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Fentanyl patch doesn't work
Fentanyl patch doesn't work
Hi I've been taking vicodin on and off for the last 8-9 years. I have three herniated discs that sometimes respond to other treatments (prednisone, epidurals) and when that happens I completely go off the vicodin. The past 4 years I've been on vicodin the whole time, but the dosages go up and down from 7.5/500 to 2.5/500 depending on my pain level. Well I finally went to a new pain management clinic since I hadn't found a treatment that worked in recent months to control my pain and the 7.5/500 were lasting me only 2 wks instead of the full month because the pain is so bad. I've just been put on the fentanyl patch, 25 mcg, generic made by Teva. At first I felt a little drunk and nauseous but that went away. I didn't get pain relief but thought maybe I needed awhile for it to kick in, but even now, 24 hrs later, I feel nothing. No woozy feeling but also no pain relief. At first I thought maybe it fell off, but nope, it's still there.
I'm wondering is this at all common? Does it sometimes take a few days to start working? Is it possible I got a dud batch that doesn't have enough meds in it? I mean I was told this was an extremely strong med, but I just want my vicodin back now, even if it wasn't really working it brought the pain down a notch or two, where these patches, just nothing.
I guess these ones are too new and no one else here has tried them?
These patches still aren't doing anything at all. If I didn't know better then I'd say they are a placebo with nothing in them.
I am not a dr. My statements are based on years of experience and related education. Consult with the professional of your choice regarding matters of concern.
The patch also takes awhile to begin to work fully, if this is your first time putting one on, I'd give it 6 hours. If you do not feel any pain relief, the mcg you are on is not strong enough. Your doc will need to titrate you to the right dose. I was put on 25mcg to start and it did nothing, then my doc put me on the 50mcg and I got great pain relief with that dose.
There is no question this is a strong medicine, but to many of us it gives us the ability to get back some of the quality of life we lost due to pain and suffering.
I called my doctor yesterday and expect her to call back today. I'll raise the issue of withdrawl with her, Robert, and see if there is something else I could try instead.
CPer, it's been three days and I'm now on my second patch and, nothing. Just sometimes a very slight woozy feeling that goes almost as soon as I notice it.
The one thing that does concern me is that I have noticed having that "heart skipping a beat" feeling a few times. Would the fentanyl cause that? I'll ask my doctor about that too anyway.
Donna, Duragesic isn't that new, we (I) know quite a bit about them, who is the Mfr of your patches? The generics are far inferior to name brand, they're reported to last somewhere around half as long. If you can, try sticking to Janssen's, and watch out for Sandoz's.
Whenever you have a med change it does take time to re-adjust, even going to stronger meds, so do give it more time.
About your heart "skipping a beat", I have a feeling it's just your imagination, but your brain can tell your heart to do funny things, you should mention it to your doctor if it persists.
I think another thing about your titration that you're noticing is, with IR drugs (like Vicodin) you're use to peaks and valleys, Fentanyl transdermal gives you a fairly steady serum concentration (until it wears off). And fyi, 25µg Duragesic is equivalent to roughly 30-60mg of Hydrocodone per day, you didn't say how many 7.5's you took in a day, but I assume 3 tabs, so you are on the right sized patch, and should be receiving adequate analgesia.
Hope this helps,
Cat's Meow, I know that duragesic and fentanyl patches aren't new, but the ones I was using were because the manufacturer, Teva, just got the green light from the FDA to distribute them. I was wondering if that might be the reason they were less effective, because these didn't have the reservoir, they were extremely thin and I think all the meds were in the glue that held the patch on. They did stick on really hard and didn't move at all, which is good since I hear other brands have a problem with that. When I am in extreme pain I sweat bad too, and I am in extreme pain, and even with the sweating the patch didn't budge.
This morning my doctor decided to take me completely off them instead of upping the dosage. I'm being put on Kadian 30s instead.
Oh, I didn't catch that they were made by Teva, Idk about their patches, but most people feel their products are inferior. I think you're right, it is too soon to tell. I'm sure the Duragesic patients will be complaining soon, they know better then anybody, this is the single most drug that I know of that has a constant.
How is the Kadian working for you? This is the hard part about pain management, finding the right medication and the right dose. But once you do, hopefully you will be able to get the appropriate pain relief. I hope it's working well for you.
I totally agree, I have had the worst time with these patches, Rite Aid refused to take them back, which left up the creek...I called Teva and they were going to send me a complaint form./..never got it. Now I have to tell my doctor that I am down to 2 for the enxt 2 weeks, how will he deal with that do you thik??
I was on patches for a couple yrs, (not teva) and they worked great, but for only 2 days, not 3.
These dont work at all..
My girlfriend has been on fentanyl 100mcg patch for almost 3 years. She was started out on the 75mcg name brand gel patches. A year after that to the 100mcg.
About 2.5 years ago the pharmacy started filling generic, they switched her sandoz gel patches. They didn't seem to work very well. A few months later the pharmacy started giving her the mylan patches. She had alot of problems with the patches sticking and she was getting really bad muscle twitches half way thru the second day. Her doctor switched her to changing them every 2 days. This helped but she still had her muscles jumping and twitching on the 2nd day.
About year ago the pharmacy switched to the teva/aveva generic patches. These patches are about twice as big as the mylan patches. At first I had my doubts. Let me tell you though these patches work SO much better then the mylan patches.
First off they stick way better, I noticed since I sleep right next to her that the jumping/twitching was gone. Normally my gf would have me change her patch 48hrs on the dot from when she put it on. Most of her patches now she is 8/12 hrs in to the third day before she has me change it. They work that much better.
Last edited by Dvin211; 05-20-2010 at 12:11 PM.
Indeed, although not usually the case, generics are not ALWAYS created equal. There are some subtle differences that in a very few cases can alter the efficacy of generic vs. name-brand. (Such as dissolution time or as above, patch stickiness.) This occurs very rarely (less than 1% of the time.)
Originally Posted by Dvin211
I can't remember the last time I or anyone I know have had an issue with a generic drug. They are (~99.9% of the time) just as effective as the name brand.
Last edited by PeterRabbit2; 05-21-2010 at 04:35 PM.
Fentanyl Patches and how to keep them on.
I have been on and off these patches for a number of years. I got off after loosing them when they would sweat off etc. And tried them again as the other meds failed to work. This time I put Tegaderm Film used for dressin wounds etc. on top of the patches. They are made by 3M and the size needed for most brands is 4"X4 3/4"s. You can order them from The Medicine Shop and they come in the next day. Your pharmacy may be able to order them for you,mine didn't. Be VERY careful to line them up so they cover the entire patch. You can bathe and shower in them and they don't sweat off. As far as dud patches goes I've had many. My pharmacy seems to never have the same brand so I'm not sure which are better anymore. When it comes to how long they last that all depends on the individual. If you have a comprimised liver they only last 2 days. But as I said everyone is different. If you do get a dud patch notify the pharmacy asap. They will in turn tell the company and you will get new patches. This is just a very unpredictable med. but does work well for the most part depending on your problem. You just have to be patient and have a good repoir with your doctor and pharmacy. Of course I'm not alone wishing I didn't have to take anything. Hope this helps.
Sometimes it takes till the next cycle of the patch for it to work, 3-6 days.
Originally Posted by Donna618
I'm no pharmacist but i am a pharmacy tech.
Hope all is well.
Originally Posted by Elisabeth Lee
I've been on the Fentynal Patches for 2 or 3 years for severe neuropathic pain from HIV/HIV Drugs. I also have Stage Three Liver Disease from Hepatitis C.
I've had many many problems with the patches ever since the beginning. Generally, goes like so. New Patch-Day One, no relief. Day Two - feel decent to pretty good. Day Three - Utterly miserable.
Not to mention the patches peeling off and the like. I'm on a generic but my insurance won't cover the real ones. I don't have a doctor. I live in a small town and drive an hour away to see a nurse practitioner in the nearest small city. He won't give me anything else no matter how much I complain.
But I'm most alarmed with your quoted statement above. There is a piece of the puzzle that I'm missing, based on your statement and my experience. What do you mean if you've a compromised liver they only work for 2 days?
I've tried everything. I started on 2 Percodan per day, for the first 5 years...then it snowballed. In 1985 I had a series of knee, hip & lower back surgeries from complications due to a MVA in 1977. I was prescribed 3 80mg OxyContin + 3 20 mg OxyContin. After awhile, they didn't work as well, so I went on 100 microgram of Fentanyl. The first time I took Fentanyl, it was like I just done an ounce of good cocaine. Just zapped for days. The Iraq war was on television and I watched it for four days straight...embedded with the troops. Watch out with that Fentanyl, it's deadly potent. It's the same stuff the Russians pumped into that theatre in Moscow when the Chechen rebels took over. Be real careful with that stuff, or you'll be a statistic for damn sure.
It sounds like you're not getting the proper dose of Fentanyl. If you're feeling >>>>>> on the 3rd day, you're not getting enough...of course, I've only been taking prescribed narcotics since early 1985. I certainly haven't read all the stuff doctors do...LOL. Who do you trust? Doctors, who have never taken a narcotic in their sordid lives, or a person who has been a guinea pig for 25 years plus, and has taken every type of narcotic there is, or a well read silver spoon fed doctor? If you're say getting 50 microgram Fentanyl patches, maybe your bones should give you 75 micrograms. I went down from 100 micrograms per 72 hours Fenanyl & 3 X 40 mg OxyContin per day to just 50 micrograms per 72 hours of Fentanyl. It doesn't friggin' work and my doctor is now being an ass about giving me 75 micrograms per day. Doctors make me ill.
Just my two cents on the issue. I wouldn't have any problem believing that some Fentanyl patches don't work for some people. The first time I got them, and I only take them every 30 days because I don't want to have to go through withdrawal, which I have heard is brutal. My Dr prescribes me 25 Mcg/72hrs. The first time I got them they seemed to work OK. They were the mylar type, looked like foil. While I did have some trouble getting them to stick they still seemed OK. Since then I have been getting a different style. It's an opaque plastic patch with rounded corners. I also get 3 10-325 Norco per day. Anyway, the plastic patches by Mallinckrodt/Covidien are not working as well. They will fall off pretty easily. I sweat at night because I hurt and I toss around alot. I have four herniated discs and advanced spondylosis and stenosis in my lumbar, not to mention nerve damage in my legs and a recent hip replacement. I am always running out of my Norcos before the end of the month, hence the patches. But, sadly, they don't really do the trick. I often get up in the morning and can barely walk across the room, even with the patch. My Dr is very understanding and has never given me any grief about pain management. He will pretty much do what is needed to control it. I am, however, the kind of person that doesn't like taking an aspirin much less these drugs but living in pain like this just isn't worth it. It's so tiring. So, I take them so as to have some kind of life because I wouldn't bother moving around much otherwise. A lot of people don't understand what it is like, that's what I really hate about the whole thing. They look at me and can't imagine that anything could be wrong. I even have to carry a cane in my car, which I am loathe to use, but sometimes I just have to. I'm only 53 but I feel like I'm 93. It sucks and I really feel for anyone going through this.
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