onthehunt11
Journeyman
Reged: 11/22/02
Posts: 92
Loc: midwest
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Hi All,
My neighbor recently got a rx for 100mcq Duragesic patches, 5 patches in all. I was just wondering....how do these compare with Hydrocodone or Oxycodone? These are patches that last for 3 days, a class II med, and the cost is about $60 per patch. Just wondering if anyone has ever used these before and if they work better than the hydro or oxy.
Thanks
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On The Hunt
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On The Hunt
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Farmer
Enthusiast
Reged: 12/23/01
Posts: 206
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That's a tough question. By weight Fentanyl is the strongest pain medicine currently in use in the US. It comes measured in micrograms so it's tough to equate to other in mgs. The patch releases the noted quantity every hour for 72 hours, so a 100mcg patch actually has 7200mcgs in it. So there is little of the ups and downs with oral meds.
As far as comparison, it is undoubtably stronger than hydro or oxy. If it were more easily available it would likley have the press that oxy received because folks would tend to like it very much. For the most part, folks are not given this med in any quantity unless they are opiod tollerent, so agian it's hard to get a handle on how it compares as most people on this med have moved beyond hydro a long time ago. Upside: no constant redosing, stronger med and more pain relief, less stomach issues - other than the standard constipation. Downside: it may take up to 24 hours to initially work, it may be tough to go back to lighter meds, for my take the 24 hour thing concerns me, if someone's opiod tollerence is not high enough and it takes 24 hours to hit the blood stream, I would assume if you were unhappy or concerned that the dose was too strong - simply removing the patch would not instantly remove the med, you may have a 24 hours ahead of you (on that part, that's my own take- I could be dead wrong, so take it FWIW)
Farmer
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LumbarSpasm
Silent Chaos
Reged: 05/07/02
Posts: 1538
Loc: USA
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I was rx'd it in the hospital post surgically and sent home on it. I was underdosed...but I couldn't keep them on. If you are active they fall off. There are adhesives you can purchase to put over the patch to help it stay put.
I didn't like them at all. But again I was undermedicated. I preferred the Oxycontin I was given after I complained and demanded something that would work.
They often times do not work for 72 hours...jmho.
But I was on the 25mcg patch...GRRR
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LumbarSpasm
Or just a pain in the butt?!
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TLT
Board Addict
Reged: 10/21/02
Posts: 358
Loc: loc. usa
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I just looked at a conversion chart, http://www.globalrph.com/narcotic.htm according to that: 100 micrograms of fentanyl, is equavalent to: 157.5-200mg of oxycodone per 24 hours. good Luck using the patch, I heard that it really works good, The only downside is keeping it stuck on. You can ask the pharmacist for info about ordering the coverlet's, these are supposed to ensure that the patch will stay on. They are free-of-charge from the manufacturer.
Terri
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"RUDENESS IS THE WEAK MANS IMITATION OF STRENGTH"
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onthehunt11
Journeyman
Reged: 11/22/02
Posts: 92
Loc: midwest
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so these patches are way stronger than oxys,wow i find this hard to belive i have seen these patches and they have just a little juice in them,i will take your alls word,my neigbor still cant tell he has taken anything yet the patch has been on for two days. i guess he wasted 120 dollars for the two patches he bought? what would happen if he cut the patch and rubbed the juice in his skin all at once? thanks
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On The Hunt
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TLT
Board Addict
Reged: 10/21/02
Posts: 358
Loc: loc. usa
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Read the insert that came with the patches. I don't believe I would mess with fentanyl in that way. Fentanyl is much more potent than morphine, if he is using 100mcg, and it absorbs into his skin all at once, it is like takin 600mg of morphine. Which I think could be fatal, if he is not used to taking that much at once.
I would tell him to call his Dr and maybe he can be swithched to oxycontin, or some other form of long-acting med.
JMO
Terri
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"RUDENESS IS THE WEAK MANS IMITATION OF STRENGTH"
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zorg
Veteran
Reged: 04/29/02
Posts: 559
Loc: Midwest
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If he cut the patch and breached the resevoir the fentanyl is contained in, he may very well die of an overdose. There is a controlled-release membrane between the resevoir and the skin. Fentanyl is measured in micrograms instead of milligrams, on the order of at least 10x stronger per physical dose.
I can't stress this enough... do not cut and apply those patches... even the smallest dose of 25mcg, if cut from the resevoir and applied, could QUITE possibly be a death sentence. That dosage is meant to be distributed across 72 hours. EXTREMELY DANGEROUS!!!!!!
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marnie64
Stranger
Reged: 06/25/03
Posts: 19
Loc: Michigan
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About a year ago, I was prescribed Durgesic patch. I was on lowest dose. I took nothing else. In the course of 6 months I was falling asleep at my job (standing cashier) I totalled my van (rolled it end over end and barrel) with my 4 year old in it. Was so constipated I had to use knife to get it to go down toilette (sorry graphic) but even thinking back to that time (what i remember of it) scares the hell outa me. I think only dying ppl should be put on this b/c when I was taken off - I was given w/d combating drugs and still flipped out. I lay in bed sweating and in the am when I awoke all my sheets were off and my fingertips were raw from clawing. This drug is aweful!!!!!!!!!! Stay away from it at all costs
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Marnie
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onthehunt11
Journeyman
Reged: 11/22/02
Posts: 92
Loc: midwest
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hi all,
thanks for all coments and sugg. hey marnie 64 sorry to hear you had a bad time with these patches.also just wanted to let you all know that my neigbor did in fact cut his patch because he got no relief from it and it still didnt do anything to him he says. well he is still alive and kicking so to speak. i just wonder why it doesnt help him? well thanks everyone who helped.
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On The Hunt
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dsack
Veteran
Reged: 01/20/02
Posts: 535
Loc: midwest
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Fentanyl is THE strongest. No other comparison. Draw -up, Bump, O.D. Sorry to be so graphic, but it's dangerous.
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yawkaw3
Pooh-Bah
Reged: 03/22/03
Posts: 1193
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Don't lick the patch either, even that's dangerous. Unless you have a considerable tolerance to opiates, they're best if left alone. Do a Google search on duragesic if you're interested, lotta information about what can really happen if you overdo or tamper w/ it.
Stay safe.
-yawkaw
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woody
Newbie
Reged: 01/07/02
Posts: 42
Loc: Pacific Northwest
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Opiate type pain meds don't work on 10% of the population. There are different types of narcotics that may work for your friend. It'll just have to be a trial and error thing. According to my Dr at the pain clinic, there are people that are unable to get relief from any drugs. Hope your friend isn't one of them.
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onthehunt11
Journeyman
Reged: 11/22/02
Posts: 92
Loc: midwest
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hey woody,and all at d.b.
my neigbor still isnt getting releif from these patches so his doctor told him to use two patches at a time and he feels o.k. for awhile then he gets a headache that lasts for hours or untill he spreads the fentanyl gel into his system, he puts it on his forehead, never tried this stuff but wow i love the smell of fentanyl,yummmie. well thanks all.
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On The Hunt
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quincy
Board Addict
Reged: 11/07/02
Posts: 333
Loc: pacific northwest
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My Pm doc is suggesting Oxycontin or Duragesic. I am really hesitant to use the patch, since my experience with fentynyl has been really bad. I have never had it in patch form, but I have had it for "consious sedation" during minor surgical procedures, in an IV. During both a wisdom tooth removal and a D&C I was given this med and the docs assured me I would feel no pain and would sleep through the procedure. Well, it didn't work at all. For the D&C I had no pain releif at all and screamed throughout the entire procedure. For the wisdom teeth removal I was "out" but not from the fentanyl, they gave me the gas to make me "sleep". I woke up in the middle of the procedure freaking out because I was in so much pain and could feel the dentist bascially using a chisel and hammer on my teeth!! I tried to get his attention by moaning, then trying to scream, then I finally has to hit him crotch to get his attention. All the while Im frantically pointing to my IV line trying to say "knock me out!!" Anyways to make a long story short neither of these worked then, so do you think they would work now? I know he will put me on the lowest dose, as he will with the oxycontin. Im scared of a patch that you only change every 3 days. I like taking pills because then you always know how much you are taking, and usually know how long they last.
Quincy
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onthehunt11
Journeyman
Reged: 11/22/02
Posts: 92
Loc: midwest
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quincy,
that post has my teeth hurting just reading that post wow i would have been pissed at the dentist big time wow,and your female problem doctor sounds worthless to me? take the oxys at least you know they will work for you. have a pain free day.
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On The Hunt
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dsack
Veteran
Reged: 01/20/02
Posts: 535
Loc: midwest
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I change my patches every-other day. Three at a time. Fentanyl is the reason I'm able to keep on working. The stuff is a godsend for me.
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onthehunt11
Journeyman
Reged: 11/22/02
Posts: 92
Loc: midwest
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dsack,
what kind of patches do you wear? 25 50 or 100 and you wear 3 at a time, is this just to be out of pain? or what. thanks.
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On The Hunt
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china020
Stranger
Reged: 02/25/03
Posts: 6
Loc: East Coast
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Fentanyl is so dangerous I get really nervous when I read that people are cutting it open and putting it on there skin. I just think you should do some reading and research on this drug. It is very unpredictable. Is your friend trying to get a high or get rid of pain? I am afraid he is going to end up dead. Please be safe and beware.
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ohd_37
Board Addict
Reged: 08/05/03
Posts: 399
Loc: up north, yankee all the way
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this here drug is top notch if you are in some bad pain!! althought it has some bad side effects that come with it. on a scale of one to ten i give this drug a 9 . but that is just what i think. hope this will help.
ohd_37
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flea
Enthusiast
Reged: 05/17/02
Posts: 279
Loc: Recently moved to Mid-West, bu...
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I tried the patches for 2 weeks but I finally had to go off of them because I was getting a terrible rash underneath the patches as well as all around them. I was up to three 100 patches at a time (also sometimes even an extra 25 and to tell you the truth, I did not get the kind of relief I had hoped for. I really thought that I was going to be pain free if I used the patches, but I was not. This freaked my doctor out, because I was only on 65 mg of methadone prior to switching to the patch, but the reason I was put on the duragesic in the first place was because the methadone was just not working any more so she was almost positive that I would feel so much better. I was so bummed that I was not pain free, as I had hoped. Really, I had more pain relief with the dose of methadone I was on, which is so weird because when comparing the two together, I would need like another 100 mg of methadone to even come close to the amount of the duragesic I was slappin' on! Plus, when the rash would get too bad, I would HAVE to take that one patch off, throw it away, and put a new one on in a different area. Then I would scratch the heck out the nasty spot that I had just freed! So I was not even waiting the 3 days that I was supposed to, if anything I rarely could wait 48 hours with any of them because of the rash. In the end I was putting them on my legs and other places that I thought were less sensitive, but no matter where they went, the rash appeared. Even though my husband has tried to be supportive through all of this, the whole "rash" thing just seriously grossed him out a little too much. It was so funny because I was like a dog with an itch, I would have dragged myself across the carpet if it would have relieved the itchiness for me. SO disgusting. I would beg my husband to scratch some of the areas for me and the look of disgust on his face was apparent. I could care less either, thats how bad it itched, I did not want to hear any complaints from him, all I wanted to see was arm movement from his hand scratching me all over. It was a real mess. I even have a few of the marks left on me. They are really light, but there is this one on my back that just never healed properly, I would scratch it at night too, even though I had stopped allowing myself to scratch anywhere. But at night I could not control it, so I finally just went to bed with socks on my hand. Pretty ridiculous huh?
So I do not know if the rash was preventing the medicine to soak into my skin properly, or if my allergic reaction just counter acted the meds? I will never know, but because I was not getting relief, I decided to go off of the patches, and was then put on oxycontin, which has actually changed my life for the better. I am absolutely feeling less pain then ever and I am able to do my PT exercises at home every day which gives me hope that I will be feeling even better soon!
So my advice to anyone that gets a bad rash from the patches, don't wait it out, get off of them right away. Also, I did find that the patches did not always stay on like they were supposed to, so if anyone uses them, they should also purchase medical tape from the drugstore. Then tape the patches on when you first use it! It will really help when you are in the shower. Once again I do not know if it was just me, but the patches did not want to stay on after a shower, but the tape really held them in place!!
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Flea
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Reel_X_4U
Enthusiast
Reged: 04/24/03
Posts: 255
Loc: Queens, New York City
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You're talking about one mean narcotic (synthetic)
It even has anlogs which are stronger then it itself, like Fentanyl is 80 time more potent then Morphine, now you have the analog "sulfenta" (sulfentanil), which is 15 times more powerful then fentanyl, and the other analog "alfenta" (alfentanil) is 20 times more powerful than Fentanyl. Physically altering the patch in any way can cause an OD in seconds, this is a last resort drug for those individuals who are in the "terminal stages of cancer", or those who are placed in a hospice (which means you have less then two weeks to live), it is now starting to be used for those who have become tolerant to all other narcotics and their pain can't be suppressed any longer, with conventional narcotic therapy. This med is so strong that "1" microgram difference in dosage can kill you, which means in an non-tolerant individual is 100mcg of fentanyl for pain relief, they will get their relief, if they are given 101mcg of fentanyl, their respiratory functions are depressed at the brain stem level and they can die a quiet death. Don't play with the patches, use them as directed by the doc and at the same time, if you can monitor the number breaths you take at rest(per minute) before you take the med and then monitor the number of breaths (per minute) after you take the med. There will slight decrease after taking the med, but if you see a sudden drop in the number of breaths you take per minute or even if you have to "think" to "remember" to take a breath, then get yourself in the ER ASAP. Since breathing is involuntary and requires no active thought from your end to make it happen. Do your neighbor a favor and watch over him the next few days and make sure he doesn't play with the patches. Read the directions and then have them reinforced by consulting with the pharmacist. Good Luck and I hope your neighbor feels better.
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Some men see things as they are and say "WHY"!!
Some men see things as they are and say "WHY"!!
I've dreamt of things that never were, and say "WHY NOT"!!
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Daycamp72
Enthusiast
Reged: 06/29/02
Posts: 284
Loc: Tara
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I agree. Like Lumbar, I was sent home post-surgically with the patches. I didn't have a problem keeping them on, but they did nothing for my pain. I was big-time opiate tolerant at the time and had had many surgeries that year. Conversly, when my doc prescribed Percocet in the place of the Duragesic, I got relief from taking two .5mg tablets at once.
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ohd_37
Board Addict
Reged: 08/05/03
Posts: 399
Loc: up north, yankee all the way
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daycamp,
these patches take like a day to start working,maybe longer and if you are in alot of pain you will need to take pills until they start working.
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LumbarSpasm
Silent Chaos
Reged: 05/07/02
Posts: 1538
Loc: USA
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Quote:
This med is so strong that "1" microgram difference in dosage can kill you, which means in an non-tolerant individual is 100mcg of fentanyl for pain relief, they will get their relief, if they are given 101mcg of fentanyl, their respiratory functions are depressed at the brain stem level and they can die a quiet death.
I doubt an opiate naive person would be prescribed this at that dosage. I doubt that 1 microgram more than 100mcg would cause death. It is all relative...but I'd like to read the information you are Reel.
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LumbarSpasm
Or just a pain in the butt?!
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Trampy
Pooh-Bah
Reged: 04/02/02
Posts: 1241
Loc: Southwest U.S.
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Quote:
... This med is so strong that "1" microgram difference in dosage can kill you, which means in an non-tolerant individual is 100mcg of fentanyl for pain relief, they will get their relief, if they are given 101mcg of fentanyl, their respiratory functions are depressed at the brain stem level and they can die a quiet death.
That's impossible. No way. No how. A 1% increase in the dose would be clinically imperceptible. No way it could be fatal. No way. Did i say no way?
Trampy
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Your mileage may vary ...
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flea
Enthusiast
Reged: 05/17/02
Posts: 279
Loc: Recently moved to Mid-West, bu...
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This does not sound right to me either. Are you saying that "1" microgram difference in dose can cause only the "non-tolerant" person to die, or it could possibly be lethal for an "opiant-tolerant" person as well?
It just seems to me that if there was such a risk then my pharmacist would have mentioned this to me when I picked up my first prescription of the patches. They barely went over how to use them let alone explain any danger involved, especailly since you made it sound like it would have a deadly affect on the respitory system if used incorrectly, or if an overdose could occurr with a difference of only "1" microgram.
I mean the pharmacists were far more concerned about the risks involved when I picked up my oxycontin then when I picked up the Duragesic Patches. Hmmm, that could have just been because of the social stigma attached to the oxycontin. Either way, that scares me to hear, since I had to take off and then put on several patches within one or two days, due to the rash I got. I told my doctor about it and she never even said that the meds could be really dangerous.
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Flea
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ohd_37
Board Addict
Reged: 08/05/03
Posts: 399
Loc: up north, yankee all the way
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Just a question, any one know approximately how many 10mg hydrocodone would equal to 1 microgram of fentanyl??
Just curious how they would equal.
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flea
Enthusiast
Reged: 05/17/02
Posts: 279
Loc: Recently moved to Mid-West, bu...
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It is pretty hard to find a conversion chart for fentanyl but I am sure someone on this board will know how.
When I was switching from methadone to fentanyl and then when I got the rash I switched from fentanyl to oxycontin, there were hardly any pharmacists out there that could help me out. That is a rare phenomenon because every time I have a question about a new med i am taking, or about possible side effects for a medication, i call a pharmacist before even asking my doctor. Therefore when I contacted 3 pharmacists and asked all three the questions about doses and conversions, I was surprised to find out that all 3 did not know. The only thing they could tell me was that 65 mg of methadone is far less than 3-100 duragesic patches.
Then when i switched from the patches to oxycontin they told me that 160mg of oxycontin a day (what I was first prescribed) was nowhere near the high dose i was receiving through the patches. It was frighteneing to find out that my family doctor could have just randomly picked a dose that sounded right to her, but was way off the amount of opiates I had in my system from the patches. I went into withdrawl when I switched over to the oxycontin.
It was a bit strange and somewhat backwards to me in that i had heard so much stuff about oxycontin and how 10mg would work well for other people in pain, but even at 160mg a day I went into withdrawl and I was feeling much more pain than before.
If anyone does find a conversion chart that has methadone, fentanyl and oxycontin could they please post it here, or point me in the right direction? It would be greatly appreciated!
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Flea
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prettyday
Threadhead
Reged: 02/09/03
Posts: 965
Loc: Coastal Sage Scrub
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Oh, I remember going thru this five years ago; you know actually there is a lot more knowledge among doctors today and still opioid conversion charts are not something they will have hanging around for quick reference. So I went thru hell as I got switched to different remedies and I thought it was me.
Well, it WAS me, but you know what I mean.
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First they ignore you, then they laugh at you, then they fight you, then you win.
- Mahatma Gandhi
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prettyday
Threadhead
Reged: 02/09/03
Posts: 965
Loc: Coastal Sage Scrub
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Okay try this conversion chart; see if it works for anyone!
http://www.globalrph.com/narcoticonv.htm
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First they ignore you, then they laugh at you, then they fight you, then you win.
- Mahatma Gandhi
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