Morphine patches. Any experiences?

[Germgirl]

Been having kidney pain for months & it's got to the point where I'm in constant pain.
Last week I was admitted to hospital (again) to treat my pain and a kidney infection. The antibiotics seem to be working but my pain relief issue is now being addressed.
I've been prescribed morphine patches (buprenorphine) rather than the Oramorph I was using as the 'hit' of oramorph makes it very difficult for me to live an anywhere near normal life. Hopefully the slow release morphine in the patches will cause less nausea & 'high' feelings.
Has anyone used these patches? Do they work? Are the side effects less than oral morphine?

I started BuTrans for chronic back and leg pain. I chose this as I hoped for more even pain control. I made note of all my side effects and when I needed additional pain relief over the weeks I used them.

It was evident in my case that at the beginning of the week I was getting plenty of pain relief and also itching a lot. By day 4-5 the analgesic effects were being lost. It is supposed to be even throughout the week.

More troublesome for me was the almost complete close down of bowel function. I don't mean constipation, either. After nearly two weeks of almost nothing and increasing weight, bloating and feeling pretty ropey I had four days of torrential diarrhoea. The patches were off by day two of this.

It's a shame. I invested a lot of hope that they would be a magical solution for me. However,mothers I know do love them. It's not so much the drug itself, it's just another delivery route. If you are happy to take oromorph regularly there's not much difference.

Nb if you visit the BuTrans uk site for professionals there is a very handy dose conversion chart. Good luck.

Thank you. It's BuTrans 20mcg patches I have. I was kind of hoping they'd be a miracle pain reliever too as everything else I've tried either doesn't work or has hideous side effects.
I stuck one on this morning so hopefully I'll see some pain relief in a couple of days
I don't 'mind' the oramorph as such but I find it gives me a 'high' and then a corresponding 'low' and a hideous morphine hangover, I daren't drive after using it & I'm often wiped out the day after too. I just want to live my life, it seems that I may have to adjust my expectations somewhat though.
I'm a bit very worried about the gastric effects you describe. Oramorph, indeed all opiates, slow my digestive transit down hugely, I'm expecting the same from the patches but I hope the effects aren't even worse.
Anyway, it's on now, I'm committed & I'll see how it goes.
Thank you so much for replying, I hope you've found some pain relief that works better for you.

Well!! The patch has been on for less than 24h & I feel completely spaced out. Really high. And I'm gurning & grinding my teeth.
On the upside, I slept through the night for the first time in forever.
No pain relief yet, which isn't good because I can't take anything else except paracetamol.
Hmmm, hopefully it'll all even out soon.

Germgirl, This is the page I mentioned before in case you haven't seen it. 20 micrograms is way above the recommended initialisation dose of 5 micrograms ( see dose initialisation). I started with 10 then added another 5 the second week. I might have ended up on 20 had I tolerated it. If you look at the chart you should be able to work out fairly easily what dose you are aiming at. I think a chat with your GP may be in order. However, my experienced GP was a bit out of her depth with this one, it's just not that commonly prescribed. It was me that located this conversion chart (actually another very kind mumsnetter!) and we worked it out together.

( I was looking to replace 180mg codeine, 150 mg tramadol and approx 5-10 ml oromorph/day)

I also suggest you keep a detailed record of any additional pain relief you need each day and side effects. As I mentioned these fluctuated a lot through the week for me. I have an appointment with another Pain Consultant soon and intend to discuss. The idea of a controlled release patch sounds fab but it's clearly not that straightforward.

For now I think you may (unusually diplomatic ) have started on too high a dose.

Sorry, should have added that a) overdosing on morphine is, of course a serious matter and b) my GP gave me a tapering regime of meds for the first couple of days until I was getting the analgesic effect. I think you've missed out on this.

I know! I read that page yesterday where it says to start off on the 5 patch & thought 'oh well, I'm sure my GP knows what she's doong, starting me off on the 20 straight away'. It appears I may have had a little bit too much confidence in my GP there!
Just had to leave work. I drove there this morning but I'm going home in a cab. I've been vomiting, my nose itches like hell, I'm spaced out & dopey.
I'll call my GP later.

Just been sick in the cab :(
Luckily I had a carrier bag with me & managed to get it in that.
Cab driver less than happy.
Thank you for your help Matilda. I will definitely call my GP later.

Well yesterday turned into a complete nightmare. I was high as a kite, not in a good way, vomiting every 10 minutes. I spoke too my GP & he said remove the patch.
He was annoyed that the other GP had started me on the highest dose & has prescribed me the 10mcg patches to start once the morphine has cleared from my system.
He also gave me some anti sickness tablets. (Metoclopramide) which have slowed the vomiting down to once an hour or so.
I've not eaten since Tuesday, havwnt managed to keep any fluids down since yesterday morning. Generally feel like crap.
I will see how the vomiting & spacey feeling goes today.
I'm very wary of trying even the lower dose patch but I need pain relief!

If you look at the dose chart you should be able to work out what you will need to top up your dose. For the first day I would think you need to take pretty much your normal dose, second day about half and by third just as and when. When I was getting good pain control I just didn't need anything additional though that was only a few days.

Keep records a see if a pattern emerges. Sorry you've had such a bad time. It makes me cross that not only did your GP get it wrong but the pharmacists also failed to notice it was too high a dose to start with. I hope you feel better soon. Do keep us posted on how it goes, I would try again if I could avoid the bowel trouble.

When ever I have 20mg I'm always sick on it and the day after I put it on just want to sleep. Try starting off with 5mg then as time goes on increase to 10mg then 20mg if needed. I've been in between 5 and 10 for 2/3 years though and still can't take the side effects of 20mg. Once you get the dose right you will soon see the better effects.

Thank you.
I've been prescribed the 10mcg patches but I'm (understandably I think) very worried about taking them. I'm seeing my GP about a completely unrelated matter on Monday so I will ask him to prescribe the 5mcg patches for me to start with.
Until then I'll continue with the codeine, oramorph and diclofenac.
I think that if I can get the disease right they'll be a useful tool, I just need to sort the dose.