Advice from others on Fentanyl Patches

[CSHobie]

Hi guys, I have had pain in my skeleton, basically for about 18 months now. Soon after diagnosis my pain went way up.

After a few months on oral Opioids, I switched to Fentanyl

I'm on Fentanyl patches 75 ucg/h changed every 72 hours.

However I found that the effect was inconsistent. First day strong, can't sleep. Second day ok Third day terrible, pain and withdrawal effects.

Now I cut the patch in three pieces, and put one piece on every day, and take one off every day, leaving three pieces on at all times . Total is 75 as prescribed.

This gives me very even drug delivery.,and I feel ok. Problem is that my Palliative Dr does not like my method at all.

Looking forward to hearing from you, and your experiences.

Charles



[Kaliber]

Fentanyl patches are extremely dangerous to mess with. I’ve known of two people that went to E.R. trying to use them recreationally. Cutting them exposes the cross section that time release dissolves and exposes you to overdose. Getting the cut edge wet or being sweaty might mean serious risk ….. never try to scrape off the fentanyl coating. Never try to inject the contents as well.

1. Please keep your prescribed Narcan nasal kit handy and make sure everyone in the house knows how to use it.

2. You have made a major mistake by telling your palliative care team about this. He will be obligated by law and medical policy, related to legal responsibility issues, to note in your records that you have misused your prescription as he prescribed them and are currently abusing your opiate meds. This will bring a combined review of you by several groups in your medical center. Your prescribing doctor, the Dr in charge of pharmacy opiate abuse and risk management … surely they will remove this prescription from your access and probably have you start major intermittent DAP urine panels. ( drug abuse panels ). All of this will have to come to pass because your organization will have to react to cover their a$$e$ because of potential law suits if you croak doing this. You may or may not croak, but nonetheless the. Org will cover itself, no matter what. Never ever tell your providers … of anything like this.

Just say’in…. Be careful , what you are doing is very ill advised.

[kaptank in reply to Kaliber]

Thank you for drawing attention. Message: do not cut fentanyl patches. I didn't know that and didn't even think about it.

[EdBacon in reply to Kaliber]

Here's some more information on the subject:

pharmacytoday.org/article/S...

[Hidden]

This isn't relative to your situation but I've used a similar approach to taking my allergy meds (non prescription now). I'll take 1/2 allegra tablet in the morning. If I need to, I'll take the 2nd half later in the day.

[doc1947g]

You should try to have 3 25ucg/72 hrs

[CSHobie]

Thanks for the replies, are any of you on Fentanyl patches?

Let me rephrase my question. Instead of using one 75 patch for three days, I am using three X 25patches.

Has anyone tried this? Other than me?

[CSHobie]

Modern Fentanyl patches don't have liquid centers, and also no membranes or any of that. It's a thin plastic film, with adhesive on it, that contains fentanyl.

It's very clear that it is made in larger sheets and cut into smaller sizes based on the dosage. Example the 50 patch is exactly double the size of the 25.

[EdBacon in reply to CSHobie]

Are they the "matrix" type patches? My understanding is that smaller doses are also available. Is that right?

[CSHobie in reply to EdBacon]

I don't know what Matrix means.

Mine is made by Sandoz. Smooth clear plastic.

[EdBacon in reply to CSHobie]

jpsmjournal.com/article/S08...

[CSHobie in reply to EdBacon]

Thanks. Yes indeed modern patches are Matrix. All the bs about cutting is not applicable here.

Incidentally I see in that report 83% of patients reported Somnolence. I have that too if I use one large dose patch. Splitting the dose in three smaller parts, eliminate the Somnolence.

[EdBacon]

"I’ve been dressed down by my GP for simply not having opiates show in my urine DAPs …. unhappy with nothing showing. Said I wasn’t taking them as prescribed.. and then popped a unexpected additional Urine DAP on me a few days later to assure my compliance. That has triggered a video visit where I had to “ count out “ my remaining meds to her on screen."

Don't doctors have better things to do than spend their time doing this kind of this bullshit? Maybe they can spend an extra minute with each of their patients with that time.

I know there's a problem with opiates, but this a bunch of crap for someone who has a legitimate medical need with stage 4 cancer. Go chase after all the people who have bogus prescriptions. Stop peddling drugs to people who don't need them instead of taking it out on people who do. This kind of thing really pisses me off. I don't give a shit what their "reasons" are. Give them 5 minutes of the kind of pain I've had and they'll snap right out of this nonsense.

[EdBacon]

Your GP reminds me of people who worry about patients in hospice getting addicted to morphine.

[babychi]

Whatever works for YOU! It is your body and your pain. I take opiates daily and have to self advocate to get pain relief. I live in Australia and I do not abuse opiates. Unlike many here in Oz who abuse booze. Sick of the stupid double standards. I am 70 and know the hazards of opiates. Do what you have to. But you made an error informing the MD. He’s not in pain, is he?

[EdBacon]

My doctor hasn't said much to me other than "don't tell your neighbors you have these, they have a pretty high street value" He also told me he did do a urine test on a guy who kept asking for more and more pain meds but had an undetectable PSA and no mets on imaging. Turns out the guy had none in his system and was selling them. He's been really good with me, hasn't asked any questions other than "what do you need?"

[Hidden]

If your oncologist refuses to prescribe pain meds maybe you need to see a pain specialist doctor? What does a GP know about intractable pain anyway? She isn't Nurse Ratched is she?

[Kaliber in reply to Hidden]

Here the oncologist only deals with the cancer. The GP heads up my medical team and oversees my non oncology meds prescribed. I have about 7 medical types on my medical team, each specializes in something different.

[CSHobie]

I'm talking to my Palliative Dr. She's a fairly young female.

But she obviously doesn't have experience with Patches. I'm her only patient on patches, they seem to prefer to prescribe MS Contin, the long acting oral Morphine.

[EdBacon]

Maybe someone at Kaiser read this thread.😂

[Kaliber in reply to EdBacon]

Yikes, that’d be kinda scary. 😂😂😂

[EdBacon in reply to Kaliber]

Actually I called them and said "Hey, knock this shit off right now!" Looks like it worked! 😀

[Kaliber in reply to EdBacon]

Omg …. Yayahahahaya yayahahahaya. Well thanks buddy … that’s what friends are for. Rotflol.

[CAMPSOUPS]

Cool is right. For now I just quickly want to say excellent!

[Kaliber in reply to CAMPSOUPS]

Thanks buddy … it’s definitely a good thing that elevates my QOL. 😁😁😁😁