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Why is it important to change the location of the patch?

Posted , 15 users are following.

Brandelyn
Brandelyn

I've asked my pain mgmt Dr why it is important to change the location of my fentanyl patch every application but he couldn't come up with an answer. I have changed the location every new patch but I'm still curious as to why they say it's important to do so. Can anyone please explain why they say this? I've tried looking it up but have come up with nothing. I'm currently on 50mcg Q72h along with oxymorphones 10mg Q8h. I've been slowly trying to wean myself off every month as I have children and am also a full time student and hate the fact I've been on narcotics for 5+ years after breaking my back in the Navy, but no-one has been able to give me a solid-legit reason as to why patch placement is imperative. Any answer or thought that makes sense would be greatly appreciated. Thank you.

0 likes, 24 replies

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  • orb
    orb Brandelyn

    Edited

    The main reason as far as I am aware is that the adhesive on the patch can be an irritant and this was the case for me. After a day or so the patch site would become red and very itchy.

    Changing the position of the patch means that the placement area that is irritated gets time to recover.

    • Brandelyn
      Brandelyn orb

      Posted

      Thank you for your responses. I greatly appreciate it.
  • timslide
    timslide Brandelyn

    Posted

    It is not 'imperative' in terms of the effect you get from the medication (though I find that it works most efficiently on more sensitive areas of skin - inner upper arm, inner thigh - than more weather hardened areas like the forearm) but the adhesive causes irritation to many people. This is not the case for me, but I also use nicotine patches which certainly do irritate me, and I am left very sore indeed from them tp the point of drawing blood sometimes. If you suffer irritation, it makes sense to rotate - beyond that it is not important.
    • Brandelyn
      Brandelyn timslide

      Posted

      Thank you for your responses. I greatly appreciate it.
  • Brandelyn
    Brandelyn

    Posted

    Thanks y'all. My Dr hounds me about it. Every appt he wants to know where I've placed the patches. Which it's no matter where I place them because I'm allergic to adhesive but it's my last option so I've just been dealing with it. But honestly I'd rather have less red patches and hives all over my body so id honesty prefer to keep it in one or two locations so I don't look like a freak medical experiment so I think I'm just going to stay doing that. I already try to keep my patch out of visibility with any type of clothing but that's getting harder to do when once I change locations the redness and hives are still there for 2-3 depending. Plus the patch never stays on so I have to put tape over it just to keep it on me which only makes things worse. Thank you for your responses. I greatly appreciate them.
    • timslide
      timslide Brandelyn

      Posted

      I had problems with patches staying on, particularly when wet, but now I get a special covering prescribed along with the patches called 'Tegaderm' (in the UK at least) - this works very well indeed.
  • jayne10080
    jayne10080 Brandelyn

    Posted

    I too am on fentanyl and I believe the reason to change the siting of the patch is to give that part of the skin that has been absorbing the drug time to recover. Sometimes the patches can cause itching raised red marks. I cannot think of any other reason we have to change patch site , I know my skin it,s grateful for the change..It would be interesting to find out if there was another reason. Best wishes jx
  • Brandelyn
    Brandelyn

    Posted

    I'm going to ask again today when I see my Dr. But I've just been putting paper tape over my psych but maybe I'll have him prescribe me the tegraderm also. I had to use that to cover my incision after I had my back surgery. I completely forgot about that stuff. So thank you. But maybe I'll get an actual answer this time and I'll post his response after my appointment with him.

    As I already break out around the patch and tape I've been using so I'd rather not have red blotches and hives all over my body 24/7. Ive begged him for the sublingual version buy because I'm not a cancer patient, just a chronic pain/broken back/fibromyalgia/myofascial pain syndrome and a messed up neck patient I don't qualify even though nothing else has worked and I'm clearly having allergic reactions to the patch. But there is nothing else he says he can give me besides my oxymorphone and just double my dose back up to where I originally started but I'm wanting to get off these meds because they don't even help with the pain anymore.... All they do is keep me out of withdrawals. I'm trying to convince him to put me on dilaudid but the injectable because that actually relieves a lot of my pain. But I doubt he will agree to that.. sad

  • bugmann
    bugmann Brandelyn

    Posted

       

    Brandelyn

     

    I have been on name brand Fentanyl patches for about 15 years, and I had wondered the exact same question as you, which is "Why change location of patches each rotation."  So one rotation I placed my new patches on the exact same place where the older ones where placed. In about 8 hrs I got the worst  pounding headache I had ever had!!!! Now that I have had time to think about this as well as the actions of the patch I think the reservoir from the old patch conflicted with the new reservoir the new patches where to make, thus making it twice as large as it should have been then it slowly released into my bloodstream causing the headache. After 15 min of this headache I did move the patches to a new place and within the following 12 hrs was back to "normal" if you can call being disabled due to painful lumbar back condition "normal." 

     

     I am on 300mcg/hr and change every 48 hrs and I run out of clean places to place 3 patches on the upper body (above waistline)

     

     

    I wish you well with your condition. I understand its possible to reduce patch to 25 mcg/hr but after you reduce to no patch you will need an equal strength narcotic to at least the 25mcg/hr patch you want to come off of. I wish you only the verhy best of outcomes in your endeavor

    BUGMANN 

     

    • bugmann
      bugmann

      Posted

      TEGRADERM can be purchased online as in the USA it is not covered by any health insurane plan. A box of 50 size 4" X 3 3/4" cost about 40 - 50 usd.  Sorry I forgot to add this to my reply.

      Bye for now

      Marty aka BUGMANN

    • Brandelyn
      Brandelyn bugmann

      Posted

      I go through minor withdrawals as it is even just changing my patch, and honestly I'm terrified to go through full on withdrawls. Even after my laminectomy with spinal fusion, I'm still in just as much pain as before. I truly do not want to be on pain meds the rest of my life, but I'm also terrified to go through actual withdrawals and not just the minor ones after changing my patch, even though they are minor, they are awful. All my meds do now is keep me out of withdrawals (for the most part) and I get minimal pain relief if any. The pain is still debilitating and I'm really unsure as what to do. I have an almost 5 year old and I can barely do things with him now. Then my husband is talking about having a kid (only to make me gain weight since I lost 70lbs after my back surgery from not being able to eat as I'd get nauseated with everything and vomiting was very painful so I just stopped eating to eliminate it all together) and I really think he might be serious about wanting a child, and I would love to have one with him, but I also know if we do make that decision I have to get off the meds and I'm right back to being terrified about withdrawals in full effect. I'm so lost and confused I don't know what to do.

      And I finally found a spot on my body that doesn't break out with the patch or tegraderm as bad as the rest of my body. So I just keep it in the same spot now and havent had serious issues with allergic reactions. Which in itself is amazing. But thank you for your input. I greatly appreciate it..

    • john29217
      john29217 Brandelyn

      Posted

      Brandelyn, you have the same withdraw issues that I run into including the extreme nausea. It's a cruel endless cycle. I would suggest lessening the dosage over time as the most humane route to this whole process. I am currently doing that but I've hit a definite wall and my back pain after 4 surgeries is back with a vengeance. Those around you have to be patient and you have to take it easy on yourself. Thanks for your service to our country, I wish I had better answers. Hang in there kid!!
  • tom18269
    tom18269 Brandelyn

    Posted

    As for the patch not sticking, other than showering or swimming too long, the brand does make a difference. I have found that using the brand Mylan sticks the best and rarely is there a danger of one coming off or losing too much adhesive for effectivity.

    I also recommend if you intend to go swimming, place a section of clear medical adhesive tape over the patch...just enough, about 1/4" past the 2 longest sides will do.

    Sorry for your pain, I truly am. I think that only those of us that share in this curse of extreme back pain can empathize.

     

  • Nasher447
    Nasher447 Brandelyn

    Posted

    The reason I'm told is that the medication is so strong it can make you sore if you keep the patch on the same place,therefore it's advisable to move areas so as to let the previous place time to recover,it makes sense to me because sometimes when I remove my patch it has gone very red underneath and could turn sore if a new one was replaced. Hope it makes sense to you. Anyone with a better reason let's have it. David. 

  • kel2112
    kel2112 Brandelyn

    Posted

    I use medical tape on all 4 edges and "x" the center to keep top layer pushed down to actually get medicine to skin. I take it off every time I shower. That 30-60 mins doesn't effect anything at all. It beats having water under patch as I sweat enough for that to happen. I then rotate to another area when replacing. I've been usingv100 mcg / 48 hrs for over 10 yrs. Have not had any issues except sometimes tape still doesn't hold. I've never lost a patch but have had 2-3 sides lifted from skin. Depends on actuvity, work, weather, sleeping, etc. Have used mainly on upper back or upper arms.

    • kel2112
      kel2112 donna03256

      Posted

      Can I ask where you are that you can even get these prescribed anymore?? All meds being tapered here in drastic time....thx!!!
    • donna03256
      donna03256 kel2112

      Posted

      I am in Oklahoma & still titrating down. See PM this week.

      But I have a probable scalp melanoma and it may have moved into a deep sinus. I guess I will know more later this week.

      Donna

    • kel2112
      kel2112 donna03256

      Posted

      I'm in Wisconsin. What PM this week are you referring to?? Sorry to hear of your condition. I hope you are being cared for correctly. U can email or text directly if u like?? thank you

      Emis Moderator comment: I have removed the email address as we do not publish these in the forums. If users wish to exchange contact details please use the Private Message service.

      http://patient.uservoice.com/knowledgebase/articles/398331-private-messages

    • donna03256
      donna03256 kel2112

      Posted

      I am being cared for properly. I am a retired nurse.

      The entire Country has been affected by the new CDC guidelines.

      Thank you for your concern.

      Donna

    • danielle2x74
      danielle2x74 kel2112

      Posted

      You can still be prescribed the patches nationwide. However the doctors because of the DEA regulations alot of doctors are scared of prescribing them unless your end of life. However there are still Pain Management (PM) doctors out there that will. However the regulations are quite tedious for them to deal with. Every Mo i must see my dr. I have to take all meds for med count with me. And spot on UAs.
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