here is my under standing
here is my under standing how it works, the fentanyl goes through the patchand your fat absorbs it, then you fat acts as a controlled release mechanism. thats my 2 pennys. i'm not a pharmacist or doc don't listen to me i just have done alot of research on this stuff. talk to your doctor about it  Here is the link to
Here is the link to Duragesic.com's .pdf file. It explains how the drug works, but you have to do a lot of reading, while googling some of the words, in order for it to make sense. gtrplayer knightmetal
see my reply below....also they started me on 25 mcg/h,50,75 til I got up to 100mcg/h in about 2 months. by the way, try to remember to change the patch at the right time ( I'm every2 days myself) if you forget to change it, you be sweating, miserable and in horrible pain.....every time I forget, I'm like whats wrong with me? DUH!
Kim I really like using
I really like using fentanyl, and am glad you are having a good response so far. The dosing of fentanyl is a little unusual because of the very long time release, and after 11 hours use you would not have a full theraputic dosage in your system. Dosage increases with the fentanyl patch are only supposed to be undertaken every 5-6 days, because it takes a few days to get to a steady state. 100mcg/hour of fentanyl is something like 400 mg of morphine a day or 133 mg of oxymorphone! re: Dr. Lois
It has been almost 2 days with Fentanyl, and it is EXCELLENT!
hydrocodone, OC are NOTHING compared to the patch. I could NOT ask for anything better, there is nothing!
Stops the abuse, releavies the pain. What more can I ask? nothing!
MIRACLE DRUG indeed!!!
--------------------------------------------------------------------- KnightMetal I am not an MD. I know by experience only. C fentanyl
It has been 2 days on the fentanyl. It is working better than any pain med I have ever took, and I have even had morphine (which I know isn't as strong) through IV and it didn't work near this well. It is almost time for the next one, and it is working like a miracle! I could NOT be more satisfied with this pain med!
This has to be the "pain med miracle drug" for years to come. One question, Dr. Lois, if for some reason (highly unlikely) I experience pain, taking something like a Hydrocodone, would I even benefit from it? I doubt it, but got to ask. I would not even feel it would I, going by the opiate calculator on here, it would be useless, yeah? It would be like a placebo in my case I am guessing. I do know not to take any other opiate while on Fentanyl, since it would be almost impossible for me to feel pain now, right? Also, I take the 2mg Xanax 4 times a day, is this normal with the patch? Thanks! Pharamicies look at me like a am a "drug addict" when I fill my prescription, but I guess that can be expected. I ignore them anyway! ---------------------------------------------------------------------KnightMetal I am not an MD. I know by experience only.  That dose of xanax is not
That dose of xanax is not normal period, especially in combination with a 100mcg fentanyl patch. Does the same doctor prescribe both medicines? If not, does the doctor know you take 8 mg of xanax a day. Although I'm sure you are tolerant to both the effects of opiates and benzos, you are still putting yourself at risk for fatal CNS depression. Do you take xanax for anxiety or as a muscle relaxant? Anyway be careful man. Also it is not that uncommon to have BT meds prescribed, but I would be weary of taking anything else with your current daily regimen. Check with a licensed MD before you take any suggestions! yes
It is the same MD. and it is anxiety, he also said 2 make sure I dont take over the prescribed amount. I also take Remeron to sleep, but he is cool with that. He used to give me SOMA, but suggested against that that.. Just in time 4 that, since insurance does not pay 4 soma anymore anyway as of a couple days ago. --------------------------------------------------------------------- KnightMetal I am not an MD. I know by experience only. I like fentanyl patch for
I like fentanyl patch for exactly all of the reasons you stated as well. However, the other reason it may be working so well is you may have been underdosed on your other previous narcotics. Like I said, 100mcg/hour of fentanyl is about equivalent to 400mg oral morphine a day. Saying one narcotic is stronger than another is misleading. 400mg of oral morphine is MUCH stronger than a 25mcg/hour fentanyl patch. So you cannot say fentanyl is stronger than morphine without specifying a dosage. Since there is really no upper dosage limit for narcotics, as you develop tolerance, you can just keep uping and uping the dosage indefinitely. You can also use multiple patches at once. I have used up to 175mcg/hour. I have seen 300mcg/hour used. Regard the temperature warning posted by Quahog! Key to not being treated
Key to not being treated like a drug addict: 1. Don't wait until you are out of meds before bringing in a script to be filled. 2. Give the pharmacist at least 4 working days before you actually need your refill. 3. Always use the same pharmacy. 4. Don't wait until you are having withdrawal symptoms to get your script filled. 5. Dress and act how you want to be percieved. answer about fentanyl
Hi, Ive been on fentanyl transdermal patches 100 mcg/h for 3 years, it leaches into your skin thru the membrane that is actually stuck to your skin. Along with the glue is a skin type membrane that allows only a certain amount of medication into your system, thats why you must never cut the patch because it could OD you, anyway I use the sandoz brand its much like the name brand in the way its made, i don't like the opaque patches(cant see thru) tthis type patch delivers the meds a bit differently but still thru the skin, the gushy ones (gel inside) work best.I'm still on breakthru meds but still better off now than before the patches. I hope this was understandable. Kim  Hey there KM, I just wanted
Hey there KM,
I just wanted to give you some friendly advice on the patches.
I am sure your doc, pharmacist, etc. has gone over this with you but just in case they haven't make sure you don't get the patches overly hot or warm. The patches are heat activated and by allowing them to get too hot it could potentially cause an overdose. Things like exercise, hot showers, hot tubs, heating pads, blankets, wearing a jacket indoors should be done on a limited basis. It has even been suggested that having a fever could cause some issues. I can't speak on the others but I know first hand how wearing a jacket indoors for too long during the winter can cause problems. Fortunately for me I have a high tolerance but it still looped me out for awhile. Also, if you find the patches are causing your skin to become red and itchy at the patch site you can use a steroid nasal spray (Nasonex, Flonase) on the skin before putting a new patch on. It helps a lot !!
Wow, wish I had the same
Wow, wish I had the same luck all you did. I found he patches were more of a pain just to work with them. Sometimes they wouldn't stick good espexially like weather we are having now, hot summer days. Depending on where you placed them sitting in a chair put more pressure on them hence med transfer was better then they get loose again and transfer was not so good. I even paid big money for name brand because my insurance is not that great. I would retry them if you all could give me some suggestions that I think would help because the one thing for sure is the length of time they should work for and not have to have a pill around. Thanks. Those are all big problems
Those are all big problems with the patches. I have a patient who swears the little skin colored patches stick great even in the summer, he has also tried a special glue that is sold for use with the patches and says it works well with the large clear patches. I have another patient who puts the patch on his arm, the wraps it with a single layer of cohesive bandage (This type of bandage is made from a very loosly constructed stretchy material, and when stretched sticks to itself without tape). Both of these patients work full time, outside, physical jobs, so the summer heating problems and sweating are a real challenge for them. To prevent variable absorption due to temperature, try putting them on an area of your body that doesn't get as hot like your upper chest or arms. Biggest plus for fentanyl for many patients who have tried it is that they can sleep in and not go into withdrawal! That also is a big advantage of Opana, and bid dosing of Kadian. fentanyl
\ / I was told about a few of those things, he just told me basically to "respect" the patch. I have had a lottle of the itching, but not enough to where it becomes bothersome, yet. Thanks for the info, quahog! / \ ---------------------------------------------------------------------KnightMetal I am not an MD. I know by experience only.  A quick point to Dr. Lois
I know it would be best to give you pharmacist four working days before you need a refill, but in most cases, that just doesn't work. As you know, C-II drugs are not refillable, so you're walking in the door with a written script in hand. I always try to give the pharmacist a couple days (if needed) before I really need the prescription. On C-III meds that might have refills, a lot of doctors don't really like you filling too early. I know my insurance company will give a five day grace period on refills, but some docs want you to fill a day or two out. You're looking at it from one side of the desk and we have to be realistic and do as our doctors approve. I do agree with you however, on the manner you dress and present yourself. Director I have
I have a unique problem. One of my patches will NOT stick, it was like it didnt have any glue or adhesive stuff on it at all. Therefore I can not get it to stick on my arm. I had no problem with the other patches, just this one. I have no idea what to do. Use tape? (although, that would look really stupid, I really dont care what it looks like) Just wondering if someone else out here ever had that kind of problem, and what they did to resolve it. I still have a couple hours til I absolutely have to change it. Thanks
_______________________________________________________ KnightMetal I am not an MD. I know by experience only. Consult YOUR MD 1st! ___ patches
"If you put it on your arm, just wrap it with an ace bandage. I used them for my nicotine patches when I quit smoking, worked fine." I actually did that before I read the message, but thanks! and it DOES work!
_______________________________________________________ KnightMetal I am not an MD. I know by experience only. Consult YOUR MD 1st! ___  I am not too familiar with
I am not too familiar with these patches, but I think I remember people saying that overheating is a problem (too much drug will be released) so Im not sure sealing it up with an ace bandage will be too good an idea. Im pretty sure they sell glue thats designed specifically for this problem also. I guess you could use tape along the edges so air can still flow over the patch so it doesnt over heat. Cant you just use a different one,if its time to replace it anyhow, and let your doctor know you had a problem and would need a replacement? the pharm
Yeah, I thought it would work right. but I called the pharmacy where I got them and they told me to NOT do that, luckily I only had it on for about an hour. They also told me that they could NOT accept it as a "return" due to some state law. So i asked them what I could do, they informed me to try to use another patch, which I did, but I would eventually have to use that damaged one. So they then told me to bring it with me before my next "refill" or if I could make it there before. I dont know what they will do, but they will do something, I suppose. Will post what happens. Apparently, this has happened many times before. _______________________________________________________ KnightMetal I am not an MD. I know by experience only. Consult YOUR MD 1st! ___ about the try everything
about the try everything before opana, i had to do that with everything before i could get my oxycontin, methadone, gave me severe reactions my doc said i could have died :( i'm not a pharmacist or doc don't listen to me i just have done alot of research on this stuff. talk to your doctor about it fentanyl patches
wow, certainly got a lot of comments and in a short time too! i just wanted to add that i was on the 50 mcg patch and as the others posted, they do NOT last 72 hrs. it took five hours after the patch was applied b4 pain relief was obtained/achieved. i was in a nursing home at the time and the nurses were VERY strict to where would NOT change the patch until EXACTLY 72 hrs (which is how i knew how long it would take, etc.) i was also on a simple darvocet at the same time, which relieved some of the pain too while waiting for peak pain relief to be obtained w/ patch. and after about a week, the nurses got to where rather than waiting 72-hrs, would change after two days just like the others said herein. --i'd leave the old patch in place rather than remove (so that ALL the drug would leach out of the patch). u're lucky your doctor prescribes adequate pain relief meds. ALL my life i've had to suffer my pain. a new pain center recently opened and i'm waiting on first appt ... p.s. have never heard of opana -- i'll look that up release of FENTANYL 50
The 100 Fentanyl patch seems to last the 72 hours as it says. But I always change it 3 hours before just to make sure. I am going against the prescription, but I really dont care. I need pain relief BAD. Broken wrist, 3 herniated discs in the neck and 5 in the back. So I take no chances. Opana is Oxymorphone, I think it has other trade names as well. But that wouldnt do me any good on the patch. _______________________________________________________ KnightMetal I am not an MD. I know by experience only. Consult YOUR MD 1st! ___  Are you still on
Hey I'm pretty new to the forum but have been on pain management for awhile I have always been a little ifiy on take anything to strong I tried vicodin 5 7.5 now 10's Then I found a new center since current doc was no longer on my insurance they gave me perc 10's that wasn't working they had me on the opana er 5mg's I was up to 6 that wasn't working it actually made me feel worse but now they say fentanyl patch not sure what dose yet find out Mon. I was reading your post I hope I have the ease of sleeping and getting up I have two kids that need ride to and from school if you have any other advice I would welcome it Thanks!! Well I can say by first hand
Well I can say by first hand experience that the Fentanyl will let you go about a "normal" life. You will sleep well, dont have to worry about feeling "sleepy" or having to remember to take a pill every 4-6 hours. Alot of people talk about SUBOTEX or METHADONE for pain management, but when you are in extreme pain, I really dont see how they would help. (I am not saying it doesn't, just not for me). If you NEED a painkiller that works and don't want to worry about all the things that come with taking a pill or dose, then it should work for you. This is my experience only, it may be different for you or anyone else. But I was dependent on painkillers for a long time before I got the Fentanyl, and it will (should) be just what you have been looking for. I am in NO PAIN at all 24/7, and that in itself is a blessing. If you have anymore questions about it, feel free to ask. I am all for the Fentanyl patch. (as you might tell)
Note: The Fentanyl patch is NOT for everyone, you might have side-effects that I don't have. And it is something that ONLY you and your doctor can determine if it is right for you. Make sure to take (use) the patch as your doctor recommended, no exceptions - this is a VERY POWERFUL painkiller. I will include a link in this message so can study.
Dr. KnightMetal
Thank You
Hey Thanks, I like you had to get a safe recently do to coming up short on my percocets. I don't like the feeling. I'm pretty sure of who it was, other than my husband only one other person knew I was on it. I will let you know how it works out on the meds but thanks!!! Thanks again
That sight is helpful thanks again it's good to talk to people that kinda know whats out there I know your not a md or anything like that but for the people in my life they aren't in my kinda pain thank goodness but they can't really relate to all of it either so thanks again. Quote:That sight is helpful
Quote: That sight is helpful thanks again it's good to talk to people that kinda know whats out there I know your not a md or anything like that but for the people in my life they aren't in my kinda pain thank goodness but they can't really relate to all of it either so thanks again. No one but you truly no what pain you are going through... Alot of MDs understand and are great, and thank god or someone for them! - others are ... well.. "dont understand" (nice as a could put it)
--I am not a professional, I know by experience only-- Side effects
"Note: The Fentanyl patch is NOT for everyone, you might have side-effects that I don't have. And it is something that ONLY you and your doctor can determine if it is right for you. Make sure to take (use) the patch as your doctor recommended, no exceptions - this is a VERY POWERFUL painkiller. I will include a link in this message so can study."
I too was on the patch and was very happy with it for pain relief. But I was having severe muscle twitching and had to move to a different medicine. If it weren't for the side effects I think I would still be on patch and very happy with it. I haven't had any
I haven't had any side-effects yet...doesnt look like I am going to, its been awhile now atleast couple months. Sorry you had side-effects, what med did you switch to? (feel free to not answer that if you dont want to.)
--I am not a professional, I know by experience only-- Thanks to All
Hey I am thankful for all the advice you guys have to offer still waiting to hear back from the doc I'm sure there was other ways to do this but it was easier for me to add to a post for advice I mainly read the post to see if others have had my reactions to certain meds or if changing then what others reactons were and so on but I will keep reading all I can to make my mind up. Thanks Again Hey I just wanted to point
Hey I just wanted to point out that people don't have to know that you are on pain meds to steal them. Don't automatically assume that in a room full of people the one person who knew you took them was the one to steal your meds. Someone may not have known you were on pain meds, but saw the bottle and THEY like pain meds and took yours. I'm a social worker, not a medical professional. All comments and thoughts are simply my opinion and experience. Wish
I wish that was the case I don't have many people over we are on differant schedules there are three people that have been in my house since I filled my script My meds are all put up I have young kids, there are only two people that knew where they were. I know who it is. I like to be hopeful and think the best of people, but there are times you have to face facts and deal with it. |
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