Discussions that mention duragesic

Pain Management board


IMHO, you should not have to stop the patch in order to get adequate post-op pain control.

You s/b able to continue the patch and be given something additional through IV. This is a no-brainer, and I hope your PM doc will work with you on this.

I had bowel obstruction surgery when I was on 175mcg/hour Duragesic patches and all they did was add fentanyl IV to cover the post-op pain. During the hospital stay, as the pain subsided they titrated the fentanyl IV downward until I was able to leave the hospital using the same amount I went in with.

Many times folks think they are getting no relief from an opioid med, and try to stop - only to learn they really were getting relief, just not enough. And, because of the tolerance developed, they suffer withdrawals too. Even though you have gone a a couple of days w/o changing a patch, that doesn't mean you will be WD free. Hopefully your PM doc will see through the nonsense about having to stop the patch and speak with your surgeon about pain control post-op. You might ask your PM to manage your post-op pain - that's what I did with my surgery.

steve

steve
Well since you are on the Mylan patch it should be easier to titrate down because you are able to cut these into smaller pieces as opposed to the ones with gel(Sandoz, Duragesic) which should NEVER be cut.

If you were on (2) 25's it would be easier to titrate down but I imagine you are on the 50's.
If you are on the 50's then measure across the patch, and

Cut it by appx. 1/4 of the width. (Do this for 1 week)

Cut it by appx 1/2 of the width (Do this for 1 week)

Cut it by apprx 3/4 of the width (Do this for 1 week)

Then, after 3 weeks you should be able to remove it completely and go through minor withdrawal. This is a BIG "IF" because many people take at least 3 months to cut down and go completely off the patch. You are going to be titrating down rather quickly so I will be interested to see how things work out. Good luck

brian
[QUOTE=kmit524;3682435]Brian,

Actually when I go to the doc. on Monday I have to pick up my script for refill, what if I got 25's instead of 50's you said that would be easier, how do you mean?

Thanks,

It would be easier to cut them down. It is going to be hard to estimate 3/4, 1/2, and 1/4 of the 50 patch.

However, if you get 2 of the 25mcg patches. You can cut 1 of them in half the first week and then you would wear appx 1 1/2 patches.

Then the second week you would only wear the (1) 25 mcg patch

Then the third week you would cut the 25mcg patch in half and wear that.

Then after the third week you would be wearing appx. 12.5mcg.

PLEASE, PLEASE MAKE SURE THAT YOU ARE GETTING THE MYLAN BRAND. YOU CAN ONLY CUT THE MYLAN BRAND.

[SIZE="3"]PLEASE DO NOT CUT ANY OTHER BRAND(DURAGESIC, SANDOZ, WATSON) OF THE PATCH

Do you see how that would be easier?

brian