Another novice Fentanyl patch question

[painenduser]

Hey guys, Just me again, this time with another question that comes from reading the package insert as well as a question I asked of the people over at the makers of my patch.

The question is, as many of you are aware, all the patch manufacturers state that regardless of how long the patch has been on for, if the adhesion between your skin and the patch become separated or if when applying the patch it sticks to itself and you pull it apart, you are not yo reapply the patch, rather wait sometime, and apply a new patch in a new area rather then attempt to reuse the same patch. Can anyone explain why, other then because "they say so" to do that? These patches dont come cheap and I don't see my Dr writing me a new script for the "wasted" patches. Why can't the original patch be used? Many thanks as always!

Pain.

Ps infact if I remember correctly and I may be wrong, I thought that the rep told me that if the patch has been on for less then the 2 days, say 2 or 2 days, and the adhesion fails, discard the old patch appropriately (in the toilet) and wait until your next regular application before placing a new patch on. That seems like a little nuts to me as you would be in withdraw by then. Thoughts??


PSS - The first set of patches I was on were made by a company called Apotex, they worked well for my pain but the adhesion just sucked and they just recommended using a cotton based tape around the edges and not anything like a tegraderm overlay. I have heard alot of great things about the Mylan Matrix patches so this round of patches I am trying them. They are a quater of the size for them same dosage, they are clear as opposed to looking like a giant bandaid and I read that they will send you an overlay called askinaderm for free with the lot number on the box, you just call them and supposedly they will send them. I just left a message to have them sent to me, we'll see what happens there. The adhesion of the Mylans seem many times better then the Apotex ones. But I also read that some people the new mylan matrix patches just didn't seem to be a potent as far as their effectiveness on pain. My hope is that they are all around a much better product as they are $100 more a box of 5, although medicaid is paying for them so the cost is really irrelevant to me.

 

[VanWeyden]

First of all the pharma companies have to be extremely careful when they write the safety instructions for the meds they sell. If someone is harmed although he uses the patch as advised he could easily sue the manufacturer which would be quite expensive for the company.

Secondly, the incidents you mentioned can really affect the distribution of fentanyl which would either lead to withdrawal or to overdose which isnt funny at all when it comes to fent. If the patch was removed from the skin once it is likely that this will happen again and again. The continuity of fentanyl distribution between patch, skin and blood stream is disconnected and the amount of released fentanyl decreases->withdrawal.
If the patch sticks to itself the matrix will be destroyed where it sticked together->overdose.

In reality it will make no differnce in most cases but it is propable that this causes adverse effects.

 

[painenduser]

First of all the pharma companies have to be extremely careful when they write the safety instructions for the meds they sell. If someone is harmed although he uses the patch as advised he could easily sue the manufacturer which would be quite expensive for the company.

No doubt we live in a world of major CYA, so that makes total sense.

Secondly, the incidents you mentioned can really affect the distribution of fentanyl which would either lead to withdrawal or to overdose which isnt funny at all when it comes to fent. If the patch was removed from the skin once it is likely that this will happen again and again. The continuity of fentanyl distribution between patch, skin and blood stream is disconnected and the amount of released fentanyl decreases->withdrawal.
If the patch sticks to itself the matrix will be destroyed where it sticked together->overdose.

In reality it will make no differnce in most cases but it is propable that this causes adverse effects.

So if I understand this correctly and again forgive my ignorance (It's always better to ask if you don't know, knowledge = saftey when used properly in my book), the "matrix" is all thats based in the adhesive correct (ie the two together plus other polymers and binders) ? Since these are not Gel packs (which I don't believe are really made anymore due to the ease of abuse and OD) the actual medication, fentanyl, is mixed in to the adhesive so as the adhesive breaks down, the rate at which the fentanyl mixed with the adhesive becomes unstable there by leading to possible OD, or possibly the reverse, less medication and there by withdraw? Am I finally beginning to understand how this works?

Also is the release of the fentanyl within this matrix activated by the heat of the body which is why they say to avoid any external heat sources on the area where the patch is, since the warmer the matrix gets the more it can potentially release? Adversely if you were to add a cold source to the patch it could reduce the amount released?

Thanks!

 

[painenduser]

Hey guys, I know bumps are not allowed, but this questions or series of questions has gone unanswered for weeks now, and I really would like to get this understanding of the med Im on. Can someone please take a second to read this and reply to my questions? Mods I am sorry I know you say not to bumb, but I have been very patient to get some answers that I know this group has. Please please dont kick me when Im down and get mad at me for bumping this. Thanks

 

[Jabberwocky]

hey man, i'll try help address a few of the questions you've posed when i'm not so baked and have more than a ten second attention span.

 

[Oxide]

Yes, it sounds like you've grasped the basics of the matrix fentanyl patches.

To answer your question about heat, I don't have anything to prove it, but it sounds to me like introducing external cold would indeed slow the release of fentanyl, as the patch uses your body heat in the releasing process. I do know for a fact that heat works pretty well at speeding the release, so it's logical to think that cold would slow it.

As for the patch being removed and reapplied, I've had it happen a few times and had to reapply it with heat, but I've also had to use a giant bandaid before to get it to stick. It worked alright, but once you pull it up off the skin all those dead skin cells stick to the matrix and clog up the works so to speak, making it nearly impossible to reapply as well as reducing the efficacy of the patch, I'm sure.

 

[AstroPrune]

Also is the release of the fentanyl within this matrix activated by the heat of the body which is why they say to avoid any external heat sources on the area where the patch is, since the warmer the matrix gets the more it can potentially release? Adversely if you were to add a cold source to the patch it could reduce the amount released?

This is something I think I can I answer.
Yes, any type of heat can increase the release beyond the intended dose, body heat included.
I made the mistake of doing some heavy exercise with a patch on.
and ended up having a bad time (I really dislike fent).

 

[painenduser]

Thanks Guys!! I knew yall could help me out with a little prodding lol...

Disposition, I understand about the 10 second attention span no worries bro lol!

Thanks for the confirmation Oxide! I thought I was on the right track but wanted to make sure...

AstroPrume.... love the name lol Thanks as well. Thankfully my body temp stays pretty solid and usually is a little colder around 97 degrees, so I think thats good for when it does get hot, I wont get inundated as theres alot of me to have to warm up, well not that much more but you get the idea. I have found pro's and cons to the patch and so far the pros are out weighing the cons.

PRO - This is the first time I am getting a 24 hour relief as opposed to an up and down from having to take the pills on schedule. I find myself in less periods of WD's and more in periods of damn I wish I had a little more but Im OK and the pain isnt running out of control. The only cons I really have are that the adhesive in not predictable and you can easily lose the cohesion resulting in the dead skin clogging up the works are Oxide said. I have found that using 2in paper medical tape which covers the whole patch but still allows it to breath does wonders! I haven't lost a patch since I started using it. The other con which is a little more concerning is that you can never tell if you are getting more fent then usual from heat or any other reason, but you sure know when it's going down cause you can go into what I call a mini WD. But its doable, meaning it's not to to bad. Other then that Im good now.

Thanks everyone and again sorry for the bump, but she's been hangin long enough

Mods, I am good if you would like to close, but feel free to leave it open if you feel there is anymore good discussion that can come of it!

Thanks BLUE!!!

 

[Oxide]

When you get that little mini-withdrawal you mentioned, try applying a heating pad in 10 minute on/off intervals onto the patch you're already wearing. It might help, just a guess though. It's better than just riding it out, anyway, I would think.

Also, the only way to really keep the skin off the patch is to exfoliate the shit out of the spot you're going to apply the patch to. Then shave the area, allow to dry and then apply the patch as carefully as possible so it'll be alright the first time. Removing and reapplying is (obviously) best to avoid when you can, lol.

 

[Brian242]

I dont mean to threadjack, but a nurse is coming with me to my next dr's visit, and wants me to be on fent and Percocet for scoliosis surgery pain. I've never even done oxycodone let alone fentanyl so I don't know if she wants to kill me or help me

Can you cut the patch in half and save the other half for later?

 

[Oxide]

Short answer: Yes. But make sure to cut it while the plastic backing is still on, and use a fresh razor blade for best results.

 

[painenduser]

Im not so sure of that Oxide... From what I understand, even if you cut the patch at best all your going to do is make the duration of the patch less, but not the per hour infusion. Keep in mind that the entire patch is coated with the medication, in my case that patches have a total of 7.65 MG's of Fent, that is to be released at 75mcg's/hr for 72 hours. You cut the patch you still have enough medication on that one patch to infuse the full 75mcg's/per hour but cut you will not have it for as long. If this is the first time going on the Fentanyl patches I would NOT deviate from how it's prescribed. This could prove dangerous. They aren't trying to kill the poor guy with the patches and they are not going to be able to monitor his progression if he's cutting the patches. I am not sure but I have talked to many people who say not to cut the matrix patches at all because the release of the fent can get all messed up and he may get more or he may get less, but just by making the patch smaller by cutting it is not going to guarrentee that he is going to get less medication, and chances are he will still get the same per hour release, it just may not be around for the full 3 days. I would really think about that before cutting it. Someone may know better then me, but since I have been put on these patches and not knowing a thing about them prior, I have asked a ton of questions and got a ton of answers, and short answer you can cut the patch sure, but will you get less of a dose? Doubtfull...

It's kinda like an 8 slice pizza and your plan is to eat one a day at lunch (8 days), you cut the pizza in half and you can still have 4 full slices (or 4 full days of 1 slice for lunch), ie 4 full dose's, but instead of having 8 days worth of pizza you now have 4. Sounds silly I know but it's kinda the same thing. I would like someone who has more experience with Fent to state their thoughts on this as I am no pro, but I think I am correct in my thinking.

 

[Jabberwocky]

Mods, I am good if you would like to close, but feel free to leave it open if you feel there is anymore good discussion that can come of it!

no worries, man. it looks like most of what you asked was addressed so i'll end this. if you want to continue discussion just pm me.