Fentanyl patch advice needed - Pain Management Message Board

brianpain33 · 10-02-2007, 03:35 PM

I am sure some of you have read my story but for those who haven't. I started on the patch about 1 1/2 months ago. The goal was to reduce and get off of the ultram (was taking 8 total/day 400mg) while increasing the patch. I started out at 25mcg on the patch. After two weeks I had gotten down to half of the dose on Ultram (4/day 200mg total). I went up on the patch to 50mcg and that turned out to be a bad idea. I ended up overdosing and very sick after being on the 50mcg for three days. I went back down to 25mcg on the patch. I have only been able to reduce the Ultram to 3/day (150mg total). If I try to reduce it any further I have a big increase in pain. I was wondering if anyone had been on two patches at once such as a 25mcg and a 12.5 mcg at the same time. I think that I may be able to handle the 37.5mcg dose and my insurance is willing to pay for both patches at the same time. I really want to get off the Ultram for good. I should also mention that I continue to take 4-6 tylenol/day as well. I would like to reduce that and possibly go off of it as well. I go see my doctor on oct 11th and wanted to hear anyone elses input/advice before I go see him.

Thanks,
Brian

IZZY'SMOM · 10-02-2007, 04:14 PM

Hi Bri~
Sorry you are having such a rough time. im on the 25's and have been for about 8 months i believe. I started on 50's then to 75's and that sent me WAAYY over the edge, so I worked my way back down to the 25's. Im happy there, and Im hoping that I can start to go to the 12.5's and get off of them. BUT, my pain is going to be worse, so I have to think about it.
I think its great if you can get both patches...Id try it for sure!
Good luck!
Let us know how it works out.
p.s. i wear two 25's for a day on the day that I change my patch. I never have any probs.
xoxoxox,
IZZY'SMOM

jodom1979 · 10-03-2007, 06:55 AM

Im also on the 25's and change every 48 hours.. I wish they actually lasted 72 but it seems on that third day i need a BT med.. I think they are the abo****e best so far. No foggy head... I still feel my pain but its like I dont care about it so im happy.

Shoreline · 10-03-2007, 09:19 AM

Hi Brian, Anyone using more than 100 micrograms per hour is combining patches of vairous strengths, whether it's a 100 plus a 50 or 4 100's, docs that use these regularly know you can wear more than one patch. If you can combine a 100 and a 50, why can't you combine a 25 and a 12.5? Talk to your doc and see what he thinks. The thing is, 6 weeks really isn't a long time, I've tried every med out there after trying every non opiate method to control pain in the last 14 years. I've never titrated or adjusted any dose of opiates in 6 weeks, It takes months to accomadate to some of the side efects and some never deminsh.

I'm not realy sure what the big deal about the Ultram is unless you have had a sieizure, if that was the case you would be off it completely by now. What's the big concern about Ultram that you don't have about fentanyl. If a little ultram allows you to use less fentanyl, why isn't that a good thing?
Good luck, Dave

brianpain33 · 10-03-2007, 05:09 PM

Hi Shoreline,
The big deal with the Ultram is that I absolutely hate the way that it makes me feel. It also interacts uite a bit with the other medications that I am taking. The goal was to definitely get off of the Ultram. The other thing that I just saw when typing all of my medications into a drug interaction checker is that the ultram and fentanyl are a Major Drug Interaction and should definitely be avoided. I think that may have been the reason that I got so sick when I went up to the 50mcg patch while I was still taking 200mg of ultram/day. I would like to up the dose of the patch a little bit and get off the Ultram for good. I also would have stopped the Ultram before now if it was not for its antidepressant effects. That makes it more difficult to get off of as well. If it was vicodin or percocet that I was trying to get off of it would be a piece of cake especially being on the patch. I will try to get down to 2 or maybe 1 ultram/day when I visit my doc next week and I will let him decide. Thanks for the advice.

Brian