Can Fentanyl Patches Be Replaced Sooner to Improve Pain Control?

Have joined this site especially to write this post in the hope that it may benefit people. I am not a nurse or an administrator of fentanyl patches - I am a patient who has to use them so I know from experience the answer to the question. The answer is YES but probably after many things are taken into consideration. In my case I think it is because of living in the tropics that they do not last for 72 hours - extra heat and excessive sweating due to humidity and also probable side effects of Femara which may cause hot flashes and sweating. (I am not a health professional so I don't pretend to be certain of causes.) When I was on the patches at first I was mentally very muddle headed due to lots of drugs etc. I was on my own during most of the day time and went through hell not knowing why I felt so bad. Some times I was not so bad, sometimes I was mediocre and sometimes I felt like I just could not possibly go on any longer. I was in contact with health professionals but none of them could/would suggest anything to help me. Finally I worked out that there was a pattern to it all - a three day pattern! Day one was quite good, day two was so-so day three was abominable. I asked if I could have the patches changed every two days instead of three and have not looked back since! (Actually that is not quite true - when the wet season with its heat and high humidity set in this year suddenly I was living a life of one good day one bad day so we have now lowered the level of the patch slightly and change it daily. I hope this information is of use and prevents someone from going through the same torture that I did.

When those patches first came out, a DENTIST ordered one for a teenager after oral surgery. The boy died. They are NOT intended for people who need short term pain relief!

I once saw them used as a withdrawal medication for a patient who had been on a ventilator, sedated with fentanyl, for about a month.

As for my earlier posts, some people have reported that patches made by certain generic manufacturers work better than others. Most of the complaints have been about the Mylan patches.

Yes, it is appropriate and beneficial in some cases to dose Q48hr with Duragesic rather than Q72hr. While it is true that the manufacturer recommends 72hr we all know that people are different, circumstances are different, and there are times when we must be creative to meet the needs of our patients. There is good evidence that a practice of changing the patches every 48hr improves pt pain control with no increase in adverse events for some patients. Clearly in hospice the option of 48hr dosing is considered if our patients are experiencing increased pain prior to the normal schedule.