Fentanyl (Duragesic) patch

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OrchidNancy
OrchidNancy Member Posts: 23
in Head and Neck Cancer #1

I want to share this about the fentanyl patch. The starting dose is based on how much you're taking of other narcotics - not based on age, weight, etc. I found a dose calculator and it recommended a dose for my husband that was the lowest strength patch available as he was only taking liquid Norco about 6 times a day. He was prescribed 4x that dose, tolerated it at first until the drug accumulated in his body, had the patch changed at the 3 day mark (as it should be) and then 2 days later was unresponsive in the morning.

He also had a fever of 102f that increases the absorption of drug from the patch. Once the patch is removed, the drug that has been absorbed into the skin is still active for days - it's a reservoir. If you are overdosed you still need naloxone after the patch is removed - taking the patch off only prevents more drug from being absorbed into the skin but does nothing for the reservoir that's already residing under your skin.  You may even need multiple doses of naloxone.

We found out the hard way.

If anyone is starting on the patch, please double check your doctor or be a squeeky wheel and ask how they know that dose is the right one for you. Ours was a medical oncologist in the group who was doing rounds that morning in the hospital. He probably just looked over my husband and thought based on his size and age that he'd need a 50mcg patch, but using this calculator it should have been 12.5mcg.

http://www.globalrph.com/opioidconverter2.htm

Balancing pain relief and not being overdosed can be a tricky business. Be careful out there.

Nancy

ps This goes for any long acting pain med. The opiod converter can be used to convert equivalences of any pain meds.

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  • debbiejeanne
    debbiejeanne Member Posts: 3,102 Member
    #2
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    that is very good info to

    that is very good info to have.  i'm hope your hubby is feeling better.  man, this stuff if really scary.

    God bless you,

    dj

  • OrchidNancy
    OrchidNancy Member Posts: 23
    #3
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    debbiejeanne said:

    that is very good info to

    that is very good info to have.  i'm hope your hubby is feeling better.  man, this stuff if really scary.

    God bless you,

    dj

    Thanks dj

    He's just hanging in there. No more patches at ANY dose. He would rather just use liquid Norco and have a pretty high level of pain than use stronger meds and risk aother hospital visit. God bless you too.

  • hwt
    hwt Member Posts: 2,328 Member
    #4
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    OrchidNancy said:

    Thanks dj

    He's just hanging in there. No more patches at ANY dose. He would rather just use liquid Norco and have a pretty high level of pain than use stronger meds and risk aother hospital visit. God bless you too.

    Nancy

    I started out with the low dose patch and worked my way up...once increased it knocked me for a loop. With my recent surgery, I declined the patch altogether.

  • wmc
    wmc Member Posts: 1,804
    #5
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    Fentanyl patch

    My Son is on that from a car accident that was very bad, almost lost him twice but he made it. After he was released from the hospital he got the patch. He went back to the Dr in three hours and said, we need to do something different with this patch. The Dr responded, it's only been three hours you need to give it time to really work. My Son responded, I can't feel my arm, I think this might be too strong. They worked it out.

    Bill

  • OrchidNancy
    OrchidNancy Member Posts: 23
    #6
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    wmc said:

    Fentanyl patch

    My Son is on that from a car accident that was very bad, almost lost him twice but he made it. After he was released from the hospital he got the patch. He went back to the Dr in three hours and said, we need to do something different with this patch. The Dr responded, it's only been three hours you need to give it time to really work. My Son responded, I can't feel my arm, I think this might be too strong. They worked it out.

    Bill

    Patch

    Bill, sorry - sounds like your family has been through a lot. I'm not surprised to hear of other people having these problems. It may work for some people, but certainly not all. Nancy

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