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orsdln · 04-08-2011, 10:13 AM

for medicare purpose we are trying to get appeal to continue on fentanly patch (have been taking for 11 years) they want me to change to MS ER when I am already taking 250 oxycodone a monthe so need to know if patch bypasses the liver and goes directly into the blood stream?

Fiona_Jo_324 · 04-09-2011, 01:33 AM

Everything I have read in regards to the Fentanyl Patch is that it goes directly into the bloodstream and bypasses the stomach and liver completely. That is one the the benefits of this type of system. I know for me it has been wonderful. I have been able to remain on the relatively low dose my PM Doctor started me on and I manage to wake up in the morning as close to pain free as I have experienced in many years. Of course there have been adjustments my Doctor has made made, I now change the patch every 48 hours, instead of every 72 hours and I do have a narcotic available in pill form to take for break through pain.

I hope this helps.

~ Fiona Jo

cleanser · 04-10-2011, 04:14 PM

It doesn't bypass the liver completely. The drug is still metabolized by the liver it just avoids first-pass metabolism.
The transdermal delivery system allows for higher bio availability (more active drug in your blood stream). The reason why you dont see fentanyl pills is because a large portion of it would be metabolized by the liver into inactive drug.
The lollipops (transmucosal) also avoids the first pass effect.

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