it s noticable within a 1/2 hour of appliying a patch.

The loly-pops are imediate

Patches are long acting and the manufacture states full effect in 17 to 24 hours. Your doctor should provide you with a "fast acting" pain medication like Percocet, to use until

the patch takes effect. The medication remains in your body for 17 to 24 hours after the patch is removed.

Technically, no.

Absolutely - in fact, you should take it off if you start feeling increased side effects. That's not uncommon if you get overheated during physical activity, or your patch is exposed to heat from another source and it increases the dosage delivery rate.

Just make sure that the edges don't get any dirt or hair on them, and you can reapply later on. If the adhesive is too weak to reattach (not uncommon) you can use a Bioclusive bandage or medical adhesive tape to reapply. It doesn't take long for the dose to start flowing again.

Of course, if you accidentally fold it over onto itself, you're screwed.

Dependence and Tolerance are the most common, but that's true with many drugs that require long term maintenance doses. I've used them for 9 years now, and I've learned how to lower my dosages if I need to after I've had to increase them. My normal dose is 100 mcg, but I do occasionally need to increase it to 200mcg.

Duragesic is well tolerated over time. Most of the time I forget I'm wearing them, and the effectiveness cannot be overstated. For long term chronic pain, there is no better drug.

If you go more than seven days without a patch, you could get pregnant. Either put the next patch on a day earlier to shorten the patch-free interval, or use a backup method of birth control for the first seven days that you use the next patch.

It MUST BE applied ABOVE THE WAISTLINE. From there, it should be in a relatively hairless area, and one that does not see a lot of skin stretching/movement.

Personally, I use both of my biceps; they're flat, smooth, have little hair, are easily accessible for swapping new patches, easy to clean, etc. Others who have needs requiring several patches at once often use their backs; the chest isn't a great area due to the amount hair.

Everyone's different, but in general it takes several hours (especially if you're already opiate tolerant by using OxyContin) for Fentanyl to achieve a dosage equivalent to what you're taking. You want to adjust your patch attachment time so that when your OxyContin dose is going down, the patch dose is ramping up.

Your doctor should have already told you this; keep in mind that initial patch doses are skewed toward the low end of the dosage chart for safety, so your initial dose might not cut it. Make sure you've got enough breakthrough meds available until you can get your patch dose correct.

No - in fact, if you're running a fever, you should remove the patch anyway. Increased body/skin temperature increases the dosage delivery rate through the skin, and if you're not careful or aware, you could easily wind up with a fentanyl overdose, or worse.

The biggest indication is you'll start feeling disoriented and confused - get the patch off and get cooled down as fast as possible if that occurs.

I have never had good luck trying to reapply Fentanyl patches. Once they are removed from my skin, I can never get the same level of adhesiveness from them. They might have been just as potent, but it was hard for me to tell because I usually would wear more than one patch at a time in conjunction with eating them (this is very dangerous and can kill). I would recommend keeping the patch on if at all possible. If it is already off, do your best to tape it back on to yourself and hope for the best.

NEVER use Fentanyl for recreational purposes. Multiple patches and/ or overdoses can KILL.

The literature for years has always recommended taking the patch off, folding it over on itself so that the adhesive sides stick to itself, then flushing down the toilet.

However, if you've got a septic system, I wouldn't recommend it as they don't break down. Personally I've always folded them over and tossed them in the trash, but I don't have small kids or have to worry about anyone nosing through my trash either. It's essentially dependent on your own situation - if you're in an environment where used patches might be abused (even small residual amounts can make non-opiate users pretty sick) then flush 'em.

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That's a tough one, and it comes down to several factors.

The bottom line is once you're at a decent tolerance level, you can drive. However, the reality is that if you're involved in an accident and you're at fault, your opiate dependence is going to be an issue. Essentially it comes down to quality of life, and making sure that whenever you drive, you're not being affected by the drug.

Most Fentanyl patients become highly tolerant after several weeks of regular use, and after that period you really don't notice any impairment - in fact, the pain you're taking the drug for is more of a driving distraction than anything else. But again, current laws are pretty anal when it comes to pain patients - most governments and law enforcement don't like to make a distinction between opiate dependence and opiate addiction, even though there is a clear line between the two.

My point is that you can, but be sure you're cognizant enough before you do to avoid any problems.

No - in fact, virtually all pain specialists/doctors who prescribe Fentanyl patches will require you to only use one pharmacy, unless otherwise agreed upon, as part of your pain management contract.

It depends totally on how long you've been using patches, but if it's even a couple of months, I wouldn't recommend it. You might make it few days, but trust me when I say it's not easy, even for someone like me who had experience increasing and decreasing my dosages several times over many years.

If you want to do it, you really need to have some type of acute meds around, though if not, you can get away with Naproxen, Tylenol (extra strength rapid release gel tabs) and Aspirin. Plan to try and sedate yourself, and have someone around to help you through it. Ask you doctor for some anti-anxiety meds to ease the shaking, and keep plenty of water/fluids around, as you'll be sweating like you won't believe. Keep some clean bedding and dry clothes around too.

It's easier if you've got Percocet (just drop the dosage in increments until you're off the patches - Percocet's easy after that). Doing it without a an opiate to help is extremely difficult, even when you're prepared and can sedate yourself.

No! You can not eat it with Fiber, with fruit, with nuts, with anything! Eating fentanyl will kill you!

Absolutely - Hydrocodone and Oxycodone are typically prescribed along with Duragesic as breakthrough pain meds.

The urine drug screen would be positive for opioids.

The lidocaine patch may have rare negative interactions with digoxin (Lanoxin) or any medications for irregular heartbeats. Some antibiotics, antidepressants, and monoamine oxidase inhibitors (MAOIs) may adversely react with the lidocaine patch

You really shouldn't - either direct heat to the patch or increasing overall body temp increases the dosage delivery rate to the bloodstream, and if you're not aware of the symptoms and how to deal with it, you can get into real trouble. You can get disoriented pretty fast, and if no one knows what's happening and how to help, it just makes things worse.

You can always take the patch off and re-attach later - see the link to my answer below on how to keep them applied. If it's not feasible, then at least be cognizant of how much time you're spending on the table and how much you're being heated. If the staff doesn't know you're wearing a patch, then tell them, but don't assume they know anything about how to deal with opiate overdoses. Most staffers these days aren't nurses, and even many RN's don't know how to recognize or deal with fentanyl overdose symptoms, particularly if they don't know you're wearing patch.

Everyone's different of course, but in general, any meds that increase metabolism or are respiratory depressants should be avoided. Usually anyone who's opiate tolerant enough to use Fentanyl patches on a regular basis isn't going to have problems with respiratory depression/arrest, but you don't want to push it if you're not sure.

Anything that increases body metabolism (e.g., Ritalin, Adderall, Phentermine, etc.) or raises body temperature should be discussed with your doctor prior to use also. Fentanyl patch doses are released transdermally through the skin, and are activated / controlled by body heat. Any increase in metabolism tends to lead to an increase in body temp, and that in turn can increase the dosage delivery rate to the point where you'll get the effects of overdose. The indications are confusion, dizziness, and a general feeling of helplessness and being "stuck in a loop" that you can't get out of.

If you start feeling that way, the 2 things you need to do are to take the patch(es) off (don't fold them - you can re-apply them later with Bioclusive bandages or medical tape on the edges), and get into a cool shower to lower your body temperature quickly. Drinking something cold to lower your core temperature helps a lot also.

The oral drug Fentanyl is made by many different companies, but Duragesic (brand name for Fentanyl Transdermal patches) is made and distributed by Ortho-McNeil/Janssen Pharmaceuticals.

Not after the first couple of weeks when you get used to the dose. Unlike OxyContin, patch doses are much more steady, and there's no steep dropoff in dosage level like there is with OxyContin as the drug wears off. Essentially, you feel pretty normal, just no pain.

True , but all it would do is make the onset of the drug quicker not stronger

Nortryptiline is actually occasionally prescribed along with Fentanly patches as an augment drug (doesn't work for most people). As far as blood pressure med, you can take them, but it's best to wait until you're patch dose is adjusted to see what your BP is going to be. Fentanyl, like most opiates, tend to lower blood pressure, and taking anything additional could lower it too far.