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    Old 10-17-2009, 06:48 PM   #16
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    Re: New Duragesic Patch Design

    I don't mean to be negative, but I think if the matrix design was the best, Janssen would have done it this way to start with. Conversely, as the original inventor of the patch, they elected to go with a gel pocket design. It provided very consistent fentanyl drips through the skin barriers.

    Mylan debuted the matrix design because it's easy and cheaper. And, I'm quite sure they take full advantage of the 20% rule and skimp on the fentanyl, as Dave says. My PM Doc, an anethesiologist, says that the Matrix design has flaws because the fent is mixed with glue. Depending on how the mix settles on the patch, the fent may get tied up too much in the glue (on some parts of the patch).

    I feel quite sure Janseen switched designs due to the repeated recall issues associated with small cuts in the reservoir. These happened when the assembly line machine cuts each patch and inadvertently hits one of the reservoirs. All it takes is an issue with one patch and then huge qtys have to be recalled. Because each controlled med manufacturer has pre-established manufacturing quotas set by the DEA, they just can't crank up the presses and make more. Consequently, the recalls cause months of supply chain issues. Things got really bad a year ago when the 25s were recalled, and then Docs switched to other strengths and then those presentations ran short, with the same supply vs quota issues. It became a whole nightmare.

    So, while the Matrix design may not work as well, it eliminates the whole recall situation. Additionally, the reservoir design was prone to some abuse, so Janseen killed two birds with one stone.

    If it were me and I was still on the patch, I would try the new Duragesic design and see how it works. If it doesn't work to your satisfaction, i would switch to Watson, who still makes the patch with reservoirs. In fact, the feedback on Watson has been very good. They can be hard to find though, but I would ask my pharmacist if they can order them for you.

    Sandoz would not be a good option because Janseen makes those patches as well (as a generic). When I was on the patch, I tried Sandoz and although it looked identical to Duragesic, it wasn't nearly as potent and I had mini WD issues.

    Hope this all helps.

    Regards,

    Ex

     
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    Old 10-17-2009, 07:07 PM   #17
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    Re: New Duragesic Patch Design

    Quote:
    Originally Posted by Executor View Post
    I'm sure the design change is in response to potential abuse and the many recalls due to accidental slit reservoirs.

    Regards,

    Ex

    This is kinda off subject but...how can someone abuse the patch. I am not on it, but just dont see how someone could abuse it. Like, put on mutiple ones????? Just curious...
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    Old 10-18-2009, 11:44 AM   #18
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    Exclamation Re: New Duragesic Patch Design

    I used to take morphine for my chronic pain. Anyone who has takens pills /used a patch knows about the addiction associated with this form of treatment for pain. My "tolerance" becuase so high that my doctor took me off the two forms of morphine that I was taking and started me on Suboxone.
    It worked great. I took it for over a year and never built up a tolerance. After stopping the Suboxone I am now currently only taking Tramadol, and it has really helped.

    The reason for this post is to warn peole about Fentanyl Patches. Luckily I never had to start using them. If I hadn't had a doctor start me on Suboxone I might be using them now.
    My Dad died March 17th of this year, cause of death: Accidental Death due to Accute Fentanyl Intoxication. When a patient uses the 75mg patch after 24 hours his blood level should have been 1.1 to 2.6. My Dad's blood level was 7.9, all from the one patch that he had on at the time.

    Please consider this when talking to your doctor about your pain management. Coming from me, someone that is constantly in pain even with the tramadol.

    I WOULD RATHER BE ALIVE AND IN PAIN THAN DEAD FROM THE MEDICATION FOR THE PAIN!

     
    Old 10-18-2009, 04:54 PM   #19
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    Re: New Duragesic Patch Design

    Quote:
    Originally Posted by pmtest View Post
    This is kinda off subject but...how can someone abuse the patch. I am not on it, but just dont see how someone could abuse it. Like, put on mutiple ones????? Just curious...
    We can't really go into ways of abusing on the boards, because it's not wise and also the administrator will go bullistic. But for sure the resivoir system can indeed be compromised and abused. In fact, a number of the deaths attributed to the patch are because people were doing things with the patch that should not be done

     
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    Old 10-18-2009, 04:56 PM   #20
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    Re: New Duragesic Patch Design

    [QUOTE=Executor;4102114]I don't mean to be negative, but I think if the matrix design was the best, Janssen would have done it this way to start with. Conversely, as the original inventor of the patch, they elected to go with a gel pocket design. It provided very consistent fentanyl drips through the skin barriers.

    You're right Ex - that's why the matrix was developed. Mylan wanted an edge over Duragesic and that's what they came up with, and in theory, it was brilliant. Unfortunately, the matrix so far hasn't worked nearly as well as the resivoir systems.

     
    Old 10-18-2009, 09:09 PM   #21
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    Re: New Duragesic Patch Design

    Quote:
    Originally Posted by daveseavy View Post
    We can't really go into ways of abusing on the boards, because it's not wise and also the administrator will go bullistic. But for sure the resivoir system can indeed be compromised and abused. In fact, a number of the deaths attributed to the patch are because people were doing things with the patch that should not be done

    Sorry, didnt realize that was a rule...but it makes sense I do understand what you are saying. That is just crazy that someone would do that, but it happens everyday it seems. Thanks for replying and I apologize for asking, I just didnt realize people did that
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    Old 10-19-2009, 11:33 PM   #22
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    Re: New Duragesic Patch Design

    Quote:
    Originally Posted by pmtest View Post
    Sorry, didnt realize that was a rule...but it makes sense I do understand what you are saying. That is just crazy that someone would do that, but it happens everyday it seems. Thanks for replying and I apologize for asking, I just didnt realize people did that
    No need to apologize. It's a perfectly logical question. Unfortunately for us CP patients, drug abusers have figured out just about every way imaginable to take advantage of pain drugs and ways to abuse them.

     
    Old 10-20-2009, 11:33 AM   #23
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    Re: New Duragesic Patch Design

    [QUOTE=daveseavy;4102661]
    Quote:
    Originally Posted by Executor View Post
    I don't mean to be negative, but I think if the matrix design was the best, Janssen would have done it this way to start with. Conversely, as the original inventor of the patch, they elected to go with a gel pocket design. It provided very consistent fentanyl drips through the skin barriers.

    You're right Ex - that's why the matrix was developed. Mylan wanted an edge over Duragesic and that's what they came up with, and in theory, it was brilliant. Unfortunately, the matrix so far hasn't worked nearly as well as the resivoir systems.
    And I have found the complete opposite- the Mylan is the patch that sticks and works for me. The Watson brand with the gel did not stick and probably because I had such a difficult time with it sticking, I did not get the amount of pain relief I needed. It was like sticking a pantyliner to my arm, just awful. I would recommend giving the matrix a chance if it is available.

     
    Old 10-20-2009, 05:09 PM   #24
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    Re: New Duragesic Patch Design

    Quote:
    Originally Posted by Medic8ed View Post
    The Watson brand with the gel did not stick and probably because I had such a difficult time with it sticking, I did not get the amount of pain relief I needed. It was like sticking a pantyliner to my arm, just awful.
    Yes, that's right...If it didn't stick properly, then one probably wouldn't get the right dispensing volume. When the patch is applied to the skin, your body draws out the medicine via absorption. This is why extra heat (electric blankets, hot baths, a fever, and etc) cause the patch to release the med too fast. Conversely, if it's not right on the skin, then the med isn't released.

    Great example....Thxs for sharing.

    Regards,

    Ex

    Last edited by Executor; 10-20-2009 at 05:10 PM.

     
    Old 10-23-2009, 10:51 PM   #25
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    Re: New Duragesic Patch Design

    I just got the new Duragesic design and thought that I had received the wrong ones. They are completely flat and about half the size that they were before. If you hae ever seen a nicotine patch, then it's similar, completely flat and no gel reservoir. So far so good but this is the first patch that I have put on with the new design. I thought they might stick better but I was mistaken and had to cover it with a clear adhesive similar to Tegaderm because the edges started to peel after taking a shower.

    I have still been using the coupon that you can get off Duragesic's site and save up to $50 off your prescription. (Mine is $45 copay - $45 coupon = FREE) You definitley can't beat that considering I got laid off and need to save as much as possible any way that I can. There are plenty of ways to save, you just have to do some searching and maybe switch meds (like I went from Lexapro $45 copay to Celexa (nearly the same thing) for $4/month). That is a huge difference when you are unemployed. Any other questions about the new Duragesic design just ask and the box looks a little different and it says Pricara (a division of Ortho Mcneil Jansen).

    brian

     
    Old 10-24-2009, 06:18 AM   #26
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    Re: New Duragesic Patch Design

    Thanks for the update Brian. Sorry to hear you got laid off. Hope you find something soon.

    Regards,

    Ex

     
    Old 10-30-2009, 06:19 PM   #27
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    Re: New Duragesic Patch Design

    Welcome to Healthboards Karen. Many here have a lot of varied experiences, thus, can offer lots of support and guidance. I hope you find you time here to be very positive. This is a great site.

    Quote:
    Originally Posted by PrettyPainer View Post
    I suffered profound withdrawal this month to the point of not wanting to live and unfortunately good pain management is about the opposite. We had to play with the new patches; first of all there are two chemical analogs for Fentanyl and Duragesic always used (1) that no other manufacturer did. As others have stated the new patch is very similar to Mylan and I have had adverse reactions to that drug.
    How quickly did you notice the effects upon trying the new patches? How did they stick (adhesive) vs the old formation? Just curious as to your overall experience.


    Quote:
    Originally Posted by PrettyPainer View Post
    I had to go through extreme side effects on the new patch this month meaning the nausea, headaches, and burning sensations (partly withdrawal no doubt at all) and partly the different delivery system made it almost impossible to get the correct dosage which was essentially halved in my bloodstream.
    Are you saying that the new patch is about half of what you experienced with the old design? Not sure I understand what you are saying.


    Quote:
    Originally Posted by PrettyPainer View Post
    We went to the 50's (normally I do 200 to 300 mcg/hour brand every 36 to 48 hours and am also on per os meds) and if they are like the "old school" Duragesic the higher the dosage on the patch the better the bioavailability. Now I am at the end of the month and will be seeing my physician face to face Tuesday and am almost out (he knows I spent over $300 this month in Fedex due to changes), so today for the first time in a month had to use an old 100 mcg/hour patch leftover (brand) and hope that I do not go back to full blown withdrawal.
    Why were you using 50s if you're on 200 or 300mcg per hour? Also, do you vary your dosage, or are you on a set amount? 200-300mcg is an awful big range for fent.


    Quote:
    Originally Posted by PrettyPainer View Post
    My biggest concern is that manufacturers of said medications do not notify
    physicians or pharmacists of these major changes and then patients suffer just as if they were on the street not knowing what they get or when. I hate to use that analogy but it often seems that legalities, poor pain management, and consequences of the few affect the MANY who require PM to survive.
    I agree strongly. I have found that patients most often get information from the internet, or sources like this site, before they do from Docs or pharmacies. In fact, when I learned about the new patch design, I called my pharmacist to inquire about it, and he didn't know a thing. In fact, he jokes to me that I am his source of information on a lot of PM related issues. It's a very sad state of affairs when patients are educating Docs and pharmacists.

    Regards,

    Ex

     
    Old 10-31-2009, 06:51 AM   #28
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    Re: New Duragesic Patch Design

    Sounds like you've got it pretty rough with these new patches. I assume your Doc knows everything you're doing and supports you. You've the first we've heard from about the new patch, so I'm curious to see how it does.

    Given all the trouble, have you and your Dr discussed changing LA meds...To something else and punt on the Duragesic? I was on Duragesic one time and was a big patch supporter. However, I was forced to change after one of the recalls when availability was an issue. I now use oral morphine and find it to be very, very good. Specifically, I'm on Kadian. I would never go back.

    Hope you continue to titrate to the new patch. Hope you feel better.

    Regards,

    Ex

     
    Old 10-31-2009, 05:47 PM   #29
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    Re: New Duragesic Patch Design

    Quote:
    Originally Posted by Executor View Post
    Sounds like you've got it pretty rough with these new patches. I assume your Doc knows everything you're doing and supports you. You've the first we've heard from about the new patch, so I'm curious to see how it does.

    Given all the trouble, have you and your Dr discussed changing LA meds...To something else and punt on the Duragesic? I was on Duragesic one time and was a big patch supporter. However, I was forced to change after one of the recalls when availability was an issue. I now use oral morphine and find it to be very, very good. Specifically, I'm on Kadian. I would never go back.

    Hope you continue to titrate to the new patch. Hope you feel better.

    Regards,

    Ex
    I was wondering how the transition from the patch to Kadian was. Was yours an immediate switch to Kadian? Did you find it difficult at all to make the transition? I will probably be getting the new duragesic next time I get my refills and I can't tell you how much I am dreading that. Anything you could share Ex would be appreciated. If this is not the correct thread to ask this question could you please pm me? Thanks for all you do
    Bullymom

     
    Old 10-31-2009, 05:51 PM   #30
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    Re: New Duragesic Patch Design

    Quote:
    Originally Posted by brianpain33 View Post
    I just got the new Duragesic design and thought that I had received the wrong ones. They are completely flat and about half the size that they were before. If you hae ever seen a nicotine patch, then it's similar, completely flat and no gel reservoir. So far so good but this is the first patch that I have put on with the new design. I thought they might stick better but I was mistaken and had to cover it with a clear adhesive similar to Tegaderm because the edges started to peel after taking a shower.

    I have still been using the coupon that you can get off Duragesic's site and save up to $50 off your prescription. (Mine is $45 copay - $45 coupon = FREE) You definitley can't beat that considering I got laid off and need to save as much as possible any way that I can. There are plenty of ways to save, you just have to do some searching and maybe switch meds (like I went from Lexapro $45 copay to Celexa (nearly the same thing) for $4/month). That is a huge difference when you are unemployed. Any other questions about the new Duragesic design just ask and the box looks a little different and it says Pricara (a division of Ortho Mcneil Jansen).

    brian
    Brianpain33 are you still having good results with your switch to the new duragesic patch? Trying to get myself ready for the switch. Hope all is well

     
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