Fibromyalgia Action UK
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20 mg Butrans Patches

Hi there 

I wanted to know if anyone had any success with Butrans patches. This is my 3rd week on the 20mg dose and I'm seeing no improvement at all. I have gained 8 pounds in weight and my ankles, feet and toes now look like trotters. 

I was wondering should I give it a bit longer or to go back and see my GP and perhaps try a different pain control method. I'm still taking co-codamol 30/500, 4 times a day and diazepam when I get spasm in my lower back. I can't take Tramadol as it messes with my heart.

10 Replies

Are you on these just for Fibro? I ask because strong opioids are not a recommended treatment for Fibro, largely because opioids are less effective in people with Fibro because of fewer available opioid receptors so the benefit/risk ratio is not good.


Hi Lindsey

I have a lumbar, cervical and foot problems which I need pain relief for. The pain keeps me awake as well as the pain from the Fibro. I've tried all the regular Fibro meds, Lustral, Pregabalin and others. I've come to terms with my illness, I just needed constant measured pain relief instead of going up and down with Co-codomol and Diazepam. The 20 mcg don't even touch the sides, so to speak :) I thought I was just a terrible 'Junkie', but your comment about limited pain receptors makes sense.


Hi Susie, that makes sense (see my response to diddle below as well). And yes, needing a higher dose is part of the problem with Fibro.

Make sure if you can that a full multi-disciplinary treatment approach is being used, including physiotherapy, perhaps hydrotherapy, psychological coping strategies, etc.

If you're already on Diazepam, you may want to talk to your doctors about considering Clonazepam. Unlike Diazepam, which can mess up your sleep more long-term, Clonazepam (and Lorazepam) can really help improve sleep quality and so treat Fibro. Clonazepam also has a good muscle relaxant effect that I personally have found very helpful with Myofascial Pain. Quite a few Fibro specialist use these drugs and Dr Holman has noted that because low doses only at bedtime are typically used, the potential for addiction is far lower.


Hi i am on the 20 mg pain patches and co codamol for fibro as that is what my GP and others i have seen have recomeneded so your comment has confused me bit as i have been on them now for just over a year

i am not saying you are wrong at all, but as i know nothing about medications and do not profess to but i will keep on them as that is what my GP and others in my surgery have put me on, it is strange how different gp s or people have different views on so many medications and treatments for fibro i suppose we all have to have an element of trial and error and take what is suited to us and what works to give us the most pain relief. just had to reply tothis as for me your theory is not true as i am sure for others it is and some it isnt , as i said we are all different.

take care diddle x


Strong opioids can be used by people with Fibro whose symptoms are not controlled sufficiently by other medications. They are also often used (as in Susie's case) when someone has other conditions that require this kind of medication. They can help to take the edge off the pain and should not be refused if that is required and there is no better option. However, side effects are a risk and it would be extremely unusual for someone to have very good Fibro symptom control from strong opioids (because of the fewer available receptors). Therefore they are not a recommended treatment for Fibro (it's a bit like saying a plaster is a treatment for a serious wound - it might help a little bit but isn't ideal!) and should not be a first-choice medication for Fibro in the long-term as there are usually better options.


mmmm that is very interesting thank you love diddle xx


I'm on butrans 15mg patches. I can't do without them as they were the only thing that stopped my skin crawling. When I was told to get off opioids and move onto other medication the crawling returned but as this is also a withdrawal effect of the patches I had to put up with it for a long time before I could go back onto the patches. For other pain relief I take Naproxen and paracetamol regularly to the maximum allowed and I am still pushing the pain barrier and getting exhausted by so doing. I also have venlafaxine which gives me much needed seratonin. I was put on this when misdiagnosed with depression, no other antidepressants worked (because I wasn't depressed?) but this did because of the seratonin.


hi i too am on 20mg butans patches and 8/10 co codamol a day but i have 3 x amitriptylyne not tramadol i have lost weight and i am on them for my fibromyalgia i have been on them about a year now they just take the edge off really but my GP put me on them as my fibromyalgia pain was getting worse i am sure that is why your GP has done this to you i would go back and discuss it with your GP and see if there is anything else if you are unhappy with the results everything does not suit everyone

i hope you get on ok love diddle xx


Thank you all for your Input everyone. I guess it's horses for courses, so to speak.

Will have to get back to my GP as I see no signs of improvement.

Gentle Hugs



i didnt get on with the patches, im currently taking gabapentin and diazapam as i have regular and 1 permenat spasms so far the only thing to help my muscles is diazapam i have only just started the gabapentin after not getting on with other medications im hoping once my gaba levels are sorted i be ok, oh i also have ibuprofen and heat packs are great!!!!


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