Should a fentanyl patch take more than 24 hours to begin working?

Dear Recon83,
First, my sincerest apologies for your recent diagnosis. I have been there. Also, I just lost my mom to glioblastoma and my Dad to squamous cell carcinoma a year ago.

NO. You have done nothing wrong.
While the overlap when changing patches can have a 4 to 6 hour period of "hanging out" if you don't stay up with the schedule*72hrs and switch to the next patch in a different location - try your upper back just over the shoulder. Upper arm is fine though for sure.

**The first application can have a delay of 24 to 36 hours- the delay is due to the serum levels gradually increasing.

It's approaching the 36 hour mark now... yikes I hope it's starting to work.

My consideration also includes your previous opioid medication-- The oxycodone; The dose, frequency, and duration of use-- could also be playing a big part. Opioid naive vs opioid tolerant, and then the degree of which someone's tolerance goes-- all important factors.

My recommendation is to ride it out 'til morning -- do what you can to help with sleep- I know, highly unlikely-- And if you're still not experiencing any analgesic relief from the patch by morning -- definitely call your team, get whomever is handling your pain management on the phone, explain well and make sure it gets documented--- and just know you will get it squared away!!
Titrated 'til you have 24/7 relief by *at least* 30% from your maximum threshold / average level of chronic pain. But a proper dose of a fentanyl transdermal system is the best thing for round the clock care you can get while being free to stay at home.

Best of luck to you, Take care!!