1. They always start at 25 mg increments. They have a titration formula that if you are exceeding the breakthough meds then they will increase the patch another 25 mg. It can go as high as 300 mg. PLEASE DO NOT ADJUST YOUR DOSAGE UNLESS DIRECTED BY YOUR DOCTOR.
2. I personally was up to 75 mg or three patches.
3. I was adjusted to it in about a week and then was fairly "normal" whatever that was. I had fatigue from the treatment. Cancer fatigue is a well known side effect of treatment in general.
4. Extreme constipation. My doctors did a poor job of managing that.

Hydrocodone AKA Vicodin is really weak.

Gary Allsebrook
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Dx 11/22/02, SCC, 6 x 3 cm Polypoid tumor, rt tonsil, Stage III/IVA, T3N0M0 G1/2
Tx 1/28/03 - 3/19/03, Cisplatin ct x2, IMRT, bilateral, with boost, x35(69.96Gy)
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"You are a mist that appears for a little while and then vanishes" (James 4:14 NIV)