Sciatica and skin-patches

[Palioly]

My UK GP has given me "Mezolar Matrix", a Fentanyl adhesive skin patch, 25 mcg/hour size, as the previously used Zomorph 30 mg ( 1 each 12 hours) was proving ineffective in combating the severe pain level.

Any help anyone on any aspects of its use - is it usually effective ? I have never used skin patches before. After 18 hours wearing the very first patch I'm hard put to detect any great effect on my pain level and am having to use either Codeine or Co-codamol or Solpadol as well - (otherwise I can hardly walk).

I understood the patch would replace the other things I used in the past, but not so, so far ?

Dan

[Bananas5]

GPs will always start on the lowest dose they can and if you need something stronger will up the strength.

Tell him what you have said and he should increase dosage

x

[Essie49 in reply to Bananas5]

I was on 122mcg of Fentanyl patches for about 5 years. I really don’t think they made a lot of difference and after a period of time your body gets used to them and they don’t work. I was told they would affect my immune system and I went through 7 months of hell withdrawing. This is at a large London hospital that will no longer give out as many. You have to sign a contract now saying you will come off them. I have a friend who has one and she says it helps. If a low dose does help stay on them and don’t keep adding them on as I was told to.

[shortandround]

The 12mcg patch is the weakest but would be even less than the 30mg bd morphine.

The 25mcg patch is usually 60-90mg morphine 24 hrs equivalent so a tad stronger. It is usually suggested to try 2 patches before judging the analgesic effect. But it comes in stronger doses such as 37.5mcg / hr patches etc. So might need one up.

[shortandround]

There are much better drugs for siatica then opioids too.

[Palioly in reply to shortandround]

DO TELL - Please !

[shortandround in reply to Palioly]

nice.org.uk/guidance/CG173/...

[Palioly in reply to shortandround]

Tried 50mg Pregabalin twice, but it make me awful strongly sleepy about 1 hour after taking just one tablet. So bad that I slept for several hours after taking the very first tablet.

[Palioly]

For now I am having to use both the Zomorph 30mg, (2 per 24 hours), and the stick on Fentanyl patch (marked 25 mcg/hour), to get any kind of relief, but I'm still suffering a lot - so do you guys think these levels are not high enough ?

I need a better balance between pain and addiction risk, but also don't really want to be an opiate eater for the rest of my existence - as well as pain relief I get both constipation and tiredness constantly.

dan.

[EvilAunt]

Used the 75mcg Duragesic patches, still needed 2 or 3 5-500 hydrocodone tablets daily. Had to quit using them as my allergy to adhesives got much worse while using them. Looked like I had burns all over. Never did last 72 hours, more like 40-48. This was pre Opioid Witch-hunt, would never get so much medicine nowadays.

[Palioly]

RE: my 30mg Zomorph, I find the effect does not last more than about 8-9 hours -

SO, is it possible to use one every 8 hours instead of the recommended one every 12 hours so as to get a more continuous coverage.

[Robto]

Hello danmdan,

I have been on the 75mcg Fentanyl patches in the past, but unfortunately they didn't work for me. It was okay to start with, but,gradually they didn't give me the same level of pain relief, at first I was changing them every 3 days, then every 2 days until I changed them daily. The Gp's thought I was becoming addicted to them. But I didn't think it was that, to me it was as I said, was less and less pain relief, they also left me very lethargic, nauseous and in a great deal of pain.

The Pain management clinic suggested I should try Morphine tablets/capsules, so they put me on Oxycontin. But the dosage wasn't the same as the patches and for the next 2 weeks was hell (all sorts of things going wrong, like splitting 24/7 headaches, shivers and roasting, insomnia and the worst pain i have ever had!). The 2 weeks to change the dosage was because the consultant went away on holiday and my GP and doctors at the pain clinic wouldn't change the prescription, so I thought I had to wait for the consultant to come back off their holiday.

The Consultant then changed the brand to Morphine sulphate and up the dosage, and that was much better.

I still suffer with the back pain (to a lesser extent), but know have all the symptoms and stress of Fibromyalgia.

Hopefully , all this might not happen to you and the patches (🤞fingers crossed🤞).

Please let me know how you get on.

Take care.

Rob. X.