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New Duragesic doseage New Duragesic doseage

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Unread 04-03-2006, 03:54 PM
12mcg Duragesic wonderful for tapering and not awful with 25mcg

My dr. prescribed the new dose of Duragesic patch. It's the 12mcg patch and makes tapering from 25mcg easier. However I actually had a lot of trouble tapering from 50mcg to 25mcg with severe pain so I asked if he could add some 12mcg patches and he fortunately did. So that means I'm on 37mcg not 25mcg like I tried and it's not as high as 50mcg. I'm glad that I could do this.
I remember one poster said.."The only caution I would offer is the profound opiate withdrawal I experienced when titrating from 50 mcg. to 25 mcg. It was awful for a few rough weeks yet not everyone goes through it and now they make a 12.5 mcg. patch to help in titrating more slowly. Good luck! Shelley"

I was so glad that after only three and a half days he prescribed the 12mcg to add to the 25mcg. I am definitely tapering and have been diagnosed with fibromyalgia so that makes matters worse since my cervical disc removal. I couldn't tell why I was still having spasms. Turns out I have spasms everywhere but I only really hurt in my trapezius muscles.

I used to get 25mcg and 50mcg patches together when I was on the 75mcg dose because it was easier to stick to my skin rather than just a huge 75mcg patch. Here's one link that shows the product and gives side effects, warnings, addiction info, and other stuff.

"While there is variation in dose delivered among patients, the nominal flux of the systems (12.5, 25, 50, 75, and 100 mcg of fentanyl per hour) is sufficiently accurate as to allow individual titration of dosage for a given patient. The small amount of alcohol which has been incorporated into the system enhances the rate of drug flux through the rate-limiting copolymer membrane and increases the permeability of the skin to fentanyl."
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Unread 04-03-2006, 04:38 PM
New Duragesic doseage

The only time I had a problem with withdrawl was when I stopped the patch totally. I started on the 25mcg, went to the 50mcg. After some time I went back to the 25mcg and did not have withdrawl symptoms. I've been on the 25mcg for several years now.

I'm glad you've found a doseage to help you. And it is good that there is another doseage out there.
Unread 04-03-2006, 07:57 PM
generic vs. brand and tapering

Yes it is so good that there is a lower dose out there for tapering. I have to add that I did not need any surgery due to the numbness of my last three fingers. It was cubital tunnel syndrome. Basically the funny bone got irritated and pinched off the nerve and took a couple months to heal. My last appt with a hand surgeon told me that I would not need any surgery. I'm so happy about that. I do still change the patches every 48 hours as it seems to be better that way since 72 hours seems to rough. Man I don't know how it will be when I will go off the patch completely. Maybe I could try to go 72 hours first just to see if I could taper or have any withdrawl. I will probably stay on the 37mcg dose for a few months like I did with the 50mcg and then go down to the 25mcg and then down to the 12mcg. So maybe another 10 months at least before I'm off this stuff maybe? It took me five months to go from 50 down to 37mcg. If I continue to do well with my other medications that include a medicine with serotonin and a sleeping medicine it may be shorter time before I'm off the patch. I just don't know. Maybe I need to find a fibromyalgia support group or maybe there are some fibro patients on here. I'll have to ask.

As for generic vs. brand name, I prefer the brand name patch. I noticed that the generic wasn't working as well and I couldn't understand for the life of me why I was hurting so much while on vacation last year for three weeks away from my PM dr. Not a good situation to be in. Anyway after getting back on the brand name of the Duragesic patch I felt much better. As for the 12mcg I called the pharmacy before going there to make sure that they had it and at first I was told they had two boxes of generic. I tried another pharmacy and they didn't have any so after I got the script from my dr's office I again called back the first pharmacy and they said they had one box of the brand name Duragesic patch 12mcg. Well when I got there they had actually two boxes of the patch and one of the girls said that the 12mcg is only available in brand name. I was thankful for that but would have accepted generic if I had to because I was really miserable. Another thing, it doesn't matter how much breakthrough meds a person is on when going from 50 to 25mcg. I was taking about 2 to 3 pills at most sometimes only half a pill at a time while on the 50 and that's when the dr. and I decided it was time to go down to the 25mcg. I'm happy but after the third day I was miserable. I did call two days after being on the 25 to let them know that I wasn't doing well and they said the dr. was out of town and wouldn't be back till Mon but to call back Mon if I still felt bad. So by Sunday am when I woke up to take another med around 2:00 I was in terrible pain and I had just applied a new patch on Sat morning and knew I had to go till Monday morning. I thought no way, I will just put on one of the "generic" 50 patch that I had left over and it held me over till I could get a hold of my dr's office the very next day. They said he wouldn't be in till the afternoon so I waited patiently but took off the patch at about noon so it was on just a little over 24 hours but I'm so glad that I had it available or I may have ended up in the E.R. I told the dr's office to mention some other things about my pain which were really bothersome and I was in tears because I hurt so bad. Well I got the call to call them back and they told me to come in and pick up a script. I thanked them and went on my way. I actually took off the 50 patch around noon and just put on a 25 mcg patch because the generic 50 wasn't working as well as the brand name 50 and figured I would be better to just go down to 25 if the dr. approved me for the extra 12mcg. I put on my first 12 mcg around 4:30 and did well. I'm happy with this arrangement and it's also better on my bladder a little.
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Unread 04-04-2006, 09:20 AM
New Duragesic doseage

I noticed one of the posts mentioned cutting the patch to reduce the dosage. I read that you should never cut a patch, as that may affect the delivery, and cause a much higher, and possibly dangerous, dosage to be delivered.
Unread 04-04-2006, 03:49 PM
New Duragesic doseage

It depends on what type of patch is it. If it's a reservoir patch than you cannot cut it. If it's a matrix type patch than it is doable. The Duragesic patch is a reservoir patch so cutting would not be a good idea. However, the generic, Fentanyl, is a matrix type patch, so while I wouldn't recommend it, it could be cut.
Unread 04-04-2006, 08:26 PM
New Duragesic doseage

HappyCM3, What was the "miracle drug" that you used that motivated you to stop wearing the Duragesic patch?
Unread 04-05-2006, 10:35 AM
New Duragesic doseage

Lyrica and Wellbutrin has helped me. There is another one that I tried called Cymbalta but it gave me severe urinary retention. I'm also taking flomax to help with the current retention I have until my next dilation before this summer. I have to go in for a follow up with the uro and I don't want to risk getting so tight that I can't empty my bladder.

Yes cutting the brand name patch of Duragesic can be really dangerous and I even read that death could occur on the info page attached to the box. Kind of scary. With the generic or matrix I didn't know that it could be cut. Hmmm... that was the patch I used till I could get 12mcg to make me more comfy. It only stayed on for a little over 24 hours.
Unread 04-05-2006, 07:30 PM
New Duragesic doseage

Happy CM3- what's your dose of Lyrica? Mine has been 200 mg but I'm struggling to take it at times due to tiredness and nausea. I tried dropping down to 100 mg but had some pain come back. I'm supposed to be on 300 mg but could not tolerate that dose at all . Thanks.
Unread 04-06-2006, 09:29 AM
New Duragesic doseage

My dose of Lyrica is 150mg twice a day. However when I first started taking it my primary care dr. gave me some samples of 50 and 75mg dosages. I have either been told by my dr. or have read that if you have to take a certain dosage per day it can be a lower dose several times per day. Example instead of taking a high dose twice a day you may want to see if you can take 50mg several times per day in order to reach your 300 maximum dose. Wow that would be taking one 50mg capsule six times per day but if it helps decrease your symptoms then maybe it would be better for you. Also if this is not possible or you don't want to take a capsule several times per day like one every four hours then maybe you could ask your dr. if he could prescribe something for the nausea if that's what bothers you most. I take zofran occasionally if I'm not feeling well. If you have a prescription drug plan I would try to get your dr. to write you a script. I had my dr. write me for 90pills 4mg to be taken for nausea as needed. My dr. did tell me that the maximum dose of Lyrica is 300mg per day and no more but the dosage could be reduced or taken several times per day if it causes me to feel dizzy or have other symptoms. Fortunately when I went from 50mg three times a day to 75mg twice a day and then 150mg twice a day I didn't have any symptoms. I do take the zofran in case I get nauseated due to other meds I'm on. Zofran does not usually cause a person to feel dizzy or sleepy. If you get phenerghan (not what I would recommend then it may list side effects on the box that it causes dizziness and sleepiness. I always will get sleepy if I take a phenerghan suppository. Another anti-nausea medicine that I took that caused me to feel sleepy was reglan. It was given to me in a very short dose before neck surgery to help prevent nausea and then the nurse stopped giving me the rest of it due to my allergy to compazine. Fortunately it didn't cause me to have a reaction but I did feel sleepy with the small amount that she gave me. I would see if you can get zofran. It is very expensive so if you have a co-pay then I would try that. As far as I know it's only available in the brand name. I have read that it is used to help prevent nausea in chemo patients.

It's worth a phone call especially since you have dizziness. I would not be comfortable driving if I were dizzy and if you were to get in an accident you could really be in more trouble. Please try and get a hold of your dr's office.

In the meantime you may want to check out these posts on nausea and zofran. Good luck to you. s

nausea after surgery

Get sick from pain meds, suggestions??

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