Tolerance - Fentanyl 100 mcg Patch Day 2 and 3 Report

[award11]

My friend seemed to be pretty comfortable on day 2 of his patch. He said it was nice to not have to worry about redosing and taking his pill bottles around with him everywhere. The pain relieving qualities of the fentanyl are no doubt superior to the oxy/roxi combo that he is used to. He said its like being at ur peak, all day, with no peaks and valleys. At one point he supplemented with a 15mg roxi and said he felt like that was a little too much. He must be careful and remember that he has a high build up of fentantyl in his body and even a slight increase can be too much. SWIM is kinda OCD sometimes but it kinda scared him. Someone had told him earlier that his face was kinda flush, red and then a few minutes later his heart rate was slow and hard so he took the patch off for a few. He put it back on after about an hour and went to sleep.

After about 65 hours use he had to replace the patch. He said when he woke up he could tell that the med was not releasing anymore so he immediatedly slapped another one on. He feels bad kinda while he is waiting on the new patch to kick in. This is one of those valleys he was trying to avoid and is kinda thinking maybe he should stay with the oxy roxi combo.... In theory though, this should be the best method for SWIM, he just thinks its going to have to take some time to get used to. I will keep you guys posted.

[Issmortor]

SWIM's glad to hear that youre experiencing good results with the patches.

From what SWIM understands, the patch works like this:

1-the patch is applied to the skin
2-the patch slowly begins to release the fentanyl into the fatty tissue located immediatly below the patch
3-the fatty tissue becomes filled, which can take anywhere from 6-12 hours
4-once the tissue is full, the remaining fentanyl released from the patch and into the tissue, the tissue "pool" then "overflows" and sreads into the bloodstream

therefore after the first patch is taken off, that pool of fentanyl will just sit there, with nothing to push it from the tissue and into the blood, and the other patch(which is used as directed) was place on a differend part of the body, would now be filling up a second pool.

so there is a span of a few/several hours where the fentanyl wil not be released into you blood, by this method.

SWIM's recommendation is to leave the first patch on for 2-3 hours after application of the second patch...you MUST BE VERY CAREFULL with this method, because once the second pool fills and starts to release into the blood, you will then start to double-dose...

[award11]

Like I said, SWIM put his 2nd patch on this morning and basically spent all day waiting on it to kick in. He has spent most of the day feeling a little crappy, not in complete withdrawl but nowhere near comfortable. He's starting to feel some better but it appears that as it did with the initial patch, this patch is also going to take 12 hours before it kicks in also. The first one ran out in his sleep. These are a little trickier to manage than one would think. In theory, it shouldn't be this difficult but because of SWIMS OCD and uncertainty of this process, it is taking some trial and error. I wouldn't be suprised if he doesnt just go back to the oxy roxi combo and be done with it. He thought highly of it yesterday but is somewhat pissed off today but he realizes it's his own fault.

[Lisa J]

SWIM finds changing the patches every 48 hours much more effective, if that is not possible keep the old patch on until SWIY feels the new one start to kick in (don't do this at night). SWIY should give themselves a week or two for getting used to a new medication before deciding it does not suit them, fentanyl is a life saver for SWIM but like all pain meds it doesn't suit everybody.

[award11]

Okay.. Today is Day 5. My friend is on his 2nd patch and not feeling good. He woke up feeling like hell this morning and it has not gotten any better. On his initial ramp up on day one there was one point where he felt like he may be getting too much medicine but here on day 5, it's obvious that this is not enough. SWIM is used to having a lot of fast acting medicine in his body throughout the day as opposed to a slow steady dose of fentanyl. His body hurts and his eyes are watering.... He feels like crap. He gets his roxicodone tomorrow and he will be so glad.... This patch by itself is just not enough....

[dyingtomorrow]

A question out of curiosity:

Does it need to be over "fatty tissues"?

If you put it over a prominent vein in the bottom of your wrist, for instance, would it take effect faster?

[Issmortor]

Originally Posted by dyingtomorrow

A question out of curiosity:

Does it need to be over "fatty tissues"?

If you put it over a prominent vein in the bottom of your wrist, for instance, would it take effect faster?

good question, ive actaully read a bit about this, but dissappointingly, i cant remember which way the table turned...

there would be two groups, the "skinny" people and the (no offense intended) "fat" people.
i know that in one group the patch absorbs faster(but is not overly intoxicating) and usually runs out(or at least is highly less effective) on the third day, and somtimes(good doctor willing) have to actually change the patch every 48 hours rather than 72...and the other group, the patch is less effective, and leave behind alot of the fentanyl/gel in the patch

i really wish i could remember which it is...kinda sucks, and somewhat pointless to not know which is which

i think it may have been the skinnies(less fatty area) absorb faster, because my friend is skinny(115lbs) and when he was on the patches, was going to ask his doc for 48hr change, but forgot on his last appointment

im not in the research mood, but if anyone else wants to look into this or do some google hunts for the sake of education, thatd be greatly appreciated...if not, i may do it tomorrow