No. This can cause a potentially lethal overdose. Venlafaxine is a cytochrome P450 3A4 inhibitor which is the enzyme which metabolizes fentanyl. Levels of fentanyl can reach lethal doses as a result of this combination.

The Lidocaine patch will float off your body and get sucked up in the pool's filtration system. Since these patches are pricey, you may want to time your swimming during the patch-off periods or remove the patch temporarily and replace it on the sheet of clear plastic to which it is attached when you first open it....bring the packaging with you. Skin has to be clean and dry...no chlorine or salty water residue either....before re-applying the patch again. You are not supposed to re-apply them, but it is possible...just be mindful of the "12 hours off and 12 hours on" rule. Some patients use medical tape to keep the patch securely on the skin after re-applying.

fentanyl will not show up on a standard urine drug screen. While it is an opioid analgesic of the same class of morphine, it is in a different subclass. Fentanyl is a synthetic opioid were morphine is a natural occurring opioid that is extracted from the poppy plant. The chemical structure is very different between these two substances which leads to different methods of metabolism in the body. The urine drug screen picks up the metabolites of typical drugs of abuse such as morphine or codein or hydromorphone. While the metabolites of fentanyl can not be detected in a urine drug test. Other drug screens are available for such drugs but must be specially ordered for direct suspicion of such substance abuse

Just like any opiate, you'll start feeling the withdrawal effects, but they're gradual, not like pills, happening over a couple of hours. Usually you'll start feeling cold/clammy first, then if you haven't replaced it in time, the rest of the usual withdrawal symptoms kick in.

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.

strong enought that if your arent opiate tolerant that the lowest dose of the patch will make you overdose, dont be stupid, when it says for opiate tollerent patients only it really facking means it.

No - they are 2 completely separate drugs. OxyContin is the time release version of Oxycodone, and typically lasts from 7-12 hours.

Duragesic / Fentanyl transdermal patches are timed release fentanyl over a 48-72 hour period. Its release is regulated by body heat. It is a much more reliable and steadier drug than OxyContin, in that it doesn't wear off as fast, and it lasts a lot longer.

The precursor used is N-Phenethyl-Piperidone (NPP) which can be easily synthesized from Piperidone and Phenethyl-tosylate or Phenethyl-bromide through a simple SN2 mechanism.The NPP is reacting with Aniline giving the Imine derivative which is reduced to the 4-Anilino-N-Phenethyl-Piperidine (4-ANPP). The 4-ANPP is then reacted with Propionyl Chloride giving Fentanyl which is then purified.

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.

It is different for each person, and also dependent on how long you've been using it. Higher levels take longer for the body to remove over time. In general, you'll start feeling the withdrawals within 6 hours after total depletion of the patch contents, and really feel it at 12 - 18 hours. This does not mean that it has left your system - it means that your body's Fentanyl level is below what it has become used to and is reacting.

The longer you use Duragesic, the harder it is to end your overall dependence. As I write this, I'm in the final stages of ending my own 11 year dependence on Duragesic and Oxycodone, Demerol, and just about every other known chronic and acute pain medication. It has taken 6 months of continuous lowering of my opiate levels, and 2 hard withdrawal periods.

For those who haven't used it for very long, it is usually out of the body within 72 hours, assuming good kidney function. However, few people like myself are ever prescribed Duragesic for a short period, and if they are, it's due to a doctor's incompetence. Duragesic is intended for long-term, opiate tolerant, chronic pain patients only, and not as a short term pain medication. Fentanyl is 30 times stronger than morphine, and I can tell you it is not easy to end your dependence at all.

For those who disrespect and attempt to misuse Duragesic, it's not a problem, since most people usually kill themselves in the process, not realizing just how strong it is, and how fast it can kill you if you are not tolerant to opiates - and by opiates, I don't mean minor street drugs like Cocaine or Heroin. For true long term opiate patients, stuff like that is nothing, and it's why addicts fail to realize the dangers of Fentanyl misuse until it's too late.

to get high if you cut it open and lick it or rub it on your mouth its absorbed right away the patch is time release through the patch eight to twelve hrs so if some one is doing this its probably to get high

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 peak of pain relief provided by the Fentanyl transdermal system is between 12 and 18 hours after application.

If your patch can't be reapplied (and as long as it isn't folded over on itself it can be with medical tape or a Bioclusive bandage) then yes, you apply a new patch to replace the one that came off.

Typically you won't start feeling withdrawals for several hours. If you have one of those doctors who isn't forgiving on your patch quantities, you can always use your breakthrough meds to cover the period you lost between patches.

After many years, I learned to bank extra patches to deal with such problems (try to stretch the period between patches using breakthrough meds). The key is really to make sure they stay applied - Skin Prep is a good product to help adhesion, but cleaning the skin properly is the best. Though the literature tells you not to use alcohol, what they don't want you to do is use it and then apply the patch, because Isopropyl leaves a film. You can use it as long as you rinse the area and dry it, then apply a patch.

Selecting a good spot on the body helps also. I've always avoided my torso since the skin tends to stretch more with activity, and that's the cause of most patch adhesion failures. Use the bicep of your arm - it's wide enough and flat enough, and doesn't get that much flexing during regular activity. Swap arms during your patch change.

You can't.

On first application it usually takes 24-72 hours for serum concentrations of fentanyl to reach a peak,

so it may not be until the second patch has been applied that a steady-state concentration is reached.

Break-through analgesia may be required initially. Wean other analgesics slowly after the first patch.2

The patch should be changed every 72 hours.

Duragesic patches do - you can get a $50 coupon for your prescription from the Duragesic site, and they often include them in the boxes. For me it's enough to take care of my copay.

All Duragesic users experience withdrawals on a regular basis - it's the nature of using them. However, you can avoid the minor withdrawals if you overlap your patch changes. It takes several hours after your patch expires (or it's removed) before you really start to feel it. Initially you'll just feel cold and clammy (opiates are Vasodilators, meaning they open the blood vessels - the reason you feel cold is because the blood vessels constrict)

Duragesic takes several hours to ramp up to full dosage delivery, and the same goes for when it's running out. Eventually you'll learn when the dosage is low enough that you'll start feeling the first signs of withdrawals - not really that strong, but enough to get your attention. Severe Fentanyl withdrawal is not a good time, so never let yourself get that low on your meds. Try to stretch your patches so that you've got one or two extras at the end of the month - I've always maintained an emergency 1 month supply just in case.

The trick to avoiding the withdrawals is to know when your current patch is winding down. If you add your new patch as the other one is winding down, you'll find that your dosage level remains fairly constant, as one is ramping up to full dosage while the other one is expiring. You can always use your breakthrough meds if you need to if the expiring patch is too low.

Like any patch, you won't feel any withdrawal effects for several hours. After that, depending on your dependence level, the withdrawals will increase steadily over time. 25mcg patches aren't very strong, so you'd probably be through it within a week, depending on how long you've used them.

However, like any opiate, it's not recommended just doing it cold turkey, as the withdrawals can be pretty bad if you're not used to it (and bad enough if you are). There are many ways to ease the process, but in general you should have someone staying with you, keep hydrated (Gatorade is great), and warm (opiates dilate the blood vessels, so when the level decreases your blood vessels constrict, making you cold and clammy). Getting a doctor to prescribe an anti-anxiety and nausea med really helps. I've also used Flexeril and Naproxen to ease the discomfort, as well as just to knock me out.

One way I've done it in the past (I've had to increase/decrease my patch dosages many times over the years) is to use decreasing levels of breakthrough meds (Percocet in my case) and OTC meds (I use Tylenol ES Rapid Release geltabs, Bayer Back & Body aspirin) to help deal with the withdrawal pain.

The final key ingredient is mental distraction - Internet, or in my case, a large game and video collection. As long as you're focused on something other than your discomfort, it's a big help.

Severe withdrawals are a lot like having a really bad case of the Flu - it's uncomfortable, but unlike Flu, it won't kill you.

Yes, but it is used and prescribed with many restrictions. It is a DEA Schedule II controlled substance, and as such, restrictions are:

1. Patients can only be prescribed a 30 day supply.

2. Prescriptions must be new every month - they cannot be called in.

3. No refills are allowed.

It's the same for all Schedule II opiates, but for those of us who use them, it's an inconvenience compared to living with extreme pain on a regular basis.

I faced a similar problem in 1999, when I was using OxyContin for a year, and my doctor kept trying to get me to move to a 100mcg patch. My only regret is that I didn't listen to her and do it sooner.

I can guess your reluctance, as it's probably the same as mine was; increasing your opiate dependence. But in the long run, you actually wind up using less medication, as your stomach and kidneys can only take so much if your pain levels are high enough and the drugs you've been using are not doing the job. Remember that the stuff you've used in the past is for acute (short term) pain, not constant chronic pain, and only lasts a few hours. Duragesic is for long-term, constant chronic pain, and lasts 48-72 hours, and trust me when I say that it works. Of course you'll run into days where you'll need to use breakthrough drugs, and eventually your tolerance level will require you to increase your dosages. But the alternative is constant agony, and Duragesic at the very least gives you back some semblance of a normal life. Eventually you'll become tolerant enough that you won't even notice it. I've used up to 200mcg's (2 100mcg patches) for many years, and at my tolerance level I feel fairly normal, save for the fact that my pain isn't there.

Using patches comes with a price, and it's a quality-of-life decision not to be made lightly. None of use likes dealing with the restrictions placed on Schedule II opiates, but on the flip side none of use likes to be in constant agony either. You need to consider your long-term prognosis, and if it's going to help you live a better life, then use it. The side effects aren't much different than any other opiate, though mood swings can be more often. But if your pain level is that high, you already know that you can only keep up mental focus for so long before the pain changes your mood anyway. Duragesic at least increases the periods between those changes, and as long as your family and friends know what to expect (my wife just closes the door to whatever room I'm in), it's okay.

If you're wondering, over the years my prescriptions have been:

1 -2 100mcg patches

120/150 Percocet 10/325's per month

100mg Demerol tab

30mg MS Contin tabs

I also use 30mg Fiorinal w/Codeine for migraines (Butalbital/Aspirin/Caffeine).

yes