Duragesic Question - Pain Management Message Board

gatsby · 03-10-2007, 11:49 AM

My mom, 84 y/o is suffering from sacroiliac joint pain. It been going on for two weeks and has completely debilitated her. She is reluctant to take medication. The medication she has tried has not worked: 1 Tylenol 3, 1 Paramacet, and then 1mg Dilaudid. Yes, I know these are minuscule amounts and that she has not given them enough of a chance. [I myself suffer from migraine headaches and need 100mg Demerol for those times when the other stuff does not work.]

So after I explained the situation to my mom's internist, I suggested Duragesic. He agreed and prescribed Duragesic 25. I put one patch on my mom and then after reading the insert, it scared the hell out of me and after three hours I removed the patch. I then spoke to a pharmacist at the local cancer agency (presuming that they would be knowledgeable about PM matters) and she thought that the dose was low enough as to not cause any complications. So I have put another patch on her this morning and its been four hours and so far so good, but no pain relief yet. Any comments?

Thanks in advance.

txmomof3 · 03-10-2007, 02:33 PM

Duragesic is a great medication, but it is very strong. One of the big reasons the warning is on the 25 mcg box is because dentists and some doctors were using it post-surgically for acute pain. The problem with that is it takes 17 hours for the patch to deliver enough medication into your body to get 25 mcg/hour into your blood. About 5 years ago, a dentist in my area put a Duragesic patch on a 17 year old boy after he had his wisdom teeth out. Well, he had some pain meds and anesthesia at the clinic and then went home and took hydrocodone every 4 hours because the patch wasn't working yet. Needless to say, when the patch kicked in, he had WAY too much narcotic in his system.

I tell you this story not to scare you, but to let you know why that warning is on the 25 mcg box. For someone with chronic pain, it is a great starting point for long-acting medications. Just make sure she does not take any other narcotic pain meds until you know the full effects of the patch (which is usually about 17 hours after you put it on).

Let me know if you have any other questions!

gatsby · 03-10-2007, 03:39 PM

Thanks. She is on no other pain medications, except for a two-week course of Celebrex. I presume that her internist did not believe that the Celebrex would be a problem. If she put on the patch on at 7:00 am this morning, then by midnight she should be experiencing the analgesic effects. Hopefully, it will do the trick, as she is somewhat depressed at not being able to go out for her walks and to do her usual activities.

txmomof3 · 03-10-2007, 03:42 PM

The Celebrex is fine...it is an NSAID, not a narcotic. I hope your mom will be back to walking soon!

onyxgates · 03-10-2007, 07:53 PM

Your mother won't find relief from the patch until it is time to put on the third one. It takes that long before the serum reaches peak levels. Hang in there and I hope your mother finds relief.