kimbell1
Board Addict
Reged: 08/20/03
Posts: 306
Loc: Route 666, Painville, Texas 6...
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I have found that due to the recall of the 75 micro unit Duragesic patch, it is IMPOSSIBLE to find either the 25 or 50 microunit durgesic patches in the Dallas, Texas area. I have called about a dozen pharmacists and they all said that the manufacturer is not shipping the patch and the 25 and 50 micro unit patches are being grabbed up for those on the 75 micro unit patches. The company stated on 5-18, that they would be shipping all units of patches by end of this week. They have not-at least to where I live.
Second major problem is that the patches will not stay on for 1 day let alone 3 days. I have tried using medical tape with various degrees of success but today and about a month ago, these patches held down with water-proof medical tape stated LEAKING from under the taped patch onto my skin.
Both times I had a leak was after taking a shower-not soaking in a bath tub. The patch was not exposed to water for a long period of time.
Personally, these patches should be eliminated from approved pain drugs. They don't work-both my opinion and others I have asked on this board with only a very few (about 3 people) liking this drug.
They are not practicle if you sweat a lot or live in a hot climate since they have to be stored at temperatures not hotter than 77 degrees. What do you do on a raod trip with the ____ things?
I have to make these ___ things work for about 4 months but they are just expensive and useless. Maybe it is just as well that they can't be found.
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bargsbeer69
Journeyman
Reged: 03/22/04
Posts: 80
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Kimbell
I was wondering how long have you been using the patch for?.
for the Patch not to give you any relief thats Odd I Tought The Fetanyl Patch was the Cream of the Crop in Pain killers
#1 ,Grade A ??.I would assume that you are in a lot of SEVERE pain.Is the Patch not working because you have a tolerance?, or because it won't stay applied to your Body?,or Is it Because it is not Producing a feeling of Euphoria when you Apply it?,Just Curious I have Posted a Couple Articles and stories on the Patch in the Past.
This the first story where i have Read that it is ineffective for a Patient ,Plus on top of that the Manufacturer Re-calling Some Patch's ?.
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oldnavy170
Board Addict
Reged: 05/12/03
Posts: 357
Loc: New York
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Hey Kim, are those patches suppose to be applies to only certain area's of the body? Do they work better on some spots better than others?
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apkjezebel
Enthusiast
Reged: 03/01/04
Posts: 214
Loc: Florida
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I don't know if you have insurance or not but there is a form you can fill out to see if you qualify to get them for free. There is also a number you can call to get covers to go over them if they are coming off. If you don't have the number i'll see if i can find it for you. Also i can send you the link for the program if you are interested. Take care.
Lisa
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"I promised myself somewhere in teenage life Id never submit to the ones I will not be like Live in a hole But stay close to my kind Cause they understand what burns in my mind ~Pantera~ "
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IMSUSCOT1
Threadhead
Reged: 10/23/02
Posts: 892
Loc: usa
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Some hopefully helpful "nursing" hints for Duragesic patch wearers...
1.) Thoroughly wash the area your applying the patch to with soap & water, then dry, then swab the are with alcohol and allow to air dry...then WAIT about 15 minutes, keeping the area your going to apply the patch to exposed to air before applying...
2.) Usually, the upper arm (not near the axilla or underarm) is a better location to apply the patch to for several reasons...
The upper arm isn't prone to "sweating" as other body parts are, i.e. the abdomen, back, etc and the upper arm remains exposed to air throughout the day, reducing the likelyhood of moisture accumulating under the patch...sometimes taping over it actually makes sweating & moisture accumulation MORE likely than not...
You can cover the arm with saran wrap and tape it, (i've found the white, adhesive medical tape works well) before showering, or you can cut the fingers off of a latex glove, put that around the arm where the patch is, and again tape both ends, you may have to use 2 gloves, to keep it dry when showering(I had a PICC or IV line & had to use this technique for MONTHS when showering, it works) MINIMIZE the amount of time you spend in the shower...get clean, QUICK and minimize contact of the patched arm with water while you are showering...
If you're not getting good adhesion and constant contact with the skin, you're probably not getting a continuous dose of medication, which may explain why it's not working well...also it takes 48-72 hours of CONTINUOUS exposure INITIALLY, to obtain full benefit...then it must be changed every 72 hours RELIGIOUSLY....I've found applying the new patch, and leaving the old one on for anywhere from 2-6 hours works best....after 72 hours there's no real risk of getting "too much" fentanyl and for whatever reason, I've had patient's tell me this is more effective than ripping off one patch & applying the new one...
Until you've established an effective blood level of medication (again 48-72 hours after the first SUCCESSFUL application), most patient's require an adjunct or break through short acting medication...i.e. hydro, percocet or Oxy IR...you really need to communicate with your provider, especially when you first begin therapy...
Fentanyl is VERY effective for many people...but application correctly makes all the difference.Also, PAIN RELIEF, NOT EUPHORIC or "FEEL GOOD" effects are the measure of success...if you've taken other narcotics & noticed more of a euphoric or feeling of "well being", you probably WON'T notice it with the patch...doesn't necessarily mean it's not working..
...good luck
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kimbell1
Board Addict
Reged: 08/20/03
Posts: 306
Loc: Route 666, Painville, Texas 6...
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Thanks to those answering my post.
Today, I stopped at a Walgreens near Dallas and the pharmacist told me that the 50 micro units are leaking. So it is not just me.
As for insurance. i am on one patch every 2 days since I metabolize the fentanyl. No problem with my insurance about cost so far.
I have called the company that makes these things for a supply of 'shields' to hold the patch in place. I have yet to receive this suply but I will post the results since they should arrive any day. Perhaps I can place the patches in areas I have been unable before due to adheasion problems.
As far as specific spots. When I called the manufacturer, they did give some tips on making the patches adhere but the pharmacist said that a lot of people have trouble with the adheasion problem. He stated that not very many are sold in his pharmacy.
The person that I talked to at the company said to attach them above the waist. However, I have tried without any success since this area of my body flexes the most. The only place I can wear them with any degree of comfort (and they are uncomfortable-much rather have a pill and be done with it) is my thigh or lower leg.
As far the patch 'being the creme of the crop', as one person stated on another post, that just because fentanyl is suppossed to be about 100 times stronger than morphine means its just a way of measuring. in other words, 1 mg of xanax is about the same as 10 mgs of valium. Yet the xanax is not less powerful. It is just deifferent medication if that example makes sense.
I hope that I have answered your questions.
One last thing, i may be one who is not effected by the patch. This drug must be successful or no one would get prescribed it. However, I have also read that the patch is more of a pain medication used in cancer treatment and the patient is more stationary. So it's possible that I should not even be prescribed this drug. However, I have read that a lot of doctors like the patch and are going to it because they feel there is less chance for abuse.
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TLT
Board Addict
Reged: 10/21/02
Posts: 358
Loc: loc. usa
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I currntly use 75mcg patch, I put on my abdomen, after washing area, with warm water only, then, let area dry about 15-20 min, after I peel backing off patch, I press on all edges, 30 seconds,, I too have used medical tape. which is sometimes needed after 2 days.
There is good consumer info at http://duragesic.com/consumer/about/faqs.jsp#fallsoff
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kimbell1
Board Addict
Reged: 08/20/03
Posts: 306
Loc: Route 666, Painville, Texas 6...
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I read my last post again and I see one big mistake about why I take the patch every 48 hours instead of the normal 72 hours. My doctor beleives that I may metabolize the drug differently than most. I do metabolize drugs differently I think-but that is just my opinion.
After reading about shower techniques from the person kind enough to post them, I say thank you. However, Texas is one of the hottest states in the country and I do take a lot of showers in hot or humid weather.
I have told my doctor this and asked for oxy time release or anything but the patch which I have been on for about 4 months. This product just does not fit my lifestyle. If this was the only pain medication or there was a special need to prescribe this over another class 2 pain killer, perhaps I would be more willing to put up with this medication's quirks. But there are pain killers that are probably better and certainly less trouble. And since the patches are not readily available right now and the fact I have asked many times to be switched to another medication ( each month I see the doctor), I wonder why my doctor wants to keep me on something I am not comfortable wearing and have a hard time finding even when it was available. At this point, I would actually prefer to go back to norco 10 than worrying how I shower or place the patch.
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IMSUSCOT1
Threadhead
Reged: 10/23/02
Posts: 892
Loc: usa
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Hey, I totally agree with you...I believe the patch is more appropriate for a patient's who are not necessarily as active..and are able to take sponge baths, because they are home, mostly in bed...and it's typically been used in the past for seriously ill cancer patients, usually as an adjunct to other narcotic therapies...
And I think you're right, it's become more popular w/PM docs because it is harder to circumvent and abuse...but that doesn't make it superior for the active, otherwise healthy patient.
Cancer patient's also have issues with oral intake, in general and often cannot tolerate the amounts of fluids required to swallow tablets throughout the day...among many other diffuclt issues that affect their overall management...
I live in Phoenix, and although I haven't used the Duragesic patch, I am FULLY expeirenced in having to take special precautions while bathing, due to having a PICC (Peripherally inserted Central Catheter...it's an IV line that is threaded into the greater subclavian or can be threaded into the Right atrium if necessary for caustic/powerful IV medications) for nearly 3 months....IT WAS A PAIN IN THE Best if kept off the board!! And I too had a terible time with the large covering required...it's hard to change your own with sterile technique on your own arm, one handed...and the Nursing service would only come out once a week...it was a terrible inconvenience & I HATED IT!!
I was NEVER so glad to finally have the friggn thing pulled...it was a major, daily logistics problem...and I live in PHoenix...where it gets to be 122..so I can relate...I think you should have a serious talk with your doc...sounds like he's not hearing the nature of the problems your having...you've got to make him see that logistically, you are active enough that it just doesn't work for you...good luck!
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lespierce
Journeyman
Reged: 11/25/03
Posts: 56
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I use a product from Nexcare, called Tagaderm, which is a transparent dressing, which fits over the patch. It works great, and since I have started using the Tagaderm, I have much better adhesion, and the patch has not fallen off yet.
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curiousdee
Member
Reged: 05/29/04
Posts: 167
Loc: Southeast U.S.
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Hello all. Kimbell I was sorry to see you were having trouble with the patch. I thought it was just me. I wore the duragesic patch for two years. I can sympathize with your dilema. If you bathe you have a problem with them. My doctor was great about it though. He asked the Jansen rep to come in and talk to me and answer my questions. I will pass along to you and I hope some of these tips help you. He did say that some people do metabolize fentanyl quicker than others. Hence you need to change your patch every two days. He told me to call the toll free number on the box and request the covering. Jansen sends it to you at no additional cost. The covering made me break out and sometimes the adhesive on the patch would make my skin break off. For this my doctor gave me a nose spray(Flonase)to put on your skin and then apply hydrocortisone, let it dry and then apply the patch, with the covering by Johnson & Johnson (they own Jansen). This was my regimen every two days. And I am in the deep south, humidity and heat! Anyway, I loved the med because it worked. But the constant battle wearing it caught up with me. I was finally changed to something else. Good luck I hope I helped. 
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catman1
Journeyman
Reged: 08/17/02
Posts: 87
Loc: SE USA
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I have no problem with keeping the patch on, even with showers and sweating. I do live in the hot south. I find that the patch works better(?) for me than oxy. I can walk better with it, but I actually do feel the pain a bit more. I am not sure how to equate oxy to duragesic (does anybody here know?)but I was taking 80mg oxy 3 times a day, now 100mcg duragesic every 2 days. I will say, i got the impression from my doctor that the patch lasting 3 days is the exception, not the rule. I am just happy that I can walk. I hope they can fix my back soon so I can stop taking this stuff.
PS. I always wear it on my chest (no chest hair) and just alternate which side I wear it on.
Edited by catman1 (06/16/04 02:45 PM)
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