Today I will be switching from Zomorph to Fentanyl (Fencino 50)
I can only use the bath and not a shower, I am a bit concerned about the patch when I am bathing. I am thinking of putting the patch on my upper arm and then putting a waterproof bandage over it when in and keeping the water cool. I am stressing too much about getting it hot, or is this reasonable? Would this be the best spot to put it? I'm a grown man, so limited on the number of spots with no hair lol
Also, for anyone who has done the switch, how do find the side effects compare between them? mostly in regards to Itching and Constipation?
Thanks in advance!!
Rob
Written by
RobBackPain-UK
To view profiles and participate in discussions please or .
First the bathing question. The issue is not getting too hot so a not too hot shower is fine. Remember to rotate the area that you apply the patch. Anywhere is fine just not anywhere where it gets caught in clothing.
I switched from MST( slow release morphine) to fentanyl. It was fine the first day but once the morphine left my system I got bad withdrawal. Stomach pains very badly.Frequent loose bowel movements . Sweating and shivering and emotonally wrung out.
Lasted about 10 hours. But that was me. I would be prepared for some body reaction though. It was nothing compared to the Fentanyl withdrawal.
Constipation not quite so bad on Fentanyl. I never had much itching with either.
As I say just one woman's experience. I would like to know how you find the fentanyl. I found it great for pain but the side effects and constant roller coaster of withdrawal around patch changing time was too much to bear.
Although I greatly appreciate your reply and the information, I can't say I like the sound of it....
The emotional roller coaster I could do without, but let's hope that is not the case for me.
For the itching, I have not found it too too bad either, but now that summer is here, that and my hay-fever together make things uncomfortable.
The main reason for the switch is the constipation, which I have heard, and you have confirmed, is not quite as bad. I suffer and take more pills and potions for this than I do for pain. Not to mention the retention, which is a bit of humiliation I could do without lol
I took my Zomorph this morning, and will put the patch on this evening. The Gabapentin will stay the same, and I will still have Oramorph for break through pain, which may also help with the withdrawl symptoms.
Thanks so much again for the valuable info and insight
Hi love can I ask why you changing I was on brutrans patch but had to change to zomorph as with me sweating like I do my patch wouldn't stick hope you get on ok with them hugs jill xxx
I find the havoc the Zomorph plays on my digestive system quite difficult. I take Docusate, Senna, Fybogel, Laxido, and Glycerin, all to combat the effects. It gets so bad sometimes that I go into retention, and then it's Catheter time.
I am hoping I have a different reaction with the patch. I'll have to see how it goes with my sweating/hot flashes. I think I'm entering 'Man'opause lol
How are you finding the Zomorph compared to the butrans? Overall, I think the Zomorph is great, and the ability to titrate up and down is a significant advantage.
Hi love I'm hoping zomorph works how long does it take to work and what dose was you on I take 20mg Morning and night and acupan duloxtine and nortripyliene xxx
Hi Rob. I've 'spoken' to lots of people on forums who get on very well with the Fentanyl patch. I hope you are one. I just wish I had had more information before I started and then I could have saved myself 3 months of hell.
It seems if it suits you one can have years of good pain relief.
It's a real pity about your constipation issues. I'm a vegetarian so that helps as my vegetable and fruit intake is large. I also drink masses of water and eat porridge nearly every morning. I am presently ribbed Fibrogel but find Movicol is better. I'd welcome any tips you have as I am due surgery in two weeks and if the surgeon finds too much matter in my bowel or too much gas he won't be able to see properly and might stop the operation. I've been waiting for a year to get this and it's my last hope for some pain relief and to help me be able to walk with less pain.
For me it has been a lot of trial and error to sort the stomach issues.
I take:
3 Docusate at night, 2 in morning.
2 senna at night, 2 in the morning
I completely got rid of the fybogel, and replaced it with a laxido/movicol most days.
If I have a few bad pain days and increase the morphine, I end up doing a 3 day stretch of 8-12 Laxido a day
the biggest help for me, was to start mixing laxido with liquids other than water, you can end up having it taste almost bearable lol
The thing is since we are all different, it's a great deal of trial and error...
I'd definitely suggest the 3 day 'cleanse' lol of laxido/movicol before the surgery.
Last night for some reason, (first night of fentanyl) my breathing became VERY depressed, and I ended up in an ambulance at 3:00AM, also have become EXTREMELY itchy... both these things happened when I first started morphine and then subsided. I am hoping they will subside on this as well.
Relatively pain free right now, we'll see how it goes!
oops Rob. I dont know what the hospital said but that happened to me when the dose was upped too much. Subsequently it was thought that I had developed seretonin syndrome from the interaction of the fentanyl and my anti depressant. Huge difficulty breathing and massive anxiety. Personally I think it was just my body objecting to the fentanyl ups and downs. I kept a diary of the worst of the time on Fentanyl and I do remember the itching but it was more of a psychological itch response than an actual skin problem.
I hope you are alright now but I assume you have been told to contact a medical person if this happens again or you get any other extreme reactions.
What dose patch are you on ?
Dee
Ps What would you recommend for this 3 day cleanse ?
I have just started a 50 patch, with Oramorph for breakthrough and my regular Gabapentin. I was taking 170 -250mg of Morphine a day which is what gave me the stomach issues.
the 'cleanse' I was talking about is just the high dose of laxido/movicol for 3 days. Keep in mind this is just if you are suffering greatly from being backed up, take a peek at the notes in the box and see what your Dr. says.
Every once in a while I do this, as it is what I found works for me, through trial and error
By the end of the 3 days though, I can not imagine your surgeon finding ANYTHING lol
Thanks Rob. That was the patch I was on eventually but I started with 25mcg. Like you I was on 120 mg slow release morphine.
I think I will try extra doses of Movicol this week to see what happens. What I don't want is gas. That is apparantly worse than solid matter for blocking the view. The danger is damaging a nerve.
Currently I am on 70 at night and 60 in the morning. Gabapentin 900mg and oramorph 50mg as needed.
This morning was the last zomorph dose, and I will put on the patch shortly.
I found within a day or two, I was stable on the zomorph. it took awhile to get the dose correct though. you don't want to keep changing it too quickly, using oromorph to top it up helps.
When I started zomorph it was 20mg morning and night , hope you don't follow in my footsteps
If your only taking 20 mg twice daily you can't really say it doesn't work. I suspect if your doctor increased your dose slowly to 40-50mg twice daily you should get benefit.
I always thought that tramadol was at one stage of the pain medication steps but morphine was higher ie stronger. Perhaps Chatterbox if you still feel that your pain is uncontrolled you should ask to increase the dose of zomorph. 20 mg twice a day isn't a terribly high dose. Not that I would suggest increasing the dose of these extremely addictive and unpleasant drugs for no reason other than pain which is badly controlled. Sadly there is no such thing as pain killers. We always have to live with a degree of pain.
what didn't work with Tramadol? you can't/shouldn't really take tramadol with zomorph, kin've a waste. Tramadol become like tic tacs lol
Hi Rob,
I've found the Fentanyl to be the best thing since sliced bread and I don't care about side effects as it eases my pain a lot.
I put my patch on my upper arm and then slide a length of Tubigrip up my arm to cover the patch and then I don't need to worry about clothing knocking the patch off, I leave the Tubigrip on while I have my shower then afterwards take it off and put a fresh piece of Tubigrip on and hey presto job done
Don't worry about getting the Tubigrip getting wet or about a hot shower, with the Tubigrip in place the temperature isn't an issue.
Tubigrip comes in various sizes , a chemist will advise you of the best size.
Don't fret about your patch, you have enough problems on your plate without adding to them.
Thanks for the great info! I'll head to the chemist later today, this may solve my biggest concern about it, nice
Thanks again,
Rob
Thanks all just feel like a druggie asking for more morphine I was on tramadol slow release 400mg a day plus zomorph I just want something to take edge of my pain sorry for moaning but really hurting today even my toes and fingers xxx
NEVER feel 'inferior' asking for what you need in terms of pain relief. I felt that way when I started the zomorph on 20mg morning and evening. Every time I wanted to raise it, I was apprehensive about asking.
Keep in mind that they have patients on over 200mg morning and night, and in the grand scheme of things 20mg is not that much.
Your Dr. will also probably prescribe Oramorph that you can take for breakthrough pain, in conjunction with the zomorph.
Toss the tramadol, it just confuses things
(obviously, confirm everything with your Dr. first)
The most useful advice I have been given in regards to pain relief is to take as little as you can, but as much as you need.
Thanks rob I have been of tramadol a few month now i need something as having trouble lifting my leg to get dressed and I got to get up coach steps tomorrow lol xxx
Hi Rob, good luck with the Fentanyl - it has a bad press but is a very effective painkiller. One issue that comes up constantly with it is that it doesnt last three days ( the patch) After a lot of questioning and research , I found the answer and soluton.
I was working with the Duragesic patch.
When you first spply the patch it lasts three days. But there is still some opiate in the system , so when the new patch is applied , it tops upthe active ingredient. You are now on a higher dose for two days ( until the half life slows it down ) the third day you are in deficit!
Solution- not officially recommended, and can only apply to transdermal patches - not gels. Is to cut the patches into thirds. EXACT THIRDS. Apply each one daily. Now you are evening out the rate of opiate supply and wil overcome the high and low of every three days application.
Of course- if this is not an issue for you , please ignore.😊
Well I got through the first night, feel pretty decent now, and will keep the oramoprph handy should I feel any 'discrepencies'
I had thought that under no circumstances were you supposed to cut the patches? I heard that if you cut them if completely messes up the way it releases the dose? Is that why you said transdermal patch vs gel? how do I tell the difference. The one I put on my arm is the first and only patch I have ever even seen
The nice thing is that you can just stick it on and forget about it, anything that makes life easier is a definite bonus in my book!
How have you found drinking with it on? I barely drink at all anymore, but the occasional glass if wine with dinner, or pint with friends. It's ok on the zomorph, have you had anything while wearing a patch?
I've been reading through your replies and thought I'd wade in regarding your query about gel patches.
The pack will say that they're 'reservoir' patches ie, have a liquid in them. The patch has the normal top layer with a tiny amount of thick liquid in,covered with another layer.
I found them to be as effective pain relief wise but they didn't seem to stick as well as conventional patches.
As others have said, the top of the arm is the best & easiest place for them if you have to use a bath; they're reportedly 'waterproof' but how long they'd last actually submerged I don't know.
The temperature issue is really for when you have a higher than normal temperature although any excessive heat should really be avoided; your blood thins a little when you get 'hot' thus the drug is transported & absorbed quicker than it should be. Having a hot shower or bath is fine unless you have the water temperature at a silly mark lol 😊
Like you say, it's something else you really could do without worrying about; so much already to deal with so try to relax a little. I think Fentanyl is by far the most effective of all the sustained release medication. Granted there are some side effects that others have experienced with them but I 'got on' with them great (apart from keeping them stuck on sometimes) so I'm considering going back to them; I'm currently on Oxycodone sustained release tablets but the extra tiredness with them is really getting me down. I changed over just to see what the Oxy' would be like (and to give my system a break from the Fentanyl; I do this every 18/24 months so that when I restart the Fentanyl I get really good results) but I'm seeing my pain doctor next week so will probably go back to the ol' faithfuls 😤
Sorry for this long reply, I was only going to tell you some stuff about the reservoir patches!! I hope you find the Fentanyl to be 'good' for you;we'll only know if anything's going to work if we try it!!
Thanks for that, I feel quite a bit better about the whole bath/heat issue after everyones replies and info.
I like the idea of switching every so often to 'kick start' the old meds.
The zomorph was great for me pain wise, but the side effects were driving me mental. We'll see how this goes. I'm on day 2 now. feel fine, pain is under control, but quite tired.
Hi rob. I too am taking fentynal patches. They're really good at not coming of while bathing and showwring. Also heat I've found that they stick tightly so I'd not worry about that. I normally rotate them around my back was told I could put them any where on my body as long as s flat surface. I've managed the change with little worry only side affect really is itching. Hope this helps. Debbs.
Hey Debbs, thanks for the reply. I have chosen the top of my arm. Seems to stick well and is out of the way. Being a big burly guy, I am limited in choice for where to pop it on lol
When you say itching, do you mean the patch itself, or your whole body itching in reaction to it?
Hi rob. I mean my body itself Itches. (drives me blinking mad sometimes). However much u try not to scratch it gets the better off ya. Lol.😊.But I also take morphine tablets so double the itch. Lol. Other than that I have no other side effects.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Fentanyl to pregabalin switch
FENTANYL PATCH WONT STAY STUCK
Zomorph
