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Doctor prescribed Fentanyl patches...seeking advice!!
Doctor prescribed Fentanyl patches...seeking advice!!
Hi everyone. This is my first post. My doctor prescribed me 20 of the 100mcg Fentanyl patches for controlled release pain relief. He said it would be better than continuing to take Lortab 10mg.
Does anyone have any experience with these patches? Is Fentanyl stronger than Hydrocodone? Why does he think it will be better for me? The reason he gave me was somewhat vague, and he is always very quick with in and ou\t of the office because he has so many patients.
At any rate, will I get the same pain relief than from Lortab? Someone suggested it was more potent than Lortab. The tablets had started to no longer work as well. I am worried that I won't get the same kind of pain relief, although the Fentanyl patches supposedly work very well.
Any insight of any kind would be very appreciated. I have not filled what will be a quite expensive medication for me.
Thank you all.
I would be careful at first I used to get 240 micro x60 hours per month now I am down to 100 per 60 hours 200 micros is a big dose to start with kim
Hi Kim, and thanks for the reply. Yes, I am planning on being extremely careful!! I'm afraid it will break in the shower, or it will leak if I lie on it improperly, but my doctor assured me that it was perfectly safe, and that they are made, so that I can go about my day normally, and that I should not even think about the fact that I have the patch on. I inundated him with tons of paranoiac scenarios to the point where he got a chuckle out of it and said "You'll forget you'll even have it on after a few days!"
Originally Posted by irondog
As for the high dosage, I don't know what you mean. The directions are one patch of 100mcg per 72 hours. Is this too high??
Also, how do you, or anyone else (please!!?), think it will compare to the Lortab?? I am on 10mg of Lortab, and I take 4-5 tablets a day, every four hours. I've done some researching on various Internet sites, and I found that the Fentanyl patches are a whole class "stronger?" than the Lortab??? It is in the same category (C-II) as Oxycontin. How much stronger will it be?
Thank you everyone!
The amount of fentanyl in the 100 patch will kill you if you only take a few loratabs a day. Your Dr should have started you on he 12.5 or 25mcs patch.
Last edited by asdf123; 03-09-2008 at 04:32 PM.
Hear hear! I've never heard of a doctor going from hydrocodone to Fentanyl, and a 100mcg! You could go to sleep and never wake up again, it's too strong. Hydrocodone is .6 times as strong as morphine, Fentanyl is 50 to 100 times stronger the morphine, .10mg of fentanyl equals 10mgs of morphine, so it's at least 20 times too strong. Oxycodone is 1.5 to 2 times stronger then morphine, you can see there's something very wrong here.
Last edited by Cats Meow; 03-09-2008 at 08:11 PM.
My Pain Management Doctor put me on the Fentanyl Patch a few weeks ago. I have been on Hydrocodone for years. It has gotten to where it won't do anything but give me peaks and valleys of pain relief...unlike it did in the beginning. However, my Doctor put me on the 25mg patch. I can't imagine starting out on the 100mg patch. They have been somewhat of a saving grace. I had completely forgotten how it was not to hurt. He did keep me on the Hydrocodone for breakthrough pain. I was terrified to be put on the patch, as well. (Especially after reading stories on this site) But it truly has helped me. I was really skeptical. As for it "breaking" or "leaking", there isn't a possibility of it, unless you misuse it. I am on the generic patch, which isn't filled with gel. And the only thing with it, is I had to go out and buy some 3M Tegaderm (clear, tape-like patches) to put over the Fentanyl to make sure it didn't peel up. The first 2 or 3 did. These keep them from getting wet, etc.
Sorry for putting my thoughts out of order, but I had to type them as they came to me.
You may want to ask your Doctor for a lower dosage to start off with--so you won't be sick. (Also--hot showers and hot tubs can make you feel a bit sick, as well, because the heat causes too much to be released into your body).
Best of luck!
Please Someone Respond Asap!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
WHAT????????????? I just picked up the script, and applied it less than an hour ago. Should I rip it off??? I thought it was sustained-release???? OMG...
PLEASE SOMEONE RESPOND QUICKLY...The girl at the counter said that they are prescribing the fengtanyl patches a LOT. My brother is a pharmacist, and VERY conservative when it comes to this type of medication. Before doing anything, I showed him the prescription, and the only thing he said was that Actavis (the name of the company making the ones I was prescribed and picked up 2 hours ago) was not the best quality, but that it would work fine. That's contrary to what the chick at the counter said, which was "The Actavis ones attach very well"...ARGHHH...I'm totally scared now!
Edit: This patch looks like a screen protector that you would put on a PDA/cellphone. It only says Fentanyl 100mcg/hr. Well, the little "weird looking u". This stands for mcg, no?
Last edited by ChronicPainVT; 03-10-2008 at 10:14 AM.
The Fentanyl 100mcg/hr is the strongest patch the make. It should only be used by people with a very high opiod tolerance. Also the have just been recalled.
So if I was you I would take the patch off.
Thank you!! Yes, I heard about that. However, I'm in Europe at the moment, and I don't know if they're not being manufactured somewhere locally. There is a German address on the package.
Originally Posted by asdf123
Also, I am susceptible to sweating a lot, and it has already come loose. Gee, maybe that's a good thing??? Where should I apply the patch? As a precaution, I picked up a prescription for Dicodid 10mg. In Europe, Hydrocodone medications do NOT come with any Tylenol (acetaminophen), which I suppose is good for the liver? I wish there was something similar in the U.S. Does anyone know as to whether there is a reason for why we don't have what amount to 10/0mg of Hydrocodone???
Anyway, once it comes loose, is it now useless? I am not feeling anything yet, but I only applied it 2 hours ago!??
The patch strength is to strong for you!!!! It takes up to 12 hours before the med starts working. You should not be on that strong of a patch to start off on.
In my opinion it is insane that your doctor jumped you up to 100mcg patches of Fentanyl from hydrocodone. Fentanyl is much stronger than hydrocodone. He should of started you on a much lower dose or prescribed the lolliposps (400mcg) to see how you would react to the med. But still it is quite a jump from a class 3 to a class 2 narcotic. Like most doctors they don't know what the hell their doing. Maybe your doc worked out some kickback deal with the pushers who make Fentanyl. I have lost almost all my faith in the medical profession. Be careful. God Bless.
I must admit I was surprised, too. Can someone compare what I have, the Fentanyl 100mcg patches to another class 2 time released medication, the 80mg Oxycontin? So as to have a valid comparison since we're talking about maximum strengths here... Which is more potent, dangerous, effective, etc.?
Thank you all for helping me like this!!!
EDIT: Alright, I put it on incorrectly. I initially applied the patch earlier today, and to be precise, it was eight (8) hours ago. I didn't really feel anything (obviously...), but now, I feel it kicking in. It is VERY noticeable after I put it on two (2) hours ago.
I am getting concerned now as to what the next 6-12 hours will likely entail. Nobody can possibly know this, of course, but I'm afraid to go to sleep at this point. Being that it has been two hours, I'd like to know what the next few hours will bring. I do feel euphoric a bit, which my doctor told me would happen. I also asked the pharmacist (TWO of them) incessantly about this drug, and they all said the same thing.
I am waiting for responses with baited breath!
Last edited by ChronicPainVT; 03-10-2008 at 05:09 PM.
Everyones body is different, and drugs effect everyone differently. Some people like me have extremly high tolerance for opoids. So my morning dose might be enough to kill someone else. This said, it does seem wierd for you start with the 100mcg/hr patch. That would be like taking 80mg of Oxy every 3-4 hours.
Is that for real? The patches I have are (a rough) equivalent of taking an Oxycontin 80mg every four hours...so, what? That would be 320mg of controlled release oxycodone???
Originally Posted by chargers619
Anyone else agree with this???
I already told you in an earlier post, comparing it to morphine, Oxycodone is twice as strong as morphine, Fentanyl is 50-100 times stronger. I think Chargers is close in his estimate.
Take it off if it's too strong, I just hope you wake up if you fall asleep, 100µg is asking for an OD. Compared to Lortab it's like taking a shot of beer compared to a coffee cup of whisky.
We don't have hydrocodone without apap because it would change the scheduling from a schedule 3 to a 2, no one wants that to happen.
Last edited by Cats Meow; 03-10-2008 at 11:16 PM.
Hydrocodone is weak and good for people with acute pain.Say you break your arm, hydrocodone is gopod for that if you only take it for a couple weeks.Your tolerance gets very high and quickly with a fast acting opiate.
The patches are very good if you have chronic pain,you won't get the euphoric high for long as you tend to pan out and operate normally.
You sound like all you really want is the little buzz you get from hydrocodone.If this is true then you should stay away from the patch and go to rehab...Good luck.....Dave
I will not make any assumptions about your intent in taking hydrocodone or fentanyl like Dave has on this occassion. It's simple, if your really that concerned about the potency of the fentanyl go back to the hydrocodone. Everyone here has told you that Fentanyl is a very strong synthetic opiate. Many times stronger than hydrocodone. Remember in the end your the one who will suffer the consequences of your actions, not your doctor. If you have chronic pain Fentanyl is an ideal pain med, but there are consequences in taking it. Comparing Fentanyl and Oxycontins seems to me to be pointless. Each med has a different effect on the body eventhough they are both strong synthetic opiates. Like I said start out with a low dose of fentanyl to see how your body reacts. Ask your doctor for the lowest dose lollipop. It is ideal because you don't have to use it up all at one time. Just realize what goes up must come down. God Bless
CatsMeow, mpvt, and vduda, (and anybody else who'd like to chime in!),
Thank you for your replies!! First of all, I am NOT taking this for fun! I think one or two people here have suggested that. And please remember, I am overseas right now, where I was prescribed Hydrocodone without apap, as it didn't come in any other form. The ONLY reason for my looking for something else is that my pharmacy informed me that it was no longer being manufactured, and that there was NO other form that Hydrocodone was available in. I have stopped using the patch, as it was making me feel sick, and due to all the alarming responses that I've received here as far as how it is hundreds of times stronger, etc. Initially, my doctor made it sound good, being that I thought "well, controlled-release, and only one patch over 3 days? Ok, done". But I did not know that it was a brutally strong and apparently very dangerous it can be!
Tomorrow, I will go back to the doctor and ask him for OxyContin then, as it also time-released, and won't give me the high's and low's. According to some reading I've done AFTER filling the prescription for the Fentanyl patches, which is consistent with everything I've read in this thread, I should be much better off with it vs. the patches. How does this sound? 40mg. over one day should be fine I guess? I took 1 Hydrocodone pill every four hours, and ended up between 5 and 6 10mg tablets in one day. It would seem to me being that oxycodone is a little stronger than Hydrocodone, I should be fine with 40mg of OxyContin. This would sound logical to me taking into account the amount of each and the respective strength, but I would really appreciaye an answer to that.
What do you guys think? And one more time. *Please*, do not think of me as someone who is doing this for anything other than genuine pain relief.
Thank you agan for your help! It is highly appreciated!!!
Re: Fentyl Patches
My doctor prescribed me 75 mcg of Fentyl Patch, and it almost put me in a coma. That is due to doctor error and the doctor forming a selfish opinion of me. Not only did I lose a week of time, I saw things on the wall, had conversations with people that were not there. You would think my doctor would give me a lower form of pain meds, but instead he just lowered my Fentyl Patch to 25 mcg, which worked, but my arms, legs, and other areas of my body broke out in a rash.
I no longer trust my doctor, who is a PULMONOLOGIST, as he only feels "comfortable" with prescribing me Methadone. Can anyone explain that one to me?
If you are on Lortab, and it works, stick with Lortab. If you decide to try the Fentyl Patch, make sure you tell someone you trust that you are using it, so they can watch/monitor you for the bad and possible fatal side effects. If it had not been for my mom, I might have been in a coma or dead, and Im sure she would have made that "quack of a doctor" I have not practice medicine anymore, especially Pulmonary medicine.
The patch works fine. You just need to be on the 25mgs instead of the 100 to start with.
I cannot believe the answers you are getting!!
Hello, I am very surprised by the answers you are getting. For one, what type of pain are you having is a good question and how frequent? I have been on the Fentyl Patches or rather Duragesic Fentyl for several years now. I started off on the 100's and kept my Hydrocodone. I used the amount of Hydrocodone needed to manage and found that it could be reduced. I still suffered though and was then put on Actiq 1200 - oh I see some eyebrows raising at this! Well, due to the Actiq which is also Fentyl I went down to 75 instead of the 100's. Every thirty days I get 10 patches at 75, 18 Actiq's and 90 Synacomp. I was also on Soma and Xanax. Actually my doctor felt the Xanax and Soma were greater dangers than the rest of the medication and took me off those, putting me on the time released Xanax and some muscle relaxers we are working through that do not work.
Originally Posted by ChronicPainVT
Quite honestly, what I found disturbing about your original post was how your doctor did not give you much time due to "his other patients!" No matter what medication you are on, you must have a doctor who takes the time to review your pain and go over your body when needed. I also get pin point injections every 6 months to a year. The Actiq is for break through pain. The patches are not too strong at 100 if you have been using Lortab's chronically. Just be sure you note if you have the slightest breathing problem. Do not think that when a problem occurs that taking the patch off is the remedy, as it takes 17 hours for just 50% of medication to disipate in your body. Be careful handling them and disposing of them. With your Loritabs you have already become opiate tolerant and the patches wouldn't seem a problem. Now, additionally, the amount of medication, the 100's could be necessary depending on your weight as well.
I would have stayed on the 100's if I did not use the Actiq's for break through pain. I don't even use a full Actiq at once, but instead spread it out as needed. It's pretty immediate and doesn't cloud my judgement like morphine would. I have heard of doctors prescribing 10 100's and then 10 25's from my pharmacist. I am sure I will get hammered for this posting, but feel like it's best to speak to your doctor and make sure that he is available to re-evaluate you each visit. On the medication you are now taking, the purpose it to give you constant pain relief without having to take pills. It's far too easy for some people to abuse the pills but the patches are one for three days and when you wake up you actually feel like getting up instead of waiting for a pill to start working. To be completely honest, no one knows I am on the patches and I can still function like driving or even playing games with the kids.
I am always leary of pain management doctors who just write the scripts without discussing and examing your full case each and every visit. I have a great deal of problems, one is also Fibromyalgia which I am now taking the Lyrica for. It is great! I used to hurt so much. It wasvused to treat just diabetics but now is the only FDA approved drug for Fibromyalgia. I hate taking pills though and would love not to be in pain and get rid of all these meds. My insurance company makes me get pre-authorization on my Actiq's and Provigil (used in Fibro patients so they aren't sleepy from fatigue) evert 6 months. I am 50 years old and have had Chron's since the age of 18 years old. It really did a number on my entire body over the years, causing me to eventually be disabled in 1997. Not a tag I like. I get SSD, but would rather still be working. Good luck to you!! My doctor is great and many of his patients are on the 100 Duragesic Patches. He hasn't lost one or had one overdose yet. He also works in a detox clinic one day a week, so he knows all sides of the opiate cycle. Quite honestly, I don't see 100 as too high coming from Loritabs. II do not believe it is an unsafe dosage. Sorry to disagree with so many, but I've been in pain for most of my life and I do read up a great deal on anything I can to better educate myself and even bring articles to my doctor. One patient brought an article about Soma being mostly for anxiety andd he took all his patients off of it.
I wear my patches rotating from the top of the arms. I have tried other places and it seems the best. If you wear a t-shirt no one will see them. My doctor actually has me keep mine on for four days, putting a new one on of course in three days. Actually not having the Tylenol is a good thing, as it does damage the liver. The anti-inflammatory drugs can pose a problem for the liver too. If your patch comes completely off, throw it down the toilet. It's probably no longer any good. The backing has glue that will clog the holes that the medication comes through. You shouldn't feel the medication as if you were high. It may make you sleepy at first - then you get used them. I have heard this from others, but never had that problem.
Last edited by TexasTornadoDeb; 03-15-2008 at 06:45 PM.
The Patch made you sick??
After reading this post, I revise my other one, you are already on a high dosage of opiates! My, I don't believe you should be taking over 4 pills per day. Luckily, no tylenol or your liver would be having problems. I honestly don't think people understand the patches. They are not as strong as people are making them out to be. My doctor used a calculator especially formulated to determine the dosage from Hydrocodone to Fentyl Patches. The amount you get during timed released is not as much as 6 10's per day! I've been over this with my doctor and that is too much hydrocodone. He knows his business and you don't need to be taking this much. Get a smaller dosage of the patch to keep yourself safe. Although, honestly I feel as if you will get use to the 100's in a day or two. And, it's not true the doctor doesn't pay, they are responsible if anything happens to you. Get your doctor to explain, you definitely need to move away from hydrocodone altogether!
Originally Posted by ChronicPainVT
You had a good doctor for opiates!
Your doctor was right on the mark. You are not the norm. Everyone is different and you are obviously not very tolerant of opiates. The reason your doctor only feels comfortable with the patches and methadone is that the other drugs are considered street drugs and potential for abuse. They will cause a person to quit breathing. Have you ever wondered why Hydrocodone was given when you had a cold? It's a cough suppresant! His field of medicine is the best for knowing what will stop you from waking up and make your body decide not to breath on it's own. My mother is like you, she sees things on the wall with Tylenol 3. She needs a lower dosage than most people.
Originally Posted by agentxdx
So my doctor is back from vacation. Since the Fentanyl was nothing but a disaster, i.e. they came off during showering, it had always left me exhausted the two times I left it on while sleeping, so I wasted a good amount of these very expensive patches. For example, I had always taken it off during the night due to fear of overdosing, and also because I didn't want to wake up groggy every morning. So the maximum one patch would last me was 1 1/2 days, instead of 3 days.
At any rate, he was ready to switch me into 100 tablets of 80mg of OxyContin, and I said wait a minute, let's lower both the dosage and the amount, as I didn't want to make the same mistake twice, and possibly end up with too high a dosage, and then having too many of them, if they didn't work either. So I asked him to please prescribe the smallest amount he could, which was 20 tablets, at the 40mg strength.
I know the active ingredient from when I was on Percocet, and it had always worked fine, although I still preferred Hydrocodone, as it would last longer, and it didn't have the "euphoric high" effect. Well, so far so good. He put down 2-3 tablets a day, and he said to see how I would do on those. I ended up taking two today, one every twelve hours, which the instruction page said to do as well.
So what do you guys think? I like the fact that it's a controlled-release form of oxycodone, with NO acetaminophen in it, as opposed to Percocet, for example. I will monitor it very closely over the weekend and into next week to see if the dose is appropriate for me. If it comes down to having to take 2 a day, should I go for the 80mg strength ONCE a day instead? How "good" is the controlled release layer? Would I really be able to take only ONE per day then? That would be great. Or would it still be better to take two of the 40mg strength??
Thanks everyone!! It looks like I'm getting somewhere now, which I'm very grateful for!!
I want to find ONE darn medication I can go with and stick with. I am currently still in Europe, and they don't come in bottles over here, but rather in a set amount. Before Hydrocodone was discontinued, I always had to buy 5 packages, as the maximum was 10 tabs per "box". Oxygesic, or OxyContin, comes in 20, 50, and 100 of these blisters with 10 each per blister in one box. So what do you guys think? I'm on my 2nd day now of 40mg of Oxygesic, and I did do what the doc "ordered", and took a 2nd one of a 40mg pill, so in total I am on 80mg "total".
My question is, as the 80mg tablets are cheaper than getting twice the amount of 40mg prescribed, and if this works (so far so good), why not go for ONE 80mg, instead of TWO 40mg?? They're time-released tablets, so would the time release layer be sophisticated enough for 24 hours??? I did not wake up all groggy and exhausted, as I did with those Fentanyl patches, so that's already a huge improvement. And it makes sense that I would respond to Oxygesic more than Fentanyl, and as Hydrocodone had always worked for me, and it, along with Oxycodone are both codein derivatives, I suppose that's the reason Oxygesic works for me, too. I will give it until at least Tuesday or Wednesday before I make a decision as to what prescription to ask my doctor for.
My insurance company is excellent, but I can't keep up this switching around, nor is it good for me, as I have to concentrate on my work here, not on these pills. So again, if I get 100 prescribed, which will be super expensive in the case of the 80mg tabs, then I won't have to worry about having to submit this to my insurance for 3 months and 10 days (100 days), as I would only need ONE per day. However, I still would like some advice as to whether this is a good idea, going with 80mg once a day, instead of 40mg twice a day!!???
I would very much appreciate any input.
My opinion, I've tried one of these patches and that don't really work well..Hydrocodone may be too strong, but I did take flexiril similar and it works better, but it made me sleepy..so maybe patch was the best thing that will not make you sleepy...only to relieve the pains..
Originally Posted by ChronicPainVT
I Can! 1) He thinks your usings needle and wants to get you off by at least partially blocking the "rush" resulting from intravenous injection of >>>>>>, morphine, and similar drugs. Or the more likely choice your using Methadone to managing chronic pain due to its long duration of action, and very low cost.
Originally Posted by agentxdx
I'm not sure if you got all the info you needed on the patch or not, I thought I'd share my experience... I was on the patch (75mcg every 48hrs)for over a year for back problems. I was totally freaked out at first. It truly was GREAT! Although, Fentanyl is way more potent than hydro, oxy and morphine, I didn't feel drugged at all! No rush or buzz! It relieves pain!!! I slept more, so it makes you a little tired. I think your dr knows what's best and he wouldn't give you so much that would knock you out. My only problem w/them was they would come off, and I wouldn't know and all of a sudden, I'd start getting sick, withdrawls...not fun!!! Other than that, they worked great for pain!!! Good luck to you!
Originally Posted by ChronicPainVT
Let me put it this way. I detoxed cold turkey from chewing 10-15 80s a day and the fentanyl WD made that seem like a day at Disneyworld.