Someone mentioned cutting the patch in half to taper off Fentanyl. I thought I read somewhere that cutting the patch can cause more of the fentanyl to be released into the system, and should therefore never be done. I may be mistaken; has anyone else heard this?

I understand that they have issued 15 mcg patches so tapering down should be even easier. Besides you can also take the equivalent amount of Vicodin or Codeine and take one less pill per day. You MUST develop a phase out plan with your doctor!

A sudden release of Fentanyl, into the system could cause an overdose, much the same as if you took a time released pain med, ground it up and poured it down your PEG tube. Sherry has it exactly right.

From the manufacturers warnings and precautions:

"DURAGESIC

This has been a very helpful thread for me. And I was particularly glad to read Kim's comments because now I don't feel so inept :rolleyes: Amy

Another factoid on Fentanyl - it's 40 times more potent then heroin

Gary, re: your post about 24 to 72 hrs. for maxinum effectiveness, it that for the first dose or does it apply to cach new application after the patch is started? The 50 mcg patch is controlling John's headache for now, but not relieving the mouth pain. [or maybe it would be worse without the patch- don't know] Amy

Amy, when I was on the patches, it was only for the first one that the time lag applied. When it was time to change it (or them) there was still enough medication in my system that there was no break in the pain control. I had no side effects, but then I wasn't taking anything else either, and the chemo was finished by the time I began the patches.

Yes the 24 hours was for the full effect to kick in. After that Joanna covered it nicely. If, after 72 hours, the pain isn't being managed to the level of about "3" or less then ask his doctor to increase the dose to 75 mcg. They will only increase it 25 mcg at a time and can go as high as 300 mcg.

Caution: DO NOT increase the dose rate or add additional patches without your doctors permission.

There is a formula for how strong the Fentanyl should be in relation to the amount of breakthrough medications taken.

Is he doing a morphine based "swish & spit" as well? i.e., "Pink Magic"

Another factoid on Fentanyl - it's 80 times more potent then morphine.

I wanted to mention that the suggestion about cutting a 25 mcg patch as part of the tapering off process was the advice to me of a physician specializing in palliative and pain management medicine.

This was before there was a 15 mcg patch available so the point is kind of irrelvant now. However, I suspect his thinking was that coming down from 175 mcg to 25 to 1/2 a 25 mcg patch would be pretty low risk given the tolerance to Fetanyl that one develops over time.

In any case, with the new lower dose patch, there is no reson to cut one now. - Sheldon

Hi JAM,

This is our experience with the patch. We found that there is the brand name and the generic.

The brans name is enclosed in a pouch and there is a single plastic backing film which is larger than the patch. To activate the glue on the patch rub the patch before removing from the plastic backing between in your hands for a few second and than peel off the patch from the backing and place on the upper arm or shoulder were there is no hair. Place your hand over the patch and hold for 10 to 30 seconds.

The generic type also comes in a pouch. The backing for this patch consist of two half plastic films. Again, rub the patch and backings between you hands for a few seconds to activate the glue. Remove one of the half backing films and apply to the patch skin than remove the other half film a fully apply to the skin.

It is important to wash the hands with a lot of cold water following application of the patch because of the possibility of having come in to contact with the fentynal.

Well guys, I have certainly learned ALOT about fentanyl in a very short amount of time :rolleyes: Since John started on the 1st one on July 6th, he has gotten progressively incoherent, confused, irritable and in short -looney! This am., when he registered a 101.5 degree fever I yanked the patch off.[O.K. there is more to the story, but I won't bore you] His Chemo Doc was not in favor of the patch to begin with and when we got to his office this am, he was glad it was gone. I really questioned him about needing to reapply smaller doses to let John come down off of the 50 mcg slowly.[John got mad at me, says I was too pushy with the Doctor] He said the Hydrocodone John is taking would stop any withdrawal symptoms. If it does not, I am going to be as mad as the proverbial Wet Hen! I do hope this thread will be of benefit to others who need to use this drug. It works great for many people, but it just did not work for us. Amy