Breakthrough Pain - I have recently started using the fentanyl patch. and when that is going on am i getting the medicine into my system??? it seems like i get relief after i put a patch on in about 1/2 hour and then for about 3-4 hours after and then the edges start to come loose and then i don't feel much relief at all after that...
As a fellow fentanyl patch user I can tell you YES, it is common to have breakthrough pain when using the patches. First of all, even the adhesive on the patches has fentanyl in it. Remember, the fentanyl in the patches takes several hours to take effect because the medication has to make it out of the patch through the transdermal membrane and get to your capillaries to geet the medication in your bloodstream and up to the mu receptors in your brain. The patch secretes a certain amount of medication per hour for the life of the patch, supposedly 72 hours. So, I don't understand how you could only be getting 3-4 hoursof pain relief. You might want to keep a chart at first to see how your pain relief is hourly. Also, in most people with chronic pain, not all of the pain is gone. Most is gone, but the fentanyl should bring it down to a tolerable level. If not, talk to your doc, might need to up the patch.
For the second part of your question, patches coming off before it's time, is common. Depending on the maker of your patch, I take Watson, the Mylans are littler... they all can come of starting around the edges, and of course you aren't getting the full dose if the transdermal membrane is not totally in contact with your skin. Think about it, There are different ways to remedy this situation. When it happened to me, I went to the drugstore and bought some "Tegaderm", ask your pharmacy tech, they will show you what is appropriate to use. Or you can place them in a strategic place where not much movement occurs... I stick mine under my breasts and have had only one come off while I was sleeping... ooops. Think about what and where you want to place them, if in a hairy place... clip the hair short with scissors don't shave, put no lotion or powder on your skin, ONLY WATER before you apply the patch.
Also, for the breakthrough pain that occurs between patches, that isn't supposed to happen because of the long half life of fentanyl being 17 hours...
ask your doc what he/she recommends. The doc might not give you and meds, but it is ok to ask. Theoretically, there should be no reason for pain, but as we all know pain is pain with it's ups and down, hurts worse then not as bad... just like every thing else in life.
I wish you well snickers, one more thing... when you ask a question on here, it is better to click on the conversation button rather than direct, because for a full discussion of your problem, conversation allows us to ask you questions and you can answer, others can join in the conversation... while direct only allows one response from each of us on here... just a little knowledge goes a long way.
Hope your luck with the patches gets better, Happy Spring!
The sweetest Happy Hippie
It's important to put the patch on an area on your body that you dont sweat too much. The instructions say you can put it on your upper chest but for me my upper arm just below your shoulder has been the best location and I've been taking the Fentanyl patch for 12 yrs now so trust me use your upper arm area only. If you need to put another patch on after you take the old one off, you CAN use the same area on your arm if necessary the directions say otherwise but you can. I require 2 100 mcg patches at all times so I use both my upper arm areas for the patches Also, pick up a product from Nexcare called Nexcare Flexible Clear Tape by 3M. This will prevent the patches from peeling at the corners and gets that nasty glue residue that always forms around the edges after a day or so depending on the brand of patch you use. I prefer Milan or Sandoz over the liquid filled reservoir patches. They stick longer, are smaller and better on your skin. You can usually get the Nexcare Clear tape at Rite Aid or Walgreens. Hope this info helps you out. Good Luck!
You can use a alcohol swap to clean the area first. I have had 25/50&75 patch. All 3 only worked for 24 hours on me. It's very common for diff people to absorb differently.because I only benefit from them for 24 hours the patch would still have gel left in them.I heard if you cut it & eat a little it's like getting an injection of good meds. I've heard, but please try at your own risk.
you should never use alcohol to clean area where the patch is going to be placed!!
IT can cause you to get much higher dose accidently.
This is common problem, mylan, will supply patients with correct type of bandage that breathes to place over it so edges are less likely to loosen during bathing or sweating.
I place mine on lower abdomen area and works pretty well for me. I did not like it where people see it and ask what it is. I even had more than few times people rip it off my shoulder!
You can use certain tape but pharmacist said to have them help pick out what kind because some tapes can cause it to release more in beginning. That can cause overdose.
I speak with your pain doctor... they should be aware of this and have some ideas on what to do. I get rashes on my skin from certain brands, glue they use i am allergic to it.
So he thought to use steroid inhaler as spray on my skin right before applying and really worked or helped.
So speak with your doctor, sure you are not firs one and i bet they have solution.
I just read the insert from my Fentanyl patches. I've been on the Fentanyl Patch for over 4 years and never read the insert. It said to clean the area with clear water. I didn't know you weren't suppose to use soap or anything. In fact, my doctor told me to lightly use spray anti-perspirant. I can't believe my doctor told me to use anti-perspirant when your aren't suppose to use anything but plain water. This is what I do and have done for years. I wash the area with Grandpa's Pine Tar Soap. Yes, it does smell like tar. The soap really cleanses and removes all oils from the area. Then I lightly spray the area with anti-perspirant leave it on for a minute, then wipe the area with a dry cloth. The patch sticks like super glue. I even sometimes have trouble getting a corner lifted to remove it. I sweat profusely (hysterectomy) hence the reason for the anti-perspirant. I've not had an issue since with the patch sticking.
I have had not side effects or other issues because of the way I prep the area, but if you choose to do this, do so at your own risk. By the way, the best brand to use is Mylan or Sandose. Watson is terrible.
- Fentanyl Information for Consumers
- Fentanyl Information for Healthcare Professionals (includes dosage details)
- Side Effects of Fentanyl (detailed)
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