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  #1 (permalink)  
Old 05-17-2009, 05:27 PM
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Question 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.
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  #2 (permalink)  
Old 05-19-2009, 09:10 PM
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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.
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Old 05-19-2009, 09:33 PM
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Quote:
Originally Posted by Donna618 View Post
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 hate fentanyl. It has all kinds of negative side effects, I try to talk every single person I see using them to stop.

Wait until it comes time to possibly get off those things. What a lovely detox fentanyl is.

Your dr is trying to start you at the lowest possible dose so you don't feel the negative effects. You're on a very small dose. Wait until you slowly get up to 100mg ... that's where the fun really starts.

I would choose a different medication, but that just me. I'm sure someone else will pop on here who will LOVE the patches. Not me. God bless.
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  #4 (permalink)  
Old 05-20-2009, 12:25 AM
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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.

Cper
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Old 05-20-2009, 02:46 AM
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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.
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  #6 (permalink)  
Old 05-20-2009, 04:16 AM
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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,
Cats
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  #7 (permalink)  
Old 05-21-2009, 09:22 AM
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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.
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Old 05-21-2009, 06:29 PM
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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.
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Old 05-23-2009, 12:42 AM
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Donna,

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.

Cper
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  #10 (permalink)  
Old 04-29-2010, 12:47 PM
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Default Teva patches

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..
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  #11 (permalink)  
Old 05-20-2010, 12:10 PM
 
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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.
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  #12 (permalink)  
Old 05-21-2010, 04:31 PM
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Quote:
Originally Posted by Dvin211 View Post
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.
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.)

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.
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Last edited by PeterRabbit2; 05-21-2010 at 04:35 PM.
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  #13 (permalink)  
Old 06-08-2011, 02:21 PM
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Default 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.
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  #14 (permalink)  
Old 06-08-2011, 11:49 PM
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Quote:
Originally Posted by Donna618 View Post
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.
Sometimes it takes till the next cycle of the patch for it to work, 3-6 days.

I'm no pharmacist but i am a pharmacy tech.

Hope all is well.
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