Fentanyl Patches In The Uk

[BigG]

They don't sell that brand in the UK.
And just because it contains the gel doesn't make it better. Easier to abuse maybe but not necessarily better for legitimate use in pain management which is the point of the thread.

 

[AdmiralPharmaGhost]

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 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

 

[BigG]

I asked to try every brand available in the UK and as car as I'm aware the only ones are durogesic (matrix), matrifen (matrix + but terrible) and sandoz make both a matrix and a gel but most UK gp's won't prescribe gel ones anymore....I didn't get breakthrough meds but since I got prescribed a huge number of patches I would use them bucally for BT pain (very dangerous if you don't know what you are doing)...._I experimented with every type of patch and every different route for months but found them very poor.....some people do get away with them though.

Also if they aren't sticking them a tagaderm plastic dressing is best as it covers the whole patch and keeps on somewhat in place and water resistant

 

[madonit]

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.

So thats why matrifen patches contain such a little amount of fentanyl to get approved for use in germany, to me these patchs made by teva appear useless no matter how you try and use them. Ive been sweating for a few days now im low on patchs and having to just wear half a patch every 3 days. Its like im withdrawing all the time. I even soaked the cut up bits of patch i had in vodka overnight and drank it the next day and it didnt appear to do anything. I should of tried evapouarting it on a pyrex dish really to see if it left any fentanyl crystals behind and just smoked or IM'd them. Ive had these matrifen patchs before in the past when i was on durogesic for a long time i asked for a different brand to see if they worked better i remember them being useless back then. Hopefuly my dr should let me go back on durogesic or give me a different brand. Matrifen almost seems like placebo patches to me in a way. Are the sandoz patches the ones that contain around 20mg per 100mcg patch i know durogesic ones are close to 17 at 16.8mg unless they have been changed scince i was last on them. I asked for gel patches years ago and pharmacy refused to dispense them even though my script was written as fentanyl. They said my dr whould have to change the script to that brand if i wanted them. Tilofyl i think they was called. Scince durogesic started making the d trans version about 2007 ive never seen a gel patch. Shame lol Theres no need to be carefull with these matrifen things as they probably only contain half the fentanyl they should but yes if i change back to durogesic or get sandoz i will be carefull with them even though i have plenty of experience with fentanyl patchs.

 

[madonit]

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

I knotice you say teva is a good brand in the usa and that the mallinckrodt is the worst ones. I did a bit of googleing and found out the teva patch's here called matrifen are made with identicaly the same ingrediants and there (supposid) fentanyl content is also identical at 11mg. Im sure those mellen crud usa ones must be the same ones that are matrifen branded in uk and europe. I wonder if teva or teva europe are linked to mallinckrodt usa.

Holy cow lol THOSE SANDOZ MEZOLAR PATCHS CONTAIN A WHOPPING 23.12MG

 

[blondin]

me love 100mcg patches cut up in to 4 and chewed keeping spit in mouth for absorbsion - lovely nod but very short lived and of course v v easy to od on if you have no tolerance or indeed knowledge of the little buggers.

HR info..... if your not sure about these and you happen to get some ask on here as there is a reason they are measured in 1000th of a gram

 

[BigG]

Yeah the sandoz matrix patched contain a huge fent load. My gp wrote me up for sandoz gel ones as well but got her to specify that one the script. The gel ones werent what they are cracked up to be though. My gp at the time had me on 150mcg/hour changed every 48hours but fucked up the script and wrote it for SIX x 50mcg patches ever 2 days instead of three meaning Iwas getting 90 of the 50mcg patches a month!

I couldn't believe he couldbe so careless and iI should have reported him (yeah right!)...it got to the point though that I was putting a 50mcg patch (a whole one) in EACH cheek and repeating that a couple of timesa dat which is crazy...I was also roughing up my gums with a tooth brush and swabbing my mouth out with isopropal alcohol to get even more absorbed bucally.....fuck knows how I'm still here....

Oh and by the way...soaking the patches in vodka will release the fent but drinking it is pointlessas ffentanyl has a very low oral ba. That's why the don'tmake an oral fentanyl pill.

 

[madonit]

So do i Blondin as long as there not called matrifen or made by teva im a happy man lol. No need to find some im prescribed them just not enough lol With those cruddy matrifen patches theres not enough fent in them to be dangerous when used as intended net lone sucking on the patchs lol Placebo patches im going to call them from now on and when i next go in the chemist im gonna let em know about how crap/faulty those dam things are. No need to worry about HR im seriously opiate tollerant i can drink over 800ml of methadone in one dose and it will only get me slightly high and i potentially have lung cancer so i have no concerns that those patches are dangerous for me. Been using patchs for a good 8 years .

Well i did a little more digging on google and it seems the sandoz patchs well uk ones anyway must have been changed They no longer contain 23.12mg per patch. Its 16.8mg now with the same surface area size as the durogesic dtrans brand so i think that they must of changed their formula to copy the durogesic patchs. Ah man thats such a shame i bet that they was either getting complaints of the nhs or patients that they was causing overdoses or sandoz realised that they could get away with putting less fentanyl in them. That would of been about 6.3mg more per patch than the durogesic and they have enough fents in them for the patch to last 1 week if they did realese the lot at a steady rate they would last 168 hours so those old sandoz would of had enough fent in them to last 231 hours thats 10 days worth of fents !!!. Those cruddy crooks at teva would make an extra 50mcg patch out of that extra 6.32mg in fact out of 23mg teva would of made 2 100mcg an hour patch (If that does not justify the argument that matrifen patch are useless i dont know what would) :/ That just goes to show that they are dreadfull and useless these teva made matrifen and dont have enough fentanyl in them to sustain 100mcg an hour for 3 days in them.

Wow englandz74 90 patchs a month fuck me im suprised your still here lol Yeh you could of sued your gp rotten for that one hahaha thinking about it i know fentanyl does have a low oral bio but im sure its at least 30% which matches morphines poor oral bio so it is bad but not as bad as people might think. Cant wait to get some durogesic or sandoz :D But got a good 11 or 12 days to go yet :'( I might have to try and locate some methadone to help untill i see my dr unless i can change my appointment. Suppose i have to see eh Hopefully i will get sandoz ones if not durogesic the sandoz patchs are about same price as than matrifen too and only cost around 39 a box of 5 Durogesic are about 60 quid for 5. Another intresting brand ive never heard of is Fencino there smaller sized patch like matrifen but contain 20.4mg per patch they are slightly cheaper than matrifen too.

Teva are bloody rob dogs selling inferior products im sure the nhs must be getting mass discounts on those matrifen the more patients they get to accept their shitty placebo patch the cheaper they get. There might be ok on older or less opiate tollerant people but people like myself i need about 1-1.5 a day of the crappy things. I wish i knew someone who worked in a lab who could anaylise one for me. I think they would be around 20-25% down on the 11mg they claim that they contain.

Peace and

 

[BigG]

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.

 

[madonit]

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 know fentanyl patchs do not work in that way but from my experience the durogesic patch continues to release the drug when matrifen matrix membrane type stops releaseing it. When i was allowed to change them 48 hourly i used to apply 2 durogesic patchs and leave them on for four days, i found this provided far superior pain relief than applying one 100mcg patch every 48 hours.

This evening i got an old used matrifen patch that i had worn for four days and removed the sticky backing of it carefully with a sharp knife, i then cut it in half and got some pritty decent releif from sucking on it. This might of been because i had lack of patchs and had only old ones on i dont know really but am feeling quite good at moment not high in anyway like i would be of durogesic but not in discomfort either. Applying them to a new area seems essential only with the matrifen brand but with the durogesic it does not seem to matter and they continue to release the fentanyl and do not stop releasing it either till they run out or are removed (thats on me I suppose other people may be different) .

I am considering switching back to morphine if im not allowed to change patch brands. If my doctor says its matrifen or nothing not allowing me to try other brands then i will go back on morphine i think. You say your on methadone tablets are these the 5mg ones or are their higher strength ones available now. Do you still find them effective after being on them a while. I found they stopped working after a while and only prevented withdrawal symptoms. If i was allowed them i would choose methadone's sister drug dipipanone as they seem stronger or more orally efficiant than the sevredol tablets i get for BP.

 

[BigG]

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.

 

[madonit]

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.

Yes indeed. Diconal as a brand is still made yes it was stopped for at least 18 months (i think there was a fire at the factory) but they are very rare Im 80/90% sure amdipharm as soverign medical do produce Both as dipipanone/cyclizine as generics and the diconal brand still. I have seen strips empty strips that say both (wasnt mine unfortunatly was hugely jelious) was looking somewhere on google and i found a link to both the patient information leaflets for diconal as a brand and as generic dippipanone and cyclizine tablets. Both links was dated as revised in 2014. I will do my best to locate them again and post links here.

Wow 36 methadone tablets a day is a very rare script to get. When i was on methadone for a while before they would acknoledge i needed painkillers even though i was opioid dependant a bout a decade ago I used to get 12-15 ml of sugar free methadone concentrate 10mg in 1ml solution branded methadose concentate due to them refusing tablets except when i was out the country thinking 24-26 a day would have a huge street value. That was best form of methadone i was ever prescribed and i could inject it via IM and IVroute. It was very safe compared to Intramuscular street heroin in my opinion as it wasnt a syrup it had same consistncy as water that had just been tinted blue. One of the best hits i ever had in my life was from rattling up 3 diconal tablets in blue methadone before i got to point i needed 5-8 diconal per hit. I suppose iim kind of lucky they stopped a lot of peoples diconal scripts in my area when they did but i cant inject now i would never try to iv diconal again (obv im diconal is a no no) they killed all my veins off except my groin and neck (would never go there) and im not going theree again. The thing about diconal that makes me want them back is they do work better orally compared to same dose of morphine and i do miss them.

 

[BigG]

Yeah iirc diconal had some kind of silicone as a binder rather than regular talc and were notoriously bad for veins. I was prescribed them briefly circa 2002 but volunteraly switched to oxycodone (I don't inject though). You seem to have done your research re. the availability of the diconal brand (I only read one article saying they were discontinued) but I was sure that they only made dipipernone/cyclazine rather than straight diconal (25/75ratio I think)......I will check my latest copy of the BNF and vet back to you on that though. Supposedly diconal is the only opoid that has a n exact 1:1 conversion rate to oral morphine as everything else is either weaker or stronger in comparison to morphine but again I guess that is a subjectivrle viewpoint.

I really hope you find something to adequately address your pain soon though as I know living in chronic pain is no fun at all. Take care mate.