Hi Amy,
Jack is using the fentanyl patch at the 50 mcg dose. He started at 25 and they increased it to 50. It takes a couple of days to kick in but he has not had any side effects from it. Some people have complained about increased nausea at first but that can also go away once the body adjusts to the patch. I think 75 - 150 is a pretty common dose range.

This has been a godsend for us, it's controlled his pain and does not make him sleepy. He's quite functional because it's time released. I've seen lots of patients do very well on this. The short acting pain meds tend to cause the sleepy effect because when you take it you are getting a full bolus effect. On the longer acting meds like the patch that's not the case because the dosing is more even. John could still use a short acting pain medication for breakthrough pain, maybe at a lower dose.

It is not true that all pain medications knock patients out. Our hospice team at work fight this battle with doctors all the time. Tell the doctor you want to try the patch. It comes in doses from 25 to 300 and can be changed every 3 days - or every 2 days in some cases where the pain is severe. They can increase it by 25 mcg doses to find what works for him.

If your doctor won't help is there a pain management team at the hospital? You have nothing to lose by trying this.

Good luck - Regards JoAnne