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-   -   Fentanyl Patch 72 hrs or 48hrs???? (https://www.healthboards.com/boards/pain-management/459042-fentanyl-patch-72-hrs-48hrs.html)

onyxgates 01-03-2007 05:41 AM

Fentanyl Patch 72 hrs or 48hrs????
 
I have noticed a pattern that every 3 days my pain shoots up to an 8. On the first day I am at a 5 or 6, the second day a 6 or 7 and the third day it is up to an 8. Now I can't say for sure this happens every time but it sure seems like it lately. So my question is this...How many of you switch every 72 hrs vs. every 48 hrs. Please respond as I am going to see my doctor tomorrow.

Thanks!

whitfield 01-03-2007 06:49 AM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
I have been on the Fentanyl Patch now for 3 years--100Mcg--told my doc they really only last 2 days--which is true, so he prescribes percocet--works for me--He would give me more patches, but my insurance will only pay for 10/month! Hope this helps--
Roger

kim4074 01-03-2007 08:47 AM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
My fiance goes through the same thing with his patches. He finds that they only really work for about 48hrs. Sometimes he changes them early cause the pain is just too much but then he is short at the end of the month and like the above poster he can only get 10/mo. He is given lortab 10/500 to take for the breakthrough. He told his Dr about this and he said on the 3rd day to just up his Lortab. Not sure if thats the best but for right now thats all he can do. I think this is common he did tell his Dr this and he seemed to understand and bumped him up to a higher dosage but my fiance was unable to adjust to the higher dose so on the 3rd day he just takes more bt meds. He was wondering if he switched the spot of where he puts them is this would help. I dont know though. Hope you get the help you need as I know how hard it is to be in constant pain. Kim

IZZY'SMOM 01-03-2007 10:49 AM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
Hi,
Im on the 50's and havent ever been able to go three days. I tried the 75's and they were too strong. So now i do as the abouve poster stated. I use my b/t meds hydro.7.5 on the end of the last day or in case of anything else. i did notice that now i am having to use my b/t meds sometimes even on the second day in the morning, so maybe I may have to tell my doc, as it is making me short on those. ugh!~ I hope that your doc will help you out. My doc does write my script for 48-72 hours so my insurance does pay for mine. If not, they cost 160.00 or more. Good luck, let us know what he says~
My doc only has myself and two other patients on the patch, so hes pretty receptive when we have all told him they dont last us 72 hours. He told me that on my last visit. The other patients said the same thing.
xoxoxoxo
IZZY'SMOM:wave:

Rrector 01-03-2007 12:47 PM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
Hi Everybody: I was on the patch (Duragesic) about four years ago at 100 mcg/hr and my doctor put me on them with a change at 48 hours from the start. He knew and it seems other doctors are starting to get the message that they just don't last for 72 hours. I was lucky, I never had any problems with my insurance paying for 15 per month.

Onyxgates, I don't have any magic words of wisdom for you, I wish I did. All you can do is talk to the doctor and if he won't up you to 48 hours on your change, see if he will at least write you a script for some additional meds (oral) to take that last day on the patch. Make sure you get something strong enough to do some good, because if you're use to Fentanyl you get from being on the patch, you need some heavy BT meds.

Hopefully, some day the insurance companies will realize that what all the patients are saying is right and the patches just don't last the three days they're suppose to. Let us know how you doctor visit goes and what he has to say.

forginon 01-03-2007 01:18 PM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
[QUOTE=kim4074]...He was wondering if he switched the spot of where he puts them is this would help. I dont know though. Hope you get the help you need as I know how hard it is to be in constant pain. Kim[/QUOTE]
If memory serves you are supposed to use a new location every time you apply a new patch. I used to rotate sites between my upper arm, my chest and my upper back/shoulder.

I believe they consider the existing site to be somewhat irritated and therefore recommend a new location each time. I learned from experience that irritated sites can be prone to draining patches more quickly than they otherwise would. This could be one reason for the patch lasting only 2 days. But, as others have said, my patches only lasted 48 hours as well.

Best of luck with insurance acknowledging the need for 15/month. I wonder if insurance is balking because of the way the doctor is writing the prescription. My doctor used to write apply a fresh patch every other day, or something close to that. I don't believe she actually wrote the duration in hours.

kim4074 01-03-2007 01:39 PM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
He puts his on his upper back and shoulder area and he does switch the spot with every new patch but it is always on that area of his body he switches sides and such with a new patch. I guess he was wondering since he always uses his upper shoulder area for the last 1.5yrs if he should try another part of his body. Maybe I will tell him to try his upper arm. Does anyone else notice that they also dont stay stuck good for the 3days? He uses tape to keep his on. Wondering if that is an issue too. He is going to discuss this with his Dr. As another poster said when he was bumped up to 75mcg that was just too much for him to handle so he was bumped back down to 50mcg's. I just wish there was something else for him to keep him comfortable. Another ? does anyone else get the RLS towards the 3rd day when it is wearing off. It gets so bad that he cant even sleep and has to get up in the middle of the night to take bt meds. Just wondering. Thanks for any response. Kim

whitfield 01-03-2007 03:08 PM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
I find that I alternate between upper arms--only place I don't seem to need extra tape--as you know the larger the patch, the higher the Mcg--with 100--the largest and therefore more prone to coming off.--Have tried thighs and chest--never seem to stay for me.
Roger

IZZY'SMOM 01-03-2007 03:26 PM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
I used to put them on my upper arms, and I use the Mylan brand, they are cheaper and smaller. Also they dont have all of the gel right there that could leak or puncture when i have small children, dogs, ect. I have had super luck with those now.
A started trying my upper thighs this last batch of patches, because I like to wear sleeveless tanks and shirts, and I didnt want them on my upper arms. I cant tell any difference. I do know that if I am going to get in the hot tub for a very short time, I do remember to do it on the nite I change my patch. My doc said I could hot tub with the patch, but only for a short time. So i dont want to take a chance on one coming off, or having one deliver too much med. at one time.
Others have suggested the Tegaderm to keep the patches on. I havent needed them but know of others that use them. I know they say not to tape down the WHOLE patch, just the edges.
I hope your docs will try to write the script different for you all, thats a shame that if its not lasting the 3 days, that the insurance wont cover it. Im always so super careful with mine and terrified one will come off or something, because of insurance being so stingy.
I havent had the RLS because I get to change my patch thankfully more often, but I never have had that, ever. I know the 75's when i tried one box of those, I couldnt even drive on them the first day. I was OUT of it. :eek: I hated it. I couldnt function, and feel much better now on the 50's. i dont know if my doc will give me anything stronger for b/t than the hydro. 7.5. i asked once and he didnt want to. So I feel like if I can change every 48, Im pushing it asking for stronger meds. They work if I take 2 tabs 3 or 4 times a day, when I need them, but I run out too soon. Guess thats something Ill have to work out and visit with him about. Good luck to everyone~
xoxoxoxoxo
IZZY'SMOM:wave:

Rrector 01-03-2007 03:31 PM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
I never had any problems getting the Duragesic patches staying on and I didn't use any tape. One thing everyone has to remember, is that the patch has to be put in an area where there is no hair. It must be clean and free of any residue adhesive from previous patches. I always used my upper arm and would just alternate them and it worked just fine.

djemcee 01-03-2007 04:27 PM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
I change them every 48 as 72 was not cutting it. Insurance payes for 15 a month for me. I change locations between upper arms to side rib cage area.

Always a different spot from the last patch. basically I go in a circle around my body :)

California Chris

onyxgates 01-04-2007 11:54 AM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
No dice every 72 hours and no breakthrough meds. He is really pushing me towards having the surgery (fusion). In fact he says he would like to try and take me down on the patch (not right now but later). Geez...talk about pressure...looks like I have no choice but to get the surgery!!

kim4074 01-04-2007 11:59 AM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
Can you get a second opinion. I have known people who have that done and it doesnt work. Ask your doctor how many successes he has had? They also get kick backs from the companys so they make even more money for doing the surgery. None of my fiances Dr's will do the surgery cause of the success rate. I dont know it just sound fishy that he is only pushing surgery that doesnt have a good recovery rate. A friend of mine just had that and is now worse off than b4 it. So do your research. Dont be bullied into an operation that your not 100% comfortable with. Kim

Rrector 01-04-2007 12:16 PM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
I'm with Kim on this one. I agree that there are too many failures to just jump in and say ok, if you think it's best. He's using the drug thing to push you into doing something you're not comfortable with. At the very least, get a second opinion. Make sure you don't get the other opinion from a surgeon.

onyxgates 01-04-2007 01:24 PM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
Okay, I am confused...If not a nuero than who should provide me with a second opinion? I am planning on going to see a neuro after my appointment next week with the ortho spine surgeon. I was told to NOT let an ortho do my surgery. Still not sure why but okay...I'll go with it. Do any of you know why?

Director: Should I go to a different Pain Mgmt doctor??? I am feeling in my gut that it might make sense.

zach016 01-04-2007 01:36 PM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
Hi all,

I was on the patch for a few months a couple of years ago (they worked better than anything I'd tried, but even after trying about 4 different creams they ended up irritating my skin so much it bled).

In the prescribing directions in the Physicians "official" directions AND on the directions in with my patches it clearly said that some people DO need to change the patch every 48 hours and if 72 hours isn't working to Rx them every 48 hours. Do your instructions say that??

Zach

IZZY'SMOM 01-04-2007 01:45 PM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
Thats a load of crap...IMO. I think that Director is exactly right on this one, and you have a right to do what YOU want. Thats just inhumane to make you go 72 and no b/t meds at all. :rolleyes:
I had a gal last summer that I golfed with, and she walked 18 holes every day. She had a surg. talk her into the surg. [fusion] and she is in an impatient rehab, has been for almost a year, due to paralysis from the surgery, learning how to live her life all over again.
Not trying to scare you at all, but she didnt feel good doing into it, and wishes so much she would have gotten more opinions.
Dont be bullied, and keep us posted. Im sure there is someone out there that will be good to you and help you out until you feel that you are ready for something. Take care,
oxoxoxox
IZZY'SMOM

Rrector 01-04-2007 03:22 PM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
Hey Onyxgates: Sorry for the confusion, mostly on my part. I thought you were seeing a Nuerosurgeon now. Are you or is he just in PM? The reason for asking is, surgeons are notorious for not wanting to prescribe, but pushing surgery. That's what I thought you had going.

A second opinion from a PM wouldn't hurt, but I was thinking more in the lines of a Nuerologist who doesn't do surgery. You're talking about having an Ortho doc do your surgery. I'm not too sure about this either. Any one else feel like it's more in the line of having a Nuerosurgeon do the procedure rather than an Orthopedic surgeon do it? I may be wrong but I thought most fusions, and other spinal surgeries were done by the Nuerosurgeons.

What ever you decide, just don't let them push you into a surgery that doesn't have the greatest success rate without at least getting a good second opinion.

whitfield 01-05-2007 07:09 AM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
[QUOTE=zach016]Hi all,

I was on the patch for a few months a couple of years ago (they worked better than anything I'd tried, but even after trying about 4 different creams they ended up irritating my skin so much it bled).

In the prescribing directions in the Physicians "official" directions AND on the directions in with my patches it clearly said that some people DO need to change the patch every 48 hours and if 72 hours isn't working to Rx them every 48 hours. Do your instructions say that??

Zach[/QUOTE]

I have looked through BOTH the Full Precribing Information and the Patient Information that comes in my box of 100Mcg Patches--the ones I get are made by Sandoz and look and feel exactly like the name brand Duragesic--even made in the same facility--But I cannot find where it says may only last 48 hours on some patients--Has all kinds of charts etc for doctor--It does say to put on every 72 hours OR as prescribed by your physician--Just wanted to show my doctor because as I said they really do only last 2 days for me--Was wondering where I can find that "official" manufacturer statement so I could show my doc. Thanks
Roger

IZZY'SMOM 01-05-2007 11:23 AM

Re: Fentanyl Patch 72 hrs or 48hrs????
 
Hi all~
I just looked on my Mylan insert and it says to change it every 3 days OR as directed by your physician.
xoxoxox
IZZY'SMOM


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