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DUROGESIC D-TRANS 50 MICROGRAMS/HOUR TRANSDERMAL PATCHES

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Durogesic® D-Trans® 25 micrograms/hour Transdermal Patches
Durogesic® D-Trans® 50 micrograms/hour Transdermal Patches
Durogesic® D-Trans® 75 micrograms/hour Transdermal Patches
Durogesic® D-Trans® 100 micrograms/hour Transdermal Patches
(fentanyl)
This medicine is known by the above names but will be referred to as Durogesic DTrans
patches throughout this leaflet.
Package Leaflet: Information for the user
Important things you need to know about Durogesic DTrans patches
• These patches contain a strong pain killer
• Ensure that old patches are removed before applying a new one
• Patches must not be cut
• Do not expose the patches to a heat source (such as a hot water bottle)
• If you develop a fever tell your doctor immediately
• Follow the dosage instructions carefully and only change your patch every 3 days (72
hours)
• If your breathing becomes shallow and weak take the patch off and seek medical help
The rest of this leaflet includes more detail and other important information on
the safe and effective use of this medicine.

Keep this leaflet. You may need to read it again

If you have any further questions, ask your doctor, nurse or pharmacist

This medicine has been prescribed for you. Do not pass it on to others. It may
harm them, even if their symptoms are the same as yours

If you get side effects and they become serious or if you notice any side effects
not listed in this leaflet, please tell your doctor, nurse or pharmacist
In this leaflet:
1. What Durogesic DTrans patches are and what they are used for
2. Before you use Durogesic DTrans patches
3. How to use Durogesic DTrans patches
4. Possible side effects
5. How to store Durogesic DTrans patches
6. Further information

1. WHAT DUROGESIC DTRANS PATCHES ARE AND WHAT THEY ARE USED FOR
The name of your medicine is Durogesic DTrans patch.
The patches help relieve pain that is very bad and long-lasting.
Durogesic DTrans patch contains a medicine called fentanyl. It belongs to a group of strong
painkillers called opioids. The patches come in five strengths (see section 6 overleaf).
The medicine passes slowly into your body through your skin.

2. BEFORE YOU USE DUROGESIC DTRANS PATCHES
Durogesic DTrans patches can be used in children aged 2 to 16 years who have previously
used opioid painkillers. If the patches have been prescribed for your child, the ‘you’ stated
everywhere below should be read as ‘your child’.
Do not use Durogesic DTrans patches if:
• You are allergic to fentanyl, Durogesic or anything in Durogesic DTrans patches (listed in
section 6 overleaf)
• You have pain which lasts only for a short period
• Your child who is in pain is under 2 years old
• Your child has not been treated with strong painkillers such as morphine
Do not use this medicine if any of the above apply to you or your child. If you are not sure, talk
to your doctor or pharmacist before using Durogesic DTrans patches.
Take special care with Durogesic DTrans patches
• Like some other strong painkillers, Durogesic DTrans patches may make you unusually
drowsy, and breathe more slowly or weakly. Very rarely these breathing difficulties can
be life-threatening or even fatal in people who have not used strong morphine-related
painkillers (like Durogesic DTrans patches) or morphine before. If you, or your partner or
carer, notice that you or your child are breathing much more slowly or weakly then:
• Take the patch off
• Call a doctor, or go to your nearest hospital, straight away
• Keep moving and talking as much as possible
• If you develop a fever while wearing Durogesic DTrans patches, tell your doctor as this
may affect the way the medicine passes through your skin
• Don’t expose the patch to direct heat such as heating pads, electric blankets, hot-water
bottles, heated water beds, heat or tanning lamps, intensive sun bathing, prolonged hot
baths, saunas or hot whirlpool spa baths. These may affect the way the medicine is
absorbed through the skin
• Check with your doctor or pharmacist before using this medicine if you have ever had:
• Problems with your lungs or breathing
• Problems with your heart or blood pressure and blood volume, liver or kidneys
• Brain tumours
• Persistent headaches or a head injury
Your doctor might need to check you more closely.
• If you are very ill, very thin or elderly, you may be more sensitive to the effects of the
patches
• If you suffer from a condition in which muscles become weak and tire easily, known as
myasthenia gravis, talk to your doctor or pharmacist before using Durogesic DTrans
patches.
• Like many other strong painkillers, repeated use of the patches may make you become
tolerant to the medicine or become dependent on it
• Tell your doctor if you have ever abused or been dependent on alcohol, prescription
medicines or illegal drugs
If you are not sure if any of the above applies to you, talk to your doctor or pharmacist before
using Durogesic DTrans patches.
Other makes of patch
There are other makes of fentanyl transdermal patch available, but they are not all the same.
If your patch looks different from one you have used before you should check with your doctor
or pharmacist before using it.
Taking other medicines
Please tell your doctor or pharmacist if you are taking or have recently taken any other
medicines. This includes medicines that you buy without a prescription or herbal medicines.
You should also tell your pharmacist that you are using Durogesic DTrans patches if you buy
any medicines from your pharmacy.
In particular, tell your doctor or pharmacist if you are taking:
• Other medicines for pain, such as other opioid painkillers (buprenorphine, nalbuphine or
pentazocine)
• Medicines for helping you sleep
• Medicines to help you calm down (tranquillisers) and medicines for mental conditions
• Medicines for relaxing your muscles
• Some medicines used to treat depression (such as citalopram, duloxetine escitalopram,
fluoxetine, fluvoxamine, paroxetine, sertraline, venlafaxine)
• Some medicines used to treat depression (called MAOIs). You should not take Durogesic
DTrans patches within 14 days of stopping these medicines.
• Nefazodone a medicine used to treat depression
• Some antihistamines (especially ones that make you sleepy)

• Some antibiotics used to treat infection, such as erythromycin, clarithromycin or
troleandomycin
• Medicines used to treat fungal infection, such as itraconazole, ketoconazole, fluconazole or
voriconazole
• Medicines used to treat HIV infection, such as ritonavir or nelfinavir
• Medicines used to treat an irregular heart beat, such as amiodarone, diltiazem or verapamil
Your doctor will know which medicines are safe to take with Durogesic DTrans patches. You
may need to be closely monitored if you are taking some of the types of medicines listed
above as this may affect the strength of Durogesic DTrans patches you need.
If you are not sure if any of the above applies to you, talk to your doctor or pharmacist before
using Durogesic DTrans patches.
Operations or tests
If you think that you are going to have an anaesthetic, tell your doctor or dentist that you are
using Durogesic DTrans patches.
Using Durogesic DTrans patches and drinking alcohol
Do not drink alcohol unless you have talked to your doctor first.
Durogesic DTrans patches can make you drowsy or breathe more slowly. Drinking alcohol
may make these effects worse.
Pregnancy and breast-feeding
You must tell your doctor before using Durogesic DTrans patches if you are pregnant, think
you may be pregnant or might become pregnant. Durogesic DTrans patches should not be
used during childbirth as the medication can affect the breathing of the newborn child.
Do not breast-feed whilst using Durogesic DTrans patches. You should not breast-feed for
3 days after removing your Durogesic DTrans patch. This is because small amounts of the
medicine may pass into breast milk.
Ask your doctor or pharmacist for advice before taking any medicine if you are pregnant or
breast-feeding.
Driving and using machines
Durogesic DTrans patches can make you drowsy. If this happens, do not drive or use any
tools or machines.

3. HOW TO USE DUROGESIC DTRANS PATCHES
Always use this medicine exactly as your doctor has told you. You should check with your
doctor or pharmacist if you are not sure.
Using and changing the patches
• There is enough medicine in each patch to last 3 days (72 hours)
• You should change your patch every third day, unless your doctor has told you differently
• Always remove the old patch before applying a new one
• Always change your patch at the same time of day every 3 days (72 hours)
• If you are using more than one patch, change all your patches at the same time
• Make a note of the day, date and time you apply a patch, to remind you when you need to
change your patch
• The following table shows you which day of the week to change your patch:
Change your patch at
Apply your patch on
the same time on
Monday
Thursday
Tuesday
Friday
Wednesday
Saturday
Thursday
Sunday
Friday
Monday
Saturday
Tuesday
Sunday
Wednesday
Where to apply the patch
Adults
• Apply the patch on a flat part of your upper body or arm
Children
• Always apply the patch to the upper back to make it difficult for your child to reach it or take
it off
• Every so often check that the patch remains stuck to the skin
• It is important that your child does not remove the patch and put it in their mouth as this
could be life-threatening or even fatal
• It may take some time before the patch becomes fully effective. Therefore, your child might
need additional painkillers until the patches become effective. Your doctor will advise you
on this if it is needed
• Children should be monitored very closely for 48 hours after:
• The first patch has been put on
• A higher dose patch has been put on
For you or your child, do not apply the patch on:
• The same place twice in a row.
• Sensitive areas that you move a lot, skin with cuts, spots or other skin blemishes
• Skin that is very hairy. If there is hair, do not shave it (shaving irritates the skin). Instead,
clip the hair as close to the skin as possible
You should allow several days to pass before you put a new patch on the same area of
skin.
Putting a patch on
Step 1: Preparing the skin
• Make sure your skin is completely dry, clean and cool before you put the patch on
• If you need to clean the skin, just use cold water
• Do not use soap or any other cleansers, creams, moisturisers, oils or talc before applying
the patch
• Do not stick a patch on straight after a hot bath or shower
Step 2: Open the pouch
• Each patch is sealed in its own pouch
• Tear or cut open the pouch at the notch, shown by the arrow
• Gently tear or cut off the edge of the pouch completely (if you use scissors, cut close to the
sealed edge of the pouch to avoid damaging the patch)

• Grasp both sides of the opened pouch and pull apart
• Take the patch out and use straight away
• Keep the empty pouch to dispose of the used patch later
• Use each patch once only
• Do not take the patch out of its pouch until you are ready to use it
• Inspect the patch for any damage
• Do not use the patch if it has been divided, cut or looks damaged
• Never divide or cut the patch
Step 3: Peel and press
• Make sure that the patch will be covered by loose clothing and not stuck under a tight or
elasticated band
• Carefully peel one half of the shiny plastic backing away from the centre of the patch. Try
not to touch the sticky side of the patch
• Press this sticky part of the patch onto the skin
• Remove the other part of the backing and press the whole patch onto the skin with the palm
of your hand
• Hold for at least 30 seconds. Make sure it sticks well, especially the edges

Step 4: Disposing of the patch
• As soon as you take a patch off, fold it firmly in half so that the sticky side sticks to itself
• Put it back in its original pouch and put the pouch in the bin with your household rubbish
• Even used patches contain some medicine which may harm children, so keep your used
patches out of the sight and reach of children
Step 5: Wash
• Wash your hands afterwards with clean water
More about using Durogesic DTrans patches
How quickly will the patches work?
• It may take up to a day before your first patch is working completely
• Your doctor may give you extra painkillers for the first day or so
• After this, the patch should help to relieve pain continuously so that you can stop taking
other painkillers. However, your doctor may still prescribe extra painkillers from time to time
If you forget to change your patch
• If you forget, change your patch as soon as you remember and make a note of the day and
time. Change the patch again after 3 days (72 hours) as usual
• If you are very late changing your patch, you should talk to your doctor because you might
need some extra painkillers, but do not apply an extra patch
If you use too many patches or the wrong strength patch
If you have stuck on too many patches or the wrong strength patch, take the patches off and
contact a doctor or the nearest hospital straight away.
Signs of overdose include trouble breathing or shallow breathing, tiredness, extreme
sleepiness, being unable to think clearly, walk or talk normally and feeling faint, dizzy or
confused.
If a patch falls off
• If a patch falls off before it needs changing, stick a new one on straight away and make a
note of the day and time. Use a new area of skin on:
• Your upper body or arm
• Your child’s upper back
• Leave another 3 days (72 hours) before changing the new patch as usual
• If your patches keep falling off, talk to your doctor, nurse or pharmacist
If a patch sticks to another person
• Only use the patch on the skin of the person who it was prescribed for
• Make sure the patch does not get rubbed off and sticks to your partner, especially in bed
• If a patch accidentally sticks to another person, take it off straight away and talk to a doctor
How long will you use the patches for?
Durogesic DTrans patches are for long-term pain. Your doctor will be able to tell you how long
you can expect to use the patches.
If your pain gets worse
• If your pain gets worse while you are using these patches, your doctor may try a higher
strength patch, or give you extra painkillers (or both)
• If increasing the strength of the patch does not help, your doctor may stop the patches
If you want to stop using the patches
• Talk to your doctor before you stop using these patches
• If you have been using them for some time your body may have got used to them. Stopping
suddenly may make you feel unwell
• If you stop using the patches, don’t start again without asking your doctor first. You might
need a different patch strength when you restart
Everyday activities while using the patches
• The patches are waterproof
• You can shower or bathe while wearing a patch, but do not scrub the patch itself
• If your doctor agrees, you can exercise or play sport while wearing the patch
• You can also swim while wearing the patch, but:
• Don’t use hot whirlpool spa baths
• Don’t put a tight or elasticated band over the patch
• Don’t expose the patch to direct heat such as heating pads, hot-water bottles, electric
blankets, heated water beds, heat or tanning lamps, intensive sun bathing, prolonged hot
baths or saunas. These may affect the way the medicine is absorbed through the skin
If you have any further questions on the use of this product, ask your doctor or pharmacist.

4. POSSIBLE SIDE EFFECTS
Like all medicines, Durogesic DTrans patches can cause side effects, although not everybody
gets them.
Take the patch off and tell your doctor, or go to your nearest hospital, straight away if
you notice or suspect any of the following. You may need urgent medical treatment.
• Feeling unusually drowsy, breathing more slowly or weakly than expected.
Very rarely these breathing difficulties can be life-threatening or even fatal, especially in
people who have not used strong opioid painkillers (like Durogesic DTrans patches or
morphine) before. If you, or your partner or carer, notice that you or your child are breathing
much more slowly or weakly, follow the guidance above and keep moving and talking as
much as possible
• Sudden swelling of the face or throat, severe irritation, reddening or blistering of your skin.
These may be signs of a severe allergic reaction. This only happens in a small number of
people
• Convulsions, fits or seizures. This affects less than 1 in 100 people.
The following side effects have also been reported
Very common (affects more than 1 in 10 people):
• Feeling sick (nausea) or being sick (vomiting), constipation
• Dizziness, drowsiness or not being able to sleep
• Headache
Common (affects less than 1 in 10 people):
• Allergic reaction
• Awareness of unusual heart beats (also called palpitations), fast heart rate
• High blood pressure
• Loss of appetite or dry mouth
• Feeling nervous, worried or depressed
• Confusion, hallucinations (seeing, feeling or hearing things that are not there)
• Sensation of pins and needles, shaking, feeling giddy
• Muscle spasms
• Stomach ache, indigestion, difficulty passing urine
• Diarrhoea
• Feeling cold, excessive sweating
• General feelings of discomfort, tiredness, weakness
• Swelling of hands, ankles or feet
• Itchy skin, rashes or redness of the skin
Uncommon (affects less than 1 in 100 people):
• Flu-like symptoms
• Slow heart rate
• Low blood pressure
• Decreased feeling of sensitivity, especially in the skin
• Bluish colouration of the skin
• Feeling agitated, disorientated, excited or unusually carefree
• Loss of memory
• Eczema and/or other skin disorders including dermatitis where the patch is placed
• Disorders of sexual function
• Complete obstruction of the intestine
• Muscle twitching
• Body temperature changes
• Drug withdrawal effects (such as sickness, feeling sick, diarrhoea, anxiety or shivering)

Rare side effects (probably affecting less than 1 in 1,000 people):
• Tiny pupils
• Incomplete obstruction of the small or large intestine
The following side effects have been reported during clinical trials in children (up to 18
years of age):
Very common side effects (probably affecting more than 1 in 10 people):
• Headache
• Feeling or being sick
• Constipation, diarrhoea
• Itching
Common side effects (probably affecting up to 1 in 10 people):
• Allergic reaction
• Loss of appetite, stomach pain
• Not being able to sleep, drowsiness, tiredness, feeling weak
• Feeling worried or depressed, hallucinations (seeing, feeling or hearing things that are not
there), dizziness
• Shaking, decreased feeling or sensitivity, especially in the skin
• Dry mouth
• Rash, excessive sweating, redness of the skin
• Muscle spasms
• Difficulty passing urine
• Swelling of hands, ankles or feet
• Skin reactions where the patch is placed
Uncommon side effects (probably affecting less than 1 in 100 people):
• Confusion
• Sensation of pins and needles
• Tiny pupils
• Feeling giddy
• Bluish colouration of the skin, eczema and/or other skin disorders including dermatitis
where the patch is placed
• Drug withdrawal effects (such as sickness, feeling sick, diarrhoea, anxiety or shivering), flulike symptoms.
If you get any of these side effects, tell your doctor, nurse or pharmacist.
Skin rashes, itching or sweating (affects less than 1 in 10 people). You may notice rashes,
redness or slight itching of the skin at the site of the patch. This is usually mild and disappears
after you have removed the patch. If it does not, or if the patch irritates your skin badly, tell
your doctor.
There have been reports of newborn infants experiencing withdrawal effects after their
mothers have used Durogesic DTrans patches for a long time during pregnancy.
Like many other strong painkillers, repeated use of the patches may make you become
tolerant to the medicine or become dependent on it.
If you get any of these side effects, tell your doctor, nurse or pharmacist.
If you switch from a different painkiller to Durogesic DTrans patches, you may notice effects
such as sickness, feeling sick, diarrhoea, anxiety or shivering. Tell your doctor if you notice
any of these effects.
If you notice any other side effects not listed in this leaflet, please tell your doctor, nurse or
pharmacist.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible
side effects not listed in this leaflet. You can also report side effects directly via the Yellow
Card Scheme at: www.mhra.gov.uk/yellowcard
By reporting side effects, you can help provide more information on the safety of this medicine.

5. HOW TO STORE DUROGESIC DTRANS PATCHES
Like all medicines, you should always keep used and unused Durogesic DTrans patches
safely out of sight and reach of children. Keep Durogesic DTrans patches dry. There are no
special storage conditions required.
Do not use Durogesic DTrans patches after the expiry date which is stated on the carton and
pouch.
As soon as you take a patch off fold it firmly in half so that the sticky side sticks to itself and
put it back into its original pouch. Now put the pouch in the bin you use for your household
rubbish. Even used patches contain some active medicine which may harm children. So make
sure your used patches are always kept well away from children.
If your patches show any signs of deterioration, seek the advice of your pharmacist.
If your doctor has told you that you no longer need to use the patches, take any unused
patches to your pharmacy.

6. FURTHER INFORMATION
What is in your medicine?
The medicine inside your Durogesic DTrans patches is fentanyl. Durogesic DTrans patches
come in four different strengths:
1. The Durogesic 25 patch contains 4.2 mg of fentanyl and gives a dose of 25 micrograms of
fentanyl every hour. The active surface area of each Durogesic 25 patch is 10.5 cm2.
2. The Durogesic 50 patch contains 8.4 mg of fentanyl and gives a dose of 50 micrograms of
fentanyl every hour. The active surface area of each Durogesic 50 patch is 21.0 cm2.
3. The Durogesic 75 patch contains 12.6 mg of fentanyl and gives a dose of 75 micrograms of
fentanyl every hour. The active surface area of each Durogesic 75 patch is 31.5cm2.
4. The Durogesic 100 patch contains 16.8 mg of fentanyl and gives a dose of 100 micrograms
of fentanyl every hour. The active surface area of each Durogesic 100 patch is 42.0 cm2.
The other ingredients in Durogesic DTrans patches are not medicines. They are polyacrylate
adhesive, polyethylene terephthalate /ethyl vinyl acetate film, red/green/blue/grey printing ink
and siliconised polyester film. The patch does not contain preservatives.
Durogesic DTrans patch is a rectangular shaped, transparent, transdermal patch with a sticky
back so that it can be stuck onto the skin. The painkiller, fentanyl, slowly passes from the
patch, through the skin and into the body.
Durogesic DTrans patches usually come in cartons containing 5 patches, but your doctor will
have prescribed the number and strength of patches which is best for you.
What kind of medicine is the Durogesic DTrans patch?
Durogesic DTrans patches contain fentanyl. Fentanyl is one of a group of strong painkillers
called opioids, which must be used only under a doctor's instruction.
Who makes your medicine?
Durogesic DTrans patches are manufactured by Alza Corporation, 700 Eubanks Drive,
Vacaville, California, USA. and are procured from within the EU by the Product Licence holder:
Caseview (PL) Ltd., 20 Alliance Court, Alliance Road London W3 0RB and repackaged by
OPD Laboratories Ltd, Unit 6 Colonial Way, Watford, Herts WD24 4PR.
PL 13826/1552 Durogesic® D-Trans® 25 micrograms/hour transdermal patches
CD POM
PL 13826/1553 Durogesic® D-Trans® 50 micrograms/hour transdermal patches
PL 13826/1554 Durogesic® D-Trans® 75 micrograms/hour transdermal patches
PL 13826/1555 Durogesic® D-Trans® 100 micrograms/hour transdermal patches
Leaflet revision and issue date (Ref.) 17/12/2013
Durogesic is a registered Trade Mark of Johnson & Johnson, New Jersey, USA.
To request a copy of this leaflet in Braille, large print or audio please call 01923 332 796.

Expand Transcript

Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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