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Pain Management/Fentanyl Pain Patch question


My 85 year old mother-in-law is on the Fentanyl Pain Patch 25mcg/72 hours for several years now.  The doctor's office and pharmacy have gotten so strict on this medicine - the doctor's office won't give me the paper prescription until it is 2 days before the 30 days and then the pharmacy will not fill it until it has been exactly 30 days.  I understand the reason for the strictness.  What would help me though is if I had 2 or 3 days before she ran out of this medicine.  I would like to stretch out her patches if possible before changing them so I could get a few days in there for wiggle room.  I have a couple of 50mcg patches but I have already read you can't cut them in half.  So, would it hurt to keep a patch on her for 1 extra day every once in a while so I can get a few days in there for wiggle room?

I cannot recommend usingnthe patches for longer than is directed - she will probably have pain on the fourth day. I can say that i unserstand the doctor and the 3 day rule but tour pharmacist is being a tool.  There is no reason thaat they ahould make you wait until the 30th day.  Your grndmother is a very ow risk patient for abuse and fentanyl patches and very low risk for abuse and low street value drugs.  You should have a talk (rationally) with your pharmacy manager and qsk him if it possible to fill them when the doctor gives them to you.  If he refuses I would go to another pharmacy.  I think pharmacists who are overly strict with schedule 2 drugs are not providing the level of care that the patient deserves.

Best of luck.
Dr joshua

There is also the option of mail order pharmacies maybe associated with your granmothers insurance but another pharmacy is still your best bet.  I would say fedex the prescription to me and i would fedex back the medications but that is just as bad because it would atill take 2-3 days for the turn around. Unless u r in florida that is.  Are you?

Pain Management

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Dr. Joshua P. Cappuccilli


I will be able to answer most questions regarding pain management with medications, physical manipulation and trigger point injections.


My current pharmacy practice is specialized to manage challenging patients with chronic pain. I work closely with a number of physicians in the surrounding area to ensure safe and effective pain management while working to minimize the potential from drug abuse, drug addiction and drug diversion. My practice is approximately 40% chronic pain patients on long term therapy.

BA from the University of South Florida 1998 PharmD from the University of Florida College of Pharmacy 2008 AphA certified in Medication Therapy Management

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