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Old 12-18-2009, 05:04 PM   #1
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Fentanyl patch help needed ASAP

Hi, I have to order my fentanyl patches ASAP and would appreciate help w/ any/all of the following questions - I don't have much time, so brief answer would be great! Pls. don't feel constrained by my questions if you have something else to add. I have been reading old posts.

I have used Mylan, don't plan to use again. The Sandoz matrix design is different than the one Mylan used.....

Anyway, help with any of the following would be appreciated.....
  1. Experience w/ new Sandoz matrix patches
  2. AND/OR comparison of Sandoz matrix OR GEL with Watson
  3. AND/OR comparsion of Sandoz (gel or matrix) with Duragesic
  4. AND/OR comparison of Watson to any of the other patches (including brand Duragesic [aware all generics can be +/- 20% of active ingredient in brand]
  5. AND/OR any help deciding WHAT generic to order for next month - currently on WATSON.
  6. AND/OR, even though everyone responds differently to medications, it would be helpful if you could rank the effectiveness of any of the patches you've tried in the past (including, I suppose, brand despite the obvious difference in the amt. of medication. [See below]

Re the last q, I've made up an possible example...it doesn't reflect my experience - I've only tried a couple...just a possible way to respond to the last q. -- could give it a number, but that isn't as informative as a few words describing what you liked/disliked..

1. Duragesic (strongest, but co-pay too high
2. Sandoz (most effective for pain, but gave me a rash or wouldn't stick)
3. Watson (best for me in every way)
4. Teva (terrible-gave me no pain relief! )
5. Mylan - loved small size, but felt pain control was inconsistent....
6. Actiivas....no idea..never tried...

Thanks,
Krit

Last edited by krit; 12-18-2009 at 05:17 PM.

 
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Old 12-18-2009, 08:55 PM   #2
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Re: Fentanyl patch help needed ASAP

Hello and welcome to Healthboards. This is a great site and I hope you find your time here enjoyable. Many here have a wide range of experiences, thus, can offer lots of support and guidance.

I will attempt to answer what I think your overall question is. I have been on the patch before and tried several different types/brands. In addition, I've done a lot of research on the topic and meds is sort of my thing.

In terms of overall patch effectiveness, the brand Duragesic is the best by far. Not only is it the most potent, but it is better constructed all the way around....Better glue, materials and etc. I've heard nothing but good things about the new matrix design. I have not tried it however.

Janssen, the maker of Duragesic, also makes the generic Sandoz. These patches are made in the very same factory as the Duragesic. However, they are not the same patches. Many automatically assume because they are made by Janssen, they are the same. The maker is going to take full advantage of the 20% rule in order to save cost and Janssen also has extra motivation in protecting their brand. Why would they make a generic patch equal to their higher priced brand? They don't...It would be market suicide. I've personally tried the Sandoz and while they do ok, they aren't nearly as potent and the glue isn't nearly as good.

I haven't heard that the Sandoz matrix is out yet. My guess is that Janssen will ensure their branded product is up and running at full capacity before investing in a generic presentation.

The Watson patch is a very good patch.....What I would consider very close to the Duragesic. Just about everyone reports that they work well and are plenty potent (i.e don't run out early). I have not heard if Watson is switching over to the matrix design or not. They have not had the recall issues that Janssen has had, so it wouldn't surprise me if they stayed with the gel. This would also give them a strong differentiation strategy in the patch market.

Mylan brings up the rear and I have rarely heard anything positive, although some people do like them. I think those who like them are either opioid naive or haven't tried the other patches, or both. This is an important distinction because if someone is opioid naive, or relatively new to PM, the overall strength of the patch probably isn't an issue. Additionally, if they've never tried another brand, they've never experienced the higher dosage and thus, their set point is lower....And consistent. IMHO, the biggest issue I've seen and experienced with patches, is when people switch around brands. The 20%+ rule can really play havoc on someone in these situations.....Especially if they are on a higher dosage patch....20% of a bigger dosage is a bigger discrepancy.

My PM Doc was so down on Mylan that he told me up front that if I chose to get Mylan and then had a problem, to not call for a change or refill because he was warning me up front. Needless to say, I never tried them. If you type "Mylan" into the search bar at the top of this page, you get dozens of hits and most posters describe the patch as running out very early, or in some cases, they go into WD.

Given everything I've discussed, I'd personally rank the patches as follows:
  • Duragesic
  • Watson
  • Sandoz
  • Anything but Mylan (I think Teva makes a patch now)
  • Mylan

I hope this answers your questions and I'll be glad to answer any other questions that you may have.

Best of luck to you.

Regards,

Ex

 
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Old 12-18-2009, 09:57 PM   #3
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Re: Fentanyl patch help needed ASAP

Sounds like Duragesic is the best option for you. Second to that is Watson. It sounds like you already know this though, so I am wondering why considering changing patches?

 
Old 12-18-2009, 11:19 PM   #4
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Re: Fentanyl patch help needed ASAP

Used all the brands and all the dosages over the years...they all work the same ...was that quick enough for you.

 
Old 12-19-2009, 10:14 AM   #5
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Re: Fentanyl patch help needed ASAP

If the Watson is the best for you in every way, then you should stick with it. My experience has been:

Duragesic - the best, although highest price copay (but I will be getting them through my pharmacy mail service for $90/3 month supply which is pretty good considering I see the actual price is around $600/1 month(15 patches) with no insurance. Keep in mind you can print out a coupon from duragesic's site for $50 off

Sandoz - pretty good, I would say slightly less pain coverage, and did not last quite as long as Duragesic.

Mylan - nearly useless, put me in withdrawal and I was in alot of pain using them. I was using ALL my breakthrough meds everyday while on them.

brian

 
Old 12-19-2009, 07:45 PM   #6
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Exclamation Re:The new generic Sandoz matrix patch

Thank you so much for all the help! I am very grateful for all the quick responses to my questions.

I was interested in an alternative to the Watson for several reasons; I don't like the size and the Watson's sensitivity to heat I was surprised when my pharmacist told me that Sandoz had both the gel and the Sandoz matrix patch available. I was thinking about trying one of the other generics before I heard the Sandoz generic was available.

I've heard good things about the Janssen brand matrix, and I like the size of the matrix patches. I also think that the matrix patches may not be as sensitive to to fluctuations in body temperature since I don't recall having any issues with heat while I was on the Mylan patch. Unfortunately, I can't afford the brand patch, so it's really a choice between generics, and the Mylan doesn't work well for me anymore. So, the new Sandoz generic looked like an attractive option.

Judging from the response to my question about the Sandoz generic matrix this must be one of the first batches of their new generic matrix patch. (??) I did some mucking around on the net, and one of the recent overdose lawsuits filed against J&J/Janssen/Sandoz alleged that Johnson and Johnson/Janssen could have prevented the overdose death by using the same design in their generic patch that they were using in the new brand matrix patch. Janssen may have agreed to speed up production of the generic matrix as part of the settlement and/or may have responded to pressure from the FDA/REMS. Whatever the reason, the patch seems to be coming out earlier than expected.

If Janssen is rolling out the generic matrix Sandoz patch way ahead of schedule in response to pressure or a settlement, I'm a bit concerned that the cost of quickly ramping up production of the new Sandoz generic patch could be passed on to the customer in the form of a lower level of the active ingredient [the +/- 20% issue w/ generics). , Perhaps Janssen will attempt to cut costs in other ways that might make their generic less effective for the customer. I don't know - maybe the delivery of the generic Sandoz is right on schedule and has nothing to do with the lawsuits, Jackson's death, the FDA/REMS pressure...etc. I have no idea what the actual roll out date was supposed to be....

At this pt., I can only hope for the best since I went ahead and ordered some of the new patches before I mucked about on the net and thought about the implications of shutting down one manufacturing process and getting another one up and running before planned .I guess I'll know shortly.

So, it looks like I signed up to be a guinea pig . . . . I would have preferred to wait until I heard some reports back from others and until after their first production runs . . . I'm not keen on being one of the first to try the new version before they have worked out any problems in the process, which is more likely if they sped up their timetable.

Thank you again for all the help - I really appreciated how thorough the responses were and how quickly you came to my assistance; thank you for taking the time to help me.

Happy Holidays to everyone!
Krit

Last edited by krit; 12-19-2009 at 08:46 PM.

 
Old 12-19-2009, 08:31 PM   #7
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Re: Fentanyl patch help needed ASAP

I'm sure you will be pleased with the Sandoz generic brand. The only reason that I switched from Sandoz (which I was on for over 1 year) to the Duragesic was because of the online coupon (up to $50 off) which allowed me to not only try the Duragesic brand but get them for FREE (I would have been crazy to have passed that up). Well, I am crazy but well treated for it Sorry if I offend anyone, it's merely a joke.

brian

 
Old 12-20-2009, 08:29 AM   #8
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Re: The new generic Sandoz matrix patch

Quote:
Originally Posted by krit View Post
I was surprised when my pharmacist told me that Sandoz had both the gel and the Sandoz matrix patch available. I was thinking about trying one of the other generics before I heard the Sandoz generic was available.
I'm sure this is just due to "older" Sandoz gel product still in the logistics pipeline. The matrix Sandoz are probably some of the first run. I fully expect Sandoz to only offer matrix since they are made by Janssen.

In addition, I strongly suspect the Sandoz will be up to 20% less potent than the Duragesic, for the reasons I mentioned in my first post. However, the cost will be much less.

Best of luck to you.

Regards,

Ex

 
Old 06-29-2011, 02:22 PM   #9
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Re: Fentanyl patch help needed ASAP

Wow! Your list of what patches work the best is interesting. I never got to try Duragesic because it WAY too expensive for me and my insurance company wouldn't cover it. The Sandoz brand worked pretty well and was so invisible, I could put it practically anywhere. Watson was absolutely the WORST for me as it was stiff, large, and the medicated gel never got fully absorbed, so it obviously wasn't giving me the full dose I needed. I never got to try Mylan, but after reading an entire message board on that one, I decided against it because EVERYONE said it was the weakest of the "dry" patches. I tired Actavis and, once again, it was the gel type of patch. While it was SLIGHTLY more flexible than the Watson and SLIGHTLY more effective, I didn't feel that my pain was being managed much at all, especially without taking the maximum dose of Percocet along with it.
My pharmacy has had some trouble ordering Sandoz, and even though it was the brand I started with, they now have to order it specially for me every single time. Sadly, that's the way it will have to be because I'm really not "good" with being in pain 24/7 and the Sandoz brand was the only one that gave me a SOMEWHAT steady amount of relief. I WISH I could have used Duragesic after reading how well it works, but a $400 difference in price convinced me to forget all about that idea.

 
Old 07-01-2011, 08:21 AM   #10
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Re: Fentanyl patch help needed ASAP

akdiva-welcome to the boards. If you look on the upper left side of the message, you will see the date that it wa poster. This thread is from two years ago, and most of hte posters are no longer here. I just didn't want you to wonder why no one had responded to your post.

Have a great weekend...and keep posting. This is a pretty talkative group!

 
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