When I started on the 12 patch, I think it took less than 24 hours to kick in. I had to take some Vicodin (as directed by my doctor) when I put the patch on. I put the patch on in the late afternoon, though, so when I woke up, I didn't need any more pills.
It probably has to do with your tolerance level and how you metabolize it. My doctor ran a genetic profile and fentanyl is the only pain medicine (I'm not sure of the terminology) of which I am not a poor metabolizer.
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