Duragesic

Generic Name: fentanyl transdermal (skin patch) (FEN ta nil trans DERM al)
Brand Names: Duragesic

What is Duragesic?

Duragesic is a skin patch containing fentanyl, an opioid pain medicine. An opioid is sometimes called a narcotic.

The Duragesic skin patch is used to treat moderate to severe chronic pain. Duragesic is not for treating mild or occasional pain or pain from surgery.

Duragesic may also be used for purposes not listed in this medication guide.

Important information about Duragesic

MISUSE OF DURAGESIC CAN CAUSE HARMFUL OR FATAL SIDE EFFECTS.

Do not use Duragesic unless you are already being treated with a similar opioid (narcotic) pain medicine and your body is tolerant to it. Talk with your doctor if you are not sure you are opioid-tolerant. Do not expose the Duragesic skin patch to heat while you are wearing it. This includes a hot tub, heating pad, sauna, or heated water bed. Heat can increase the amount of drug you absorb through your skin and may cause harmful effects.

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Duragesic may be habit forming and should be used only by the person it was prescribed for. Never share Duragesic with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

Keep both used and unused Duragesic patches out of the reach of children or pets. The amount of fentanyl in a used Duragesic skin patch could be fatal to a child or pet who accidentally sucks on or swallows the unit. Seek emergency medical attention if this happens.

Avoid drinking alcohol, or using other medicines that make you sleepy (such as cold medicine, other pain medication, muscle relaxers, and medicine for depression or anxiety). They can add to extreme drowsiness or breathing problems caused by fentanyl.

The Duragesic patch may burn your skin if you wear the patch during an MRI (magnetic resonance imaging). Remove the patch before undergoing such a test.

Before using Duragesic

Do not use Duragesic unless you are already being treated with a similar opioid (narcotic) pain medicine and your body is tolerant to it. Opioid medicines include codeine (Tylenol #3), hydrocodone (Lortab, Vicodin, Vicoprofen), hydromorphone (Dilaudid, Exalgo), oxycodone (OxyContin, Combunox, Roxicodone, Percocet), methadone (Methadose, Dolophine), morphine (Kadian, MS Contin, Oramorph), oxymorphone (Opana), and others. Talk with your doctor if you are not sure you are opioid-tolerant.

To make sure you can safely use Duragesic, tell your doctor if you have any of these other conditions:

• a breathing disorder such as chronic obstructive pulmonary disease (COPD);

• a history of head injury or brain tumor;

• a heart rhythm disorder;

• liver disease; or

• kidney disease.

FDA pregnancy category C. It is not known whether Duragesic will harm an unborn baby. Fentanyl may cause breathing problems, seizure, or addiction and withdrawal symptoms in a newborn if the mother uses the medication during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant while using Duragesic. Fentanyl may also cause addiction and withdrawal symptoms in a nursing infant. You should not breast-feed while using Duragesic. Older adults may be more likely to have side effects from this medicine.

See also: Duragesic pregnancy and breastfeeding warnings (in more detail)

Duragesic may be habit-forming and should be used only by the person it was prescribed for. Duragesic should never be shared with another person, especially someone who has a history of drug abuse or addiction.

Store the medication in a secure place where others cannot get to it.

The Duragesic patch may burn your skin if you wear the patch during an MRI (magnetic resonance imaging). Remove the patch before undergoing such a test.

How should I use Duragesic skin patches?

MISUSE OF A DURAGESIC SKIN PATCH CAN CAUSE HARMFUL OR FATAL SIDE EFFECTS.

Use Duragesic exactly as prescribed by your doctor. Never use Duragesic in larger amounts, or for longer than recommended by your doctor. Follow the directions on your prescription label.

Read all patient instructions carefully before using a Duragesic skin patch. Follow the directions on your prescription label.

If the skin must be washed before you apply a skin patch, use clear water only. Allow the skin to dry completely before applying the patch.

Do not use soaps, oils, lotions, alcohol, or other chemicals on the skin where you will apply a Duragesic skin patch. These substances could increase the amount of fentanyl that your skin absorbs, possibly causing harmful effects.

Apply the Duragesic skin patch to a flat, dry, hairless area of the chest, back, side, or outer side of your upper arm. To remove any hair from these areas, clip the hair short but do not shave it. Press the patch firmly with the palm of your hand for 30 seconds. Make sure the patch is sticking firmly, especially around the edges. You may wear the patch for up to 72 hours. Never wear more than 1 Duragesic skin patch at a time unless your doctor has told you to.

After removing a Duragesic skin patch fold it in half, sticky side in, and flush the patch down the toilet. Apply a new patch to a different skin area on the chest, back, side, or upper arm. Do not use the same skin area twice in a row.

Do not use a Duragesic skin patch if it has been cut or damaged. Doing so could expose you to too much fentanyl, which can cause a life-threatening overdose.

Store the Duragesic skin patches at room temperature.

Keep each patch in its foil pouch until you are ready to use it. Keep both used and unused Duragesic patches out of the reach of children or pets. The amount of fentanyl in a used skin patch could be fatal to a child or pet who accidentally sucks on or swallows the unit. Seek emergency medical attention if this happens.

Keep track of how many Duragesic skin patches have been used from each new package. Fentanyl is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

What happens if I miss a dose?

Since Duragesic is used as needed, you may not be on a dosing schedule. If you are using the skin patches regularly, apply the missed patch as soon as you remember. Continue wearing the patch for up to 72 hours and then apply a new one if needed for pain. Do not wear extra patches to make up a missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A fentanyl overdose can be fatal.

Overdose symptoms may include extreme drowsiness, weak pulse, fainting, and slow breathing (breathing may stop).

What should I avoid while using a Duragesic patch?

Duragesic patches are for use only on the skin. Avoid touching the sticky side of a skin patch with your fingers. Do not allow the medicine to come into contact with your eyes, nose, mouth, or lips. If it does, rinse with water. Do not use soap or other chemicals. Fentanyl may impair your thinking or reactions. Avoid driving or operating machinery until you know how Duragesic will affect you. Avoid drinking alcohol, which can increase dizziness or drowsiness. Do not expose the skin patch to heat while you are wearing it. This includes a hot tub, heating pad, sauna, or heated water bed. Heat can increase the amount of drug you absorb through your skin and may cause harmful effects.

Duragesic side effects

Get emergency medical help if you have any of these signs of an allergic reaction to Duragesic: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Remove the skin patch and call your doctor at once if you have any of these serious side effects while using Duragesic:

• slow heart rate, weak or shallow breathing, sighing;

• confusion, hallucinations, unusual thoughts or behavior;

• severe weakness, feeling like you might pass out;

• cold, clammy skin; or

• pale skin, easy bruising or bleeding.

Less serious Duragesic side effects may include:

• fever;

• constipation, diarrhea;

• dry mouth, nausea, vomiting, upset stomach;

• headache;

• drowsiness, weakness, tired feeling;

• feeling anxious or nervous;

• cold symptoms such as stuffy nose, sneezing, sore throat;

• sweating, skin rash; or

• itching, blistering, redness, or swelling where the patch was worn.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Duragesic side effects (in more detail)

What other drugs will affect Duragesic?

Cold or allergy medicine, sedatives, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by fentanyl. Tell your doctor if you regularly use any of these medicines.

Many drugs can interact with fentanyl. Below is just a partial list. Tell your doctor if you are using:

• aprepitant (Emend);

• nefazodone;

• isoniazid (for treating tuberculosis);

• St. John's wort;

• an antibiotic such as clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), rifabutin (Mycobutin), rifampin (Rifater, Rifadin, Rifamate), telithromycin (Ketek), and others;

• an antifungal medication such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), miconazole (Oravig), or voriconazole (Vfend);

• heart or blood pressure medication such as diltiazem (Cardizem, Cartia, Dilacor, Tiazac), nicardipine (Cardene), quinidine (Quin-G), verapamil (Calan, Covera, Isoptin, Verelan), and others;

• HIV/AIDS medicine such as atazanavir (Reyataz), delavirdine (Rescriptor), efavirenz (Sustiva, Atripla), fosamprenavir (Lexiva), indinavir (Crixivan), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir, Kaletra), saquinavir (Invirase), and others; or

• seizure medication such as carbamazepine (Carbatrol, Equetro, Tegretol), oxcarbazepine (Trileptal), phenytoin (Dilantin), and others.

This list is not complete and other drugs may interact with Duragesic. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about Duragesic.