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Pain Management through the utilization of transdermal fentanyl

Sent to Health Experts June 21 01:04 PM

Does the placement of a duragesic patch affect the amount of medicine transferred into my system? I recently started on pain managment therapy utilizing duragesic patches. I'm on my 3rd patch, and each time, I've gotten different amounts of pain relief. I'm wondering if there are more effective placements for the patches, and where they are. I'm making sure the site is cleaned and dry, and if necessary free of any long hairs. I'm getting ready to put on my forth patch this evening, so I'm trying to determine if there are optimal places for the patch for maximum relief. The first patch I wore on the left side of my chest, about 2" below my collarbone, I hadn't gotten a lot of relief from the patch, but I thought maybe it was because I just started it. My second patch, I placed on the right side of my chest about right below the breast (even though I'm a man, it's still a breast.. LOL) I had felt wonderful, and almost completely pain free. My 3rd patch is on my left shoulder, and I'm not getting as much relief. I know you're not supposed to use the same site twice in a row. I don't want to have to go to my doctor and tell her I'm not getting enough relief, and have her give me a larger dose which may work anywhere I put it, but make me feel doped up though. I don't know if she'll provide me with anything for breakthrough pain or not, but that's a question she will have to answer. So if you know of some sites on the body which will most easily allow for the transdermal transfer of the medication, that would be greatly appriciated. Thank you, Joe

 

Optional Information:
Male , Age: 37

Already Tried:
I asked my pharmacist, but he said, oh, you can put it anywhere really.

Customer (name blocked for privacy)
Status:  Closed   Value: $5
Answer
June 21 1:14 PM (9 minutes and 55 seconds later)
         
REPLIEDCheck Mark
Based on the results of this study
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=1978306&query_hl=17&itool=pubmed_docsum
the rates do not seem to vary based on location - although there is considerable variability between different people.

I would just take note of where you seem to get the best effect. Chronic pain tends to be variable in many people - mood, weather changes, activity level, time of day - so I would continue to monitor it and record the location and effectiveness of patches. You could use it on the upper chest - moving it from one side to another side - and up and down to keep it from always being on the same piece of skin - to prevent irritation.

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Family Physician -- Doctor (MD) -- 99% Positive Feedback on 4128 Health Accepts
Physician with 22 years experience in Emergency Medicine / Family Medicine
Reply
June 21 3:22 PM (2 hours and 7 minutes and 34 seconds later)
         
Reply to Family Physician's Post:

I'm trying to figure out what probably 30% of the words mean in the above article, and if I'm reading it correctly (and interpreting correctly), that if the skin is cleaned well (but not rubbed to the point of irritataion) the patch would be more effective? I think it also said that if used on areas of "thinner" skin, I would get better a analgesic effect. I'm not sure though, if you could translate the page into layman's terms, that would be great.

Thanks,

Joe



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Thanks,

Joe
Customer (name blocked for privacy)
Answer
June 21 3:28 PM (6 minutes and 29 seconds later)
         
REPLIEDCheck Mark
Yes - Skin that is thicker - the palms and the soles of the feet for example are going to have less absorbption. As for the trunk - chest/back/upper arms/shoulders the skin is about the same thickness in all locations. Obviously there are issues with hair - which you are aware of.

One theoretical disadvantage ot some locations might be the likelyhood that the patch would come unattached from clothing and/or activity. If the patch became partially or completely dislodged (possible for example on a shoulder if you turned over at night) - you would lose a portion or all of the surface area from which to absorb the medication.

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Family Physician -- Doctor (MD) -- 99% Positive Feedback on 4128 Health Accepts
Physician with 22 years experience in Emergency Medicine / Family Medicine
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June 21 8:14 PM (4 hours and 45 minutes and 36 seconds later)
         
Reply to Family Physician's Post:

Okay, one other quick question, I know the adhesive can cause irritation, (I've felt it), which is why the site needs to be moved around. The one thing regarding the glue, is what is good for taking it off? It's been 5 days since my first patch came off, and I'm still unable to remove the glue that was left on the site.

Thanks,

Joe



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Thanks,

Joe
Customer (name blocked for privacy)
Answer
June 21 9:17 PM (1 hour and 2 minutes and 58 seconds later)
         
ACCEPTEDCheck Mark
You can use baby oil or commercially available skin adhesive remover pads (ask you physician to order them for you through a medical supply or pharmacy)

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Family Physician -- Doctor (MD) -- 99% Positive Feedback on 4128 Health Accepts
Physician with 22 years experience in Emergency Medicine / Family Medicine
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