Fentanyl

You can, but you must be aware and extremely careful that you don't become overheated (body temperature) or let a patch become exposed to sunlight. The patch dosage is regulated by body heat, and if core body temperature rises or if the patch is heated externally, the dosage delivery rate increases significantly. If you're not aware of what's happening or what to do, you can easily find yourself in a confused or delirious state, or worse if you're not that tolerant to high doses of opiates.

It's important to understand the effects to recognize the symptoms when they first occur, and to also educate family/friends on what to do if you start acting confused and it appears you're overheated. While it affects each person differently, I can only describe it as like being in a loop you're stuck in but can't get out of. You know what's happening, but your mind can't process enough to help yourself. Feeling completely helpless is a good description.

In such instances, the key is to both cool down your core body temp, and to remove the patch immediately (you can reattach it later as long as you don't fold it over on itself) to stop the dosage delivery through the skin. It takes about an hour or so before you're feeling fairly normal.

Over the years, it's happened to me several times when working around the house when it's hot during the summer, and it overtakes you pretty fast if you're not aware of what's happening. I have an extremely high opiate tolerance, so respiratory depression has never been a factor for me, but the mental confusion that comes with it is very unnerving to say the least. If it comes at a really bad time (operating equipment or driving) it can be much worse for you and others.

If you're working outside, make sure the patch is covered by clothing so it's not in direct sunlight, and that you keep well hydrated to maintain normal body temperature. Don't forget that increased activity will increase sweating, so if you've got problems keeping your patches on keep that in mind as well.

You will die.

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.

fentanyl is a strong opioid and falls into the same drug group as diamorphine (Heroin, actually the brand name of a childrens cough mixture that contained Diamorphine in the early 20th century) but contains no "heroin"

The lidocaine patch is composed of an adhesive material containing 5% lidocaine that is applied to a polyester felt backing

you don't.it should be prescribed to you in the first place..........which is acceptable on any drug test if you have chronic pain

Like any drug, if you keep them in their original packaging, and in a cool, dry storage area (below 75 degrees F), then they'll last indefinitely. The expiration date on most drugs is the date of full potency and effectiveness; however, drugs like Aspirin or drugs containing it should adhere to the expiration date due to Aspirin's breakdown over time, which can make you sick.

less than can be determined by visual identification think a low dose aspirin is 81 mg and very small it would be impossible to free handed cut it into 81 separate and equal 1 mg pieces if it were the cuts would be very minute indeed and far too small to work with without one cough or breeze blowing it away. and the amount of fentanyl in the highest dose fentanyl is 100 micrograms so one 81 mg aspirin contains by weight the amount of fentanyl in 810 ( 100 micrograms) patches so one low dose aspirin weight of fentanly is enough to kill 810 people if rapidly released by doing something foolish such as swallow the patch please find a safer high. fentanyl overdose will depress your breething it has been used both intentionally and unintentionally to cause death.

Transdermal fentanyl patches (Duragesic) are a common example of a long-acting opioid drug often used for cancer pain management.

Assuming you are alert for respiratory depression and breathing rates below 12/minute, I have seen immediate release Dilaudid used for acute breakthrough pain when Duragesic patches were being used for chronic pain management.

The source of synthetic fentanyl is 4-piperidinonehydrochloride, which is the first step in the production of this powerful medication.

nalaxone

This is hard to answer. Morphine can cause the inhibition of some muscle contraction but there is many factors whether or not it will interfere with analgesia.

1. The amount of morphine taken.

2. The user's tolerance to opiates.

3. Would need more info about the analgesia.

If you are on low doses morphine (50-80mg) Daily or less, this shouldn't be an issue. Past this dosage, i would talk with your physician about it before.

Jennapsyche

Fentanyl comes in many forms - tablets, liquid (IV or injectable), even lollipops. The most common usage is via transdermal patch.

It depends on your opiate tolerance level, but for first time users you should start feeling it around 3-6 hours after application.

A number of factors affect the dosage rate as well - adhesion to the skin, body temperature (which regulates the dose), and again, your tolerance level. Doctors typically prescribe the lowest dose first, and it's important to know that the dosage equivalence table (Fentanyl-Morphine) used to determine the initial dose is purposely skewed to the lower end for safety reasons. As such, its not uncommon for first time users to not get the desired effect on the first patch dose, and it's something you need to tell your doctor about.

Keep a record on how well (or not) it's affecting you so that you can show your doctor you need to increase if you need to.

Feels good if you've got the tolerance for it... But fentanyl in the right dose works WELL all by itself.

way better

Not so much affected to stomach. from patch fentanyl directly goes to the blood with out stomach.

Side effects of using Fentanyl patches are pretty common. Mood swings (typical with most opiates), urination (you won't feel it until you're ready to bust), respiratory problems (if you're not tolerant to the drug - if it happens at all call your doctor immediately), euphoria for first time users (until you get used to it). 25mcg is a pretty low dose, but if you're not that tolerant, increased body heat can increase the dosage delivery to the bloodstream. In such cases it can lead to confusion - as a 200mcg patient myself, it's happened to me several times over the years. You literally feel like you're stuck in a loop you cannot get out of. If you ever feel this way, remove the patch immediately (you can put it back on - just don't let it get stuck to itself. See my answer on keeping patches applied). Opiates are Vasodilators, meaning they open the blood vessels wider. As long as your body heat is higher from exercise or moving around, the drug will continue to be delivered at a higher rate, and if you're not that tolerant it will affect you adversely. It is difficult to realize what is happening to you, harder still to do anything about it until your body heat returns to normal. You should alert family and friends about what to do if they find you in a confused state and it's apparent you're overheated. Tell them to get your patch off and get you cooled down. Fentanyl takes several hours before you'll feel any withdrawal symptoms at all, and you should be well recovered before then.

If you have specific questions about side effects you can email me at my WA email listed on my Supervisor bio page. After nearly 10 years, there aren't many side effects I haven't experienced from it.

Additionally, nausea can be a major problem. As a 300 mcg patient, I lost 40 lbs. in 3 months. Zofran helped, but Marinol worked best .

if you rub it on your gums and are not opiod tolerant; 1-2hrs maxium, re rubbing fentanyl opiod analgesic onto gums.

It depends - if you're just removing it by the edges, you're not going to get any real contact with the gel. If the patch is cut and you come into contact with it, that's a different story, but if you wash it off quickly, you'll likely not have any problems with it.

The contact issue only affects non-users if the gel comes into contact with the skin, since the gel itself contains a concentrated amount of Fentanyl within it. Used patches approaching the 72 hour mark (I used to change mine at around 68 when I was on a 3 day dose, 44 when I changed to 2 days) are already pretty depleted of the gel, but it's still good to take precautions when handling used ones.

For the newer non-gel patches, you'd need to have skin contact for at least a few minutes to get any real exposure, as the dosage delivery is generated by body heat. Even so, with or without gel I'd recommend using either your fingernails or a pair of tweezers to remove the patches by the edges, then fold it in half per the patch literature and dispose of it, you're pretty much covering yourself from exposure. The best option if you're removing old patches is to just use nitrile gloves - you can't use them for applying patches, but you can use them to remove and dispose of them. Just grab the edge, pull it off, fold it and dispose, or if just one, hold it in your gloved hand then pull the glove off over it and dispose.

There aren't many studies or data available on long-term Fentanyl (or opiate for that matter) patients for a variety of reasons, but in general it's because that until the last few years, opiate therapy wasn't really widely accepted, and it still hasn't been by all doctors. The other reason is that opiate patients typically tend to be terminally ill, so they're not around long enough to study the effects on. A smaller percentage of patients are long term chronic pain patients and Duragesic users like myself, but the number is growing who are being prescribed it.

Pain management hasn't really been at the forefront of medicine until the past few years. However, again it comes down to a quality of life decision - if you're in constant extreme pain 24/7/365, it doesn't make a difference what the long term effects are - I guarantee you that the short term effects of that pain will kill your spirit long before the effects of long term opiate use will.

For any long-term user of Duragesic like myself, it is fundamentally a quality of life decision to start or continue with opiate therapy. Of course there are long term physical considerations, and the normal side effects of opiates in general (mood swings, urination problems, constipation, etc.), but those can be dealt with as long as you learn how to deal with them. The reality is that if you're in enough constant extreme pain to require Duragesic use, then long term effects aren't really an issue, as the extreme pain will kill your spirit long before the effects of using opiates long term will.

If you're referring to stored patches, they can, but if stored in a cool dry place in the original packages, they can last for a very long time. They're damaged by heat, as it's body heat that regulates the flow of the drug.

I keep mine in a plastic container in a nice dark, cool room.

Duragesic and other Fentanyl patches release Fentanyl dosages transdermally (through the skin and into the bloodstream). The dosage is regulated by body heat, which is why immersing the patch in hot water, exposing it to sunlight, getting a fever, or engaging in activity that raises core body temperature, can increase the dosage delivery rate and cause problems if the patient/family/friends aren't educated on the precautions and what to do if they start feeling the effects of an increased dose.