As most Duragesic/Fentanyl patch patients know, the recommended procedure is to clean the area with water and then apply the patch. However, for anyone who has used Fentanyl Generics or Duragesic, we know that's ridiculous. Skin oil, patch location and hair are the 3 biggest adhesion factors for the patch adhesive to contend with.
Having used Duragesic 100mcg patches (x2 on occasion) for 13 years, I know of 4 good ways to keep the patch stuck:
1. If you're using Duragesic, Janssen Pharmaceuticals has long had a program for its Duragesic users who have this problem. They will send out free of charge 300 Bioclusive bandages (clear adhesive bandages) that will fit over the 100mcg patch. I've used them many times and they work well. You need to call them at the 800 number on the box. Only Duragesic users are eligible; you can get them online or order them at a pharmacy, but they're not cheap, around $100 a box.
Note: It's unclear as of 2013 whether or not Janssen still runs the Bioclusive program, but it's an automatic NO if you don't ask. You can of course just by them outright, but as I said, they're not cheap.
Worst case, you can always use medical tape to tape the edges of the patch.
2. Skin Prep - Skin Prep is a product made for Colostomy patients. It applies a thin film to the skin that helps the adhesive bond strongly to the skin. The tricky part is to only apply it to the skin area where the edges of the patch are going to be, since applying it to the transdermal area will block release of the drug. It works fantastic though, and most pharmacies carry it. They make 2 types, a lower cost one that stings, and a non-stinging one for double the cost. It doesn't sting that bad compared to the pain you're already dealing with.
2013 Note: Skin Prep works well with the older style patch type that used an adhesive edge and gel pocket, but it's impractical if you're using a patch such as the new Duragesic patches that are essentially a one-piece adhesive patch. Using SP will block the release of the Fentanyl.
3. Isopropyl Alcohol - all patch literature will tell you not to use Iso to clean the skin and then put the patch on. The reason for this is that Isopropyl leaves a residue on the skin that can interfere with the drug release. However, to get around that issue, clean the area with Iso, then rinse it with water to remove any residue and then dry well before applying. Iso is the only real way to get skin oil off of the skin, which is the primary reason the patch adhesive comes unbonded from the skin.
Of course if you use Grain alcohol (purchased from a liquor store), it leaves no residue.
The other reason is that Iso can cause skin irritation if not rinsed prior to the patch being applied.
4. Location, Location, Location - SRE (Skin Real Estate) is a major factor in how well your patch stays applied. The instructions tell you not to use the patch in the same spot over and over - this is to let the skin breathe between applications. It must be applied on the upper torso in order for the heart to properly distribute the drug throughout the body. I've always applied mine to my upper biceps, as the area is flat, relatively hairless, and the skin there doesn't flex like it does on the chest or elsewhere. Normally my regular dose is 1 100mcg patch, so I just switch arms every 2 days when I change it out for a new one. However, there have been times where I've needed 2 100mcg patches, and I have used them on both arms simultaneously. In those cases, I've overlapped the application by several hours so that the skin has time to breathe before reapplying. I also will apply it vertically or horizontally so that the same area isn't always completely covered. Edge scarring on the skin from the patch will occur, but it will go away in time if you stop using them.
If you're having difficulty with the patch staying applied and the area doesn't appear to have any hair, keep in mind that the small micro-hairs that we all have can interfere with the patch adhesive. In those cases, shave the area or use a hair remover / wax to ensure there's nothing to get in the way between the patch and your skin. Make sure you rinse it well with warm water and dry it well before you apply the patch though.
I know of terminal cancer patients who have required up to 6 100mcg patches, and in those cases they were applied on the back. The problem with that is you need someone to apply it, and if you're like me, you probably like doing it in private by yourself.
In a pinch, if your patch comes off, don't toss it. It's a misconception that it cannot be reapplied and used; as long as it doesn't stick to itself, you can re-use it, but if it does, of course you're out of luck. If you're using generics, you can buy Bioclusives yourself. Alternatively, simple transparent medical tape on the patch edges will keep the patch in place or help you to re-attach it. Make sure you clean the skin before reapplying, and put it in the same place. It takes about an hour, but if there's enough adhesive and medicine left, the body heat will start the drug release again.
When applying your patch after you've prepped the area, make sure you hold it between your hands for about a minute (BEFORE you remove the backing...) to warm and soften the adhesive. After you put it on, hold your hand over it for a minute to help the adhesive stick better
One other bit of advice - all doctors are required by Federal Law to only give a month's worth of Schedule 2 opiates to any patient, making us slaves to the system, and making it a real pain if a patch comes off and cannot be reused, especially if it was just applied recently. I learned early on to build up an emergency month supply of meds that will help me in such situations, or in those rare times where you have problems with medical insurance companies or prescription supply interruptions. It takes time, but most Fentanyl patients have breakthrough meds like Percocet. Use that to help you get by and try stretching your dosage in order to bank up extras so you don't fall short if a patch does get screwed up. If you're seeing a doctor that tells you to turn in any extras, get another one. Federal Law prohibits transfer of any narcotic to anyone other than whom it was prescribed for, and I know of no such exception for doctors, even prescribing ones. I have always been up front with my doctor about my emergency supply, and over the years he's been willing to give me a bit more when it's run low.
Having used Fentanyl (Duragesic) patches for over 10 years, I can say that of course opiate dependence is the primary effect. As I write this, I am going through my second voluntary withdrawal in the past few months, the need for it no longer exists. It is not easy at all - I've been steadily dropping my dependence levels for 6 months, and from dosages of 200mcg (2 100mcg patches) and up to 150 Percocet 10's per month. To say I've been catching up on my Supervisor work here at WA is an understatement, as the mental distraction really helps.
Other than dependence and the increased tolerance level it brings, if you tolerate opiates well there aren't any real other problems I've incurred, aside from the occasional bout of constipation, but any opiate patient learns to deal with that. I will say though, that one thing that surprised me was that it was hard to realize when I fully recovered from my last spinal surgery (check my bio page for the full skinny) that the pain I was having was actually from withdrawal and not my back.
This second period is longer than the first one - previously, I was only able to go 5 days before requiring another patch, the hold was just too much. This time, I've gone over a week now and believe I've made the switch back to pills, which are much easier to get off of. I've cut down my Percocet to 5mg and 2.5's so that I can do gradual reduction.
Fentanyl in any form is a wonderful drug if you absolutely require it, but it should only be used in a Quality of Life decision. For myself, there was no other option until 3 years ago and until now. However, with it comes responsibility and essentially slavery to the drug and the system - as a Schedule 2 opiate, you're required to get new prescriptions every month, and only 30 days worth.
You can, but it depends on your overall tolerance level. For most people, drinking any alcohol won't really do much if you're already a Fentanyl patient. However, like any opiate with alcohol, it will increase the depressant effects, which can lead to respiratory failure if you're not careful.
yes you can, there is however and increased risk of CNS depression and psycho-motor impairment, so be careful and only do so if instructed to by your doctor
It depends on the person and how long patches have been used, but in general you'll start feeling withdrawals around 6-8 hours after the patch dose expires. It takes another few days before it's really out of your system. If you've been using Fentanyl for a long time, it'll take days or weeks depending on how much and how long.
While each person of course is different, for many of us in formal pain programs it's actually very common. Duragesic is your primary pain control med, while the Oxy is your breakthrough. Gabapentin is what's known as an "augment" drug, as it and similar drugs in its class have been found in research to help augment opiate therapy. The exact mechanism isn't fully understood, and it doesn't work for everyone. Never did for me. Your drug mix is actually very commonly prescribed for long term pain.
So you understand how much someone can tolerate, my current dosages are 1 100 micro Duragesic patch and Percocet 10/325's for breakthrough pain. I normally use between 120/150 per month. At times I've had to increase my patch dose to 200 mike's, and add 100mg Demerol and 30mg MS Contin when things get really bad. I've been using the combination dosage of Duragesic & Percocet for almost 9 years now. I've known of other patients who were terminal cancer patients that were using up to 6 100 mic Duragesic patches. I've literally been to the edge of the abyss when it comes to pain, but that kind of dosage tells all of us there are areas of pain we never want to see.
TSD -RAVEN- Category Supervisor
I take gabapentin, while wearing the Fentanyl Patch (50mg) and taking Perocet occasionally for spinal nerve damage. I have had no interactions that I can tell. Gabapentin is usally well tolerated and doesn't seen to interact with much. I am on the 50 patch and also on 4800mg of gabapentin a day and also tke 5/325mg of oxy for breakthrough reliever about 8 a day, Gabapetin is an anticonvusive drug that was for epilepsy and guess what the patch and oxys side effect are convusions so they cancel each other out. I have been on these drugs for over two years and they are very safe to be together as long as you stay away from alcohol. That will really mess you up
Ending Duragesic dependence is not easy, nor can it be done in a short time. Of course it totally depends on the patient's current dosage and how long they've been using it as to how long it will take to get off it it. I can tell you that after 10 years of Duragesic use (2 100mcg patches, plus 120 Percocet 10/325's per month) it took a total of 8 months to lower my dependence enough to where I could switch to Percocet and lower those amounts as well.
Keep in mind that it comes with a cost - you'll find out how much real pain you're in once your levels are low enough, and in the end it might be easier to keep using it. It'll take time, as there's a point where the withdrawal pain is strong enough you can't get a good read on your actual pain. You'll know when it's gone and your real pain is letting you know it's still there.
Even though I've not used one since August '09, my pain is still strong enough that I consider starting to use them again every day. But for me, I resigned myself to the fact years ago that I'd be an opiate patient the rest of my life. I've experienced extremely high levels of pain without the benefit of opiates in the past (hospital & doctor screwups - read my bio if you're curious) and as such my mental tolerance for pain is extremely high. But regardless of how mentally focused you are, you can't keep it up all the time - all of us who are chronic pain patients need some type of pain relief, and that's just reality. If you're at the point where your pain is low enough you can discontinue Duragesic, that's great. But be prepared for the possibility that you might not like what you find once your opiate levels are lowered to the point where your brain is really feeling your pain. Regardless, it's good to do it to better assess your actual pain level, which you can't really do while using Fentanyl.
Depending on your current dose, there's a couple of ways you can do it. You can get lower patch doses and drop your dependence that way, using your breakthrough meds to cover the withdrawals from the difference in dosage. Over the many years I've used Duragesic, I've had to increase my dosages several times from 100 to 200mcg's and then back again - I never did it by using smaller patch doses as it's easier to do it another way. But everyone's different.
First off, you need to stretch your patches to where you're getting the absolute most out of them - change them only when the current one has expired and you're already dealing with withdrawals. Use smaller doses of your breakthrough meds to help ease the pains. Eventually you'll get used to incremental lowering, and be ready to head into your first major withdrawal period. For me, it was about 5 days of major withdrawals - I used Percocet instead of Duragesic until the withdrawals were such that I had to apply a patch. After another month, I was at a point where I was able to do it again, and successfully switched back to Percocet after 3 weeks of withdrawals that weren't nearly as bad as the first period.
To say it's not easy is an understatement, but it's not impossible either. Aside from setting aside time to deal with it, the things I always recommend are:
1. Be completely prepared mentally - eventually you'll get to the point where you'll know you're ready to deal with the discomfort that's to come. Anyone who uses Fentanyl deals with withdrawals regularly - it's no different, just longer.
2. Have lots of water and Gatorade available - Staying well hydrated is essential, as you'll be sweating buckets. You can literally smell and taste the Fentanyl sweating out of your pores. Keeping your electrolytes up is essential as well.
3. Stay warm - You'll be sweating but freezing as well. The best way to describe it is like having the flu, but without the fever. I did it in the middle of Summer, and I was freezing every day.
4. Have a family member around - Trust me when I say you're not going to feel like doing much of anything besides getting up, going to the bathroom, and going back to bed for more misery. That includes making something to eat.
5. Stay sedated - Virtually every instance where I've needed to lower my dosage levels and had to deal with withdrawals for extended periods, I've asked my doctor for something or used one of my other meds to help keep me sedated. When you're sedated, the discomfort is much easier to deal with.
6. Anti-anxiety / Anti-nausea meds - Anti-anxiety meds will help with the withdrawal pain; Anti-nausea meds help when you're near the end.
7. Movies, Music, Games - Anything to distract your mind from the discomfort. Personally I use David Gilmour (Remember That Night BD Live), though gaming helps a lot as well. I also got a lot of WikiAnswers Supervisor work done on this and my other categories during that period. It doesn't really matter what it is, as long as it's a mental distraction strong enough to focus your attention away from the discomfort.
8. Breakthrough Meds - Don't even think about this unless you've got a good supply of Percocet or other meds that you can use to help lower your dependence. My normal supply/dose is 120-150 Percocet 10/325's per month. I started with 10's, then cut them in halves and quarters, taking them together to make 7.5 and then 5mg's.
9. OTC Meds - 2 OTC meds I've used for years are Bayer Back & Body Aspirin and Tylenol Extra Strength Rapid Release Gel-Tabs. Both work fast and really ease pain, enough that I've used them when I don't feel the need for a Percocet. They'll help take up the slack for the pain that your BT med can't cover so you don't have to take as much of it.
10. Doctor - Make sure your doctor knows what you're doing - most will support your efforts. But don't get discouraged if you find that your pain is still great enough you need to continue using it. Remember Duragesic use for all of us is a quality-of-life decision. Using it sucks, since none of us like being a slave to Schedule 2 opiate regulations. But being in constant agony 24/7 isn't a picnic either.
If you've got any specific questions, feel free to contact me through my WA Supervisor email address on my bio page.
The Aura Patch Therapy system is based on the research in bioelectronics that has identified the resonant frequencies of various substances. By providing the energetic signature of HGH the energy systems of the body may receive similar benefits. At Atrium Health Services we have extensive experience with the Aura Patch system and are amazed at the results. As a practitioner and lecturer in alternative medicine for almost 30 years and as a healthy skeptic, I am very hard to impress. Joseph F Unger Jr, DC, FICS
Absolutely - in fact, Hydrocodone (Vicodin, etc.) and Oxycodone (Percocet, etc.) are commonly prescribed to Fentanyl patients as their breakthrough pain med.
Absolutely not. It will cause the med to absorb to quickly and may cause death.
It depends on how long you've been using them, but generally if you've been using long enough to become tolerant without constant headaches and other side-effects, then it's likely your getting headaches from increased dosage regulation.
Duragesic and other Fentanyl patches are regulated by body heat; normal dosage is transferred through the skin to the bloodstream when the body's temperature is normal. However, if the patient becomes overheated (fever, sunlight exposure, increased activity) the dosage regulation increases, and so does the side-effects. Along with headaches, if the dosage gets high enough (no pun intended), you'll also feel dizzy, disoriented, and sweaty. That's why the literature specifically tells you to keep the patch from direct sunlight or heating pads.
It is not something to take lightly if this is what's happening; the easiest way to deal with it is to take the patch off (by the edges, and don't fold it - you can re-attach it later) and cool yourself off inside and out to get your temp back to normal.
If this isn't what's happening to you (you'll know if it is or isn't) then I'd suspect either another drug you're using in combination with the patch. You have to be opiate tolerant to be prescribed Fentanyl anyway, so if you've not had problems with other opiates it's unlikely the patch is the culprit. The key is whether or not your headache is constant or occasional; if it's constant, the patch could be contributing. If not, then you need to look at what you've taken prior to the headache. Keep in mind also that Fentanyl won't deal with a headache; even as high dosages as I've used, I still got serious migraines, and had to use Fiorinal w/ Codeine to deal with them (been using it for over 20 years).
On another note, there's always the possibility if you're using a generic patch that it's the patch ingredients themselves. Generics are "chemically equivalent", bu they're not always "quality equivalent" to the brand name. I've had problems in the past with both generic patches (when they first came out I had been a Duragesic patient for about 8 years) and generic Percocet as well. To this day, I always pay more for brand meds, because I know the quality and potency will be what I'm used to. For long term opiate patients, drug consistency is a bigger deal than doctors tell you.
It's extremely common for Duragesic patients to have Hydrocodone, Oxycodone, or other acute opiate meds (Demerol, Methadone, etc.) as their breakthrough medication. Remember that patches are for primary, chronic pain; increased activity can cause the pain to increase past the point of patch effectiveness, which is termed "breakthrough pain". In those cases, an acute (short term) pain med like Vicodin or Percocet is used to deal with the short term increase.
I myself have used Percocet 10/325's for about 10 years in conjunction with my patches, about 120/month. At some point though, if breakthrough becomes constant, then it's time to re-evaluate the need for a higher dose patch or patch combination. I've had to deal with this several times over the years, and I prefer to use pills because it gives you more spot control of the pain. But for severe increases (see my bio for more), adding another patch is really the only way to go.
Fentanyl is very strong and extremely dangerous. A patch contains 3 day's worth of medication, so if you open up the patch, you may soon be DEAD. I know this because the liquid from a single 75 MCG/hr Fentanyl patch KILLED MY BELOVED DAUGHTER on the first of June, 2011. One single patch contains A LETHAL DOSE of narcotic medicine. Please NEVER fool around with a Fentany patch. Please do not make another father cry every day, thinking of his daughter and wanting her back.
You can't - the only thing you'll do by increasing the delivery rate is subject yourself to an overdose if you're not careful.
If you want to cut down on the drop off between the last patch and a new one, put the new one on 6 hours before the one you have on is supposed to wear off. Over time you'll know when it's supposed to wear off.
It depends on your overall condition, reason for pain, your overall tolerance level, and the length of time you've been using Fentanyl Transdermal patches of any type. However, in general, if you're up to the task, then yes, it's okay, as long as you're aware of the potential risks involved.
Fentanyl patches (either Duragesic or its generic alternatives) work by slowly releasing the drug through a transdermal membrane into the bloodstream via the skin layer. The dosage delivery is controlled by body heat, and naturally any strenuous physical activity will increase your heart rate and elevate your core body temperature. This alone increases the dosage delivery rate, and if you're not yet that tolerant to the drug or opiates in general (rare since the patches are only supposed to be prescribed to prior opiate tolerant patients), then confusion or other increased side effects can occur.
As a long time Duragesic user and chronic pain patient on opiate therapy for many years (see my bio for specifics), I've experienced this several times while doing outside work or remodeling around my home. Even though I knew what was happening, the confusion level is so much that it's difficult to get out of the situation on your own. I describe it as being stuck in a loop you can't get yourself out of. Only removing the patch (if you do it properly you can re-attach it later - see my answer on that) or cooling your body to normal will alleviate the problem. It's also important to understand that opiates are Vasodilators, meaning they open the blood vessels (that's why you feel cold when the dosage tapers off - they start constricting). Opening the blood vessels wider naturally warms your body, but again if you're tolerant to the constant dosage over time then your body is already used to it.
However, if you take simple precautions to keep yourself from getting overheated (stay hydrated and cool while working) and your overall physical condition doesn't limit you from the work (e.g., you're dealing with extreme pain but are physically able to work), and you're prepared for what can happen (my family knows what to do if they find me in such a situation, and I always have my cell with me when working) then there isn't much you can't normally do that you didn't do before.
As you become more tolerant, the depressant effects will become less. I found years ago that a cerebral stimulant will help overcome the depressant effects to the point where I feel relatively normal. Of course I don't use them often, only when I'm using higher opiate dosages to control pain.
As far as driving, it's an individual situation. Not everyone handles opiate therapy the same way, and again only tolerant individuals can deal with the depressant side effects over time. I've never had any driving restrictions, though I've always been acutely aware that in any accident it would likely be an issue. Having said that, unless I told you that I was a high level opiate patient you'd never know as I feel normal most of the time. It's really a topic for your pain specialist and yourself, but if you've already got handicap driver plates or a placard, then your doctor has already signed off on the fact that he/she believes that you're okay to drive. How responsible you are is totally up to you. I won't drive if I need to increase my normal dosages to deal with increased pain.
You should also be aware of the fact that the patches will and do slow your reaction time, so you need to be more aware of safety factors and compensate for your slower reaction than normal when working. Also, remember that opiates work by altering the brain's perception of pain, and if you over-exert yourself, you could further aggravate your condition without realizing it until the pain becomes worse. Be smart.
If you're wondering, at my highest dosages I was using 2 100mcg Duragesic patches for primary pain, Percocet 10/325's for breakthrough (120/150 per month), 100mg Demerol tabs, and 30mg MS Contin tabs for pain. My normal dosages are 1 100mcg patch and the same amount of Percocet monthly. Those have been my normal dosages for about 9 years.
It depends on the person and the amount of gel involved. If you're extremely tolerant to Fentanyl, you won't be affected as quickly, but for most people, respiratory / cardiac arrest and death are the most common results. It's slower than Cyanide, but the end result is the same.
Fentanyl patches are designed to deliver a continuous, small dose over a period of 2-3 days. By removing the gel and applying it directly to the skin, the person is bypassing the timed-release component. Most people, high dose Fentanyl users as well, aren't capable of handling that high a dose at one time.
You can, but they are typically not prescribed together since they perform the same function - long term dosage delivery of opiate for chronic pain. They can be prescribed together when the patient is making the transition from OxyContin to Duragesic or vice-versa, but there's really no reason for it. All Duragesic patches come with information instructing the patient and doctor on the minimum starting dosage with a morphine equivalence chart that allows them to estimate your current equivalence with the drug you're using to the equivalent Duragesic dosage. Janssen Pharmaceuticals does skew the dosage estimates lower than they normally should be though for safety reasons, since all patients should start at the lowest dose and then work up to maintenance levels.
The difference is in the time factor - OxyContin has an advertised dosage time of 12 hours effective dosage, while Fentanyl patches are good for either 48 to 72 hours depending on the individual. For most people it's 72 hours, but a small percentage of the population (myself included) only gets 48 hours.
Since they're both controlled delivery drugs, Fentanyl patches are often prescribed when OxyContin tolerance has lowered to the point where the patient is only getting relief for about the same time that an acute pain medication does - just over 6 hours. Before I started using Duragesic, I was barely getting 7 hours out of OxyContin. The idea in pain management is to maintain a controlled dosage with less medication at a steady rate over long periods so that the patient doesn't have to rely on more medication to achieve the same results. Of course as tolerance increases, dosages may have to be adjusted, or increased if the pain increases. I've had to do this several times over the many years I've used Duragesic, but ultimately was able to return to my normal dosage levels after the reason for increased need was dealt with.
the fentanyl patch is a long timed system patch in which it lasts up to 72 hours per patch and dosage in your system compared to the tablet of Oxycontin in which it only lasts about 6-8 hours per pill depending on dose and your tolerance of pain medications
The amount of time it takes for the amount of drug in the body to reduce by 50% is called the half-life. It takes approximately five to six half lives for the drug to be cleared from the body. The half-life for fentanyl patches is 9.5 to 12.4 hours. Multiply that by 6 and it could take up to 74.4 hours to clear the drug. You can do the math. Fentanyl lozenges-approx. 7 hours.
Duragesic takes a few hours to kick in and is supposed to last up to 72 hours (like how Oxycontin is supposed to last 12 hours) but most people find it lasts 36-60 hours. From my experience I've found fentanyl patches to last about 48-54 hours. In regards to drug testing, assuming it's a UA, fentanyl takes longer to clear than most opiates, it would take AT LEAST 48 hours after the removal of the patch (assuming you wore it for at least 2 days)
As a registered nurse who has been on Fentanyl dermal patches, after 2 major unsuccessful spinal fusions surgeries, I realized the scarring and normal arthritic changes over some years, can actually diminish our acute or even chronic spinal pain. That includes the radiation of pain down their spinal nerves, causing anterior (top to side) pain in your legs. Also, this can happen with upper cervical, thoracic and as in my case, thoracolumbar pain. The patches were a life saver for 20 almost 21 years. I was able to improve my exercise tolerance, increase going to family functions. Most importantly as you who are in the same boat know, there is a certain amount of guilt, when you feel, you can not make future plans, with family & friends, since one never knows, exactly how severe the pain will impede your activities of daily living. Therefore, I decided, I would with my physician's help and both our knowledge of pain management, try to totally withdraw from the application of these very expensive & sometimes, dangerous methods of chronic Opioid tolerant pain management. As a nurse, I feel compelled to make this statement. Using the Fentanyl systems of pain managment, can and have, been implicated in patients' deaths. There are many causes but the most common one believed, is due to diminished respiration, failure to breath well enough to oxygenate our bodies, improper application, duplicate application of patches if one does not write down, the placement on your body, the time and day it was applied, or by other errors. Heat increases the medication to coarse through our bodies. If you have a fever, or are too warm, pay much closer attention to your breathing. Never use alcohol to clean the patch site, again, rubbing or any alcohol, will increase the amount of drug in your system and can potentially cause, hypoventilation or complete cessation of breathing completely. This of course will be disastrous. The more senior you are the more, one needs to consider every aspect of your overall health. I'm right up there folks, in my 60's. That's why I wanted to answer this question with my own experience.
I personally am decreasing my Fentanyl patch dosage, in what I feel is a safe manor. I was able to decrease my dosage from Feb.6th through the end of March, (2 months) from 100 micrograms, down to 50mcg. During this decrease, whether from personal issues in my family, with several deaths of younger family due to accidents, or as a result of the decrease in the Fentanyl, I became morbidly depressed. Signs included, decrease in my physical activity. I needed to force myself to eat and drink properly with concomitant weight loss. I cried at the drop of a hat. I lost interest in all the hobbies I loved, and generally was sad, just not my bubbly self.
I failed to mention one very important warning whether about Lexapro or Fentanyl use, I stopped even social drinking a glass of wine, when I began applying Fentanyl and of course I still won't drink and wouldn't on Lexapro, on or off Fentanyl. There is an increase in the drugs' effects which can be severe. So please? Do not drink alcohol or mix any other psychotripic medication while on both of these meds.
Additionally it need to be mentioned: from the day I applied my first Fentanyl patch, and over the past 20+ years, I keep thorough records of my Fentanyl patches and Lexapro. It's actually a very good idea, to keep an up to date chart, (on your person) when and how much medications you've taken on a daily basis. Fentanyl in particular, can be a bit difficult to remember, the date and time you applied this patch which is either prescribed, on a 72 (3 day) basis, and lately I've read, even every 48 hours (two day period). I continually read the package inserts each time I open a new box, there have been many changes in how to apply and use them. If you're smart, you will read the package inserts and if you do not understand something written, call your pharmacist or the company's patients telephone answer line, for any questions you may have. Both of these medications can be life savers and both can be dangerous if used improperly. Get to know your meds and how they work in your body. Again, I cannot emphasize enough do not drink alcohol. If you must take a sip for a family wedding, etc., simply put a little wine on your lips, but NEVER swallow enough to alter how you feel emotionally.
I'd like to share how important age is when using either of these type of meds. I'm sharing with you, I am now 60 years old and I am extremely careful how I "chart" my medications. Or have a family member chart them for you. I feel very proud of myself, that I have successfully decreased my Fentanyl medication by half over a twp month time frame. However, once I hit the 50 mcg. level, I tried to decrease my dosage down to 25 mcg every 3 days and went into withdrawal, and major depression. I realize it's taken me a while to get to the question's point, but here is my experience:
YES, I did take and I am still am taking Lexapro 5 mg twice a day. I've been on Lexapro since February which is now three and one-half months, without any untoward or negative symptoms, in conjunction with MY Fentanyl patches. I hope you will ask your doc and remember, they are working for you! Don't feel you can't call and ask you doctor, if you have any questions such as this one: Can I SAFELY take Lexapro anti-depressant, if I am also applying a very strong Opioid analog pain patch such as Fentanyl.
Fentanyl, like Oxycodone, does not show up on most standard urine screens for opiates due to its chemical makeup, which differ from natural opiates. However, it is detectable in urine and blood, with specialized testing using gas chromatography.
Much of the information that has been released concerning Fentanyl and Oxycodone urine testing is inaccurate - read the link below to the Mayo Clinic report which clarifies errors in the record.
You will die! Get some help if this what you are using it for. I have chronic pain and use a fentanyl patch, Norco, methadone just to be able to walk. your an idiot if this is your intent. People like you make it hard for people like me to get these drugs from dr! Get help and please don't eat the patch !
A 50mcg (patch dosages are in Micrograms, not Milligrams) fentanyl patch is equivalent to approximately 200 mg/day of oral morphine.
Yes - in fact, it's not uncommon for Xanax and similar drugs to be prescribed to chronic pain patients, either as part of normal mental therapy or for easing withdrawal symptoms.
It depends on the patient - by instruction, the patch must be applied on the upper torso or upper extremities (arms). Most people tend to put them on their back or chest, but I learned early on that for the back you need someone to change them, and the chest/stomach area has both too much hair and the skin flexes too much with activity.
As a result, for many years I've worn them on my biceps - they're flat, the patches easy to put on them with one hand, and the skin doesn't flex very much there. When using 1 100mcg patch, I just switch arms when it's time to put a new one on. When I have to increase to 2 100mcg patches, I use both arms, but take one off a few hours before the other to clean it and let the skin breathe before putting on a new one and taking the other one off. That way your dosage doesn't drop much during the process, and if you feel breakthrough you can take a Percocet or whatever your breakthrough med is to cover it.
The key to keeping a patch on (see the link to my answer on that below) is to make sure the skin is clean and there's no hair present. The literature says not to use any Isopropyl alcohol - that's because it leaves a residue. Problem is, it's difficult to remove skin oil and dirt without it. To get around the problem, clean it with Iso, then rinse the area well to make sure any residue is washed off. Dry the skin well, then apply the patch. If there's a lot of hair or micro-hairs, you might need to shave it off as well. Before you put the patch on, hold it between your hands (still attached to the backing) for about a minute to soften the adhesive. Apply it, then put your hand over it for another minute to ensure the adhesive gets a good bond to the skin. You'll find it sticks pretty well after that.
YES YES YES, Is all I can say ! I have chewed these and wore these and IF
u take enough it WILL CAUSE confusion & Many other things !
Depends how much you chew OR do and what else is in your system
just the patch ONLY = YES it will CAUSE CONFUSION if taken to much
all I say Is :
BE VERY CAREFULL when using this medication, stronger then oxycontins as well,
I take both for my Pains, and so I am telling you the REAL TRUTH Here !
Give me food and I will live give me water and I will die what am I?
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