Generic Name: fentanyl transdermal skin patch (FEN ta nil trans DERM al)
Brand Names: Duragesic
Medically reviewed by P. Thornton, DipPharm. Last updated on Dec 12, 2018.
What is a fentanyl patch?
Fentanyl is an opioid pain medication, sometimes called a narcotic.
Fentanyl skin patches are a strong prescription pain medicine. The patches are used to treat moderate to severe chronic pain around the clock.
Fentanyl skin patches are used when other pain treatments such as non-opioid pain medicines or immediate-release opioid medicines do not treat your pain well enough or you cannot tolerate them.
Fentanyl patches are not for treating mild or occasional pain or pain from surgery. The patches are not for use to treat pain that is not around-the-clock.
Fentanyl can slow or stop your breathing, and may be habit-forming. MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.
Using this medicine during pregnancy may cause life-threatening withdrawal symptoms in the newborn.
Fatal side effects can occur if you use this medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing.
Before taking this medicine
Do not use a fentanyl skin patch if you are allergic to fentanyl, or if you have:
a severe breathing problem such as asthma attacks;
a blockage in your digestive tract (stomach or intestines); or
if you are NOT already being treated with a similar opioid (narcotic) pain medicine and are tolerant to it.
To make sure fentanyl patches are safe for you, tell your doctor if you have ever had:
any type of breathing problem or lung disease;
liver or kidney disease; or
problems with your gallbladder, pancreas, or thyroid.
Do not put a fentanyl skin patch on any child who does not have a personal prescription for this medicine.
If you use fentanyl while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant.
Fentanyl can pass into breast milk and may cause withdrawal symptoms in a nursing infant. Do not breast-feed while using this medicine.
How should I use a fentanyl patch?
Apply the fentanyl patch exactly as prescribed by your healthcare provider. Use the lowest dose possible for the shortest time needed. Follow all directions on your prescription label. Never use this medicine in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain. Do not use a skin patch if it has been cut or damaged, or you could receive a fatal overdose of fentanyl.
Fentanyl may be habit-forming, and the transdermal skin patch contains a high concentration of this medicine. Never share this medicine 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. Selling or giving away fentanyl patches is against the law.
MISUSE OF THIS MEDICINE CAN CAUSE HARMFUL SIDE EFFECTS OR DEATH, especially in a child who gets a hold of the skin patch and places it in the mouth or on the skin.
When placing a skin patch on a young child, choose a wearing area where the child cannot easily remove the patch unsupervised.
The skin patch is for use only on the skin. Do not allow the medicine to come into contact with your eyes, nose, mouth, or lips.
Keep both used and unused patches out of the reach of children or pets. Even the amount of fentanyl in a used skin patch could be fatal to a child or pet who accidentally sucks or chews on the patch. Seek emergency medical attention if this happens.
Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.
Apply the patch to clean, dry skin on the chest, back, side, or outer side of your upper arm. Wear the patch around the clock for 72 hours. Never wear more than 1 patch at a time unless your doctor has told you to. Remove and replace the patch after 72 hours. Apply the new patch to a different skin area on the chest, back, side, or upper arm.
Avoid sources of heat while you are wearing the patch. Do not use a heating pad or electric blanket, a waterbed heater, tanning bed or sauna. Do not sit in hot water, sunbathe, or raise your body temperature with vigorous activity. Heat can increase the amount of drug you absorb through your skin and may cause an overdose or death.
Store the patches at room temperature. Keep each patch in its foil pouch until you are ready to use it. Keep track of how many 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.
After removing a skin patch: fold it in half with the sticky side in, and flush the patch down the toilet right away. Do not place a used skin patch into a trash can.
Do not keep leftover opioid medication. Just one dose can cause death in someone using this medicine accidentally or improperly. Ask your pharmacist where to locate a drug take-back disposal program. If there is no take-back program, dispose of any unused skin patches in the same folded manner. Do not flush the foil pouch or patch liners; place them in a trash container out of the reach of children and pets.
Fentanyl Patch dosing information
Usual Adult Dose for Chronic Pain:
Due to the risk of respiratory depression, the transdermal patch is for use in opioid-tolerant patients only; opioid tolerant patients have been taking at least: morphine 60 mg daily, oral oxycodone 30 mg daily, oral hydromorphone 8 mg daily, or an equianalgesic dose of another opioid for 1 week or longer.
-Discontinue all other extended-release opioids when beginning therapy.
Initial doses: The initial dose should be individualized taking into account the patient's prior treatment experience. This dose may be calculated based on the dose conversion guidelines in the product package insert, local protocol, or another reliable reference; when calculating, be aware there is substantial inter-patient variability in the relative potency of different opioid drugs and products and therefore it is preferable to underestimate a 24-hour fentanyl requirement and provide rescue medication than to overestimate which could result in adverse reactions.
-Initial: May increase dose after 3 days based on the daily dose of supplemental opioid analgesics required by the patient on the second or third day of the initial application.
-Further titration should occur after no less than two 3-day applications as it may take up to 6 days for fentanyl levels to reach equilibrium. Titration should be based on the daily dose of supplementary opioids required and the following ratio may be used: Increase transdermal fentanyl by 12 mcg//hr for use of supplemental oral morphine doses of 45 mg/24 hours.
Maintenance dose: Adjust dose to obtain an appropriate balance between pain management and opioid-related adverse reactions. During chronic therapy, periodically reassess the continued need for opioid analgesics.
-Do not begin a patient on a fentanyl transdermal patch as their first opioid.
-A small number of patients may require a 48-hour dosing interval; an increase in dose should be evaluated before changing dosing intervals.
What happens if I miss a dose?
If you are using the skin patches on a schedule, 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, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include slow heart rate, severe drowsiness, muscle weakness, cold and clammy skin, pinpoint pupils, very slow breathing, or coma.
What should I avoid while using a fentanyl patch?
Do not drive or operate machinery until you know how fentanyl will affect you. Dizziness or severe drowsiness can cause falls or other accidents.
Do not drink alcohol or dangerous side effects and death could occur. Check your food and medicine labels to be sure these products do not contain alcohol.
Avoid wearing a skin patch on a part of your body where a child could reach or remove the patch from your skin. Avoid allowing children to watch you put on a skin patch. Never tell a child that the fentanyl skin patch is a "bandage."
Fentanyl patch side effects
Get emergency medical help if you have signs of an allergic reaction to a fentanyl patch: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Like other narcotic medicines, fentanyl can slow your breathing. Death may occur if breathing becomes too weak.
Remove the skin patch and call your doctor at once if you have:
slow heart rate, sighing, weak or shallow breathing (up to several days after removing the skin patch);
chest pain, fast or pounding heartbeats; or
extreme drowsiness, feeling like you might pass out.
Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
Serious side effects may be more likely in older adults and those who are overweight, malnourished, or debilitated.
Long-term use of opioid medication may affect fertility (ability to have children) in men or women. It is not known whether opioid effects on fertility are permanent.
Common fentanyl patch side effects may include:
nausea, vomiting, stomach pain, loss of appetite, diarrhea, constipation;
drowsiness, dizziness, tired feeling;
sleep problems (insomnia); or
increased sweating, or cold feeling.
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.
What other drugs will affect fentanyl patches?
Some drugs can raise or lower your blood levels of fentanyl, which may cause side effects or make fentanyl less effective. Tell your doctor if you also use certain antibiotics, antifungal medications, heart or blood pressure medications, or medicines to treat HIV or AIDS.
Fentanyl can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:
other narcotic medications - opioid pain medicine or prescription cough medicine;
drugs that make you sleepy or slow your breathing - a sleeping pill, muscle relaxer, sedative, tranquilizer, or antipsychotic medicine;
drugs that affect serotonin levels in your body - medicine for depression, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting.
This list is not complete. Other drugs may interact with fentanyl, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use fentanyl patches only for the indication prescribed.
Copyright 1996-2018 Cerner Multum, Inc. Version: 11.01.
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