What are the side effects to Fentanyl duragesic patches?

Answer 1

Duragesic/Fentanyl generic patch side effects are pretty much consistent with those of morphine and other similar opiate derivatives. It's important to understand that you shouldn't even be using patches unless you've been using other types of opiates for some time (e.g., Percocet, OxyContin, Morphine, Demerol, etc.). Fentanyl is 100x stronger than morphine, and if you're not already tolerant to opiate side effects, it can be a lot tougher to adjust (deadly if you've no experience with it at all.

Typically though, the most common are constipation, urinary retention, withdrawal effects (as the patch dose winds down after 2-3 days, depending on your usage). Euphoria is a common misconception for those not familiar with regular patch use - you might feel some effects as you get used to it, but after a few weeks, you'll feel pretty normal.

The biggest problem most people have, and the one that friends and family (and co-workers if you're still working) need to be aware of are mood swings and depression. Depression isn't necessarily a side effect of Fentanyl, but it is a common problem with chronic pain patients. Anyone in real, constant pain who says they're not depressed is either not in pain, lying, or in total denial. Pain and depression are constant companions.

The combination of constant pain (even with Fentanyl you'll have some pain) and the opiate effects can cause mood swings when you least expect it. It's what usually alienates friends first, and family members who aren't aware of the complications often think they're the problem, you've gone nuts, or you've got some other type of mental problem. As long as you're aware of the effects, and your friends and family know what can happen and why, you have a much better chance of dealing with it. Most families of chronic pain patients don't survive this because they just don't understand it.

My own family just closes my bedroom door and leaves me alone - I'm amazed they've stuck by me for so many years.

The one potentially harmful side-effect is caused by increased body temperature (fever, sunlight, hot tub, etc.). Fentanyl patch doses are regulated by body temperature, and as long as you're within normal limits or cool, you're okay. However, if your core temp rises, or the patch itself is heated directly while it's applied, it will increase the dosage delivery rate, which can make you delirious or dizzy at best, and send you into respiratory arrest at worst if you're not that tolerant. There have been several times over the years where I've experienced this as a result of increased physical activity, and it's not fun, even when you know what's happening. It's important to let friends and family know what to do if they find you in such a state. My daughter's saved me a couple of times when I was that way.

The quickest way to deal with it is to remove your patch (you can re-apply it later if you maintain the edges) and then get yourself into a cool shower. You can put the patch back on (see my post on doing that) after you've recovered.

The easiest way to avoid that is to be aware of situations you're in that might increase your body temperature.

Patches aren't to be abused or considered taking lightly - they should only be considered when you're not getting long-term benefits from any other opiates, and it's become a quality of life decision. I'm not saying don't use them or avoid or them altogether, but they're not like swallowing a pill every few hours.

Answer 2

Duragesic side effects are consistent with those of other opiates. The most common are:

Mood swings (let family & friends know it's the drug and not you before it happens)

Drowsiness (which goes away after you become tolerant)

Constipation (chocolate pudding is the answer)

Respiratory Depression (if you're sensitive to opiates, but you're not prescribed it unless you're opiate tolerant)

Euphoria (not for long - you get tolerant pretty fast)

Confusion (if your body heat is up and it increases the dosage delivery rate)

Duragesic is only prescribed to those who have already been using other opiate medications and are tolerant to opiate effects, so there's not much of a difference except that you're not dealing with withdrawals every few hours. Withdrawal symptoms typically don't appear for several hours after dose has been exhausted, which is a lot better than acute meds (Oxycodone, Hydrocodone, etc.)

The biggest danger is increased body heat. The patches use body heat to regulate the dosage delivery through the skin, and if the body's internal temperature is increased by activity, or the patch is exposed to external heat sources (heating pad, sunlight, etc.) it can rapidly increase the dosage rate to dangerous levels if you're not careful. The first indication is confusion and a bit of dizziness. If you get into such a situation, take the patch off (don't fold it - you can re-attach it later if you keep it intact) and get yourself cooled down internally and externally ASAP. It's not a fun feeling - you know what's happening, but feel powerless to do anything since you can't think straight. Always tell a family member or friend what to do if they ever see you in such a condition, as they might not realize what the problem is otherwise. My daughter's had to bail me out a couple of times when I've become overheated doing stuff around the house.

Answer 3

Pretty much the same as they are with most opiates - feels like a nasty flu without the congestion, coughing, and fever (feeling cold and clammy, weak, shaky), but the difference is that it takes a lot longer for you to start feeling it once the patches start to wear off. Unlike acute pain meds (Percocet, e.g.) that last only a few hours and have a steep dropoff from effectiveness to withdrawal symptoms, once you're tolerant to patches, it takes a couple of hours before you start to notice the symptoms, and they're very gradual. There's plenty of time to get another patch on or take some breakthrough meds (Percocet, Vicodin, etc.) before it gets too bad.