Watson brand is the way to go as its got the gel. Par also makes gel but is inferior to Watson the one time they gave me the plastic matrix I put on about 15 and was still in w/d but the Watson I took 1hit and got loaded (smoking the gel) I had a monster tolerance the plastic would get you feeling good if your tolerance is lower than mine but more than the overage user
AS YOU HAVE ALREADY BEEN TOLD BE CAREFUL WHEN MESSING WITG FENT
I'd forgotten all about this thread!!...
I started it about 18 months ago when I first joined BL... If you do a bit of research on the matrifen patches it appears that they use a slightly different delivery matrix which SUPPOSEDLY allows a lower total fentanyl load to deliver the same hourly rate. This was apparently done in order to get the matrifen patches licenced in Germany as the Germans weren't happy about the total fent load in dtrans patches being so high.... As anyone who's used the matrifen can attest though this "novel delivery matrix" fails abysmally. I came off the patches in the end and switched to methadone tablets for my pain instead.
The only other brand in the UK that I would recommend other than the duragesic dtrans is sandoz....they make both a matrix style patch and a gel reservoir type....I've tried both and the sandoz matrix ones are really good...they adhere even better than the dtrans and have a higher fentanyl load as well....I believe they are a lot cheaper than durogesic also....if your doctor won't prescribe the durogesic ask for Sandoz matrix patches instead.
I broke 3 vertebrae cracked 2 more and muscular pain on top of it so I get fent patches for all day pain relief but I get 90 patches per month so there's always extras to smoke. I personally have responded better to the gel may be because the gel contains alcohol which opens my pores just a theory and I get more analgesia from the gel. I get pain relief from the matrix as well just not as much as I would get from the gel
GOOD BRANDS:
Duragesic (best matrix patch)
Osmil
Teva
Actavis
Alza
Par
Hopefully those are available in the UK. And Watson is unavailable over there so there's no point in putting it in the list
TERRIBLE BRAND
Mallinckrodt-Earlier post I mentioned I was wearing 15 100mcg patches not only did I not get any pain relief it couldn't prevent withdrawals. Luckily I had all my breakthrough pain medicine to get me by till I got the Watson again. They also fall off as if there is no adhesive I had to use almost an entire role of medical tape. I use remove the patch every 48-72 hours
The thing is with fent patches is that you can't just divide the total content by the hourly release rate and assume they will last that long as that's not how they work. The fent from the patch is absorbed through the skin by passive diffusion into the subcutaneous fat where it builds up and forms a dept which releases into the blood stream. Once the depot of fent under the skin reaches a high enough level the diffusion gradient levels out and the rate of flow from the patch slows down and eventually stops even though there is still probably a load of the drug left in the patch. Onece this diffusion gradient has levelled out and the process of passive diffusion has stopped the patch must be removed and a new one placed on a DIFFERENT part of the body to again passively diffuse out of the patch and form a new subcutaneous depot. It takes approximately 17 hours for the subcutaneously dept to build up when a new patch is applied but the subcutaneous depot from the old patch will still be present when it is removed and will be transported into systemic circulation while the depot from the new patch is building up at the new site. This should in theory mean that plasma levels remain fairly constsnt.
The upshot of this is that there will still be a substantial amount of fentanyl in the patch that is taken off but due to the aforementioned diffusion gradient levelling off it will have stopped being absorbed and also when a new patch is applied it MUST be put in a different place so that a new subcutaneous depot of fentanyl can be established.
The pharma dynamics of how transdermal patches work is quite interesting and well worth researching in order to get the most from them.
I get 36 x 5mg tablets of methadone a day (180mg) so it works quite well for me.
You would be very, very lucky to get dipipernone prescribed nowerdays as it is almost never given. The only form its available is in combination with cyclazine which limits the amount that can be given to 3 tabs per day. In fact dipipernone along with diamorphine and cocaine require a special home office licence to be prescribed to addicts (although not for pain patients). Due to the epidemic of diconal (dipipernone) injecting in the 70s and 80s almost all doctors are advised not to give it under any circumstances especially since there are so many other alternatives..
Also diconal has been discontinued in the uk alltogether but i believe a generic dipipernone/cyclazine formular still exists.