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    Old 09-18-2005, 10:42 AM   #1
    wolfmarket
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    Fentanyl Patch Users

    I started on the 50 mcg patch and now I'm on the 100 mcg patch. I've always had a 3 day cycle that goes like this:

    DAY 1-a few hours after application, I get tired. Pain relief is very good, but I am sleepy. Sometimes, I get combination of being tired but unable to sleep. I'd be unable to drive.

    DAY 2-A little after awakening, I am much more alert than previous night. Pain relief is less, too. Able to drive.

    DAY 3-Pain relief is mild to minimal. Alert.

    The thing I'm wondering about is that first evening. Does anyone else get that very tired feeling on the first night?

    Alan

    PS: I note that lawyers are now advertising to try to represent relatives of those who died while on the patch, similar to Celebrex and Vioxx ads!

    Last edited by wolfmarket; 09-18-2005 at 10:43 AM.

     
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    Old 09-19-2005, 10:00 PM   #2
    jdlfmc
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    Re: Fentanyl Patch Users

    Alan, Iwas on the patch for a couple of years and had much of the same effects, I never did get more then 48hrs of Pm from them and have since changed to methadone for Pm and like it much better with less side effects and I like having more control over my meds then I had with the patch.
    Linda

     
    Old 09-20-2005, 07:08 AM   #3
    Drewtn
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    Re: Fentanyl Patch Users

    The patch has some fentanyl on the outside sticky part so that it will instantly start to work once applied to the skin. That is probably why you are experiencing the initial sleepiness. You also have something like 10 hours left in the skin from where you had it applied the last time. How did the 75ug work?? Maybe a 75ug every 2 days is a better idea?

    If you look at the full prescribing information sheet there is a chart of the ups and downs of the medicine. (The second part of the chart is of 3 days) If I notice a particular pattern that I don’t like I shift the time I change the patch. Maybe you can change the time so the time you are very tired is at night while you sleep. Just a suggestion. I also think the longer you are on it the better it evens out. The temperature of mine also greatly effects how I feel.

    Best of luck to you!
    Drew

     
    Old 09-20-2005, 08:02 AM   #4
    wolfmarket
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    Re: Fentanyl Patch Users

    I'm on the 100's now and just applied #3 last night. I find the later in the evening I put in on, the less tired I get and the easier I rebound the next morning.

    Alan

     
    Old 09-20-2005, 06:04 PM   #5
    Josie115
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    Re: Fentanyl Patch Users

    I've been using the patch for about 3 months now. Started at 75mcg 72 hrs. didn't last for one and didn't do a whole lot for pm..vicodans for bt. first month my doc upped it to 2- 75 mcg. every 2 days..better..but to jump up to 150 from 75 and go to 2 days...I eased into it a bit..by adding one on the 2nd day..and switching off each day until both went on at the same time..I also put mine on in the evening due to the first hit of sleepiness..seems to be working. Either I've had just way to much of a flare, but 150 mcg. isn't doing a whole lot..taking the vicodans now..(was trying to cut down)..not sure what to do next..the vicodans seem to make me a bit sleepy when I add them..I need to be clear headed at work..I am in big pain by mid afternoon though..

    Always wondered about that initial wave of sleepy when I put new patches on. I've also tried leaving the 2 old ones on for a day or so after putting the 2 new ones on..can't tell if I get the extra help or not..flare up was bad this past 2 weeks.. Anyway..thanks for sharing this info..I'm still finding my way here..suggestions are helpful..also, i'm using the mylan generic..maybe I should consider switching to sandoz?? also, had been applying the patches to my hip and read that upper body is better..It may have added some help to moving them up..

     
    Old 09-20-2005, 07:52 PM   #6
    wolfmarket
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    Re: Fentanyl Patch Users

    I've always used Sandoz so I really have nothing to compare it to. Many who use Mylan either love them or hate them!

    Sandoz patches are very similar to the brand Duragesic because they are mfg by same company, Alza.

    Alan

     
    Old 09-21-2005, 10:31 AM   #7
    StMishl
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    Re: Fentanyl Patch Users

    Hi, I just wanted to add that I too use the Sandoz patches, and have issues on day 3. I used to change every 2 days, but due to a change in insurance, I now have to last the whole 3 days... Can those of you who overlap patches (leave on the old when putting on the new??) explain how this works? When do you do this? Would I put the new one on on day 2 ? Would I run short this way? I ONLY get the 10 for an entire month.

    Also, jute a note that my Pain Dr. just added a low dose of MSContin (15 mg 2 x day then 3x day on day 3) to my pain regimin to help cover the pain for the fact I was not get complete pain relief.... instead of increasing the dose on the patch, he added a different class of med... it seems to be working so far... anyone else do this??

    Thanks...

    Michelle
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    Last edited by StMishl; 09-21-2005 at 10:33 AM. Reason: spelling

     
    Old 09-21-2005, 05:07 PM   #8
    Josie115
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    Re: Fentanyl Patch Users

    I just got so screwed up trying to overlap at first...I would have one patch on, then add the new one the next day..then take the first one off the next day and add the new one..and so on..I just kept getting screwed up on which one came off when and tried my best rotating sides..eventually, i just slapped 2 on and took both the old ones off..no problem..but I never did figure out if I was really accomplishing anything.. I do use the vicodans the second day..I try to get through the first day, most times I can manage..lately it's been bad..sounds like the bt meds are working..and that adding the 3rd on the last day makes sense..

     
    Old 05-18-2007, 04:40 PM   #9
    pima58
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    Re: Fentanyl Patch Users

    Quote:
    Originally Posted by wolfmarket View Post
    I started on the 50 mcg patch and now I'm on the 100 mcg patch. I've always had a 3 day cycle that goes like this:

    DAY 1-a few hours after application, I get tired. Pain relief is very good, but I am sleepy. Sometimes, I get combination of being tired but unable to sleep. I'd be unable to drive.

    DAY 2-A little after awakening, I am much more alert than previous night. Pain relief is less, too. Able to drive.

    DAY 3-Pain relief is mild to minimal. Alert.

    The thing I'm wondering about is that first evening. Does anyone else get that very tired feeling on the first night?

    Alan

    PS: I note that lawyers are now advertising to try to represent relatives of those who died while on the patch, similar to Celebrex and Vioxx ads!
    Below is my post copied from a different thread, aplogies if you have read it already. I just put on my new patch with some plastic backing I cut out with scissors to block about 1/3 of it, I am hoping i don't get such a dramatic increase of pain medication and then a lousy day at the end such as the one I had today.


    Isues w/product info for blister patch

    Hi all.

    I use a 25ug/hr patch for IC bladder pain and IBS.
    Recently My drugstore filled my prescription with the
    Sandoz product instead of the Mylan product which I
    specifically request.
    I prefer the Mylan product becaise I find the pain
    relief to be more uniform over the 72 hours and, if my
    symptoms are not bad, I can cut the patch into parts
    and put on less. I find that I can put these parts on
    later as needed.
    I understand that modifying one's prescribed dose is
    usually not recommended, but, my pain is not at all
    predictable.
    I am completely disgusted with this Sandoz product. I
    have been finding that it delivers MORE pain relief
    than I need for the first 12 hours, and an ABSOLUTELY
    insufficient dose during the final 12 hours. The Mylan
    patch tended to do this as well, but to a much smaller
    degree.
    I put my patch on my chest as I am sometimes quite
    active and have had patches detach and stick to
    clothing when on my arm.
    I was wondering if the increased temperature level on
    my chest is the reason.

    If you look at their little graph in their paperwork
    that comes with the box, they don't show peaks and
    dips in Fentanyl blood serum level that I clearly
    experience. I am planning to place a small section of
    the clear plastic backing from my next patch between
    the blister part and my skin to slow the absorbtion
    rate. I would prefer not to have to tape it to my arm.
    I am ****** at my pharmacist for not stocking the
    Mylan product (he assures me he will have it next
    month, but I am usually so miserable when the patch
    runs out that I am not into going through the trouble
    of finding a pharmacy that does have the Mylan
    product), and I am wondering whether their statistcal
    method for evaluation of average (time versus dosage)
    is a valid way of of representing this product to
    Doctors and patients. My life has become a chaotic
    battle against debillitating pain arising
    unpredictably, and I find myself losing at least 1 in
    three days because I have not slept and/or ache so
    badly that I cannot concentrate on what I need to do.
    I am sceptical that the data presented accratelly
    repesents the experience of users.
    I used the duragesic patch for a few months when I
    was first on the pain patch and didn't know any better
    until it was replaced by the mylan patch by my old
    pharmicist because it was cheaper. I was immediately
    struck by how much more uniform the pain relief was. I
    concluded at that time that the Mylan delivery system
    was more linear.
    I plan to make this complaint again to my doctor. In
    the mean time I am curious as to opinions of other
    users of this dosage (25ug/hr) if they have had
    similar experience with these two types of delivery
    systems.
    Also any suggestions on how best to use these blister
    patches, would be welcomed.

    =8-]

     
    Old 05-18-2007, 07:38 PM   #10
    BrittleBones
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    Re: Fentanyl Patch Users

    Wow!! Is it just me that is blown away by what folks are doing with their patches?? I just started using the Sandoz brand 100 mgl (or whatever the dosing unit is) and it says that the patient should NEVER cut their patches or try and interfere with the delivery system in any way. Also, placing two patches on and then putting another 2 on until the first 2 have run out of medicine sounds pretty touch and go to me! I would be very scared if I was trying to do that, but hey....it's just my opinion. I find that the patches stick best on my upper arm. I've tried my thigh, but that was not a good spot. I'm trying to get ahold of some of the Johnson & Johnson Bioclusive bandages or tape that are supposed to go over top of the patch for better adhesion. I called the company only to find out that you can't get them just for the asking anymore. The recording instructed me to mail in the label from my prescription or a copy of the original prescription. They are free, but sounds like a bit of a hassle to me. Anyway - maybe somebody else will come along who has tried doing what you are talking about with blocking part of your patch, etc., I'd be interested in what others think. All the best - KathyMac

     
    Old 05-18-2007, 11:07 PM   #11
    erfan
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    Re: Fentanyl Patch Users

    The original post I wrote is over 2 years old. I now wear a 100 mcg patch and I have developed an ingeneous way to keep the patch on. I use Band Aid "Tough Strips" and put one strip along the top and edges of the strip like a box around the patch. It always sticks even in the shower.

    Still using 30 mg Oxycodone for bt, up to 120 mg daily.

    Alan

     
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