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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Should A Butrans Patch Be Removed During A HIDA Scan?

I am using a 10 mg Butrans patch. I am getting a HIDA scan next week since utrasound showed 2 tiny stones and sludge in the gall bladder. When I made HIDA scan appointment I was told to stop pain meds 4 hours before the scan. A pharmacists at Butrans told me the patch has a 24 to 26 hour half life and if I need it out of my system it needs to be 3 to 5 days with no patch. He also advised me to call my doctor but doctor is on vacation. I spoke to a radiologist at the hospital who will be doing the scan and he said I can leave the patch on. I can not go without pain meds for an extended time. I was on Tylenol #4 but was recently put on Butrans patch due to high liver enzymes. So can I leave the Butrans patch on during HIDA scan. My hope is yes, but I also want an accurate assessment.
Mon, 30 Sep 2019
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Addiction Medicine Specialist,  's  Response
Hi,

Opiates change gall bladder tone. The pharmacist is correct of course although it is complicated. The drug in the blood has a much smaller half life BUT the patch is not only a pile of Fentanyl, it works by a pile of Fentanyl building up in the skin from the patch so removing the patch doesn't immediately end the drug being in you.

Hence, the good part is removing the patch doesn't stop it from working for quite a while and the bad part is the same. Furthermore, it works both ways. Once the drug is out of your system, it takes days for it to build up in the skin again.

You're likely to have 3 days without patch BUT 2 of those will be AFTER THE TEST AND THE PATCH IS BACK ON, but before the drug has had enough time to build back up in the skin and start getting into you.

Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Matt Wachsman, Addiction Medicine Specialist
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Should A Butrans Patch Be Removed During A HIDA Scan?

Hi, Opiates change gall bladder tone. The pharmacist is correct of course although it is complicated. The drug in the blood has a much smaller half life BUT the patch is not only a pile of Fentanyl, it works by a pile of Fentanyl building up in the skin from the patch so removing the patch doesn t immediately end the drug being in you. Hence, the good part is removing the patch doesn t stop it from working for quite a while and the bad part is the same. Furthermore, it works both ways. Once the drug is out of your system, it takes days for it to build up in the skin again. You re likely to have 3 days without patch BUT 2 of those will be AFTER THE TEST AND THE PATCH IS BACK ON, but before the drug has had enough time to build back up in the skin and start getting into you. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Matt Wachsman, Addiction Medicine Specialist