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Fentanyl

Fentanyl is an odorless,rapid-acting opioid,it can alleviate pain without causing any loss of consciousness. It is powerful,nearly 80 times more than morphine.

1,782 Questions

Can Fentanyl and marijuana use interaction cause heart disease?

Fentanyl Cardiovascular side effects:

  • Hypotension
  • Bradycardia
  • Arrhythmia

Marijuana Cardiovascular side effects:

  • Increase heart rate

How do you keep Fentanyl patches applied?

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.

What are long term effects of using Fentanyl?

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.

Is it safe to mix alcohol with Fentanyl patch medicine?

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.

How long does a 100mcg Fentanyl patch dose stay in your body?

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.

Can you mix gabapentin and Fentanyl patch?

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

Can you put Fentanyl patch on your leg?

Absolutely not - Fentanyl patches should always be placed above the waist, the closer to the heart the better. They should NEVER be placed below the waist, as the effectiveness is significantly reduced due to the distance from the heart.

Can you cut a Fentanyl patch?

Absolutely not. It will cause the med to absorb to quickly and may cause death.

Can you mix Xanax and Fentanyl?

Please seek an Answer from a licensed doctor or pharmacist. Both are powerful drugs that if used (or abused) could potentially have lethal effects. Fentanyl can be especially dangerous if used improperly.

What is the street name of Fentanyl?

From wikipedia.com: A dosage form of fentanyl which has appeared on the streets are the fentanyl lollipops Actiq, which are sold under the street name of "percopop"; a mixture of fentanyl and heroin is known as "magic"; "china white" a form of fentanyl refers to the clandestinely produced analogue α-methylfentanyl (AMF).

Can you use suboxone after a Fentanyl anastesia?

Don't do it, it would only be stupid to attempt this. Of course it does depend on how long afterwards you were to take the suboxone but within 36 hours and your sure to go into detox from it making u very sick and very very uncomfortable.

What is a lethal dose of Fentanyl?

Approximately 0.5mg to 1.0mg per kg body-weight in opiate-naive subjects.

Can you take hydrocodone with Fentanyl patch?

Absolutely - in fact, Hydrocodone (Vicodin, etc.) and Oxycodone (Percocet, etc.) are commonly prescribed to Fentanyl patients as their breakthrough pain med.

Why are you getting a headache with your Fentanyl patch?

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.

How can you make Fentanyl patch work quicker?

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.

What is the strongest opiate prescription for human consumption?

The strongest opiate currently prescribed for humans is the Fentanyl Transdermal Patch, in 100mcg (microgram) dosages, which can be increased as necessary. Fentanyl (brand name Duragesic) is 30 times stronger than morphine. Like Oxycodone, Morphine and others in its class, it is a DEA Schedule 2 opiate, requiring monthly new prescriptions as refills aren't permitted and only a 30 day supply can be dispensed. It really puts a damper on your life, having been Duragesic user for many years.

Duragesic is typically prescribed for long-term chronic pain patients who are in constant extreme pain. The most common patients who use them are terminally ill cancer patients. I know of one such person who had up to 6 100mcg patches applied - I myself have only required 2.

The difference between Fentanyl (which is used as an anesthetic normally) and drugs like Diluadid, Demerol or Oxycodone, is that it is a timed release drug - it lasts up to 72 hours for most, 48 hours for some like me. It also comes in 25, 50, 75 and 100mcg doses that can be combined to achieve the proper dose. It also requires the patient to be highly opiate tolerant, since it is in the body continually for days, weeks, months, or for some like me, even years.

Can you mix Fentanyl with Oxycontin?

Yes, it is done everyday. Pain patients may have the Duragesic patch and also have emergency oxycodone tablets up to 30mg. However, these people have a largely developed tolerance to the opiate drugs. I would not recommend doing it unless you have a very large tolerance. Hope this answers your question. Stay safe!

-Patrick (Future Pharmacological tech)

How long does Fentanyl stay in your system?

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)