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Old 03-30-2009, 08:43 PM   #1
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Has Anyone Tried/Prescribed Kadian?

Hi Everyone,

I haven't been on in awhile. I been dealing with this tremendous pain in my neck and lower back and FINALLY have gotten some answers after a VERY long goose chase in getting the GOOD doctors to LISTEN to me!!!

First off, I went and got xrays of my lower back and hip and MRI's done on my neck and lumbar. What was extremely disappointing and very frustrating is that the reports did not reflect the actual MRI's. This made it extremely difficult to have every doctor that I went to take me seriously. They would always ask for the films or disk and reports but in all reality they relied on the report for them to "judge" me and the severity of my pains.

I finally found a fantastic pain mgmnt doctor after much searching as I've complained about on these boards in the last few months.

I asked my PM to look at the MRI's before looking at the reports before he determines how to treat me and explained to him that I feel the reports are wrong and do not explain hardly any of my pains. The reports read as follows: cervical spine showed herniated disc c6-c7 and lumbar showed mild scoliosis and that was it!!! I am in MUCH more pain than what the reports say and for this reason I asked the PM to read the films first; he abliged and good thing!!!!

My PM doctor found that my cervical spine shows a herniated disc c6-c7 that is touching my spine, spinal stenosis, no spinal fluid is getting through my neck at all. The lumbar shows scoliosis, Disc Degenerative Disease, Bulging Disc at L5-S1 area and possibly ankylosing spondylosis.

I finally got some answers for my debilitating pains and someone that took me seriously!!! So my problem is that when I started with this PM doctor he said that taking the amt of percocets (6-7/day) that I've taking was too many and prescribed half the dosage (4/day)!! But i didn't want him to think any of me so I went along with with much dismay! My next appt I complained and he gave me the fetnayl patches and just 3 percocets/day. He also scheduled me for a steroid shot in my neck which I did about 10 days ago. Well, the injection was the worse thing I could have ever done and put me in so much pain; the worst I've felt in awhile. The fetnayl patches actually worked wonders but they don't stay on. All of a sudden I'd be in excruitiating pain and looked at my arm and the patch was gone! These patches worked but no matter what I do I can't keep em on.

So the next appt I complained and he gave me something called Kadian with percacets for BT. I was nervous that it wouldn't take care of the pain but he assured me that it was equivalant and in fact that it is morphine. So I agreed to give it a try. Well, I definitely felt that it was working somewhat but nowhere near what the fetanyl patch did for me. The Kadian also gave me a very massive headache that was truly unbearable. I have headaches every single day to begin with and to have this headache on top of it was just too much to handle. I couldn't function at all. I did some research on this medication and found out that this was a number one complaint. I still had some patches left so I went back to them and was in heaven!!

My question is has anyone else tried Kadian? How did it help you? Or did it not help; what were your cheif complaints? Did your PM dr switch you to something else and if so what was it that you were prescribed next?

I have my next appt in 10 days and will tell him or rather the PA since he won't be there that the Kadian is terrible for me. The patches don't stay on either. I am reading all over the place that people get such relief from the oxycontin; I want to ask him to put me on this for relief!! I'm also in a way afraid to because I keep hearing all the negatives about it as well but if it gives you tremendous relief than that's what I want. I've been trying to cope with debilitating pain for over 10 years with just vicoden or percocets and think that I need a big change. I'm afraid for asking for this medication; I don't want them to think anything of me but I have done everything they've asked me to do or try with no reservations. Has anyone specifically asked for oxycontin and they gave it to you or were you offered it? How did you go about asking for it?

Sorry this is long!!!!

 
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Old 03-30-2009, 11:51 PM   #2
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Re: Has Anyone Tried/Prescribed Kadian?

Hi Cheryl!

I have similar back and neck issues. I took Kadian for 2 years and because of cost and insurance, I just switched to the generic of Kadian (morphine sulfate ER). It is a long term release Morphine. You may just be "morphine sensitive" if it is giving you such bad headaches. I would have called the pain doc within a couple days if I were having side effects like that. Out of curiosity, did you start taking the Kadian around the same time you had the steroid injection in your neck? When I had the steroid injection in my neck, I was in SEVERE pain for over a week. I had excruciating headaches. It was just a side effect of the injection in my neck.

I tried oxy's. I called the dr. after 3 days and said NO MORE. It made me deathly ill (alot of vomiting). I can't take codeine or codeine derivatives because I break out in hives and now vomiting. Oxycontin ER is an extended release codeine without the acetaminophen filler.

I, personally, can't live without my Kadian. It did take me about a week or so to get used to it. When my insurance ran out last year and I was waiting on my disability to be approved, I didn't have my meds. That is when I realized how much Kadian helped me. I couldn't hardly walk for 3 months. It really helps my back and leg pain but not so much my neck. My neck is just in a league of its own pain wise. I take dilaudid for break through pain.

Everyone is different in how they react to pain meds. It took my pain doc almost 6 months to come up with the right combination for me. Do NOT be afraid to tell him what you are going through! My pain clinic is awesome. I have sat down with them at length and discussed how certain meds help, how I don't like the side effects etc until we got a combination that helps.

I hope you find the right combination to give you some relief!!!

p.s. I just looked at the Prescription Information sheet. It states: CONTACT YOUR DOCTOR IMMEDIATELY if you experience confusion, fainting.........severe or persistant headaches. You may want to go ahead and call them.

Last edited by hugg724; 03-31-2009 at 12:05 AM.

 
Old 03-31-2009, 12:15 AM   #3
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Re: Has Anyone Tried/Prescribed Kadian?

Quote:
Originally Posted by cheryl810 View Post
Hi Everyone,



I finally found a fantastic pain mgmnt doctor after much searching as I've complained about on these boards in the last few months.

I finally got some answers for my debilitating pains and someone that took me seriously!!!

So my problem is that when I started with this PM doctor he said that taking the amt of percocets (6-7/day) that I've taking was too many and prescribed half the dosage (4/day)!! But i didn't want him to think any of me so I went along with with much dismay! My next appt I complained and he gave me the fetnayl patches and just 3 percocets/day.

He also scheduled me for a steroid shot in my neck which I did about 10 days ago. Well, the injection was the worse thing I could have ever done and put me in so much pain; the worst I've felt in awhile.

The fetnayl patches actually worked wonders but they don't stay on. All of a sudden I'd be in excruitiating pain and looked at my arm and the patch was gone! These patches worked but no matter what I do I can't keep em on.

So the next appt I complained and he gave me something called Kadian with percacets for BT.

I was nervous that it wouldn't take care of the pain but he assured me that it was equivalant and in fact that it is morphine. So I agreed to give it a try. Well, I definitely felt that it was working somewhat but nowhere near what the fetanyl patch did for me.

The Kadian also gave me a very massive headache that was truly unbearable. I have headaches every single day to begin with and to have this headache on top of it was just too much to handle. I couldn't function at all. I did some research on this medication and found out that this was a number one complaint.

I still had some patches left so I went back to them and was in heaven!!

My question is has anyone else tried Kadian? How did it help you? Or did it not help; what were your cheif complaints? Did your PM dr switch you to something else and if so what was it that you were prescribed next?

I have my next appt in 10 days and will tell him or rather the PA since he won't be there that the Kadian is terrible for me. The patches don't stay on either.

I am reading all over the place that people get such relief from the oxycontin; I want to ask him to put me on this for relief!! I'm also in a way afraid to because I keep hearing all the negatives about it as well but if it gives you tremendous relief than that's what I want. I've been trying to cope with debilitating pain for over 10 years with just vicoden or percocets and think that I need a big change.

I'm afraid for asking for this medication; I don't want them to think anything of me but I have done everything they've asked me to do or try with no reservations. Has anyone specifically asked for oxycontin and they gave it to you or were you offered it? How did you go about asking for it?

Sorry this is long!!!!
Welcome back...I'm happy that you finally found a good PM doc...Having said that, there's some issues you need to workout with the doc. Kadian, aka morphine, is definitely NOT equal to Fentanyl...Fentanyl is one of the strongest opiate pain meds available. In fact, it's distributed in MCG. not MG. and it's roughly 80xs stronger than morphine. So you would need a whopping dose of Kadian for you to get similiar pain relief as you did with the patch. Even the percocets are stronger than morphine...

As for keeping the patch on, there's a variety of tapes around that make them stay on and you can ask your pharmacist or call the doc for some suggestions. I'm not sure if you got permission from your PM to go back on the Fentanyl or if you just decided to do it because of the headaches you have while on Kadian. If you didn't call the PM 1st before changing meds then you could have a BIG problem...If you signed a contact or your PM does drug screens, you can be dismissed as a patient for changing your meds. As for your next appt with the PA, he/she probably won't change your meds, because most changes are made by the PM and the PA just does follow up appts and continues your current meds. I would call the PM before the appt and explain about your headaches while on Kadian...I think you would be ok asking to go back to the patch, but I wouldn't bring up Oxycontin...Asking for a particular med is a, "red flag" and many PM's don't rx it anymore, especially to a new pt who ask to be rxed it.

It sounds like the patch is working, so just get permission to go back on it and get the tape to make it stick better. I would hate to see you get kicked out and have to be looking for a new PM for not following ALL the rules.

Good luck

 
Old 03-31-2009, 07:44 AM   #4
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Re: Has Anyone Tried/Prescribed Kadian?

At your next appt, I would just be honest and tell them that the Kadian gave you a monster headache. In fact, you probably should have called right away. I'd go ahead and call now...You still have 10 days to go. Call and tell them that the Kadian is giving you bad headaches and that you've tried to hang in there but just can't anymore....Ask if you can use the patches that you have left over? They'll probably say yes.

Then, at your appt, you've set the stage for your discussion re: what's going on. You might get OC by default. If the patch and oral morphine aren't working, all that's left is OC, Opana (you don't want that) and methadone (to early for this). I agree with the other poster in that you don't want to specifically request OC....Just tell them that you can't keep the patches on and there have been periods of relief, but you want to keep trying.

If they insist on putting you back on the patch and using tape & etc., then you'll know that the office doesn't like to prescribe OC. It just has a bad stigma right now. For you, it makes a lot of sense because you've done well with Percs, which is the same active ingredient. However, some Docs just won't script it, but many will.

Hope this helps.

Regards,

Ex

Last edited by Executor; 03-31-2009 at 07:45 AM.

 
Old 03-31-2009, 11:15 AM   #5
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Re: Has Anyone Tried/Prescribed Kadian?

Wow, thank you!! Ya know, I didn't even think that I would be jepordizing my relationship with the PM office; never came to thought. I just figured to go back to the patches since they gave me a decent relief and I had a few left! I never even thought about the drug test that I could possibly get on the next visit if they decide to do it; thank you all for your great advice!!!

I kind of figured that it would not be a good idea to directly ask for OC; I've heard stories on these boards of people being blacklisted just for asking. As you said I don't want to jepordize my new found great relationship with my doctor; I hope he will offer it soon though. Either that have the patch mcgs increased since I'm on the lowest dosage and I'll find a tape that will help the patch stay on.

My last appt I was practically in tears explaining the amount of pain I'm in and that I'm fed up with the patches and just not getting that much relief. His response was "you've been dealing with your pains a long time and you need a change; are you willing to try a long acting medication?" With a sigh of relief I said "most definitely!!". That's when he prescribed the Kadian. I'm not sure how the office runs since I'm fairly new but maybe they start you off low and work you up to OC; I'm not sure but I won't directly ask for it.

I started taking the Kadian about 10 days after the injection. As I said the injection made everything so much more worse and then adding the Kadian just topped it off!! I will take everyone's advice and call the office right now and explain to them my experience. Maybe they can prescribe a stronger patch or have me come in for a different prescription. It's very possible that I'm morphine sensitive. The percocets do work well but I'm not happy nor is it working that he cut my dosage in half.

I am in the beginning stages working with this office so I guess I just have to keep working with them to get the right medications/dosages that work for me to function. I hope soon; my family is getting pretty tired of hearing me complain of being in pain and always just laying down on the couch since that's all I can do to be comfortable. Heck, just to take my daughter to dance over the weekend was too much for me and ended up on the sofa for the rest of the day.

Last edited by cheryl810; 03-31-2009 at 11:18 AM.

 
Old 03-31-2009, 12:12 PM   #6
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Re: Has Anyone Tried/Prescribed Kadian?

What is wrong with Opana ? I have a friend who is on it and swears it works best than anything he has tried. My PM tries anything BUT Oxycontin for some reason. I tried it for a short period of time and when I was transitioned by my PM I had the WORST WD's of my life.

 
Old 03-31-2009, 04:51 PM   #7
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Re: Has Anyone Tried/Prescribed Kadian?

i am taking kadian and percocet for break-through pain. i didn't really have any side effects. it works pretty well, but i usually end up having to take the bt meds at least once a day. i will say that i tried the generic morphine sulfate er and it didn't come anywhere close to the relief i get from kadian. i was even taking more of the ms er than of the kadian, but it still wasn't as good.

i actually had the same problem with my mri reports. i had a discectomy/fusion at c5-6. i got a subsequent mri and for level c5-6 the report said 'no disc bulge or protrusion.' there wasn't any mention at all of my fusion or hardware. a doctor who simply read the report -as one pain doc did - would not know that there was anything at all wrong with my neck. the one doc i went to said 'there's nothing wrong with you, see it says right here on this report.' i asked if he wanted to see the films and he said there was no need. i couldn't believe my ears. needless to say i didn't go back for a second appointment with him.

i think kadian is great, but if you are getting such bad headaches for more than a week, morphine may not be right for you.

 
Old 03-31-2009, 05:49 PM   #8
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Re: Has Anyone Tried/Prescribed Kadian?

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Originally Posted by lifeaftr40 View Post
What is wrong with Opana ? I have a friend who is on it and swears it works best than anything he has tried. My PM tries anything BUT Oxycontin for some reason. I tried it for a short period of time and when I was transitioned by my PM I had the WORST WD's of my life.
Opana's claim to fame is that it supposedly targets those receptors that don't cause euphoria. However, the receptors that are susceptible to euphoria are also the ones who are responsible for a majority of the pain signals. Thus, if the med avoids those same receptors, then the pain goes untreated.

The reason some people feel they're going into WD, is because the receptors who were once occupied by OC or whatever med they were taking, are now left empty (those that cause euphoria).

Opana has been pitched to PM Docs are more abuse proof, but it hasn't caught on in the PM field and overall, is a minor player. I've never tried it, but if one does a search on this forum, the feedback is 90%+ negative. That's more than enough for me to stay away from it.

Regards,

Ex

 
Old 03-31-2009, 07:41 PM   #9
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Re: Has Anyone Tried/Prescribed Kadian?

To be honest I never heard of Opana. So I would do a search first and see what others are saying. I'm really nervous trying something that I've never heard of or how the drug works; I'm truthfully afraid to go through wd's since every medication works differently and I would be afraid to take something that won't work. This is what is happening now for me with Kadian. I never heard of it until my PM offered to me and trusted him when he said it is along the sames lines as what I'm taking which are the Fetanyl patches. This is exactly why I'm afraid to try something new unless I hear from others how great something works for them. So far I've heard that Kadain works on a pretty small percentage of users and most have suffered from headaches. My PM dr didn't tell me any of the side effects. I also come to find out that Kadian is much weaker than Fetanyl; it's no wonder I had a lot of pain with the Kadian.
This is why I love these boards!! I can get honest real people experiences with various medications and treatments. This gives me knowledge and helps to have a good serious talk with my dr without sounding ignorant or oblivious. I can now go to my PM dr and say "alright, I've done some research and found that the Kadian is not like Fetanyl which is why I'm in more pain plus some". I can sound educated.

The ONLY reason why I'd consider OC is for the relief!! All I keep reading is that it works wonders and just takes away the pain!! I am desperate for relief!! It's just getting worse and my quality of life is discinigrating over night; I can't have this with 2 young children (4yrs and 18mos). I've been in chronic pain for over 10 years and the last 12 months have been debilitating and rapidly getting worse.

It sickens me because it took a VERY long time to get to this point with medications and I blame the MRI reports for creating these detours!!

I've actually had one doctor say to me "well, you look fine. You don't look like you're in any pain!" Get this!! He confessed that it makes it difficult to tell if someone is telling the truth if they don't look like they're dying!! So because I take pride in my appearance even if it takes a little longer to get dressed and such because of pain that I will be penalized. I have to play the part and dress and "act" like I should be in the hospital?? I was completely stunned and now have a whole different prespective on doctors!! I realize that there are many fakes and frauds out there but it's ridiculous that I have to play the part up 10x over to be taken serious...

TOONCES1: I have had one doctor (neurosurgeon) do exactly what happened to you; I went into my car and cried!! He also told me that the pains and numbness in my hands, fingers and arms have nothing to do with my herniated disc!! He completely made me feel like I was making it all up!! I ran for the door so fast I got lost getting out of the office. I didn't want to look at this guy or his staff, just find the exit!!! I did research when I got home and clearly all the research shows that my pains stem from the disc!! I confirmed this with my PM dr and told him my experience, needless to say he was floored! He also continued to say that many neuro surgeons are known to have that arrogant disposition; ;it's just not fair or right. People that are in legitament pain have to go through hoops to get someones attention!! To be honest I'm quite sick of it!!

 
Old 04-01-2009, 07:48 AM   #10
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Re: Has Anyone Tried/Prescribed Kadian?

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I also come to find out that Kadian is much weaker than Fetanyl; it's no wonder I had a lot of pain with the Kadian.
Everything is weaker than fentanyl. Fent is the strongest med on the market for non hospital use. All meds are different, in terms of basic strength. The key is getting the right transition dose. Oral Morphine works for many, many people, but in general, you have to take much more of it because it has poor bioavailability. Think of bioavailability as miles per gallon in a car, or efficiency. Well, oral morphine has poor MPG. You can do some research and find charts that show common transitions from drug A to drug B.

In fact, if you've been on the patch, there is a prescribing white paper that comes in the box of patches that has a chart in it that shows the equivalent amt of other meds to fentanyl. You can use the same chart to go back the other way.

PM protocol calls for any transition to start slow and be on the conservative side...And then, adjust from there. This would explain why the Kadian isn't all that effective right now. It can take some adjusting to get completely dialed in. Rarely do docs get it 100% right the first time....Each person is very different, and all meds effect each person different. During a transition once, when I complained about mini WDs, my PM Doc told me that "it was better for me to be uncomfortable than dead." Each med effects each person differently, and you could even be allergic to it, so they start slow.

Good luck with this.

Regards,

Ex

 
Old 04-03-2009, 04:45 PM   #11
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Re: Has Anyone Tried/Prescribed Kadian?

I think that it is morphine sulfate like mscontin. Had a doctor that put me on it and i could never even tell i took it. He never tried another med on me. It was weird. Found a med that works for me but now another new doctor came in and changed me to opana. Doesn't work for me either. Better than mscontin. I would just assume take aspirin than either one though. The opana justs adds to my pain with severe headache.

 
Old 04-08-2009, 08:13 PM   #12
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Re: Has Anyone Tried/Prescribed Kadian?

I had my appt to see how I did w/ the Kadian and explained that it was just horrible for me. In fact I called the office a few days prior and they prescribed another drug to controll the headaches which of course didn't work. I've suffered with daily headaches since I was 20 so ONLY opiates work! Anyway, I asked to be put back on the Fetanyl Patch but increase the mcgs plus prescribe 4 percocets a day for BT rather than 3 in case I have "bad" days and have room for these days. She did fulfull my request but did say that I should not need to take the BT as much with the increase on the patch.

Well, this is day 3 on the increase and I FINALLY feel relief for the first time in a year!! I think I took the BT 2-3/day mainly for my headaches that the patch doesn't seem to really help with but I try to take the BT as few as possible. My back and neck feels so great that I'm able to excerise for the first time in months without feeling debilitating right after or during!!! I think I found the right dosage/prescription for now. I hope this regimine works for a long time. I hear people need to increase their mcgs on the patches.

I did ask about the oxycontin and said that I'm just asking questions since I don't anything about them and hear they work great and I'm tired of the pain! The PM dr was great and explained how they prescribe this which is not often and explained the problems with them. I told her I was asking merely cause I keep hearing about it and thought could help. I then told her that if it's that addicting than I'd rather not bother with it; just want relief!! That's when she increased the mcgs of the patches and BT's. This is actually a happy ending for now and hope it lasts for a bit!!!

 
Old 04-08-2009, 08:51 PM   #13
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Re: Has Anyone Tried/Prescribed Kadian?

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My back and neck feels so great that I'm able to excerise for the first time in months without feeling debilitating right after or during!!! I think I found the right dosage/prescription for now.
Congrats! Doesn't it feel good to finally get the relief you need? I'm very glad to hear about your good news.

Quick question...Do you have any issues exercising with the patch...i.e does it work loose, or come off? Just curious. I had great success with the patch, but once spring rolled around and the temps rose (even with natural sweating), I had some issues, so my Doc moved me to oral morphine. It's worked well also.

Regards,

Ex

 
Old 04-09-2009, 03:22 AM   #14
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Re: Has Anyone Tried/Prescribed Kadian?

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Congrats! Doesn't it feel good to finally get the relief you need? I'm very glad to hear about your good news.

Quick question...Do you have any issues exercising with the patch...i.e does it work loose, or come off? Just curious. I had great success with the patch, but once spring rolled around and the temps rose (even with natural sweating), I had some issues, so my Doc moved me to oral morphine. It's worked well also.

Regards,

Ex
Thank you!! It's been such a long road with SEVERAL doctors and trying to plea your case and just as many others on here just to get dismissed or not taken seriously was/is extrememly frustrating!!! The entire time you're in such debilitating pain that you just want to cry. I just can't believe how many doctors have a license to practice medicin that should NOT have one; in my opinion!!
Anyway, that is my big problem right now with the patch, it's not staying on. I complained about that first with the lower dosage I was given and that's when they switched me to Kadian which as you know if Morphine. This gave me HORRIBLE headaches!! I'm extremely senstive to headaches as it is so for the Kadian to add to it was just a miserable time. I told my doctor that I wanted to go back to the patch even though I have a hard time with them not staying on; I had the best relief with them but asked to have the mcgs increased to 50mcgs. Now that I have the 50mcgs the patches are much bigger and gel substance which are sticking to my clothes. I worked out yesterday and then took a shower; the patch was hanging by a thread! This was my concern when I saw my doctor; she had wrote the prescription as 1 patch every 48 hours although she said try to keep it on for 72 hours. She wrote it this way so that I have room for error and when the patches come right off. I told her that I love to excerise and she mentioned that she has other patience that are on this that swim so she writes the Rx this way for them as well. I'm going to a surgical supply store today to see about some tape since the prescription she gave for tape is not covered under my insurance. I also just read on the boards last night that one of the manufacturers of the patch will send you tape if you call their 800 # which I'm going to attempt to do today also.

Bottom line is that this prescription works so good for me that I'll do whatever it takes to keep these patches on; I'll never go back to this Kadian or any other drug. Going through hell for the last few months trying to find what works for me was enough for me. I have 2 small children that I can't afford to miss out anymore on anything with them because of my pains; it wouldn't be fair. I've already wasted about a year laying on the couch in pain; it's not fair to them nor is it fun for me!! I just have to find a good spot on my body that it will be hidden for the summer; I really don't want this huge patch sticking out like a sore thumb and getting a tan around the patch and tape!!

 
Old 04-09-2009, 07:42 AM   #15
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Re: Has Anyone Tried/Prescribed Kadian?

Just a couple of tips....They may or may not work for you.

(1) I had the best success using the patch in places where the human body has the least amt of sweat glands. Those places are some of the same ones recommended by the manufacturer....Outter arm (like where one would get a tattoo), the flanks, area under your arm pit...about 6-8 inches down, but still on the side...Up from the flanks. You could rotate, for example, between each outer arm.

(2) Conversely, avoid areas where there are a lot of sweat glands....lower back, or really anywhere on the back. Plus, if you lean or lay on it, it creates heat which causes the patch burn through more med.

(3) I changed mine every 48. Not only did it not fall off as much, but it worked a lot better. The patch was originally developed for people at end of life, cancer, & etc. Therefore, they used it laying down, in hospice, hospital and etc. Hence, they got almost zero exercise, little activity, and most importantly, their metabolisms were very slow. This is what all the test data and approval data is based on.

Since that time, the manufacturer applied and was granted a much broader label for the patch. However, the FDA requires a manufacturer to use the initial data, which is every 72 hours, or that original test group. It says point blank in the white paper (comes in your box) that some patients may need changing every 48.

Simply put, for many people, especially those who are still active, the med won't last 72. Changing every 48 keeps your blood plasma level (BPL) up and they stick better. Do some research on these boards and you'll see lots of stories of people going into WD between 60 & 72 hours. Some even sooner, depending on metabolism and activity level.

(4) I actually planned my patch changing around my activities and moderate exercise (walking). For example, on patch change day, I would do some things on those days, and then shower and change the patch. Exercising with the patch doesn't work well. It has to have direct contact with the skin to work.

(6) The covers have been recommended by many.

(5) Lastly, be careful with exercising and the patch. Exercising raises your body temp, which in turn causes the patch to release more med. Then, it will run out sooner. Thus, you may want to plan around the change like I said above.

Hope this helps,

Regards,

Ex

 
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