Guided by several on this forum i have successfully stopped ( not cured) RLS following augmentation from DAs. I use weekly 15mcg/hr patches and top up with a small portion of sublingual tablet.
I experience Nausea as a side effect but I have managed to live with that . I also suffer from what i can only describe as skin damage in the patch area after only one application. |The area is not sore but very inflamed and itchy.
i am due to see my GP next week but i am worried he will say go onto tablets which i find give me an unacceptable level of nausea.
I would appreciate any comments on similar experiences and solutions to the problem?
Davchar23
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davchar23
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The non-recommendations apply to the sedating antihistamines. Non-sedating ones like cetrizine or (des)loratadine don’t give problems, as many of us can testify, including me.
Davchar, skin irritation is a known (side)effect of the patches. Did you have a look at the information leaflet as I think it mentions this issues. So sorry this is happening, you deserve an easier ‘ride’.
Given your history, your best bet would be to pamper and strengthen your skin in the whole area (usually upper body) where you put the patches. And apply an ointment or cream after you remove the patch on this patch side. What creams etc to use, discuss thoroughly with your doctor. It may help. Both my daughter and myself have been very sensitive to eczema and taking special and very good care of our skin helps. It took a while to find out what works best, though.
I have been using a moisturising cream on the patch area after removal of patch but will check alternatives with my doctor next week.
Getting a little frustrated as patch "planning" seems to ease, not stop, nausea and don't want to go back to tablets which give peaks in buprenorphine level in system and very bad nausea.
Davchar, I do understand. I can imagine you want to be able to continue to use the patch without yet another hassle. I hope a stronger cream may help you skin and prevent irritation to a large degree. You can also try to get advice from the pharmacist.
I continue to be confused by the effectivity timing with BUP patches. I think i am getting not RLS breakthrough but mini withdrawal symptoms. i am getting a lot of "cold sweating". Does this indicate a lack of BUP in system ie mini withdrawal ?
Last night 11pm I decided that the 4 day+ patch was "done" and so added a new patch but left the old one on overnight. This morning woke up in a severe cold sweat. i have now removed the old patch.
In my experience the sweating is a side effect. With me, withdrawal presented as all over body restlessness and general flu-like feeling of unwell. Re the sweating, an otc non-sedating anti-histamine, like cetrizine or loratadine may help a little.
If I understand you it means the sweating is a side effect of the Buprenorphine and not a sign of withdrawal? I do not feel unwell or restless and so yes it seems as if it is a side effect. i will try cetirizine
Hi davchar23 - I note your problems with the buprenorphine patch. I now take the tablets but was on the patches a couple of years ago. At that time someone told me to use a spray containing a little steroid and let it dry before applying the patch. The spray was Flixonase nasal spray (Flonase in U.S.A.) I think you can but this over the counter. This certainly did help me but eventually I managed to get the sublingual form which I can manage. I am sorry about your reaction to these tablets.
By the way we are of the same vintage so perhaps this spray might help you too. Best Wishes
Thank you for your reply and i have made a note to check out the nasal spray.
I think I might have to change back to tablets eventually as the patches seem to vary a lot in their effectivity period. This varies between 4& 6 days and causes all sorts of problems trying to avoid mini withdrawals. Did you find that?
How do you take the sublingual tablets ie split between parts of the day or just once and how much.?
Hi davchar23 - I had similar difficulties with the patches. I was on the 15 mcg patch and it only lasted 4 days at the most. My GPs would not allow me to change them more frequently although some folk on here are allowed to do this. I eventually got a phone appointment with Professor Walker (privately) who suggested changing me to the sub-lingual tablet and I got these in spite of the great annoyance of my GP practice. They are totally against opioids and not pleasant to deal with!!!😒
However, I made the change and I now take a 200 mcg tablet at 1.00 pm, 200 mcg at 6.00 pm and 400 mcg at 10.30 pm. This keeps the RLS at bay apart from an occasional breakthrough if I have eaten sugary food or had an ice cream (which I love). I tried a lower dose at the start but eventually settled at 800 mcg per day. I can be a bit sleepy about three hours after the daytime doses but this is not a bother as at my age I have time to rest for a while. I tried taking just the 400 mcg at bedtime which Joolsg takes but found marked mini-withdrawal symptoms the next day and Prof Walker worked with me to get the right dose and timings. I do suffer some skin itching and dryness but do not know if this is due to BUP or to an oral chemo-therapy drug which I have to take daily and which can cause these side effects. I do have occasional slight nausea but again this could come from the chemo. All-in-all I am pleased with the outcome.
I should have also said I get pretty good sleep - about five hours in total per night and sometimes six hours which is a lot better than 2 - 3 hours before and sometimes no sleep at all.
I do hope you can get sorted and enjoy a better time in the future. Stay in touch and let me know how you are getting on. Good Wishes
Thank you for sharing your experiences on the BUP patches and tablets with me. I found the details quite relevant to my own situation.
I am fortunate with my GP who has not only been prepared to learn about RLS as we have tackled my augmentation but has also kept an open mid about opioids in both patches & tablets. my problem now is to try get to what is my best balance etc.
I could not believe that the so called weekly patch was not lasting even 5 days and now i can understand why I get mini withdrawal nausea and cold sweats after only 4 /5 days. Your information will enable me to plan my way forward and i will let you know how I get on.
I am still trying to get my head around the buprenorphine nausea/hot/cold sweats. I have managed to reduce the buprenorphine input a little and this also gives me some reduction on the severe morning nausea but the sweats are worse making me think it is some kind of withdrawal symptom causing the hot/cold sweats?
I wondered whether you think my sweating is caused by my mini withdrawals or simply my being sensitive to the opioid. Joolsg has suggested increasing the small dose (25mg/day)to try reduce the sweating. have you any thoughts on this?
Hello again davchar23 - Sorry for delay but I have been off-line for a couple of days. I am sorry to hear you are still having problems. I don't know if I can help much. I certainly have not been able to take just a night-time dose of buprenorphine as others have (like Joolsg for example) and I certainly feel the effects of the drug wearing off. I do feel that ideally I would require perhaps another 200 mcg per day but my GP is completely against any change and in a way I want to keep on the smallest dose which works reasonably well for me. I waken up any time from 5.00 am and suffer the most horrible depression. Because of my medications I am unable to take any antidepressant for this and have just had to accept it. I do find I get really hot at times but cannot pin down which drug does this to me. I have to take a chemotherapy capsule daily for a blood cancer and this could also cause sweating. I can manage up until lunchtime and then take my first BUP tablet. If I am late in taking this some RLS kicks in. Again coming up to 6.00 pm I start to get breakthrough and I take my second tablet about 6.30 just after my dinner. The evenings are probably the time when I feel happiest - the depression improving throughout the day.
The depression may be caused by the opioids but as I have been tried on everything else for RLS this is the best I can be and I put up with any side effects.
However, for you the nausea is a bad symptom which is impossible to "put up with" on a long-term basis. You say that Joolsg has suggested increasing the small dose of 25 mg which you are now taking (I assume this is Pregabalin) and she certainly found that it helped her.
I know for a fact that my system seems to cycle through drugs much more quickly that is usual and I think this is why I have the dosing difficulty with BUP which others do not suffer. Perhaps you are like this too. It was a pharmacist when I was in hospital who talked to me about this but according to her there is nothing to do about it.
I am sorry I have not been able to help and I sincerely hope your nausea settles soon. Do keep in touch. You can private message me if you want. Good Wishes
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