Fentanyl

You should NEVER downstep your fentanyl patches by CUTTING them. The way the drug is delivered, this will completely mess up how the medication is absorbed and metabolized into your system.

If you're going some 50 to 25, get a prescription for the patches at the lower dose. If you're already at the lowest dose and looking to gradually step it down, do so by only uncovering half of the sticker, apply the patch and then use tape to hold down the half that is not yet exposed. You can use the same principle to step down to a quarter of a 25 patch, but never use scissors to cut the patch itself.

40 days

None! My God! Eating a fentanyl patch could kill you!

Everyone is different, but I was clear after 72-84 hours.

No. They are not chemically related and must be tested for individually and specifically.

yes it does made by Mylan. They stay on much better and work just as well if not better because they don't come off as easily.

Fentanyl will show up as fentanyl but this is almost never tested for. It is a special test which is also expensive and I would only suspect it being tested for if one had access to it, i.e. anesthestiologist.

Jackpot and china girl

Duragesic (Fentanyl Transdermal) patches are used for Primary Chronic Pain; they last for up to 3 days depending on the patient and tolerance level. For example, I'm one of a small percentage of the population that only gets 48 hours from my patches, and that's due to my high tolerance level - I've been using them for 9 years.

Percocet (Oxycodone and Tylenol) is used for Breakthrough Pain - Breakthrough Pain is that pain which the patient feels after activity causes pain being controlled by the patches to exceed the pain controlling capability of the Fentanyl. Percocet, being an Acute pain drug, is used to compensate for the temporary increase in pain.

The combination of Fentanyl patches and Percocet is very common - I myself have used the combination in varying strengths and doses for a very long time. While I'm currently using the strongest doses available, at times I've had to increase my dosages and augment them with other opiates such as Demerol and MS Contin.

Vicodin, like Percocet, is prescribed for patch users as a pain breakthrough drug. Normally, you'd take it in instances where increased activity has increased your pain level beyond the patch's control point (breakthrough) and you need something short term to handle the pain.

You can also use it if you've waited a bit too long to change out your patch to a new one. It usually takes a while for a new patch dose to ramp up to where you're feeling the effects, so in those cases, you can use Vicodin to bridge the withdrawals until the Fentanyl takes effect.

Supposedly there isn't any long term research data on Fentanyl use or other opiates.

However, I can tell you that after 9 years of using 100 micro patches at doses of 100 and 200 (2 x 100 patches) that I don't have any problems with it. I also use a rather large quantity of Percocet 10/325's for breakthrough pain (120/150 per month) and I have no ill effects from that either. I've used both for the same period, and use other less potent opiates prior to using these.

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

yes

You can, but it's typically not recommended since both drugs are chronic pain medications generally prescribed in their timed-release form. Either one or the other is used - OxyContin lasts up to 12 hours, while Fentanyl, generally prescribed as a transdermal patch, can last up to 72 hours. Oral Fentanyl and OxyContin can used, but again it's generally not done unless the Fentanyl is in pill form and short acting. Fentanyl is more likely to be prescribed as the primary chronic pain med with Percocet (which has Oxycodone, the base drug for OxyContin, the time release version) for breakthrough pain.

As long as you're using one as a timed-release drug and the other in short acting form (4-6 hours), it's okay. It's using both together in timed-release versions where problems can arise.

It is perfectly ok to use both, contrary to above. I suffer from chronic pain, and take 20mg Oxycontin 2 times a day, and apply a 75mcg fentanyl patch every 72 hours. I have been on each seperatly and I find several pain "holes". but on both, I can actually function to 95% of my original capabilities.

Actually the above poster is correct. I take 240mg of Oxycontin a day and my dr prescribed 100umg fentanyl to better even out the levels of narcotics I had in my system. Now this just happened to be what worked for me so you should ask your doctor before trying. Fentanyl is some bad mojo if abused.

You don't. You get Watson brand and eat them.

roughly a dollar per microgram..nomore than that ...but u can make them last a long time...i get the mylan brand and u can chew them a bit , then save it and hit it back and forth for a couple of days,,,,gel doesnt last as long but makes u really really high and comming off of them is abitch unless u have methadone to fall back on...

It depends entirely on the individual. Fentanyl stays in the system for a lot longer than acute meds do, so you've got several hours to either put a new patch on or swap the old one. Ideally, you want to put a new patch on a couple of hours before the old one is supposed to expire, but it's important to note that the normally prescribed 72 hour mark doesn't apply to everyone, and isn't fixed in stone, something that a lot of pain doctors have trouble understanding.

Fentanyl transdermal patches regulate the dosage by body heat - this means if you're engaged in physical activity or anything else that raises your body temp, the dosage delivery is increased, and the expiration time is decreased. Also, a small percentage of the population (myself included) require a 48 hour change rather than 72. It's more typical of high-dose opiate patients like myself.

The problem lies in that for many years, Janssen Pharmaceuticals' literature on Duragesic had 72 hours as the effective dosage period. However, they knew that some people didn't get that much. Though they finally changed the literature about 4 years ago to say that 48-72 hours, a lot of doctors don't keep up with those kinds of minor changes, and a lot of pain patients don't understand the proper way to communicate with their pain doctors. The real problem is that if you're getting patches based on a 72 hour dosage rate, and you're falling shorter, you'll wind up having less patches for your monthly prescription. In those cases, keeping an accurate Pain Diary is essential in showing your doctor that his prescription isn't right for your particular case and needs to be adjusted. If you're a fairly new Pain Management patient, or have an idiot for a pain doctor, it can be frustrating.

Where you place the patch is important as well. I've always used my biceps in the 10 years I've been using them, since it's easy to add them and the skin doesn't flex as much as it does in other areas. Even during the times when I've had to increase to 200mcg (2x100mcg patches), I still use both arms, taking on patch off for a few hours to let the skin breathe, clean it, then put a new one on, and then do the same with the other one.

As I said, if you overlap the patches (put a new one on in a new location as the other one is about to expire) you'll have no withdrawals to deal with. It takes a couple of hours for the new patch to ramp up to full delivery, so as the old one is getting weaker the new one is slowly catching up. The result helps to keep your overall maintenance dose fairly steady.

Yes, they will both show up as opiates.

No

Depends on the area of course.Im in West V so its expensive since pain pills are the drug of choice around here.They go from 9 to 10 doll a piece!

As long as your duragesic patch has been applied properly, you should have no problem showering with it on. If you take hot showers make sure that you dont leave the water on the patch for very long, it can cause the medication to disperse into your body faster, that could cause breating problems which may lead to death. Also no heating pads on your patch. If you have kids make sure you dispose of them properly, there has been several deaths of children and pets that have stepped on them and stuck aswell as chewing on them.

Slowly

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.