I am taking Fentanyl patches, 50 mcg/h, changing every 48 hours

Posted , 6 users are following.

I have been on the Fentanyl patch for just over a month. On the day I put a new patch on, right around 5-6 hours AFTERWARDS, my pain level increases quite a bit. The pain stays that way for about  3-5 hours, then goes back down. 

This seems strange to me. Has anyone experienced this?  Every day I change the patch this always happens. 

I am on the 50 mcg/h patch, I've asked my pain doc if it would make  sense if I went up to a higher dose as it is helping me but I'm still having to take a good qty of OxyCondone 10 mg tabs. She stated that she won't go up on my dosage because I am already at "cancer level" dose. Well, I've never had cancer and my pain was caused by a stroke(post-stroke pain).  I see people posting taking 25 mcg/h patches to 100 mcg/h patches, any thoughts on why she won't budge on upping the patches if it means I can reduce more of the OxyCondone?

Thanks in advance for your thoughts 



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  • Posted


    I wish my doctor had been as careful and not allowed me to continue. This is about as pure opiate as you can get and I just had the worse year of my life coming off it. Not to mention the damaging effects on my personality whilst on it. I was post cancer but I can tell you withdrawal was worse than the Pain, chemo , radio and surgert all rolled together.

    be careful buddy


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  • Posted


    Your doctor may be keeping you at a control level of Fentanyl to see how you adapt to it. 50mcg/h is a resonable level. But perhaps you do indeed need a higher dose to keep the pain at bay. Can't say I had what you describe regarding the return of pain after a few hours....However to be quite honest Fentanyl didn't kill much pain at all for me. I was on 75mcg/h.

    I ended up on 400mg of extended release Tramadol twice a day amongst other things which helps a little better. Plus with the Tramadol I don't get the sweating, itchy skin and bad head like I did on Fentanyl.

    If your willing to continue on the Fentanyl route please do be very aware of the dangers of the stuff, especailly as the dose increases. Many folk mention terrible withdrawls from Fentanyl although I didn't get any at all going from Fentanyl back to my usual max allowable doses of Dihydrocodeine. Although when coming off the Dihydrocodeine to go onto Fentanyl ..Wow, that was 3 day nightmare eek  I'm sure the initial 12.5mcg/h Fentanyl dose was too low.

    Perhaps head back to the docs & ask him/her if you can try coming off the oxycodone to try a higher Fentanyl dose?

    Hope you get sorted out.


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  • Posted

    Hi Rick,

    I take 200mcg of Fentayl for a severely degraded spinal injury and am also prescribed 15 Loratab pills per month for breakthrough pain. Your doctor may be making that call because she feels that should manage your pain depending on what the issue is. She could ALSO just be super conservative in these early stages and want to make sure that you can tolerate the drug without an adverse effect.

    I started using the patch in 2003 because I am a gastric bypass patient and only receive half of the benefit of anything I take orally. I started with 50mcg and we slowly upped the dose until I leveled at 150mcg. I was on that dose for years until it no longer worked a had to go to 175mcg. and finally to 200mcg. You will eventually have to up your dose as your body grows accustomed to the drug and/or your condition worsens. What surprised me is that she allows you to change your patch every 48hrs! I agree, the effectiveness wains after that, but the DEA has strict guidelines about the patch only being changed every 72hrs.

    A lot of your relief will depend on your body type. If you're a little bit "fluffy" the medication lasts longer because it stores in your subcutaneous fat cells. If you're lean and rather muscular, you'll burn through and metabolize the medication faster. How many patients does she have that are also prescribed Fentanyl? Her conservatism could just be inexperience and a healthy dose of CYA! If she cares at all about the state of your liver, she should embrace you taking less oral medication. My advice is to do your homework before your next visit and appeal to her logic. Tell her you'd like to be off pills and see what her response is. You may have to look for a doctor that is more sympathetic to your need for relief. smile

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  • Posted

    Hi Rich,  Im sorry to hear that your not getting a good reaction to the fental patch  I started on a very low dose over should I say very quietly  20 years ago.  Yes I can hear you all who read this saying  OUCH  yes I know  it seemed to be  because, my arthritas pains as wellas this shingles nerve attack, I was on 100 mg  and vowed that I wanted to come down from that, but because of the shingles pain its now been increased to 125mg.  I dont understand why  they take me off tramodole and increased my patch to 125.  Only one thing I can advise any one on these patches  it states put the patch in different parts of the arm   I DONT  instead I buy medical wipes and wipe the skin, after my shower. and I always put them on the same area of the arm.Have you attended a pain clinic and tell them about your pain  Only one other thing you state you change you patch every day.....Mine  I put  them on every 72 hours.  I wish you well stay in touch

    Jocelyne from the UK

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  • Posted

    I'm not sure as to why your Dr will not increase your dosage and drop down your other pills. But I am also on the 50mcg but mine are 72h patches. But I'm also on oxymorphone 10mg X3. I would ask for a second opinion. As for the pain levels increasing, mine don't really increase, but when I change my patch I have to take a pain pill 2 hours before I change it otherwise I will start going through withdrawls which last 3-6 hours depending on if I don't take my pills within enough time. I can kinda understand why she doesn't want to increase, but if your trying to get off the pills, it's easier to go up on the patch, down on pills then eventually back down on the patch, so I don't truly understand her reasoning as for being completely opposed to it. I suggest a second opinion. Good luck.
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