#1.Please respond if you have experience using fentanyl patches
#2. What dosage were you on?
#3. Did it make you sleep all the time or were you functional?
#4.Did you experience side effects?

The reason for these questions is that my husband is experiencing headaches anytime time he is awake. He is only taking hydrocodone for pain and it puts him to sleep, but the headache is there as soon as he wakes up. We are looking for a pain med that will allow him to be up and moving more during the day. His Doc is of no help- just says all pain meds. will knock him out. Amy

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

debated whether to post given i only just started on this patch monday evening. figured i can post again if anything changes. started at 25 mcg and had it bumped today to 50 mcg. no fatigue nor nausea and oxycodone had given me nausea in beginning but it got better. not finding it terribly efffective for my pain given i'm also still taking 15 mg of oxycodone every 3 hours and i still have periods where there is serios pain. pretty sure i am at a phase (2 rad sessions left) where pain is still increasing fast so i have to increase meds fast or faster. instinct says at higher doses this will work well. hope thats somewhat helpful

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.

Amy, I used those patches for the extreme burn pain at end of treatment and did not have ANY side effects. I was awake and active every day that I was using them, and when I no longer needed them, just stopped and had no withdrawal. As far as I am concerned, Fentanyl is a wonder drug with no downside, and if I ever have serious pain again, I will ask -- no, I will DEMAND it.

Go for it. I will bet that after it kicks in, which I think is about 24 hours, if I remember correctly, John will feel great relief. It did such a good job for me that I didn't need anything for breakthrough pain. My neck was raw and bleeding and oozing and the docs cringed to look at it, and I felt NO pain.

Amy,

My mom was extremely anti-drug and has been her whole life but she broke down and started using the patches after a couple weeks of radiation and they were very effective. She did not feel doped up and didn't feel the pain. She was also up to 3 patches at a time but started at 1 and as the pain increased she applied more patches. They did not make her too tired and seemed to be functioning normally... well as normally as one can under the circumstances. You and John are always in prayers.

Hugs,
Dani

Amy,

My mom was extremely anti-drug and has been her whole life but she broke down and started using the patches after a couple weeks of radiation and they were very effective. She did not feel doped up and didn't feel the pain. She was also up to 3 patches at a time but started at 1 and as the pain increased she applied more patches. They did not make her too tired and seemed to be functioning normally... well as normally as one can under the circumstances. You and John are always in prayers.

Hugs,
Dani

Hi
Charlie was up to 150 mg and still is after 3 months post treatment. We change them every 3 days with a fresh shower. They dont make him sleep all day, but he avoids driving. The RO told him that the patches will be the last thing to come off of. There were no side effects and Morphine was still needed every 3 hours for breakthrough pain.
As a caretaker I had to demand that Charlie recieve the dose that would relieve pain. The doctor and I (God love him) were more concentrated on him feeling no pain and less about dependancy. One step at a time.
I hope your husbands headaches will subside. Does he take asprin? Could they be tension headaches?

Hi,

I can'r remember my dose, but they did not mak eme sleep, I was able to function, and I had no side effects. I alctually wore towo patches at once for a while. i also was taking morphine whenever i felt the need.

Steve

The only side effect Barry experienced from the Duragesic patch was (the first few days) very vivid dreams/nightmares -- this is mentioned as a side effect which goes away after a few days, which it did. It never made him sleepy or dysfunctional, whereas the Oxycodone made him feel "out of it." He also had bowel issues with the latter but not with the Duragesic, which may have been because he was only on a 25 mcg dose,

It was a god-send. Insist that John get a chance to try it, and also, give it a few days to kick in. I cannot imagine trying to get through this treatment on the "baby" pain-killer John's being given; bluntly, your doctor is failing his patient -- adequate pain relief is a *patient right* and should not have to be fought for!

Be aggressive and go to "patient rights" person at the hospital if you are being blown off...

Gail