BuTrans patch skin rash/burn?

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Sha49
Regular Member


Date Joined Nov 2010
Total Posts : 27
   Posted 12/20/2012 7:45 PM (GMT -6)   
I have been on the BuTrans 20mcg patch for about a year or so. I have mentioned to my pain doc, when I first started using them, that they do not stay on my skin for longer than 4 days (almost like my skin rejects them) and I have a bad rash where the patch was removed in the shape of where the medicine part laid against my skin. She said it was normal to have skin irritation at site of patch, so just assumed what I had was normal. I started googling the burn like rash and it actually a says in several sites that if you have this burn type of rash to discontinue use and report it to doc right away so now I'm going hmmmmm!!!

Has anyone else had this? It looks like a chemical burn an remains for about 3-14 days where it was applied.

Thanks

Sha

Snowbunny21
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Date Joined Jan 2010
Total Posts : 3557
   Posted 12/20/2012 7:53 PM (GMT -6)   
Hi there....I took a peek to see your other posts and it's been almost a year since you've been on the boards so welcome back:)

I see that getting hives and bad rashes have been something that happens even before you started the Butrans, correct? If so, it just sounds like you have extra sensitive skin to where a patch doesn't seem like the best option. I think there is a difference for those whom just have a bit of itching in the beginning or need extra tape to help keep on the patch and yourself where this is downright painful!
 
Is your Dr. just flat out refusing to believe you? It seems so strange that you have told him how awful this is and how you can't even keep a patch on for the full 7 days and he is not doing a thing.

May I ask when your next appt. is? I would make sure you take photos of the rashes so that you can show him at your next appt. and say that you have given this more than a fair try by being on it a year but it's not working and need to switch to something else.

Let us know how it goes..

getting_there
Regular Member


Date Joined Dec 2012
Total Posts : 34
   Posted 12/20/2012 9:15 PM (GMT -6)   
the 3 day fentanyl patches seem like the perfect solution to your problem it would be worth suggesting to your Dr at least

take care

Snowbunny21
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Date Joined Jan 2010
Total Posts : 3557
   Posted 12/20/2012 9:20 PM (GMT -6)   
I would think that if they are having reactions to the adhesive from the patches...it would also happen with the Fentanyl patch.

Some people are just too sensitive (skin wise) to handle any type of patch. Thankfully there are many oral long acting medications from which to choose.

Either way I hope that Sha can get the help they need from their Dr.:)
SB (Snowbunny) and the pup that snores (my yellow lab:))

3, two-level, cervical fusions over the past 11 years. The last one was anterior and posterior with lots of fun titanium!
Still have active herniations along with knee problems and another Morton's neuroma in left foot.
I try to find joy in each day even with chronic pain:)

Sha49
Regular Member


Date Joined Nov 2010
Total Posts : 27
   Posted 12/20/2012 9:53 PM (GMT -6)   
Thanks for the replies! Yeh, it's been a whole since I've been on the board, so can't remember what ya guys know about my dx's, but I have spondyloarthropathy, fibromyalgia, sjogrens, UC and a mixed connective tissue disorder of some kind (they've said lupus or RA). I have a great pain doc and she put me on the BuTrans and writes it for dispense 8, change patch every 3-4 days. I wasn't too worried about the rash until it seems it looks more and more like a burn and itches like crazy. It always has, but thought this was normal. I have my next appt in February so will talk to her about it. I have oxycodone 10mg for BT pain. I can't stress enough that I am lucky to have the pain doc I have!:)

I was just wondering how normal the burn like rash is for those who use it.
35 yo. Married w/5kids. dx sjogrens with+ SSA, ANA, scheimer test. Joint pains/swelling, change in taste/hearing/smell and sight (got plugs in now), severe back pain, brain fog, weird rashes that peel and look like a sunburn, fatigue, etc:p
heavy on the "etc"
Just got 44 vials of blood drawn, xrays and lip biopsy/rheumy thinks it's an overlap dx...waiting in dx limbo land right now!

Snowbunny21
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Date Joined Jan 2010
Total Posts : 3557
   Posted 12/20/2012 10:05 PM (GMT -6)   
Wow...I've never heard of being prescribed the Butrans to be changed every 3-4 days instead of the 7...But if your PM is ok with this as well as your insurance company then that is great.

Seems like the situation with the itching and burning is getting worse so this is why it may be best to move to an oral extended release medication....Obviously whatever you all decide...

One of the main reasons I switched off the Fentanyl patch was because I take pretty hot showers and it was releasing too much medication...I wound up in the ER the first time I used it! I also like to have greater flexibility with my medications and be able to take less on days I feel better and more on the worse days.

So, hopefully you can figure things out with your PM. It really is wonderful to have a caring Dr.!
SB (Snowbunny) and the pup that snores (my yellow lab:))

3, two-level, cervical fusions over the past 11 years. The last one was anterior and posterior with lots of fun titanium!
Still have active herniations along with knee problems and another Morton's neuroma in left foot.
I try to find joy in each day even with chronic pain:)

Sha49
Regular Member


Date Joined Nov 2010
Total Posts : 27
   Posted 12/20/2012 10:39 PM (GMT -6)   
Wow I just noticed my signature was way out of date cuz I'm now 37 and not 35 any more haha I updated it to reflect my dx's and px's. it was actually my pharmacist who had the idea to prescribe the patches that way and when he checke to see if my insurance would cover it, they would so talked to my Pain doc who said she was ok with that cuz they just wouldn't stay on no matter what I did. I now think that the reason they don't stay on is my skin is saying GET OFF OF ME to the patch. I also wear them on my upper thigh cuz I have more places to choose from. They only stay on the 3-4 days on my upper thighs and my upper arms, but changing them as frequent as I do, I have to try not to place them in same spot for 3 weeks. I brought up the fentanyl at the last visit since my twin sis was just denied butrans on her new insurance, and she wanted to wait until the insurance kicked me off of them or refused to pay cuz she likes those and considers the BuTrans a better option. She also thinks if I go to fentanyl, my insurance company may deny me since it isn't on their formulated list and I skated through some how;)
My dx's that all my specialists can agree on are: spondyloarthropathy, fibromyalgia, sjogrens, UC and a mixed connective tissue disorder unspecified (lupus or RA, but not sure so is unspecified as of right now). Meds: 20 mcg BuTrans patch change patch every 3-4 days, Flexeril 10 mg 3 x a day and oxycodone for BT pain up to 4 times a day.

Sha49
Regular Member


Date Joined Nov 2010
Total Posts : 27
   Posted 12/20/2012 10:47 PM (GMT -6)   
Oops let me clarify...my pain doc thinks if I choose to change to fentanyl and it doesn't work for me, I might be denied the BuTrans that I'm on now cuz BuTrans isn't on my insurances formulated list so I skated by being allowed not only the one month, but basically 2 months cuz I change them every 3-4 days. Sorry was at a indoor soccer game and texting from phone:)
My dx's that all my specialists can agree on are: spondyloarthropathy, fibromyalgia, sjogrens, UC and a mixed connective tissue disorder unspecified (lupus or RA, but not sure so is unspecified as of right now). Meds: 20 mcg BuTrans patch change patch every 3-4 days, Flexeril 10 mg 3 x a day and oxycodone for BT pain up to 4 times a day.

Sha49
Regular Member


Date Joined Nov 2010
Total Posts : 27
   Posted 12/20/2012 11:14 PM (GMT -6)   
This is the one I keep coming across that has me a lil worried and not sure if I should call my PM and ask or if I'm worrying for nothing! I first started googling the burn like rash cuz i asked my twin if she was having any burn like rash at application site of the fentanyl like she got from the BuTrans, and she said she didn't get one like that...I was like what, wait, I thought you did too!! So all this time I thought it was a normal side effect:(

Anyways here is the warning that freaked me out:

Application Site Skin Reactions
In rare cases, severe application site skin reactions with signs of marked inflammation including “burn,” “discharge,” and “vesicles” have occurred. Time of onset varies, ranging from days to months following the initiation of Butrans treatment. Instruct patients to promptly report the development of severe application site reactions and discontinue therapy.
My dx's that all my specialists can agree on are: spondyloarthropathy, fibromyalgia, sjogrens, UC and a mixed connective tissue disorder unspecified (lupus or RA, but not sure so is unspecified as of right now). Meds: 20 mcg BuTrans patch change patch every 3-4 days, Flexeril 10 mg 3 x a day and oxycodone for BT pain up to 4 times a day.

getting_there
Regular Member


Date Joined Dec 2012
Total Posts : 34
   Posted 12/20/2012 11:45 PM (GMT -6)   
AFAIK the fentanyl patches are stronger and at the lower dose are much smaller than the butrans in size so would irritate you less that's why I suggested them as an option

seems patches are probably not the way to go for you though from what you've posted, I've been on the fentanyl over a week now and it does itch but there's no burn just a red blotchy mark after removing

is the red mark at all visible outside the surface area of where the patch is? basically is the rash bigger than the patch if so I'd strongly suggest speaking to your doctor about stopping them especially if it at all feels like it's burning

keep us updated good luck

Ryobi
Regular Member


Date Joined Apr 2012
Total Posts : 114
   Posted 12/21/2012 3:46 AM (GMT -6)   
I have no problems with my 20mg butrans but I do alternate my upper inner arm right below my armpit, works great
Mindy
Diagnosed Fibromyalgia 2010
Diagnosed Rheumatoid Arthritis 2011
Diagnosed Hypothyroidism 2012
Medications
Butrans 20 mg patch, Hydrocodone 10 mg as needed for BT pain, Arava, Ambien 10mg as needed for sleep, Valium 10mg as needed for stiff muscles
I'm selfish, impatient and a little insecure. I make mistakes, I am out of control and at times hard to handle. But if you can't handle me at my worst, then you sure as hell don't deserve me at my best." — Marilyn Monroe

Sha49
Regular Member


Date Joined Nov 2010
Total Posts : 27
   Posted 12/21/2012 12:57 PM (GMT -6)   
The burn like rash is brightened and is only on the area where the medicine part lies against my skin. The part where the adhesive is, is not red at all. The redness and irritation will itch as long as it is red.
My dx's that all my specialists can agree on are: spondyloarthropathy, fibromyalgia, sjogrens, UC and a mixed connective tissue disorder unspecified (lupus or RA, but not sure so is unspecified as of right now). Meds: 20 mcg BuTrans patch change patch every 3-4 days, Flexeril 10 mg 3 x a day and oxycodone for BT pain up to 4 times a day.

BearHuntress
New Member


Date Joined Jun 2013
Total Posts : 1
   Posted 6/11/2013 2:16 AM (GMT -6)   
HI I just was googling and came across this post!! im really concerned. I had to create a profile to log in and post.... Ive been using the buprans 20 patch for a few months now...no problem... then on Saturday my arm started burning and aching under the patch...not like allergic reaction to the adhesive...so I took the patch off, even tho it was 3 days early...exactly where the medicine area was is bright red and BLISTERED!!! tiny white blisters!! I took the patch off and put on a different one in a different spot, but that was 3 days ago!! its getting worse everyday!!!I wish I could post a pic!! around the edges its kinda crusty brown looking?? I know I should go to the dr but im scared! I was on narcotics for 2 yrs! they made me so sick but it outweighed the pain....I really really don't want my dr to take me off this and put me back on crap that makes me sick and gets me all weird feeling!!! there are NO side effects with this patch and it helps with the pain! its perfect!!! IDK what to do :(

Sha49
Regular Member


Date Joined Nov 2010
Total Posts : 27
   Posted 6/11/2013 2:40 AM (GMT -6)   
I know exactly what you are describing!! I started putting them on my upper thighs cuz my arms couldn't handle them any more. This was okayed by my doc. I am now on 75mcg of fentanyl with no side effects. There's hardly any itching whatsoever and no burning!! I glad I switched cuz it was getting worse instead of better!! Hope you get some answers...maybe ask doc if ya can change every 3-4 days like my doc did, the worst that can happen is that the insurance denies the the 8 patches instead of 4 a month. She wrote it...dispense 8 patches and change every 3-4 days.

Linds_
Veteran Member


Date Joined May 2013
Total Posts : 843
   Posted 6/11/2013 9:42 AM (GMT -6)   
This happened to me when my doctor tried Butrans to control my pain and I went into the office and as soon as they saw it, I was taken off the patch and given a round of steroids. They said I'm allergic to burpunorphine (I'm not sure if I'm spelling that correctly) the medication in the patch and not the adhesive. I had tiny blisters that would pop after taking the patch off for a few days.

Talk to your doctor... I know it's scary to think of being in pain or being on meds again but with the right medications there will be limited side effects and many benefits.

Good luck to you, BearHuntress!
Chronic Pain Warrior since 2007
Diagnosed in 2007 - Chronic Pelvic Pain and Stage 3 Endometriosis
PM Patient since 2009
Current Tx Plan - Oxycontin 15mg 3xday, Percocet 10/325 2xday for BT, Elavil 50mg 1xday, Depot Lupron 2xyear (injectable)

My daily Goal - to make at least one person smile a day. Smiles are contagious and create a ripple effect... that one smile may lead to a miracle :)

Sha49
Regular Member


Date Joined Nov 2010
Total Posts : 27
   Posted 6/12/2013 2:50 AM (GMT -6)   
I believe that's exactly what it is, an allergic reaction! Have you tried fentanyl patch? They tried me out on 50 mcg and I'm currently on 75 mcg with breakthrough oxycodone 10 mg 3 x a day instead of butrans 20 mcg and oxycodone 10 mg 4 x a day. I am also on the flexeril 10 mg 3 times a day for muscle spasms and a 5 mg diazepam at night. The butrans is the only change other than tweaking the oxycodone and the fentanyl. I am actually thinking about asking to go back on the tramadol instead of the oxycodone cuz I believe I had better mood when I was using it cuz of the SSRI type properties of it.
My dx's that all my specialists can agree on are: spondyloarthropathy, fibromyalgia, sjogrens, UC and a mixed connective tissue disorder unspecified (lupus or RA, but not sure so is unspecified as of right now). Meds: 20 mcg BuTrans patch change patch every 3-4 days, Flexeril 10 mg 3 x a day and oxycodone for BT pain up to 4 times a day.

cwbyfan
New Member


Date Joined Jul 2013
Total Posts : 7
   Posted 7/30/2013 1:29 AM (GMT -6)   
I use both a 5 & 10mcg butrans patches and spend a lot of time in the sun which does a job on the adhesive. Not to mention the sunscreen and all.
When the adhesive starts to fade I cover them with 3M Nexcare Tegaderm waterproof dressings. You can buy them up 4x4 3/4in sizes but I usually use 2 of the 2 3/8 x2 3/4 size so it's a little cheaper. My pharmacist recommended them but I would check with a doc before you do!

Clee76
New Member


Date Joined Oct 2013
Total Posts : 2
   Posted 10/26/2013 11:45 AM (GMT -6)   
I too have the rash like chemical burn. I am on 10 mg and they itch hurt and burn so bad I sometimes have to rip them off or itch to the point of piercing my skin. The site of patch is raised an warm bright red. Did you learn if this is dangerous? Anyone know a way around this. I love the butrans patch. It enables me to actually have a bit of the life I had before my accident. But the patch is driving me crazy!?

Linds_
Veteran Member


Date Joined May 2013
Total Posts : 843
   Posted 10/26/2013 12:06 PM (GMT -6)   
I didn't find out a way around it... Unfortunately I was very allergic and that was pretty dangerous. Have you shown your doctor? You can also Google Butrans rash and see what comes up!
Chronic Pain Warrior since 2007
Diagnosed in 2007 - Chronic Pelvic Pain and Stage 3 Endometriosis
PM Patient since 2009

My daily Goal - to make at least one person smile a day. Smiles are contagious and create a ripple effect... that one smile may lead to a miracle! :0)

Luie
Regular Member


Date Joined Jun 2012
Total Posts : 175
   Posted 10/27/2013 12:53 AM (GMT -6)   
butrans sucksssss , I was on it before I was put on fentanyl... I would ask ur dr to switch to fentanyl I had the same problem.
23yearold with Severe Chronic Neck/back pain due to - Fx C-7 vert, Herniated C234567 t1/24/5/6/ L1/2,DDD, Left and right Arm Radial Nerve Damage, Complete Wrist Drop of left hand.
Fentanyl 100mcg q 48h, opana ir 10mg 1-2 qid prn, valium 10mg q6hr prn , Naproxen sodium 500mg Bid.

Luie
Regular Member


Date Joined Jun 2012
Total Posts : 175
   Posted 10/27/2013 12:56 AM (GMT -6)   
Snowbunny21 said...
I would think that if they are having reactions to the adhesive from the patches...it would also happen with the Fentanyl patch.

Some people are just too sensitive (skin wise) to handle any type of patch. Thankfully there are many oral long acting medications from which to choose.

Either way I hope that Sha can get the help they need from their Dr.:)
 
not true butrans uses a totally different adhesive (silicone), where fentanyl hardly has any.
 

Linds_
Veteran Member


Date Joined May 2013
Total Posts : 843
   Posted 10/27/2013 1:19 AM (GMT -6)   
I'm on Fentanyl now as well and I haven't had any reaction like I did with Butrans. My sensitivity was definitely not to the adhesive but instead to the medication.
Chronic Pain Warrior since 2007
Diagnosed in 2007 - Chronic Pelvic Pain and Stage 3 Endometriosis
PM Patient since 2009

My daily Goal - to make at least one person smile a day. Smiles are contagious and create a ripple effect... that one smile may lead to a miracle! :0)

Luie
Regular Member


Date Joined Jun 2012
Total Posts : 175
   Posted 10/27/2013 9:44 AM (GMT -6)   
it might of been the cloth bandaid thing they use on butrans. that was making me break out like hell ,
23yearold with Severe Chronic Neck/back pain due to - Fx C-7 vert, Herniated C234567 t1/24/5/6/ L1/2,DDD, Left and right Arm Radial Nerve Damage, Complete Wrist Drop of left hand.
Fentanyl 100mcg q 48h, opana ir 10mg 1-2 qid prn, valium 10mg q6hr prn , Naproxen sodium 500mg Bid.

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 11393
   Posted 10/27/2013 11:54 AM (GMT -6)   
Hey guys this is an old thread, if you would like to continue posting on this subject please start a new thread. Thanks....Susie
Straydog
Moderator for Chronic Pain & Psoriasis Forums

Clee76
New Member


Date Joined Oct 2013
Total Posts : 2
   Posted 10/27/2013 4:31 PM (GMT -6)   
I have shown my doctor and he says its just a normal side effect. Mind you, I am his only patient using the patch. So I don't think he's too familiar.

What medication are you using as a substitution?
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