The composite of a patch

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(Seashell)
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Date Joined Dec 2012
Total Posts : 665
   Posted 4/29/2016 8:04 AM (GMT -6)   
I have been reading this forum for a few months . . . this is my first question to the group.

I am on the Fentanyl patch, 75 micrograms, changing ever 48 hours.

The patch I have been provided has been of a gel composition on an adhesive backing applied to the skin. I have experienced a fairly good ramping down of pain with the gel patch.

This past prescription, the brand of patch provided to me was changed. As is true in all areas of life, the pharmacy was able to get a better price on a different brand than what I had been issued on a regular basis.

The new patch is a weaved/honeycomb material on an adhesive backing applied to the skin.

The issue: I feel almost no effect from the new composite of patch.

Can it be that a gel-based composite is that much more effective for me than the weaved/honeycomb based composite patch?

Should I trust that I am not feeling the same level of effectiveness?

I realize that not all generic brands are biochemically equivalent. But can there be that much of a difference between brands?

Thank You for any insights to share,
- Karen -

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 14992
   Posted 4/29/2016 8:14 AM (GMT -6)   
Karen, yes this is something that has been brought up several times in the past. Different brands being more effective than others. I would ask the pharmacist if he/she can order whatever brand you like, usually they will do this.

Take care.
Susie

Derwood
Regular Member


Date Joined Jun 2016
Total Posts : 294
   Posted 8/24/2016 8:58 PM (GMT -6)   
:-)

Being relatively new to the fentanyl patch ( mine is proving effective and sounds like the first type you mention ) this is very good to know. Like so many , I too have had the brand of different types of meds changed by my pharmacy from one maker to a different one on occasion. I will be keeping this info in my old memory bank ( ok, my
middle-aged memory bank ;) in case this happens to me.

Thanks Seashell and Susie :)

Best,
Derwood.

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 14992
   Posted 8/25/2016 8:38 AM (GMT -6)   
Derwood, hopefully you will continue to receive the patch that provides the best relief. It stinks when the pharmacies mess with different brands. I recently ran into a problem with my Baclofen brand being changed. It made a great difference & some of the side effects were not pleasant.

Take care...
Susie
Moderator in Chronic Pain & Psoriasis Forums

Derwood
Regular Member


Date Joined Jun 2016
Total Posts : 294
   Posted 8/25/2016 9:11 AM (GMT -6)   
Thanks Susie. So far my pharmacy has been consistent by giving me the brand TEVA ( TEVA-FENTALYN ) but I will be watching closely for any attempt to change from this. This kind of occurance can really throw a person for a bad loop, which is why I am greatful for knowning about it.

My patch is clear , thin and flexable , with fine blue print that says
" fentanyl 100mcg/h " along one edge.

Thanks so very much for the help.
Best,
Derwood.

BTW- my patch causes some redness ( like a rash ) to my skin where a patch has been , and clears up after about a week , but I don't think it is anything to be concerned about, although I am not
100% sure that it is normal. I must remember to ask my doctor when I see him next.

Chartreux
Veteran Member


Date Joined Aug 2006
Total Posts : 9657
   Posted 8/26/2016 8:09 AM (GMT -6)   
To SeaShell, ask your pharmacy to re stock on the gel pads, you can search your medication on:www.drugs.com or do a google search

To Derwood321, your having an allergic skin contact issue with the patch your on and it might get worse with time, for now look for a Benadryl cream to apply to the area for help and then talk to your doctor about this reaction. an allergic reaction can get serious and could need ER treatment, right now its considered a local reaction on the skin and a benadryl cream could help, if the benadryl cream clear it up, then talk to your doctor, it's probably an reaction to the adhesive part of the patch, but it is a reaction and you do need to seek out medical help if it gets worse. I also get skin reactions easy and know about this type of reaction (no not a doctor) from experience .
If you cannot find the benadryl cream then break a benadryl tablet up and spread it on your skin with the powder...or take a benadryl tablet by mouth... .
**********************************************
* So many dx's I could write a book* "It would be nice if we could use the edit button in real life"...
********>^..^<********>^..^<*******

Derwood
Regular Member


Date Joined Jun 2016
Total Posts : 294
   Posted 8/26/2016 8:21 AM (GMT -6)   
Thanks for the info Chartreux. Very good to know that these red patches are not completely normal and how to deal with it until I see my doctor ( about 3 weeks from now ). I will deffinetly check with doctor to see what he thinks. I made that common mistake of assuming the redness is normal. The patch also makes me itchy on the areas that the patch is/has been. I will mention this to my doc as well.

All the best Char,
Derwood.

Tirzah
Veteran Member


Date Joined Jul 2008
Total Posts : 2312
   Posted 8/30/2016 8:36 AM (GMT -6)   
I definitely believe there is a difference between the gel & the matrix patches. I cannot tolerate the gel patches. I've accidentally overdosed on the gel patches 3x when using as intended. Once it was in a shower that was barely warmer than tepid, two other times it was in an un-air conditioned classroom. Plus, I had other times when I had to pull them off because I was starting to feel woozy & breathing was getting too slow. My insurance does not cover the matrix patches. They only cover the gel patches because the gel patches are cheaper. We tried applying for an exception, but it was denied multiple times & I have no more appeals. Fortunately, since I switched down to 12mcg patches last year, it's now a non-issue as the 12mcg's only come in matrix form.

Sometimes pharmacies will special order a particular generic "brand" if the doctor writes that on the script & you give them a week or so advance notice. My local pharmacy used to do that for the matrix patches for me. Now, they're being encouraged by corporate to only order the matrix patches as they are less likely to cause accidental overdose due to abuse or instances like mine where it simply dumped too much medication into my body at one time.

In fairness, likely part of the issue for me with the gel patches is that they are thicker. They were cutting into my super sensitive skin, which may have allowed some of the medication to enter directly into my blood stream rather than being absorbed through the skin.

Hope you can sort out a solution!

DianeB
Veteran Member


Date Joined May 2013
Total Posts : 1340
   Posted 8/30/2016 9:23 PM (GMT -6)   
Derwood321

Welcome!

If you have not yet done so, read the insert that comes with the patches, especially re:body temp / heat! If patches don't stick well some brands offer 'covers' too.

By Trial & error I discovered I was allergic to adhesive used on First brand of patch. The redness quickly became ugly weeping blisters.!

Immediately Tried a different brand which causes itching, mild but constant. Gel type.

Researched online & tried several suggestions. This is what ended up working for me:
(usually ) immediately after showering wipe area w/alcohol pad to remove natural oils (pads come with supplies for TENS ). Let dry.

Spray with 'F' steroid nasal spray & let dry.

Apply patch.

No itching!

Doctor specifies my brand on the patch scrip. He told me to leave patch on after the 48 hr as it still has med in it.

I Suggest, right from day 1, make notations of day & time tevery time a patch is applied. Since I leave old patch on awhile, I also note location (left or write).

You can use the search option at top right & find other's recommendations.
Herniated cervical discs & other disc / spine issues, Arthritis, spurs
Injuries &/or pain to/in shoulders, elbows, wrists, knees, legs, ankles
Fibro / myofascial pain, neuralgia, neuritis

Derwood
Regular Member


Date Joined Jun 2016
Total Posts : 294
   Posted 8/31/2016 4:22 PM (GMT -6)   
Thanks for the tips Diane , and thanks for the welcome. :-)

So glad I found Healing Well and all the nice people!

Derwood ( and my sweet cat Lupin ).

rocckyd
Veteran Member


Date Joined May 2012
Total Posts : 1082
   Posted 8/31/2016 7:19 PM (GMT -6)   
I've also been told to use a steroidal nasal spray, which was prescribed by the doc.

Maybe something to bring up.
Single mom to my little man 11yrs old
39yrs old. JRA since a kid. Chronic Uveitis, pleurisy, pericarditis, intersticial lung disease, sjorgrens syndrome, Cushing's Syndrome, gastroparisis
Bilateral TMJ replacements due to bone fusion, port-a-cath, g/j feeding tube, antiphospholipid antibody syndrome(my blood fights itself) epilepsy, MCTD, dysphagia(unable to swallow correctly)

Derwood
Regular Member


Date Joined Jun 2016
Total Posts : 294
   Posted 9/17/2016 9:50 AM (GMT -6)   
Hi all. Some of you are aware that after Feeling great on 100mcg/h of fentanyl for about 3 weeks ( my doc upped the dose from 75 about a month ago ) I have recently been feeling sore again.

Today I took a close look at the patch I have on, and at least 1/4
of the patch will NOT stick to my skin. I have tried surigal tape and thought that would work, but looking closely, I can see areas that the patch isnt touching my skin, and no matter how much I press on it, it doesn't stay. I really dont think the tape helps.

So this is what I think is causing my very recent pain trouble...the patch is only sticking to my skin in some areas, but not all.

So I found this thread again and re-read it and found this:

"
Researched online & tried several suggestions. This is what ended up working for me:
(usually ) immediately after showering wipe area w/alcohol pad to remove natural oils (pads come with supplies for TENS ). Let dry.

Spray with 'F' steroid nasal spray & let dry.

Apply patch.

No itching!"

I have read that alcohol should not be used??? But I think I might need it to get all the surface area of the patch to stick to my skin.
What do you kind folks think?

BTW- intitially I was itchy and had red patches on my skin from the patch but this doesn't occur any more ( no idea why ), but I have to get my patch to STICK.

Please share your thoughts with me on using alcohol before applying the patch, and also , if anyone has a better idea, I really would love to know.

I really feel this must be the reason for my recent spike in pain.

HELP. PLEASE.

Thanks very much,
Derwood.

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 14992
   Posted 9/17/2016 10:07 AM (GMT -6)   
Hi Derwood, when I was on Fentanyl I used Tegaderm to keep my patch in place. This can be bought at any pharmacy. If they do not have it in stock they can order a box for you. It is like the clear plastic covering used on an IV. It also kept it nice & dry.

Take care.
Susie
Moderator in Chronic Pain & Psoriasis Forums

(Seashell)
Veteran Member


Date Joined Dec 2012
Total Posts : 665
   Posted 9/17/2016 5:19 PM (GMT -6)   
Derwood: I also use a patch of TegraDerm over my Fentanyl patch. It holds the patch in place nicely.

TegraDerma is sold by NexCare 3M products and is available over the counter at any pharmacy in the band-aide and first aid section.

Best to you and to Lupin,
- Karen -
Pituitary failure, wide-spread endocrine dysfunction
Addison's disease
Mixed connective tissue disorder
Extensive intestinal perforation with sepsis, permanent ileostomy
Avascular necrosis of both hips and jaw
Receiving Palliative Care (care and comfort)

Derwood
Regular Member


Date Joined Jun 2016
Total Posts : 294
   Posted 9/17/2016 5:58 PM (GMT -6)   
Hi Susie and Karen.

Well now I have a nice, simple reason to get out of the house tommorow. Off to the pharmacy for some Tegraderm. This is great info my friends; Healing Well has been such a great find for me. Today I bought some rubbing alcohol, so will be trying that along with the Tegraderm when I change patches tommorow evening.

If the alcohol feels like I am getting too much meds I will remove the patch and just use the Tegraderm. I have a couple of extra patches so I can manage this if need be. I feel sure that the Tegraderm will most certainly help me at bath time too, as I have had a bit of trouble with the patch getting too wet and getting loose on corners etc. I dont shower often for fear of slipping, and soaking in the tub helps me get more flexable at the start of each day, so I tend to be in the water longer than if I were showering.

I was out for a walk yesterday and today, and had coffee with friends, so I have gotten out of the depression rut I was in for most of last week. Feels so good when the depression monkey is not on my back :-)
Tommorows errand will ensure that I get out of the house again, which will help me from slipping back into the blues. Getting out of the house really does help me feel better, just as the doctors say.

Lupin and I have a nice, quiet evening planned for tonite; starting a new book I bought today and reading in bed till my eyes are heavy with sleepiness. Lupin always cuddles with me when it's bed time...she's my little wildflower :-)

I will report back on this thread in a few days and let everyone know how things go.

Thanks once again for the help yeah

All the best to everyone,

Derwood ( and lupin )

Derwood
Regular Member


Date Joined Jun 2016
Total Posts : 294
   Posted 9/24/2016 5:10 PM (GMT -6)   
Hi everyone, I hope you are all doing well.

I just want give a brief update on my patch experience. I have tried the Tegaderm ( thanks again for the tip Seashell ) and I can say that it
is a game-changer for me. I have had no problems with my patch and its effectiveness since I started putting the Tegaderm patch over my
Fentanyl patch. :) I have been using this waterproof covering
( Tegaderm ) for a week now, so my results should be reasonably accurate.

I am not completely sure, but my experience with fentanyl patch
WITHOUT the tegaderm barrier is that once a bit of soapy water gets
between the pain patch and my skin, the patch will no longer provide
meds in the area that has gotten wet. The tegaderm has kept my pain-
patch completely dry, and I will be continuing to use it.

Peace and best wishes all,

Derwood & Lupin.

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 14992
   Posted 9/24/2016 8:02 PM (GMT -6)   
So glad that the Tegaderm works well for you too. I simply would not have been able to use the patch had it not been for the Tegaderm. I was able to cut the Tegaderm in half which worked well.

Take care.
Susie
Moderator in Chronic Pain & Psoriasis Forums

Derwood
Regular Member


Date Joined Jun 2016
Total Posts : 294
   Posted 9/25/2016 12:26 AM (GMT -6)   
:-) Thank you for the kind words Susie :-)

(Seashell)
Veteran Member


Date Joined Dec 2012
Total Posts : 665
   Posted 9/25/2016 7:04 PM (GMT -6)   
Derwood:
It is great to hear that a Tegraderm overlay has made such a positive difference for you.

I always place a Tegraderm patch over my Fentanyl patch. The Tegraderm binds the pain patch to my skin and ensures that the pain patch stays in place.

Before I began using Tegraderm routinely, I would sometimes inadvertently remove a Fentanyl patch in my sleep . . . or a Fentanyl patch would get snagged on the edge of a blouse as I was getting undressed, and off it would fly. I only get an extant 15 patches a month. There are no extra patches, even if removed inadvertently.

I am glad that we can share tips and practical advice with one another on this forum. People helping other people.

Best wishes to you and Lupin,
- Karen and Molly (tea-cup maltese)
Pituitary failure, wide-spread endocrine dysfunction
Addison's disease
Mixed connective tissue disorder
Extensive intestinal perforation with sepsis, permanent ileostomy
Avascular necrosis of both hips and jaw
Receiving Palliative Care (care and comfort)

Derwood
Regular Member


Date Joined Jun 2016
Total Posts : 294
   Posted 9/26/2016 12:42 PM (GMT -6)   
Thank you Karen and Molly :-)

Yes, sharing and caring make Healing Well the great place that it is. Everone
can help in one way or anouther ( generally the more feedback on a thread the better ) and we all need some help from time to time. It's
also nice to visit a site that almost exclusively has no haters etc smurf

It's probably worth noting that Tegaderm is available in different sizes
to suit the individual. And they ARE nice and watertight. Part of my
day-to-day living now that I've experienced the difference they make.
White surgical tape might work for some, but Tegaderm is the best
sollution for me ( and you ).

Purrs and kind thoughts,
Derwood and Lupin.

Derwood
Regular Member


Date Joined Jun 2016
Total Posts : 294
   Posted 3/16/2017 5:43 PM (GMT -6)   
I dug this old thread up to add a bit of news to it.

Scince going on the fentanyl patch about a year ago I have been on
a brand called teva-fentanyl. When I received my monthly refill
three weeks ago I noticed that they had given me the brand called
mylan-fentanyl matrix patch.

I only had this new patch on for about 6 hours before I realized I
was getting more relief than from the older brand. Three full weeks
with this different brand has assured me that the new brand works
significantly better for me than the teva-fentanyl. I will be calling
my pharmacist tomorrow to ask that if I can receive mylan-fentanyl
matrix patch from now on.

The only visible difference between the two patches is that the new one is a bit smaller than the older brand for the same dose
( which is actually a slight benefit in itself as it leaves more areas
of skin to continually place the patch in a different place at each change time ).

I have also found that the initial skin irritation that I was getting
gradually went away over a period of months. Anouther positive
event, but not attributed to the brand change. Perhaps it was just my body getting adjusted to the fentanyl contact with my system (?) that caused the initial irritation ? I think so.

I just offer this news up ( as always ) in the hope that it may be of
use to others. HW ROCKS !

Cheers friends,
Derwood.

(Seashell)
Veteran Member


Date Joined Dec 2012
Total Posts : 665
   Posted 3/17/2017 3:05 PM (GMT -6)   
Derwood + Luprin:
It is good to hear from you.

Has it really been a full year since you started the Fentanyl patch? Time has passed quickly.

The tone of your writing seems genuinely light and upbeat. A good level of pain control is a genuine gift that lessens life's burdens.

I do find subtle differences between brands of the duragesic patch, and I felt a significant difference in medication delivery between the gel and matrix patches. I am on the Mylan brand, as well.

I am surprised that you can take such long, hot soaks in the bathtub with the patch submersed. It is usually an area of caution to avoid overly hot pools, baths, and whirlpools, as higher temperatures result in premature release of the time-released medication. Just be aware of the effect.

I am glad to hear that the fentanyl patch has been such a good fit for you in restoring meaning and pleasure to your life.

Chin rubs to Luprin. There is simply nothing that can replace the love and companionship of our companion pets. My little tea-cup Maltese, Molly, has had a rough 5-6 weeks with severe inflammatory bowel disease. She has pulled through but her situation was looking grim at a few points. This little dog means the world to me.

Take care and stay in touch.
- Karen + Molly (tea cup Maltese)

Derwood
Regular Member


Date Joined Jun 2016
Total Posts : 294
   Posted 3/19/2017 3:53 PM (GMT -6)   
Hi Karen and Molly, and thanks for the welcome back smile

Yes, time does fly...it has been a year...hard to believe. I find it interesting that you noticed my upbeat note because I had a difficult
winter with significant depression, but because the new brand of
fentanyl is working so good I have been feeling a great deal better,
both physically and mentallysmile

It was after two weeks of feeling better on the Mylan that I remembered your post that started this thread, and that is when I decided to add my news to this thread. This method of sharing that
we use at HW is what makes it work so well imho. There is a huge
amount of experience in the cyber-pages of HW smile

Lupin asked me ( just now - she is right beside me ) to say hello to
Molly and you. She loved the chin rubs ( she is a smart and sensitive lady ) and asks that you reciprocate with Molly. I'm very
very glad that Molly is over her sickness. It is so heart-wrenching when our pets are not well...

Just as Molly means the world to you, so too does Lupin to me. I'm so happy that both are doing well...

It's good to be back and I plan to stick around.
All the very best ;
Derwood and Lupin. smile

DianeB
Veteran Member


Date Joined May 2013
Total Posts : 1340
   Posted 3/27/2017 12:49 AM (GMT -6)   
Glad you are doing well!! (My doctor writes the brand name on my prescription)
Herniated cervical discs & other disc / spine issues, Arthritis, spurs
Injuries &/or pain to/in shoulders, elbows, wrists, knees, legs, ankles
Fibro / myofascial pain, neuralgia, neuritis

Derwood
Regular Member


Date Joined Jun 2016
Total Posts : 294
   Posted 3/27/2017 5:32 PM (GMT -6)   
Thank you Diane smile

Do you have a preferred brand, or are you on the same one you started on? I'm just curious to learn more about this difference that quite a few of us notice.

All the best Diane,
Derwood and Lupin smile
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