How long does it take for Duragesic Pain Patch to work?

[yobo626]

Does anyone know how long it takes to feel the effect of the pain patch? Thank you

[toolmaker]

It will probally take 8 to 12 hrs on the 1st dose before its fully in your system.

[Tuckamore]

Hi Again Yobo,

The fentanyl patch can take up to 8 hours before the full release of the medication is reached in your system. As I said in my earlier post it took my mother only 5 hours before she had failyy good pain relief. However in eightnhours her pain went from a 10+ on a scale of 1-10. At the end of five hours she was at a 4 and in three more hours she was at a 2-3.

So hopefully you will soon notice reduction of your pain level if you took this recently.

Good luck to you, Tuck

[Mollyrae]

The comments above are correct....8-12 hrs. for the full effect. When you wake up in the morning, you will feel the difference :-)

[stnick_77]

Hi, I was on the fentanyl patch for quite a while. And i guess it depends on the person, but usually it takes about 24hrs in order to get the full dose of the fentanyl in your blood stream...If you are in serious pain and can't wait hours for it to kick in you can put a heating pad on the fentanyl patch, the heat releases the fentanyl from the patch alot quicker, there for reducing the waiting period substantialy. Also..normally you will change the patch every 72 hrs, but at the end of 48 hrs you can put another patch on, and remove the old patch as directed, usually after 72 hrs. This will keep a continous level of fentanyl in your system, and according to my experience and my Dr. it is safe to do. Hope I could help!

-Nick-

[yobo626]

I only have a little relief. Is it possible this dose is not working? Thank you everyone for your help.

Amy

[C123x]

Ian with u on that.

[yobo626]

I have been on the 25mcg for 6 hrs with only a little relief. Is it possible to get more relief?
Thanks,

Amy

[Mollyrae]

Yes it is. Be patient. Like others have said, everyone is different.
Hang in there. I sent you a personal message.........

[Jaybay]

FYI - it's a real bad idea to put on a new patch sooner than the usual 72 hours unless your doctor writes that explicitly on the prescription.  If you run out too soon, you'll have a whole lot of explaining to do, and most pain docs will not be happy that you used this powerful of a medication inappropriately.  Taking more than prescribed of any pain medication can get you fired as a patient in some practices.

[Tuckamore]

Jaybay is so right. I know you are trying to be helpful. But please understand that at MedHelp we only take medications as our individual physician prescribes them. What your physician may prescribe for you, may not be right for Yobo.

It is never OK to change your patch early, increase your dose or take medications any other way than how they are prescribed. And as far as applying heat, it is not recommended in the packet instructions and therefore unless directed by her physician Yobo should not follow your well intended suggestion.

Take care, Tuck

[stnick_77]

Yobo asked how she could get more relief from her patch...I was not telling her to do anything illegal. I'm guessing you have never been on the fentanyl patch. Putting a new patch on at the end of 48 hrs is safe to do, and is recommended to do it that way by the majority of PM doctors. Because at the end of the 72 hr period when you remove the old patch, and apply a new one, it will once again take approx. 24 hrs for the new patch you jst put on to reach it's theraputic syrum levels of fentanyl in your blood stream, and people who really suffer from sever chronic pain that 24 hr waiting period is miserable. Also when you put a new patch on at the end of 48 hrs and leave the old patch on and then remove it at the end of 72 hrs. you are not double dosing, or getting more of the medication than you should beings that it takes approx 24 hrs for the fent. to get into your blood stream anyways. So by the time you take off the old patch at the end of 72 hrs, the new patch that you put on at the end of 48 hrs will just begin to start releasing the fentanyl into your system, therefore it does not increase the fentanyl serum levels at all. So...not to sound rude but before you try criticizing someone for giving advice that was asked for, you might want to make sure you know exactly what you are talking about, and get your facts straight.
-Nick-

[stnick_77]

....Also, by putting a new patch on at the end of 48 hrs. is NOT using more fent. than prescribed, beings that it takes 24 hrs for the release of the fentanyl in the blood, and nor is it using more of the medication than prescribed!  If you put the new patch on at the end of 48hrs and keep the old patch on, you will still be getting the dose of fent. prescribed from the first patch you applied, b/c the second patch is not releasing fentanyl yet, and will not release it for approx 24 hrs, the exact same time that you should remove the old patch at the 72hr mark! Therefore it is NOT over medicating nor is it abusing it in any way, shape, or form. I hope that you guys understand the concept of how the fentanyl patch actually works now.
-Nick-

[sandee1818]

Hi stnick_77,
    I believe the point that was trying to be made is that you should never take it upon yourself or from advice from someone else to alter your pain medication regime in any way shape or form from that in which the Dr has ordered.
I have asked someone who knows about the patch to stop by and clear up any misconceptions so I look forward to her input.
Thanks,
Sandy

[Mollyrae]

OK, Here's my two cents worth.

Putting a heating pad on the Patch is EXTREMELY DANGEROUS. And to tell a first timer using the patch is just wrong.......There are warnings 10x over in the leaflets that come with the box of patches that you should never use a heating pad over the patch.

I came across a story of a woman that used a heating pad over the patch to increase the effect and speed up the process....Well, she went to bed and never woke up....

So don't tell someone to use a heating pad...That's foolishness

[Jaybay]

I am not saying that changing a patch in 48 hours is unsafe.  Not at all.  What I AM saying is that your doctor must write the prescription that way.  My doctor writes mine to be changed every 72 hours.  If I change it every 48 hours, I will come up short at the end of the month.  If I used the patch in any way other than as prescribed, I would be in violation of my contract and discharged as a patient.  Some doctors are very unwilling to write this prescription for anything less than the 72 hours recommended by the manufacturer.  It's just a personal choice for the doctor.

And yes, I have used the patch for well over 3 years now and I do know whereof I speak.

Mollyrae is also right: putting a heating pad on a patch is very dangerous.  Heat causes the fentanyl to dispense too quickly, risking an overdose - particularly in new users.  It also results in the patch losing its effectiveness too soon beause so much of the medicine has already been dispensed.    

Some patients have a great deal of trouble with the heat issue if they go outside and sweat, have hot flashes, run a fever, or do anything that increases body temperature.  My personal experience is that any of the gel-filled patches dispense too quickly and run out too soon.  For me, the flat Mylan generic does a much better job of dispensing fentanyl at a regular rate over the entire 3 days.  The adhesive also works better for me.

The point I really want to make here is that no pain patient who is prescribed narcotics should do anything different with that medication other than prescribed.  If the treatment isn't working, you should talk to your doctor.  The last thing you want to do is take anyone's advice on the internet without first running it by your doctor.

[stnick_77]

I understand what you are saying, I'm not a Dr. and I have made that clear, I was simply stating what my Dr. had told me....and i dont really appreciate being criticized over a post that i left when all that I was doing is giving information that my PM dr. gave me...thats it, period. All i did was share a comment that was told to me by my doctor. When someone posts something on this website people SHOULD KNOW thats all that it is a comment, espcecially when i specifically said that that is what MY dr. told ME, and thats what  MH is all about, sharing your experiences. So if I all of you still think that I am wrong for sharing information that a physician told me, especially when I made that 100% CLEAR, than i am sorry.

-Nick-

[Jaybay]

Nick, nobody is criticizing you.  Tuck and I merely tried to point out to present and future readers that any change in medication use should be first approved by one's doctor.  My own doctor would never in a million years tell a patient to heat up a patch.  So I guess we'll have to agree to disagree on that issue.

[Mollyrae]

Nobody here is being critical...The information you gave to yobo was dangerous and I just can't believe the Doctor told you to use a heating pad when the warnings clearly state that you should avoid heat.....Especially heating pads....That Doctor is just plain wrong and I would question his practice.....I the future, when posting, please don't give dangerous information out. Be sure that what your suggesting is safe. I know you were trying to give helpful advise but please be careful when giving it.
Thank's, Mollyrae

Patches can be changed every 48hrs. Mine are prescribed that way because of my tolorance......

[sandee1818]

http://www.nytimes.com/2005/07/16/health/16patch.html


I had debated om whether to leave the post up about the heating of the patch and decided its better to leave it and make others aware of the dangers of heating these patches.
I have included a link on this from the New York Times about the FDA investigating 120 reports of death from misuse.
please read the article.

[stnick_77]

Sorry for the comments that I made. It obviously started a large controversy.....so in closing...I guess that all PM Dr. are trained diff. and prescribe and change instructions depending to the patient and severity of the pain. I never mean for anyone to try any or the examples that had have given, until you of course talk to your Dr. First, If you didnt talk to ur Dr. first that would jst be insane...I really hope i could clear this up....fell free to leave me comments.

-Nick-

[Jaybay]

Nick, you make a great point in that doctors are individuals just like we are, and not all of them follow the manufacturer's prescribing guidelines.  Once a medication goes to market with FDA approval, it's open season to be prescribed in any manner an MD sees fit.  In medspeak, that's called "off label use."  

I don't entirely trust any doctor or pharmacist's opinion alone, and take the time to look up the drug information myself.  Case in point being a steroid inhaler I was prescribed for allergies.  I got worse, and looked up the "words" on the medication and learned it was contraindicated for people with asthma due to allergies.  Using that thing for three days actually caused a whopping case of bronchitis and the doc was a tiny bit po'd with me for pointing out the problem.

[worried878]

scary stuff...fentanyl patches are...i had a patient once who took it off and chewed it up!  DEAD in a heartbeat and I had to all a code...it was my patient and i placed the patch on him...i had no way with my workload i could be in there 24/7 to check if he would chew his patch up and never dreamed he would have done this!  he died and i felt bad for some reason for a long time after...  so to me any type of quick release method on a patch spells DANGER to me after finding out just how strong those jokers are...young guy...years ago but i am guessing 28 years old at the time...i remember his b-day was nov 6th cos we talked alot...same as my sons.....awful experience...dont mess with patches.....and this is an addiction forum....not sure if this is ur area of need

[worried878]

yikes...i thought i was on the addiction forum!  LOL...u r in the right place...the pain forum....call me crazy but i am used to being on the other forum and saw this post...be safe and ask ur doctor anything u need to know...no one on here can heklp u like someone who knows u and sees u/knows ur history etc....no one should attempt ot give out medical advice to anyone on these forums as far as doses and usage of narcotics...perhaps a medhelp MD but still a good history would also be needed...please be safe with the patch...God bless

[downnout]

the 72 hours that the patch is supposed to be on takes into consideration those level that remain in your blood stream.at the end of 72 hours there is enough in your system to keep your levels in a comfort zone.that is why you put them on every 72 hours....and yes i put a 100 on every 3 days,and there is never a problem and that is why it is prescibed for every 3 days.after 48 hours is not the way it is to be done.the makers of the drug and the dr. prescibing it know what they are talking about and if they thought the levels would be to low to get a good "jumpstart" on your next patch they would have you change ity evry 2 days instead of 3.your body is not a diesel engine that has to be primed if it runs out of fent....there is plenty in you after 3 days to let the new patch start working so any suggestion that it is ok to put it on after 2 days to keep your level up is hogwash and the only thing that you gety is a good buzz for that double day that amounts to patch stacking.hope i didnt **** in anyones wheaties but thats the way it is......i know.

[sandee1818]

Jaybay,
  I totally understand your comment about the Dr being po'ed about your pointing put he made a mistake. This really gets me that some Dr's feel they are gods and do not make mistakes, they are human!
I had a Dr give me a prescription for Valium instead of the phenergan suppositories for my daughter. I was so mad because he insist to the pharmacist that he did no such thing and I even too the script which I copied for proof that he did and he still insisted that I altered it! I mean come on he gave me one script and it was for Valium in HIS handwriting!
I would have simply overlooked it had he admitted he made a mistake but I felt his obvious god complex needed an adjustment so I filed a complaint with the hospital and he was fired.
Doctors are human too and they can and will make mistakes, I tell people all the time YOU have to be YOUR OWN advocate and do not ever take one Drs word unless you trust that Dr.
I have caught mistakes by Dr's and pharmacist and thats because I am my own advocate and my children's. When I first started taking Oxycontin I had a prescription for 20 mg and the script said 20 mg but the pharmacist filled the 40 mg and when I started having adverse side effects I went to the Dr and he was like this should not be happening with this dose as I had a tolerance already from short acting opiates. He asked to see my script I filled and he was so irate when he realized I been taking double the amount he prescribed because of a pharmacist mistake. I did not know as it was my first time filling the script for this med.
You have to be knowledgeable and willing to ask questions and look out for yourself as people do make mistakes all the time.