Hi all just been released from hospital as i had work done on the Nerve -Endings on my Stump .They reckon that it should ease the pain from the Prosthesis .Anyway i was discharged yesterday with a couple of packs of these pain patches .(Durogesic Transdermal Patches .) They apparently work for 3 days im was given the 50mcg /hr .It is a patch similar to the Nicotene patches .Anyway what i wanted to know has anyone used these before if so did they work and how were the side effects . Thanks Bungi.

How does it work?

Durogesic DTrans patches contain the active ingredient fentanyl, which is a type of medicine called an opioid analgesic (painkiller). The opioids are a group of very strong painkillers that are related to morphine.

Opioid painkillers work by mimicking the action of naturally occurring pain-reducing chemicals called endorphins. Endorphins are found in the brain and spinal cord and reduce pain by combining with opioid receptors.

Fentanyl mimicks the action of natural endorphins by combining with the opioid receptors in the brain and spinal cord. This blocks the transmission of pain signals sent by the nerves to the brain. Therefore, even though the cause of the pain may remain, less pain is actually felt.

Durogesic DTrans skin patches are used to treat relieve long-term, ongoing severe pain caused by conditions such as cancer, when other painkillers do not provide sufficient pain relief.

The patch is applied to the skin of the torso or upper arm and worn continuously for 72 hours before being replaced. The fentanyl is steadily absorbed from the patch through the skin into the bloodstream, to provide continuous relief from pain.

Some people may also require extra doses of a short-acting painkiller from time to time for 'breakthrough' pain.

What is it used for?


Long-term, ongoing severe pain due to cancer


Long-term, ongoing severe pain not relieved by ordinary painkillers


Warning!


Durogesic DTrans patches should be applied to a clean, dry, non-hairy, non-irritated, non-irradiated area of skin on the torso or upper arm. If you need to clean the skin before sticking on the patch use only cold water, not soap or other cleansers. Don't stick the patch on straight after a hot bath or shower, wait for the skin to cool down first, and don't use talc, creams or moisturisers before applying the patch as they may prevent it sticking.


Each patch should be worn for 72 hours and then removed. New patches should be applied to a different place on the torso or upper arm, and you should avoid using the same area for several days. If a patch falls off before it needs changing, stick a new one on straight away, and remember this replacement will need changing after 72 hours.


Removed patches should be folded in half, sticky side innermost, and placed inside the open sachet or a piece of tin foil, for careful disposal away from children or animals. This is because used patches may still contain some active ingredient that may be harmful to children or animals.


The patches should not be divided, cut or damaged in any way.


While you are wearing the patch you should avoid exposing it to external heat sources, such as hot water bottles, electric blankets, heat lamps, saunas or hot whirlpool spa baths, as heat can increase the absorption of the fentanyl into the body, resulting in a greater risk of side effects.


It is important that you carefully follow the instructions you have been given with this medicine.


This medicine may cause drowsiness and various other side effects that could impair your mental or physical ability to safely drive or operate machinary. You should be aware of how you react to this medicine before driving or operating machinary.


Alcohol should be avoided while using this medicine, as it may increase the risk of drowsiness.


If this medicine is used for prolonged periods of time, the body can become tolerant to it and it may become less effective at relieving pain. This means that with time, higher doses may be needed to control pain. With prolonged use the body may also become dependent on the medicine. As a result, withdrawal symptoms can occur if the medicine is stopped suddenly. For this reason, when a person no longer needs this medicine it may be necessary to reduce treatment gradually to avoid withdrawal symptoms.


Use with caution in


Elderly people


Weak or debilitated people


Decreased kidney function


Decreased liver function


Lung disease such as asthma or chronic obstructive pulmonary disease (COPD)


Slow, shallow breathing (respiratory depression)


Brain tumour


Increased pressure in the brain (raised intracranial pressure)


Impaired conciousness


Unresponsive unconscious states (comatose states)


Slow abnormal heart rhythms (bradyarrhythmias)


Fever (pyrexia)


Not to be used in


Acute pain

Breastfeeding.


There is insufficient information regarding the safety and efficacy of this medicine in children. It is not recommended for children.


This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.


The safety of this medicine for use during pregnancy has not been established. It is not recommended for use in pregnancy, particularly during the third trimester, unless considered essential by your doctor. Seek medical advice from your doctor.


Significant amounts of this medicine may pass into breast milk. It should not be used by breastfeeding mothers as it may be harmful to the nursing infant. Alternatively, mothers who need this medicine should not breastfeed. Seek medical advice from your doctor.


Label warnings


This medication may cause drowsiness. If affected do not drive or operate machinery. Avoid alcoholic drink.


Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.


Nausea and vomiting


Constipation


Drowsiness


Rash, redness or itching of skin at site of patch application


Headache


Low blood pressure (hypotension)


Slow, shallow breathing (respiratory depression)


Slow heart rate (bradycardia)


Confusion


Difficulty in passing urine (urinary retention)


Sweating


Itching


False perceptions of things that are not really there (hallucinations)


Feeling of well-being, optimism and cheerfulness (euphoria)


The side effects listed above may not include all of the side effects reported by the drug's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.
How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while using this one, to ensure that the combination is safe.

There may be an increased risk of side effects such as drowsiness, sedation, low blood pressure and slow, shallow breathing, if this medicine is used with other medicines that have a sedative effect on the central nervous system. These include the following:


antipsychotics, eg haloperidol


barbiturates, eg phenobarbital, amobarbital


benzodiazepines, eg diazepam, temazepam


general anaesthetics


muscle relaxants


other opioid painkillers, eg morphine, codeine


sedating antihistamines, eg chlorphenamine, hydroxyzine


sleeping tablets, eg zopiclone


tricyclic antidepressants, eg amitriptyline


The anti-HIV medicine ritonavir may increase the blood level of fentanyl if it is taken at the same time. This can increase the risk of fentanyl side effects, and for this reason this combination is not recommended unless the patient is closely monitored.

not sure mate,my gran is on pain releif patches(not sure what sort/dose)she has cancer. they are heavily supervised,even the used ones have to be accounted for.she seems well comfy.about time too.

Thanks for that Danzig .I read the slip that came with them i was just curios how it worked through the skin .I have only put one on this morning for the first time i wont be able to say if it works or not because of having had some Oramorph as i had a very bad night .Want to let that work of and see if the patches make a difference as ive really been struggling with the pain since i had my leg off .I hope that what they did in hospital works so that i can wear my leg and start getting around a bit .Anyways thanks Bungi .

There's a lady at my Occupational Therapy Art Class who uses Morphine patches - she says they're the only thing that lets her get around - she has a spinal condition.

Whenever my doctor gives me any meds she always tells me NOT to read the information slips as they will scare me she's not wrong is she?

I think they work by being contained in a "carrier" type substance that allows the absorption by the skin.

Hope they help your pain bungi.

Too right, some of those leaflets are terrifying

The worst I've seen so far have been for steroids and immune modifiers, although for sheer shock value you can't beat the original leaflet that accompanied Gabapentin when it was first released, which included "sudden unexplained death" amongst it's possible side effects Thankfully they've since taken that bit out.

Hope the patches help your pain, Bunji

Edit: Before I worry anyone taking Gabapentin I should probably point out that the "sudden unexplained death" referred to is actually a complication of a certain type of epilepsy, which Gabapentin was developed to treat hence its inclusion on the original leaflet