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Old 06-22-2011, 10:38 AM   #1
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Fentanyl patch placement on body...

I am a new patch user and am wondering if patch placement on one part of the body or another matters...I am on my second patch..the first one I put on my upper chest...it worked very well...the second and current one I put on my upper thigh...does not seem to be working well at all...does one place or another make a difference??? Any pointers you can give would be very much appreciated.

 
Old 06-23-2011, 09:25 PM   #2
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janiee08 HB Userjaniee08 HB Userjaniee08 HB Userjaniee08 HB Userjaniee08 HB Userjaniee08 HB Userjaniee08 HB User
Re: Fentanyl patch placement on body...

Hello, and welcome to HealthBoards!! For starters, it would be best if you asked this question on the Pain Management Board; lot's of discussion there about pain meds including the patch. Since I used to be on the Fent. Patch, I can tell you that you should never place the patch on a body part that has hair on it, or that tends to sweat or move a lot. There should be a huge piece of paper (instructions) inside your box of patches. Please read all the instructions carefully. This is a medication that you have to be particularly careful with. Hope they help your pain!...janiee

 
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Old 07-16-2011, 08:11 PM   #3
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Re: Fentanyl patch placement on body...

Fentanyl should always be place above your breastline. If you read the 800 page insert on the box it will give you the complete breakdown of absorbtion and why it goes there, *s*. So, try moving the patch or placing the new one above your breastline and you should get better results. Also the initial dosage of the drug entering your system can be more heavily felt at first, once your BPL levels off, you might sense a decrease.

good luck

kat

 
Old 08-17-2011, 12:07 PM   #4
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Re: Fentanyl patch placement on body...

I don't have an answer to you question but I have a script for fentanyl and am scared to get them filled as I have a 2 year old and there is NOONE else to help with her and I am afraid they will knock me out. Can you tell me how they make you feel and if you got sleepy? Are they anything like a percocet or lortab I have a high tolerence for those.
Thank you

 
Old 08-18-2011, 09:04 AM   #5
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Re: Fentanyl patch placement on body...

Smoof,

Fentanyl is nothing like Lortab or Percocet, those are SA (short acting) meds generally reserved for break thru pain, once you move to LA (long acting) meds for pain management. A curious Q here, did your doc jump from percocet to Fentanyl?

I used Fentanyl patches for 3 years, and had the same fear as you the first time I used it, fortunately I have an adult age son, and he was more than willing to hang out with me that day. The drug never made me sleepy, or "high". It's a time released product, so you don't get a large dose all at once, it breaks down over a period of 72 hours for most people and 48 for some that have major tolerance issues, generally after being on top tier, LA pain meds, i.e. Oxycontin, Morphine.
Fentanyl is the STRONGEST pain med marketed for at home use. That's where my Q came in about how you got to this point. Most docs only go this route if your tolerance and Oxycontin and Morphine are is so highly elevated that in order to get pain relief you have to take large doses, or if your pain has just gone beyond the threshold of these 2.

In my 25 years of Pain Management, Fentanyl was the med that I had the least side effects and problems with. The only big thing was keeping the patches on, they tend to want to come off. So all you need to do is get patch covers or Tegaderms from the pharmacy and place these over the patch. They're like a big clear band-aid. 2 other important things to remember, ALWAYS place your patch above your breast line. If you look at the insert it will tell you why, basically it's a matter of absorption rate and body temp. Body temperature is a major factor in how your patch will work and keeping safe. Heat makes the patch release more narcotic than it should, so you have to avoid hot baths, saunas, jacuzzi's, etc. This is the main reason I stopped using it, as my pain is joint related and scalding hot tubs gave me great relief.

Good luck, take care and yell if you have any more Q's.

Kat

 
Old 08-18-2011, 03:43 PM   #6
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Re: Fentanyl patch placement on body...

Thanks so much! And yes she did jump straight to Fentanyl I had an issue at the pharmacy today with her asking the same questions. Not only did she jump straight to Fentanyl she jumped to 75mcg. I haven't tried them yet and don't think I will. Thanks so much for your help.

 
Old 08-18-2011, 04:27 PM   #7
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Re: Fentanyl patch placement on body...

Smoof,

That is...I won't say wrong, because all docs have their favorites and reasoning, but it's very unusual. I'm not shocked that your pharmacist asked about it, any good ones do, but hopefully they didn't harass you or refuse to fill the RX, as that is illegal and not their business.

I'm glad that your doing what makes you feel comfortable. A lot of folks are so pressured or in "awe" of their docs, they just do whatever he/she says without stopping to think what this will mean for them in the future. The better the relationship and communication are with your doc, the easier your PM Journey will be. I have had the same doc for 12 yrs and I think my lucky stars at least once a day, when I read the nightmares that some folks have to go through. My PM doc, who is my PCP also works very well with my pdoc, neurologist and orthopedic surgeon. Communication between your doctors is also very important.

I would definitely talk to your doc and explain that you have no desire to jump from a to z, you'd rather go to B! After percocet a normal course would be and LA med if your pain is not controllable. The LA med would be some form of Oxycontin or Morphine. Fentanyl should be saved for the "what ifs", what if Morphine or Oxy don't work, what if I have a reaction to them. In Pain Management as well as many other diseases, you never want to skip steps, as with every drug that you take you are building up chemical tolerance to, and it can be hard to go "down" once you've been at the top of the tier.

Good luck with your doc, I hope you are able to straighten this out. I'd call them soon, like tomorrow to get a new appt.

I can tell you what my progression was, as it was pretty normal and fit with that of a lot of PM patients.

2000 Vicodin and ibuprofen, heat and cold to control pain
2001 Percocet and ibuprofen, heat and cold to control pain
2002 Oxycontin, Percocet for BT, ibuprofen, heat and cold to control pain
2004 Oxycontin, Percocet, ibuprofen, Voltaren Gel, Lidocain patches and heat and cold.
2006 Same meds but significant dose increase of Oxy
2008 Fentanyl, percocet, ibuprofen, Voltaren Gel, Lidocain patches, heat and cold

2010 Went back to Oxy, all other meds remained the same

2010 Switched to MSContin (Morphine) after Purdue reformulated their Oxy, to be safer and not as easy for druggies to use, unfortunately they screwed up the formula and myself like many others went from a drug that worked very well in controlling pain, to an LA drug that barely lasted 3 or 4 hours as opposed to the 12 it was made to.

Today: MSContin 140 mgs./day, Percocet 10/325 up to 6 per day as needed, Ibuprofen 1600mgs/day, Voltaren Gel used twice a day, morning and bedtime, Lidocaine patches if needed, and the old standbys, heat and cold. I'm a bit different in that I take a total of 12 meds per day, have 2 other onset meds which are generally used at least once a month, and 1 injection per day.

So my case is not the standard, but my Pain Management med progression is pretty standard for the type of pain I have.

Sorry this is so wordy, I hope I was able to help in some way.

Take care and let us know what you decide with your doc.

Kat

 
Old 08-19-2011, 02:31 PM   #8
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Re: Fentanyl patch placement on body...

Thank you so very very much for taking all that time. I have only seen this doc for 3 weeks. I don't have time right now to tell the full story but I think it is a pill mill place. I am not going back to them. But thanks so much for taking your time out of your day to help me.

 
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