Fentanyl is a potent opioid pain reliever used in transdermal extended-release patches to treat severe and persistent pain in people already taking opioids. Fentanyl also comes in other forms like injections, lozenges, and tablets, but these dosage formats contain fentanyl citrate. This article will focus on the use, dosage, and problems of fentanyl skin patches.
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No brand-name patch formulations are currently available
Formerly branded as Duragesic
Fentanyl
Pain relief
Analgesic, opioid
Transdermal skin patch
Absorbed through the skin
Pure fentanyl is only available as extended-release skin patches, which are used to treat severe, persistent pain in people who are already taking opioid pain relievers. A slightly different chemical version of fentanyl called fentanyl citrate is used for other pain conditions and anesthesia.
Fentanyl patches are only appropriate for severe pain in patients who have already been on an opioid regimen for pain.
Patches must remain in their sealed pouch until they are applied to the skin, and they should never be cut.
Patches should not be changed more frequently than once every 72 hours and should not be applied to the same skin area as the previous patch.
Patches must be kept away from children and disposed of according to the manufacturer's recommendation. Do not throw used patches into a trash can.
Fentanyl patches carry the risk of serious and fatal side effects, including respiratory arrest and death. You must only use fentanyl as directed by your healthcare professional.
Patch
12 mcg/hour
25 mcg/ hour
37.5 mcg/hour
50 mcg/hour
62.5 mcg/hour
75 mcg/hour
87.5 mcg/hour
100 mcg/hour
For more information about fentanyl dosage formats such as injections, buccal tablets, and lozenges, click here.
For severe and persistent pain in opioid-tolerant adults: One 12–100 mcg/hour transdermal patch worn for 72 hours
fentaNYL
1 patch 72 hour of 100mcg/hr box
fentaNYL
1 patch 72 hour of 25mcg/hr box
fentaNYL
1 patch 72 hour of 75mcg/hr box
fentaNYL
5 patch 72 hour box
fentaNYL
5 patch 72 hour of 100mcg/hr box
fentaNYL
5 patch 72 hour of 12mcg/hr box
fentaNYL
5 patch 72 hour of 25mcg/hr box
fentaNYL
5 patch 72 hour of 37.5mcg/hr box
fentaNYL
5 patch 72 hour of 50mcg/hr box
fentaNYL
5 patch 72 hour of 75mcg/hr box
fentaNYL
1 patch 72 hour package
Take your medicine as directed. Your dose may need to be changed several times to find the optimal dose for pain control.
This medicine should come with a Medication Guide and Instructions for Use. Please read both these inserts before starting fentanyl.
How to use fentanyl patches
Fentanyl patches are only used for severe pain in people already taking an opioid pain medication.
Your doctor will tell you how many patches to use, where to apply them, and how often to do so. The patient instructions can also show you the body areas where the patch can be used.
Do not use more than one patch at a time.
Before applying a fentanyl transdermal patch, remove the old patch and fold it up so the two glued halves stick together. Immediately flush it down the toilet.
Only remove a fentanyl patch from its protective pouch when you’re ready to apply the patch.
Always make sure that the dose written on the patch is the dose you’ve been prescribed.
Tear the wrapper open carefully. NEVER CUT the wrapper or the patch with scissors.
Do not use any patch that has been cut by accident or is damaged. Do not use the patch if the pouch seal is broken.
If any medicine leaks out of the patch and gets directly on your skin, wash it off right away with water.
Do not put the new patch in the same place you wore the last one.
Do not put the patch over burns, cuts, or irritated skin.
Immediately wash your hands after applying the patch.
Wear the patch for 3 days (72 hours) and remove and dispose of it immediately.
If the patch falls off, dispose of it immediately and apply a new patch.
You can bathe, shower, or swim, but do not use hot tubs, saunas, tanning beds, tanning lamps, electric blankets, or heating pads over the patch. Do not exercise hard or sunbathe. Anything that increases the temperature of the body or the patch will increase the dose and could cause serious side effects or death.
Store the patches at room temperature in the original package in a secure and locked area out of the reach of children and other people.
If you forget to wear or change a patch, put one on as soon as possible. Wear the replacement patch for no longer than 3 days (72 hours).
Do not use two patches at once. Always remove the old patch before applying the new one.
This medicine is not right for everyone.
Fentanyl is not used in people who have:
Allergies to fentanyl or similar morphine-like drugs such as codeine.
Breathing problems, including slowed breathing and acute or severe bronchial asthma
Digestive system obstruction
A large intestine that is not working (paralytic ileus)
In addition, fentanyl patches are never used in people who:
Are not opioid-tolerant
Have mild pain
Have temporary, short-term, or intermittent pain
Who have pain due to a medical procedure (postoperative pain)
Fentanyl is a hazardous drug that can cause severe problems, including:
Slowed breathing (respiratory depression) or stopped breathing (respiratory arrest)
Breathing problems while sleeping
Adrenal gland dysfunction
Drug abuse
Dependence
Overdose
Death
Before using this medicine, tell your healthcare provider if you have:
Breathing or lung problems such as COPD, asthma, or sleep apnea
Liver disease
Kidney disease
Low blood pressure
Slow heartbeats
Pancreas or gallbladder problems
Stomach or bowel problems
A history of seizures, head injury, or brain tumor
Mental health issues such as depression
A history of alcohol or drug abuse
Tell the healthcare provider if you are pregnant or planning to become pregnant before using this medicine.
Do not breastfeed while using this medicine.
This medicine may make you dizzy, drowsy, or lightheaded. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
When wearing a fentanyl patch, do not let the patch or the skin under it get too hot. This will increase the dose and could result in serious side effects or death. Avoid direct sunlight and do not use a heating pad, electric blanket, heated waterbed, sauna, sun lamp, or hot tub. Do not exercise hard enough to raise your body temperature. Call your doctor if you have a fever higher than 104 degrees F (40 degrees C).
Be careful about letting other people come in contact with your patch. If any medicine gets on another person, wash it off immediately with water and call your doctor.
This medicine may cause constipation, especially with long-term use. Ask your doctor if you should use a laxative to prevent and treat constipation.
Do not stop using this medicine suddenly. The healthcare provider must slowly decrease the dose before you stop it completely.
This medicine can be habit-forming. Do not use more than your prescribed dose. Call the healthcare provider if the medicine is not working.
Fentanyl can injure or kill children or other people if they get into it. Keep this medicine locked up in a secure location that children or other people can’t access.
Some medicines can affect how fentanyl works. Tell your healthcare provider if you are using the following:
Medications that treat mental health issues such as depression or anxiety
Migraine drugs called triptans
Blood pressure medications
Drugs that make you pee (diuretics)
Carbamazepine, clarithromycin, erythromycin, fluconazole, itraconazole, ketoconazole, metaxalone, nefazodone, phenytoin, rifampin, or ritonavir
Tell your healthcare provider if you use anything else that makes you sleepy. Some examples are:
Allergy medications
Other types of opioids
Sleeping pills
Muscle relaxants
CBD
Alcohol
Do not use this medicine if you are using or have used an MAO inhibitor within the past 14 days.
Do not drink alcohol while you are using this medicine.
Do not eat or drink grapefruit juice while using this medicine.
Talk to a dhealthcare providerif you notice any signs or symptoms of a possible serious side effect, including:
Trouble breathing or slow breathing
Blue lips, fingernails, or skin
Extreme dizziness or weakness, shallow breathing, slow or uneven heartbeat, sweating, cold or clammy skin, seizures
Severe constipation, stomach pain, or vomiting
Severe confusion, lightheadedness, dizziness, or fainting
Anxiety, restlessness, fast heartbeat, fever, sweating, muscle spasms, twitching, nausea, vomiting, diarrhea, seeing or hearing things that are not there
Seizures
Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
Nausea
Vomiting
Sleepiness
Headache
Dizziness
Trouble sleeping
Diarrhea
Constipation
Fentanyl patch prescribing information, DailyMed (NIH National Library of Medicine)
Kristi C. Torres, Pharm.D., is a 2005 graduate of The University of Texas at Austin. Her professional background includes academic teaching roles, district-level management for a nationwide pharmacy chain, and clinic-based pharmacy management. Dr. Torres has a wide range of experience in pharmacy operations and has traveled to many states to open and convert clinic-based pharmacies for one of the largest healthcare systems in the nation.
Currently, she works for Tarrytown Expocare Pharmacy in Austin, Texas, serving the intellectual and developmental disability community. There, she leads the order entry team, overseeing orders from across the country.
Dr. Torres began working in pharmacy at the age of 16 in a small East Texas town. She currently resides in Round Rock, Texas, with her daughter and a Shih-Tzu puppy.
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