What is a fentanyl patch?
Fentanyl patches are a strong prescription opioid pain medicine. The patches are used to treat moderate to severe chronic pain around the clock. Fentanyl 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.
Before taking this medicine
You should not use fentanyl unless you recently used opioid medicine and your body is tolerant to it (ask your doctor if you’re not sure).
Do not put a fentanyl skin patch on any person who does not have a personal prescription for this medicine. You should not use fentanyl if you are allergic to it, or if you have:
- severe asthma or other breathing problems; or
- a stomach or bowel obstruction (including paralytic ileus).
To make sure fentanyl patches are safe for you, tell your doctor if you have ever had:
- breathing problems, sleep apnea;
- a head injury, brain tumor, or mental illness;
- alcoholism or drug addiction;
- urination problems;
- a seizure disorder;
- liver or kidney disease; or
problems with your gallbladder, pancreas, or thyroid.
How should I use a fentanyl patch?
Apply the fentanyl patch exactly as prescribed by your healthcare provider. Follow the directions on your prescription label and read all medication guides. Never use fentanyl patches in larger amounts, or for longer than prescribed. Tell your doctor if you feel an increased urge to use more fentanyl patches. Never use a skin patch if it has been cut or damaged.
Stop using all other around-the-clock opioid medications.
Never share opioid medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it. Selling or giving away opioid medicine is against the law.
Do not allow the skin patch to come into contact with your mouth, eyes, nose, or lips, or another person’s skin.
Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.
Wear the fentanyl skin patch around the clock, removing and replacing the patch every 72 hours (3 days). Do not wear more than 1 patch at a time unless your doctor has told you to.
When placing a skin patch on a young child, choose a wearing area where the child cannot easily remove the patch unsupervised.
Do not stop using fentanyl suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.
Store each patch in its foil pouch at room temperature.
Keep both used and unused patches out of the reach of children or pets. The amount of fentanyl in a used skin patch can be fatal to a child or pet who accidentally sucks or chews on the patch. Seek emergency medical attention if this happens.
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.
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 the 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.