fentanyl transdermal patch, Duragesic (cont.)

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PRESCRIBED FOR: The fentanyl transdermal system is used for patients with severe chronic pain, for example, the pain of cancer.

DOSING: Patches should be applied to a flat, non-irritated area on the upper torso. The area of application should be clean and washed with water only prior to application. The patch should be applied immediately after removing it from the package and pressed firmly against the skin for 10 to 20 seconds especially around the edges. Patches should never be cut or otherwise damaged. Doses required to control pain vary widely among patients. The recommended dose is 25 to 100 mcg/hour patch applied every 72 hours. The manufacturer considers a fentanyl transdermal dose of 100 µg/hour approximately equivalent to 360 mg/day of oral morphine.

DRUG INTERACTIONS: The use of fentanyl with other central nervous system depressants can intensify the effects of fentanyl to depress breathing, depress the brain, sedate, and lower blood pressure. Other drugs that should be used cautiously with fentanyl include: antipsychotics, for example, Thorazine; Stelazine, haloperidol (Haldol), anxiolytics for example, diazepam (Valium), lorazepam (Ativan), and zolpidem (Ambien), certain antihistamines, for example, diphenhydramine (Benadryl), and hydroxyzine (Vistaril), barbiturates, for example, phenobarbital (Donnatal), tricyclic antidepressants, for example, amitriptyline (Elavil, Endep) and doxepin (Sinequan), ethanol, and skeletal muscle relaxants, for example, carisoprodol (Soma), cyclobenzaprine (Flexeril), and baclofen (Lioresal). The use of fentanyl with amiodarone (Cordarone) may result in slow heart rates. Cimetidine (Tagamet) when used with fentanyl can cause confusion, disorientation, or seizures due to impairment in breathing and brain function.

Medically Reviewed by a Doctor on 2/27/2014

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