Tag Archives: what is Butrans

Week 3 on Butrans patch, Side effect?

Just wanted to check in and give an update about the Butrans patch in case anyone out there is either on it themselves or is thinking about it.  This is my 3rd week on the patch.  My pain level is definitely decreased and I don’t feel those “peaks and valleys” like I used to on just the oral pain meds.  One drawback is that on Saturday in the late morning I feel a little sick to my stomach until I change the patch and I can’t help but wonder if that is withdrawal from the patch losing effectiveness after a full week.  Once I put a new patch on, I am fine inside of 30 minutes.  If that’s true, I am really concerned about the day that I stop using it entirely, that the withdrawal will be pretty bad.  I have had no problems with the patch staying sticky.  So far it’s been on my upper left chest, and under each of my arms on my side.  Right now it’s on the left.  My instructions were to keep it heart level and above and not put it on my back.  The website said you can use a specific type of medical tape to secure it if it starts to fall off but even with showering every day, it stays stuck until I take it off.

The only other thing I have noted is a very odd rash that started on my calves and has now moved all the way up both sides of my legs, my stomach and chest and back.  It’s not itchy at all but extremely unsightly especially in the summer.  The rash is composed of fawn/pink patches, some with a clear spot in the center.  The fact that it is spreading has me concerned, so far it’s not on my face or arms so no one can tell I have it unless I am wearing shorts.  So, at least while I am work, no one can see it.  I work at the front desk of a doctor’s office so I wouldn’t want people to walk in and see me there and think I am contagious or anything.  I read that you are supposed to avoid becoming over- heated while using this patch.  The drug company website said to avoid sunbathing and hot tubs but it indicated that it was because it could cause the patch to release toxic levels of the medication into your system and cause overdose not that it would cause a rash to appear.  Of course, I live in SC where in the summertime it gets to be extremely humid, in the high 90% in humidity level on a daily basis and being the end of July it’s about to get very hot, each day will be approximately in the high 90’s through August so  in this environment how do I avoid over-heating?  When I sweat, I have noticed that this rash tends to form in those areas and hydrocortisone cream didn’t make any difference.  I will have to ask my Dr. at my follow-up appt on the 30th.  Other than that, I am happy with this course of treatment.  I feel closer to my old self than I have since I had the surgery in the first place last October 19th.  I have no trouble walking or standing or doing heavy housework like I used to.  If anyone knows anything about the rash I described please feel free leave a comment or email me at c.reed.cate99@gmail.com

As always,

Thanks for reading 🙂

24/7 Pain Managment in a Patch

I think I have finally found the right type of pain relief for me.  All this time, 16 years, of having a back injury the only thing I have been given are pills and the occasional Toradol injection in office which only lasts about 6 hours (it’s really just a strong anti-inflammatory).  Just when I was ready to give up on my pain management practice they completely surprised me by turning back into the empathetic staff that I remembered from when I first started seeing them.  Of course this was after I sent a strongly worded letter to them about the poor treatment I was given on the phone with their staff regarding that procedure I was supposed to have but in any case it worked.

My PA and I talked at length about the fact that despite all the different oral meds I have tried, I still have pain.  Then she said something I had never thought of.  When you take oral pain medication especially long-term what happens is this; you take a pill when you feel the pain, you feel better but then when the pain comes back you take another one so it makes you have “peaks and valleys”.  I really had never thought of it that way but it made sense to me immediately.  This explains why when I wake up in the morning I feel like the tin man from the wizard of oz, I literally feel like my lower back is locked up and I have to do some gentle stretching and take a pain med to be able to get going.  I am up at 530am and have to be out of the house by 640 to get to work on time so “I haven’t got time for the pain” to quote Carly Simon.   But I really don’t have time to be in pain, I have too much I want to do.

Her solution was to prescribe me a pain medicine in a patch form called Butrans.  I put one patch on anywhere on my body but above my heart, it stays on for a whole week and then I replace it with a new one.  This way the medicine is gradually absorbed through my skin into my bloodstream 24/7 so no more peaks and valleys.  She told me to expect it to take 3 days to build up to a therapeutic level in my system and once it did that, the level would remain constant as long as I kept wearing it.  She has written me an rx for a low-level breakthrough medicine in pill form but so far I have only needed 1 of those a day and rarely 2 and she allowed for me to take up to 3.  She also warned me that if I took more than the allowed 3 a day it would negate the patches effectiveness by shutting off the receptors.


Here is the run-down on Butrans from their website:  http://www.butrans.com/patient/medicationguide.aspx#loosen

Also on their website is a first-month free trial card as well as a $40 off card that would cover your co-pay for refills if it works well for you.  My first month was free and who can say no to free!

“What is Butrans?

Butrans is a strong prescription pain medicine that contains an opioid (narcotic) that is used to treat moderate to severe around-the-clock pain.


  • Butrans is for transdermal use (on intact skin) only. Each Butrans is intended to be worn for 7 days
  • Instruct patients not to use Butrans if the pouch seal is broken or the patch is cut, damaged, or changed in any way and not to cut Butrans
  • Instruct patients to apply immediately after removal from the individually sealed pouch
  • Apply Butrans to the upper outer arm, upper chest, upper back or the side of the chest. These 4 sites (each present on both sides of the body) provide 8 possible application sites. Rotate Butrans among the 8 described skin sites. After Butrans removal, wait a minimum of 21 days before reapplying to the same skin site
  • Apply Butrans to a hairless or nearly hairless skin site. If none are available, the hair at the site should be clipped, not shaven. Do not apply Butrans to irritated skin. If the application site must be cleaned, clean the site with water only. Do not use soaps, alcohol, oils, lotions, or abrasive devices. Allow the skin to dry before applying Butrans
  • If problems with adhesion of Butrans occur, the edges may be taped with first aid tape. If Butrans falls off during the 7 days dosing interval, dispose of the transdermal system properly and place a new Butrans on at a different skin site”

So far so good, I am on day 6 today with this patch.  Today I am feeling pretty achey but it’s raining and I usually have worsening pain when it rains.  All in all I am happy with the new treatment, As always thanks for reading and please feel free to ask if you have any questions.  Have a great weekend!