Can I get info from anyone that's used the duragesic patch 50 ?

Question

I have bad back problems, in the last year I have used the following meds for pain: all strengths of lortab, vicodin, & percocet. darvocet, demerol (sp?), morphine 30mg, oxycontin 40mg. then for muscle relaxers: valium 10mg, soma, robaxin (sp?), flexril (sp?), and skelaxin (sp?). So far oxycontin 40mg has worked the best, but it's still not anything great & super expensive...it's just better than the other painkillers ive tried. as far as muscle spasms Soma is the keeper, i'm happy eventhough my insurance wont even cover it. i've had issues with my insurance covering anything above percocet so im weary of trying expensive meds that i might be wasting hundreds of $ on. my Dr just recommended i try duragestic patch 50, vicodin for breakthrough pain and Soma. i am not familiar with the patch at all and am looking for info from people who have used it, not just the general info i've found on the 'net. I'd appreciate any help at all.

*my awful, cheap insurance does not cover the generic version of this patch, i've already priced the generic patch & it's $178
*along w/the patch (50 strenght) my PM Dr is prescribing vicodin 7.5 for breakthrough pain and soma for muscle spasms.

*my insurance does NOT cover the patch (generic or brand), i have to pay. they dont seem to cover anything above percocet. for example oxycontin is only covered for patients with cancer or AIDS. and my PM Dr has written to them, they just wont budge. i have tried lots of other meds, believe me,. i didnt just jump to meds that are expensive & aren't covered by my insurance seeing as i'm unemployed (therefore broke) due to my back pain.

Answer 1

We use it a lot in the nursing home I work at for people with chronic pain. Usually we start them on a low to mid dose of 25-50 mcg. The patch is changed every 3rd day and releases a continuous stream of pain medication in to your blood stream to provide pain relief 24/7. When you first put the patch on it takes about 13 hours to start being effective but once it starts working you get continous pain med in your blood stream. The Vicodin aka lortab aka hydrocodone/APAP is what you would use if you have pain that the med is not covering aka breakthrough pain along with the muscle relaxer as needed. I would recommend trying it but get your doc to get it approved by your insurance company so you don't have to pay full price out of pocket. It is available as a generic patch now called fentnyl. Hope this info is helpful.

Answer 2

The Duragesic patch releases fentanyl (the actual pain reliever) into your system. You should be glad that the doc is giving your med for breakthrough pain, as it can take up to 17 hours for the Duragesic to 'kick in' or reach it's level in your system.

You may expect the same side effects that you had with other narcotics, especially constipation; given that you'll be taking the double-whammy of Vicodin ES and Duragesic.

But, that's a VERY manageable problem. Get yourself on a bowel regimen. Glad to hear that Soma works. Oftentimes, insurance companies will cover a med (in this case Soma) if the doc (pain med doc) writes a letter of medical necessity.

They really don't want you to be in pain; they just want to know that you've tried less expensive meds and they've not worked. They have a 'bottom line' but they do have breathing room.

Back to the patch; never cut it in half; let's say, if the physician says you need to increase the dose to 75. You could get an immediate release of that much fentanyl into your system and it someone else is helping you change the patch, don't let them get any of the 'sticky' stuff on their fingers.

Surprised that insurance will cover Duragesic but not Soma. Last I knew, Duragesic was incredibly expensive! But, we needed to use what worked.

Best of luck in managing your pain; remember these meds are just masking the pain. Hope you're working to find the CAUSE of the pain.

Answer 3

First you do not state what type of 'back problem?' I have psoriasis; skin condition, rheumatoid arthritis, scoliosis sideways curvature of my spine and last year a MRI reveled the Discs in the spine have bulged. At that point my Doc prescribed Durogesic transdermal fentanyl patches. He stated 'Now looking at long term pain relief', while I was hoping for surgery. I was already taking evening primrose oil, anti-inflammatory dual release, valium, so on with the Patch. First three days I was unable to keep anything in my stomach, food, liquid, nothing and had to see a on-call Doc who told me to 'stop' using the patch and gave me a injection. After the injection all the nausea went. I was never one for popping the daily pain medications, perferred to see how long I could last. My CBC, or white cell count was always up in the 20's and as soon as I started the patches it came down to 11%, which I guess proves the amount of pain and stress I was under. I had no problems with the patch, change it every three days, attend Aqua Jogging, go to the Steam and Sauna, my only complaint trying to open the sealed foil pouch the patch comes in and taking the plastic backing off it. I also have problems removing the 'old patch'. I was starting with pains in my hands and feet, what they call neuropathic pain, so they added Lyrica, which nailed it. However it is important that you exercise the back. I did Pilates for Nine Months, learned about posture, exercise and now I am Aqua Jogging, kinda Pilates in water. The patch enables me to maintain a quality of life that I enjoy, being active!

Answer 4

I was on the duragesic patch for three years. It does give you a continuous dose so you won't have the lows and high like with oral medication. Constipation can be a major problem. Myra lax is good for that. The worst thing with the patch is that it doesn't always stay stuck. I had to use alot of medical tape. Also it can cause skin problems from the adhesive. There is only so many places you can put them. But if you can afford it they are definitely worth trying. Also talk to your pm dr about a spinal cord stimulator or an intrathecal pain pump. Good Luck.

Answer 5

Chronic acute pain of any kind is debilitatiing, affecting all areas of your life. Like you I've been on all sorts of meds over the past 30 years trying to control it. I have degenerative disc disease along with osteoarthritis, spinal stenoes, etc. in my lower back as well as my neck, along with Fibromyalgia and degenerative knee joints (need surgery in the near future). The patch is very similar to Oxycontin. It works very well for some people and not so hot for others. My doc has told me I may need to take a vacation at times to keep the meds working effectively (trading out one med for another). Oxycontin is also now available in a generic version so ask your pharmasict about that. I am currently taking 40 mgs. oxycondone ER (Oxycontin 40 mg) 3 x's day - with oral transmucosal fental citrate (Actiq Loz 400 MCG) that is dispensed in a quick acting sucker format for break through pain. Since the acute phase has gotten better, I'm ready to quit using the fental suckers and go back to one of the other short term drugs again. As others have mentioned, getting a letter of medical necessity to your insurance co. will often make meds they wouldn't prevously cover available to you. I am well known to the folks at my insurance co. as I call and question everything that they don't cover, persisting to get an answer on how I can get it covered or what other drugs they will cover. I have had the best luck with getting my meds covered now that I'm in a good pain management program. I've also had epidurals, facet blocks, and radial ablation in my lumbar spine. All of those treatments worked for a time to help decrease the acute phase of the pain. I will continue to use them as needed to help keep the acute pain more tolerable. The use of exercise and physical therapy have caused major improvement in my quality of life. When the insurance company sees that you are actively pursuing treatments other than just pain pills, that also will improve your chances of getting those pills covered. Pain treatment is expensive, but necessary if you are to ever be able to return to work or have a quality of life that makes life worth living. This isn't an easy path. Keep trying different treatments and don't just go for the pills. My former husband refused to follow the doctors recommendations for other treatments and is now in serious trouble with pain control. He's 50 yrs. old, hasn't worked or done anything orther than watch tv for 5 years. I was no longer able to effectively treat my pain and the depression that it can cause with him taking all of his medication too soon and then searching for my pills. I had to leave and let him become responsible for his actions and allow myself the opportunity to obtain that better quality of life I had worked hard to achieve. After 6 weeks I can already tell a difference! Keep the faith and follow whatever program they offer you. If it doesn't work, let them know so they can try something different. It's a different plan and program for each person. Best of Luck!

Answer 6

Patients must be told that DURAGESIC® patches must be implemented to intact, non-angry, and non-irradiated epidermis on a flat floor such because the chest, again, flank, or higher arm.