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View Full Version : Wearing a patch for more than 72 hrs?



StaffWriter
05-17-2008, 10:48 AM
Hey guys. I've got this 100mcg/hr patch that has been on for exactly 71 hours. I would like to know if the patch would actually still be secreting fent into my system even though I'm approaching the 72 hour limit? Or does it mean that the patch no longer secretes exactly 100mcg per hour after the 72 hr. point? Does it just stop producing anything after the 3 days? How exactly does that work? BTW it's a mylan and I will be using the patch buccally (through the cheek and gums) after I peel it off. Also, I know many people have to change patches after 48 hours, so the time might be arbitrary. Respond at your leisure. Thanks!!

Papa Verine
05-17-2008, 10:57 AM
It's just that the patch won't be delivering exactly 100mcg anymore after 72 hours. The dosage being delivered starts to drop off after that point. There's a total of 10.2mg of Fentanyl in the 100mcg patch so after 72 hours there's still 3,000mcg left in the patch. Don't throw it away!

Princess
05-17-2008, 11:06 AM
Papa's right. The levels will start dropping off after the 72 hour mark.

StaffWriter
05-17-2008, 12:30 PM
Well, would it be worth wearing another day or should I go ahead and take it off to use buccally or sublingually?

Dan Steely
05-17-2008, 12:41 PM
ewww! jk i've done it. still gross though. If you don't need to, save it til you do or your tol is really low.

Princess
05-17-2008, 12:47 PM
I would take it off and save it until you are really in need.

Nate
05-17-2008, 01:07 PM
I would take it off and save it until you are really in need.

Yeah for sure, save the patches for when you run out.

Be careful, but when they are needed suck on them making sure not to swallow, (as fent is absorbed through the mucus membranes in the mouth, if you swallow it has poor bio-avaliability.) there is still lots of goodies in the patch so be careful, but this way no fent is wasted and it is there when you need it.

It is just pointless to keep it on after 72 hours as the levels of fent released are getting lower and lower.

StaffWriter
05-17-2008, 01:32 PM
Yeah, this is the only patch I have and I'm probably going to be going thru some pretty bad wd's soon. Thanks to you all for such good advice.

Princess
05-17-2008, 01:48 PM
WAIT! If that patch is all you have...I'd leave it on in that case... Fent wd's are the WORST! Maybe let it gradually wean out, it *might* make the wd's a little less intense.

Nate
05-17-2008, 01:53 PM
WAIT! If that patch is all you have...I'd leave it on in that case... Fent wd's are the WORST! Maybe let it gradually wean out, it *might* make the wd's a little less intense.

Do this, or you could always suck a little as needed sort of thing, but yeah if u wear the patch it should help taper you down, though be prepared to feel some w/ds after 72 hours cause the levels released get pretty low and they might not keep you well. Thats why I was saying maybe suck on it but I dont think it would last as long (self control would be needed). Id listen to PTO Mom though, she is one of the most knowledgable when it comes to fent.

StaffWriter
05-17-2008, 07:24 PM
Well, I meant it was the only patch I had but I have about 15 lorcets, 7 darvocets and 10 ultrams. I'm going to wean down with that and cut the patch into three pieces to use buccally. Thanks for the concern though. But in general, how long would it take for all of the fent to be released out of the patch if there's still 3,000mcg left after 72 hrs? BTW, I've only been on this site for less than a week and have received excellent advice. This messageboard is awesome. :)

Nate
05-17-2008, 08:02 PM
^^ I am really not to sure how much fent will be released after that length of time, they were only designed for 72 hours max, anyone have any ideas?

Glad you like opiophile, it is a great place, very INFORMATIVE.

wafflehead77
05-17-2008, 08:33 PM
I guess it depends on exactly how the fent is released from the patch. Does anyone Know? Osmolarity causing a concentration gradient? If this is the case, I would assume that once the gradient is neutralized, the patch would stop releasing the goodies.

I will have to look into this.

Princess
05-17-2008, 10:26 PM
By looking at the structure of the patch, it won't just "stop releasing" after 72 hours. There is gel left in the Duragesics after 3 days, however it would not be releasing at the same steady levels as it was prior to the 72 hour mark (same as Mylan, I would *think* yet the Mylans are made differently).

There isn't ANY way to give an exact amount that would be remaining after 72 hours. There are many studies that show certain things make the fent release quicker. So, if you've taken a hot shower/bath, used a heating pad, live in a hotter climate, have had a fever, etc.... more fent would be released from the patch. So to tell exactly how much is left is impossible to tell and will vary from patch to patch.

Young Professor
05-17-2008, 11:06 PM
By looking at the structure of the patch, it won't just "stop releasing" after 72 hours. .

The patch actually contains a little more med than 72 hours worth, just as a precaution....Call it "safety stock." Your 100mcg patch contains 7200mcg of fent + some extra as safety stock. PTO is correct in that it just won't stop at 72 hours. As long as there is med in the pouch, it will keep releasing at the same rate. I can't imagine, however, that there is more than about 10% extra. The manufacturer will include a little extra as a precaution, but because most users take it off at the scheduled time, they don't want to "waste" any by having lots of unused med in it. Wasted med = wasted profits.

I dare say, however, that most patches will actually run out early.....Especially this time of year. It's well documented that excess body heat causes premature dosing. Additionally, the patches were originally designed for patients with cancer and at the end of life.....Most were bed ridden. Therefore, the clinical trials showed the patches lasted a full 72 hours. A person just laying there will consume much less fent than an upward active person. Because the label was expanded, and now many non-cancer patients wear them, most report that they don't last the full 72 hours. Every 48 seems to be a much more practical dosing.

I have heard that there is a little fent in the glue as well, but I'm not 100% sure.

YP

StaffWriter
05-18-2008, 11:18 AM
^^^Well, there's obviously some left in the patch if you can chew them up after they have been used for three days. I just wanted to know how quickly the dosages fall because I contemplated keeping the patch on for another day. I have heard on bluelight that the patch uses a "concentration gradient" of some sort as it's way of filtering the medicine thru the patch. Don't know the exact mechanism, tho. I have an elderly friend who wears her patches for 5 to 6 days before she starts to feel her pain come back. That kinda tells me she still benefits from wearing the patch way after the 72 hour period. This all could be placebo, tho.

wafflehead77
05-18-2008, 11:34 AM
The patch actually contains a little more med than 72 hours worth, just as a precaution....Call it "safety stock." Your 100mcg patch contains 7200mcg of fent + some extra as safety stock. PTO is correct in that it just won't stop at 72 hours. As long as there is med in the pouch, it will keep releasing at the same rate. I can't imagine, however, that there is more than about 10% extra. The manufacturer will include a little extra as a precaution, but because most users take it off at the scheduled time, they don't want to "waste" any by having lots of unused med in it. Wasted med = wasted profits.

I dare say, however, that most patches will actually run out early.....Especially this time of year. It's well documented that excess body heat causes premature dosing. Additionally, the patches were originally designed for patients with cancer and at the end of life.....Most were bed ridden. Therefore, the clinical trials showed the patches lasted a full 72 hours. A person just laying there will consume much less fent than an upward active person. Because the label was expanded, and now many non-cancer patients wear them, most report that they don't last the full 72 hours. Every 48 seems to be a much more practical dosing.

I have heard that there is a little fent in the glue as well, but I'm not 100% sure.

YP

The Duragesic patches contain, on average, 28% more fentanyl than is "needed" for 72 hours, assuming that the average release is consistent with that of the labeled strength.
The standard deviation is+/- 2%, with the 12.5mcg/h patch having the highest percentage of unused fentanyl, at 31% excess, and the 75mcg/h patch having the lowest %, with 25% after use.

There is a table on the Duragesic monograph expressing the actual amounts of fent, and the fent release/hour to cubic centimeter surface area ratio.

And the site does say that release is based on a concentration gradient, so as the potential energy of the gradient declines, so to the release of fentanyl across the membrane. So, it is possible to still have gel in the patch, and not have it release anything, as long as the gradient has been satisfied, since there is no energy for the drug to cross the semipermeable membrane.

Princess
05-18-2008, 11:40 AM
Hey Staff~

There is fent in the adhesive so even if the patch is bone dry, chewing it will give off some fent from the adhesive itself.

I'm not sure about any "gradient"...but I know for sure all over the packaging it clearly says be careful of heat as it will release the med quicker. There is no way go control this within the patch itself. For example it says not to use if you have a fever. Whenever I have a fever, the dr switches me to methadone.

I suppose it is possible for the patch to last 5 days in your elderly friend if they are constantly laying down with no change in body temp, no hot shower, etc... Once the fent is at the proper levels in the system, it doesn't leave the body as soon as the patch is empty....so it could appear to be working for a day or two after it is dry.

Even if I wear mine for 3 days and do the same activities every day... at the end of the week you can clearly see there is a bit more gel in one patch vs another.

wafflehead77
05-18-2008, 11:45 AM
Hey Staff~
There is fent in the adhesive so even if the patch is bone dry, chewing it will give off some fent from the adhesive itself.
I'm not sure about any "gradient"...but I know for sure all over the packaging it clearly says be careful of heat as it will release the med quicker. There is no way go control this within the patch itself. For example it says not to use if you have a fever. Whenever I have a fever, the dr switches me to methadone.
I suppose it is possible for the patch to last 5 days in your elderly friend if they are constantly laying down with no change in body temp, no hot shower, etc... Once the fent is at the proper levels in the system, it doesn't leave the body as soon as the patch is empty....so it could appear to be working for a day or two after it is dry.
Even if I wear mine for 3 days and do the same activities every day... at the end of the week you can clearly see there is a bit more gel in one patch vs another.

The reason the doc switches you to methadone is that body heat effects the rate of absorption. Without changing the gradient, you can change the rate of release if it is "easier" to move the substance across the membrane.

ndoftaworld
05-18-2008, 11:50 AM
*Sniff*, gosh i wish my doc would have gone ahead and given me the patch. But, aren't they expensive? He might be waiting for me to get disability/medicare b4 putting me on something that I will become dependent on instantly and possibly not be able to afford more. Just would have been so much easier, 1 patch 2-3 days, instead of oc's sort of helping the pain and having to take them 2x a day.


Nd

Princess
05-18-2008, 11:58 AM
Oh, I know why I get switched to 'done. I've been on fent for 4 & a half years. I'm trying to answer the OP's question... the bottom line is that there is NO WAY to tell exactly how much fentanyl is left in the patch after 72 hours of wearing. It will vary from patch to patch, from person to person.


The reason the doc switches you to methadone is that body heat effects the rate of absorption. Without changing the gradient, you can change the rate of release if it is "easier" to move the substance across the membrane.

ND~ I get mine free thru the Patient Assistance Program. If you need the info, just leave a message on my profile :) It saves me over $1000 a month.

wafflehead77
05-18-2008, 12:05 PM
Oh, I know why I get switched to 'done. I've been on fent for 4 & a half years. I'm trying to answer the OP's question... the bottom line is that there is NO WAY to tell exactly how much fentanyl is left in the patch after 72 hours of wearing. It will vary from patch to patch, from person to person.
ND~ I get mine free thru the Patient Assistance Program. If you need the info, just leave a message on my profile :) It saves me over $1000 a month.

You are absolutely right. There is no way to tell exactly how much is left: everyone is different. It all depends on activity, climate, personal physiology, etc.

I see. You were stating there is no way to tell how much is left, due to personal variables. I was just explaining the actual release, and the theoretic remainder, when every variable is exactly controlled, ie not possible.

God_Albino
05-18-2008, 12:09 PM
if there's any possibility you might not be able to afford it in the future, dont even think about it. i wish i wouldve never got on it in the first place, kicking oxy is one thing, but the patch is a fucking animal

Princess
05-18-2008, 12:28 PM
Exactly! Thank you. I think the OP was looking for an exact answer as to how much is left after wearing for 72 hrs. There is no absolutely exact/correct answer.


You are absolutely right. There is no way to tell exactly how much is left: everyone is different. It all depends on activity, climate, personal physiology, etc.

I see. You were stating there is no way to tell how much is left, due to personal variables. I was just explaining the actual release, and the theoretic remainder, when every variable is exactly controlled, ie not possible.

wafflehead77
05-18-2008, 12:43 PM
Exactly! Thank you. I think the OP was looking for an exact answer as to how much is left after wearing for 72 hrs. There is no absolutely exact/correct answer.

It seemed like we were disagreeing, but no, just poor communication. Oh well, it all good.

Papa Verine
05-18-2008, 03:15 PM
I had the 100ug Mylan patches before and it says right on the packaging that they contain 10.2mg of Fentanyl. So, assuming they deliver exactly 100ug/hr. for 72 hours, there's 3mg left after 72 hours.

As it has been pointed out, they aren't so precise. But just to give you an idea of what could be left in it at this point...

I found a used patch lying on the ground in a CVS parking lot once and I picked it right up and started chewing on it. (You know you're a junky when...)

ndoftaworld
05-18-2008, 03:39 PM
I had the 100ug Mylan patches before and it says right on the packaging that they contain 10.2mg of Fentanyl. So, assuming they deliver exactly 100ug/hr. for 72 hours, there's 3mg left after 72 hours.

As it has been pointed out, they aren't so precise. But just to give you an idea of what could be left in it at this point...

I found a used patch lying on the ground in a CVS parking lot once and I picked it right up and started chewing on it. (You know you're a junky when...)

Yuck! U started chewing on a used patch not knowing who's skin it was stuck to for 3 days? U are braver than I am, by far. :)

Nd

Princess
05-18-2008, 03:41 PM
I found a used patch lying on the ground in a CVS parking lot once and I picked it right up and started chewing on it. (You know you're a junky when...)

That's fucking hilarious!
:) :) :)

wafflehead77
05-18-2008, 06:24 PM
I had the 100ug Mylan patches before and it says right on the packaging that they contain 10.2mg of Fentanyl. So, assuming they deliver exactly 100ug/hr. for 72 hours, there's 3mg left after 72 hours.

As it has been pointed out, they aren't so precise. But just to give you an idea of what could be left in it at this point...

I found a used patch lying on the ground in a CVS parking lot once and I picked it right up and started chewing on it. (You know you're a junky when...)

That's great! Did you get anything from it?

Young Professor
05-18-2008, 07:20 PM
I had the 100ug Mylan patches before and it says right on the packaging that they contain 10.2mg of Fentanyl. So, assuming they deliver exactly 100ug/hr. for 72 hours, there's 3mg left after 72 hours.

As it has been pointed out, they aren't so precise. But just to give you an idea of what could be left in it at this point...

Yes, and as many have discussed, the dosing isn't consistent. Metabolism, for example, plays an important role. My guess is the reason they include up to 30% extra is to ensure one gets med for as long as possible. If your activity level / metabolism is higher than average, you will draw more med throughout the entire dosing period, thus, the safety stock plays an important role.

Lastly....Not to make this more complicated than what it is already, you have to keep in mind my post on "brands vs generics." According to the Hatch-Waxman Act of 1999, the FDA permits generics to have up to 20% less of the active ingredient. So, depending on your patch strength, 20% (less) of a bigger number is a bigger number.

YP

Inspektahdek
05-19-2008, 01:59 PM
^^^Well, there's obviously some left in the patch if you can chew them up after they have been used for three days. I just wanted to know how quickly the dosages fall because I contemplated keeping the patch on for another day. I have heard on bluelight that the patch uses a "concentration gradient" of some sort as it's way of filtering the medicine thru the patch. Don't know the exact mechanism, tho. I have an elderly friend who wears her patches for 5 to 6 days before she starts to feel her pain come back. That kinda tells me she still benefits from wearing the patch way after the 72 hour period. This all could be placebo, tho.



I understand maybe an extra day but 2 days, hmm, might be that they have hair in the place they are placing it, not much but some to where it sticks to that and takes longer to seep in the skin, also; there might not be anything in the patch left but residual fent on the skin and is taking time to absorb. These are just educaed guesses though. the elderly person might not move around much and less activity-less heat and we all know heat speeds up absorption of fent.