How long does the Duragesic take to get into system

[brians2000]

On Thursday of last week my doctor changed my Avinza 90mg to the Duragesic patch 50mcg. I was surprised that we went to 50mcg instead of the 25mcg that I was on prior to switching to Avinza 90mg. I have looked at a morphine to Duragesic chart and it recommends the 25mcg instead of the 50mcg. I put my first patch on Thursday evening even though I took my Avinza earlier in the day. Tonight I used a second Duragesic Patch at 72 hours and I am hoping it starts working soon. I was in so much pain last night and almost all of today. How long before I start getting relief? The only thing I have got so far was a rash where my first patch was. Please tell me if you like the Duragesic over Avinza and why. Right now I don't like the patch near as good but maybe tomorrow will be different. Brian

[Spiney]

My pain doc switched me from Avinza 90 to Duragesic 50 and that was the correct dosage for me. I was switched because my med plan would no longer pay for Avinza. I use the generic Fentanyl patch made by Mylan because the Duragesic breaks me out too. I understand that the Mylan generic is the best generic. I have no complaints concerning strength or breaking out. Let your doc know about the rash as it will most likely only get worse. Best wishes.

[Pharmacist.steve]

By the end of the first patch... you should have 50% of the blood level that you should finally attain.. It may take upto TWO WEEKS for blood levels to peak and stablize..

Pharmacist Steve
www.chronicpainresourcecenter.com

[brians2000]

Originally Posted by Spiney

My pain doc switched me from Avinza 90 to Duragesic 50 and that was the correct dosage for me. I was switched because my med plan would no longer pay for Avinza. I use the generic Fentanyl patch made by Mylan because the Duragesic breaks me out too. I understand that the Mylan generic is the best generic. I have no complaints concerning strength or breaking out. Let your doc know about the rash as it will most likely only get worse. Best wishes.

Hello Spiney and others. I feel like it is working better now since I am on my second patch. I was also surprised at how expensive the Duragesic Patch 50mcg is. This med cost more than Avinza 90mg. When I start paying for my own meds I will switch to the Generic patch but right now i still have insurance that pays for brand name. How does the Mylan compare to the original Duragesic patch? thanks, Brian

[CODDLING REQUIRED]

It takes awhile for the full effect of the Duragesic patch to be appreciated.I was on about 6-8 hydrocodones a day when it just wasn't doing much anymore.I too was switched to the patch.I hated it at first also but what I can tell you is this. The pills give you a relief you can identify as you can feel the effect come and go.The patch seems slow to start but if you are consistant and keep a fresh one on every 72 hrs. you will have steady relief without the drop off...like when you get up in the morning etc...
It is possible that 50mcg.s may not be enough for you over time.If so they will increase you to 75mcg. or 100mcg. which is my dosage and what started as 25mcg.
Just a word of caution.Don't forget your patch! If you miss a day, trust me you will get very sick and it will take you a full 24 hours for it to get back in your system.I found out the hard way once when I was unable to get my script filled! I threw up so many times I lost count.On the flip side, if there was any doubt of how potent they are, you quickly find out when all that pain you have kept at bay come rushing back.
I was diagnosed with a malignant tumor in my breast that had metastisized and had reached my lymph nodes.During 6 months of chemo. I developed fibromyalgia in 2004.It has been hard for me to wrap my mind around the concept that I have the cancer under control but this fibromyalgia thing will never go away.I guess I keep hoping to wake up one day and the pain will be gone...but that never happens.In time you will like the patch.And yes the price without insurance is like 439.00 for a months supply.Best of luck to ya.

[Maggie]

I use the generic patch and I have to change mine q. 48 hrs. The difference in my co-pay is $100.00 for brand and $11.00 for generic. Problem is that next year hardly any of the Medicare Part D ins. companys have coverage for the period they call the "gap". They show on the printout that they pay $1,200.00 for the 90 day supply. I am still trying to figure out what I am going to do about that.

By the way, last month I decided to see if I could manage my pain with lortab 10 q. 4 hours without the patch. Strange thing, I went for two weeks without the patch and didn't have any sign of withdrawal. Although the oral meds didn't control my pain, I am really puzzeled as to why I didn't feel different
.
That isn't something I would advise anyone else to try, but I have been at this level for two years and was curious to see if my basic pain situation had improved.

[brians2000]

CODDLING REQUIRED mentioned I may have to go up in dosage which I have heard many times but does everyone end up having to increase their duragesic patch strength. I was on Avinza 90mg for four years without an increase. I have read where at least 10 forum members start out at 25mcg of the patch and are now on 150mcg although their pain hasn't increased that quickly. Does your body just get used to the Duragesic quicker than morphine. Sometimes I will only take half of my 90mg Avinza by sprinkling some over applesauce and I have no withdrawal when I do that. A year ago I wanted to see if my pain level has decreased so I told my doctor I would like to try short acting meds for one month. He prescribed Lortab 5mg four times per day. I didn't go thru withdrawals but I found I could no longer work because my pain was still very much there. Anyway I may end up going back to Avinza if my Duragesic patch decides it is time for an increase. I am in some pretty bad pain but nothing like the pain I was in right after my surgery. I know my pain could be a heck of a lot worse and I don't want to keep increasing my dose unless my pain gets worse. I would hate to increase my meds because they stopped working as well although my pain hasn't increased. Does that make sense. I would rather just switch meds if I become tolerant from a certain strength of meds.

[Pharmacist.steve]

Increase in opiate dosage is normally due to three things. Drug tolerance, disease progression, increased activity. Since you were on a stable dose of Morphine for those years ... it would be expected that just going to Duragesic would not change things. BUT .. anything is possible..

Pharmacist Steve
www.chronicpainresourcecenter.com

[DiMarie]

Originally Posted by brians2000

On Thursday of last week my doctor changed my Avinza 90mg to the Duragesic patch 50mcg. I was surprised that we went to 50mcg instead of the 25mcg that I was on prior to switching to Avinza 90mg. I have looked at a morphine to Duragesic chart and it recommends the 25mcg instead of the 50mcg. I put my first patch on Thursday evening even though I took my Avinza earlier in the day. Tonight I used a second Duragesic Patch at 72 hours and I am hoping it starts working soon. I was in so much pain last night and almost all of today. How long before I start getting relief? The only thing I have got so far was a rash where my first patch was. Please tell me if you like the Duragesic over Avinza and why. Right now I don't like the patch near as good but maybe tomorrow will be different. Brian

My family ember is on Duregesic a long time. The doctor did recognise that there is not a full good coverage at 72 hours. By 60 it is pretty much gone, Also, after 48 hours they developed the rash. Really bad from generics.

Now the script is 48 hours replacement, (because of the rash) and There is still enough medication in the system while the new patch kicks in. There is no time of without the med until the next patch kicks in. Doctors that use this on the paitients generally observe the reduce effect long before the 72 hours. Just finding a doctor taht accepts and perscribes according to pain coverage needs.
Di

[brians2000]

Right now I am on 50mcg every 75 hours and it is fine the first week or two and hopefully it will always be fine. when I was on the 25mcg I had to change it every 48 hours and my doctor was fine with that. He knows me and knows I wouldnt want a change. Actually when he took me off my Avinza 90mg and changed it to the 50mcg patch I questioned him and told him I was on 25mcg about four years ago. He said going from Avinza 90mg to 50mcg was going to be easy. He told me he thought I would have a rough time trying to go from 90mg of morphine to a low dose patch such as the 25mcg. I guess he sees so many people wanting narcotics it surprised him when I asked for about a lower dosage than what he prescribed. I only did this to make him aware that I was on the lower dosage years ago incase he forgot about that. I am now on my fifth patch and I really like this even better than the Avinza. I didnt think I would be I do like putting it on and forgetting about it.