Hydrocodone/Vicodin conversion to Fentanyl patch?

Question

Hello,
I have been taking Norco 10mg, 4-5 times a day for about 3 months for chronic pain, legally prescribed of course [Norco is just hydrocodone like Vicodin, but without so much tylenol]. But the pain is still pretty bad, so I was just today prescribed the Fentanyl patch which is longer acting.

I haven't put one on yet because the included leaflet kind of scared me. It mentions that you need to be tolerant to opiates before starting the medicine so that your body doesn't accidentally overdose. Since I've been taking the Norco for a few months, I guess my body is somewhat tolerant. But in the instructions it lists the minimum doses of other opiates that you should be taking prior to starting so that it's not too much of a shock to your system I guess. It lists morphine, oxycodone, etc. but not hydrocodone. It's the same doctor and pharmacy that gave it to me that has given me the Norco, so I'd assume they'd know, but I didn't want to be too careful.

The prescription is for 1-2 patches every 3 days, at 50 MCG/HR each (Told to start with 1 first and see if that's enough). I'm not looking to overdose, and was hoping someone could shed some light on this a bit. Is my hydrocodone dose (40-50mg/day) enough to start this? Thanks!

Answer 1

The patch won't work for several days. You should take your vicodin with it for the first 2-3 days. There is a conversion between hydrocodone and fentanyl. However, it is rare for a person to go directly from norco to fentanyl, and so, it just not listed. You are on a reasonable high hydrocodone dose. You do have opiate tolerance if you've been taking Norco for 3 months.
Fentanyl is a very strong pain reliever. Hopefully, it will work and you'll be pain free.

Answer 2

This Site Might Help You.

RE:
Hydrocodone/Vicodin conversion to Fentanyl patch?
Hello,
I have been taking Norco 10mg, 4-5 times a day for about 3 months for chronic pain, legally prescribed of course [Norco is just hydrocodone like Vicodin, but without so much tylenol]. But the pain is still pretty bad, so I was just today prescribed the Fentanyl patch which is longer...

Answer 3

Fentanyl Patch Conversion

Answer 4

I hope it works for you.I have chronic pain from 6 back surgeries and after years of hydrocodone I tried the patch and it didn't help at all so I'm back on the pills.The problem here is my Doctor is only allowed to write 120 a month but he wants me to take one every 3 hours and that means I run out in 2 weeks.Makes life really bad for the last 2 weeks of the month.Good luck.

Answer 5

Been an RN for over 40 years, worked as an anesthesia tech to get through nursing school. NEVER, EVER cut a Fentanyl patch in half. The only patch you can safely cut in half is a Lidoderm patch. Sublimaze (Fentanyl) is a powerful anesthetic agent which directly effects the respiratory system and could leave you unable to breath. Your pain would go away, but the side effects are no good. I agree with what what someone wrote many years ago: when in doubt get your pharmacist to act as your advocate and call your doctor. Let the two of them hash it out for you! Good luck to everyone with the chronic pain problems.

Answer 6

Hello and I"m sorry your pain is not controlled! These patches don't work as quickly as pills because the medicine first must be absorbed into the tissues, and then it is released to your body. They therefore often take 12 hours or more to reach full effect. You should apply them as directed to clean, dry skin-no lotion etc-and it will help if you press down over the patch with your hand for 20-30 seconds to warm the adhesive and help it stick when you apply them. Because of the slow onset of relief, you may need a pill to cover your breakthrough pain. Please contact your physician as soon as possible. NEVER use more patches than directed! You may indeed need a higher dose than what he initially gave you, but you must work up to that dose as prescribed or it can have serious consequences, up to and including overdose/death. Please do call your doctor and explain your pain levels and concerns. There are several oral pain meds available that can be given with the Fentanyl patch. If the doctor does not hear from you they will assume you're doing fine. Blessings, cryllie

Answer 7

30mg of oral hydrocodone is approximately equivalent to 30mg of oral morphine. This does not mean you would use this to switch, when converting from one to the other you use about 50 to 70% of the equivalent (for safety) and adjust as needed.

The table in the package insert shows a starting dose of 12.5mcg/hour for a morphine-equivalent dose of 45-59mg.

So 1 or 2 of the 50mcg/hr patches seems high. Absolutely DO NOT put 2 patches on.

It it was me, I would not put one on either. I am not saying you would not survive using one patch, but I would not do it.

I would ask the doctor to reconsider. If you prefer, you could ask the pharmacist to contact the doctor for you. In the meantime, you can take a higher dose of Norco, at least until tomorrow. Do not exceed 12 per day, however.

Overdosage of Duragesic can cause life-threatening respiratory depression. Patches over 25mcg are labeled "for opiate-tolerant patients only" and can cause an overdose.

Do not cut a patch to get a lower dose, it will cause an immediate release of the drug which can be fatal.

Answer 8

Fentanyl Conversion

Answer 9

I would start off with the minamum amount with the patches maybe even cut one in 1/2 to see how your going to react to it.
I am takeing Vicodin and i am allso useing the Lidoderm patch for cronic back pain. I'll cut the patches up and use them accordingly.
I was concerend about all the medications that i was percribed to take each day. I asked a Doctor about what reactions i might get from takeing all this medication and he told me that i could take the whole days worth at one time and it would'nt kill me, however it would impair my driveing etc.

Answer 10

I have been on the fentenyl patch for about 3 years now.The doctor should have started you on the 25 mg..If you find the 50 is too much you can cut the patch in half.I do the 100's every 2 days.They are great for chronic pain but you will find that you will also need some other pain meds with it.If you would like to email me with any questions feel free.I do know quite a bit about the patch and chronic pain.My name is Linda and my email is ([e-mail] ) Feel free to write me and I will you as best I can.