fentanyl patch (Duragesic)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

What is the fentanyl patch? What is the fentanyl patch used for?

The fentanyl patch is indicated for the management of pain in opioid-tolerant patients, severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate.

Patients considered opioid-tolerant are those who are taking, for one week or longer, at least 60 mg of morphine daily, or at least 30 mg of oral oxycodone daily, or at least 8 mg of oral hydromorphone daily, or an equianalgesic dose of another opioid.

Limitations Of Use

Because of the risks of addiction, abuse, and misuse with opioids, even at recommended doses, and because of the greater risks of overdose and death with extended-release opioid formulations, reserve fentanyl for use in patients for whom alternative treatment options (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain.ride

What brand names are available for fentanyl transdermal system?

Duragesic

Is fentanyl transdermal system available as a generic drug?

Yes

Do I need a prescription for fentanyl transdermal system?

Yes

What are the uses for fentanyl transdermal system?

The fentanyl transdermal system is used for patients with severe chronic pain, for example, cancer pain.

What are the side effects of fentanyl transdermal system?

Physical dependence occurs commonly during therapy with opiate agonists such as fentanyl. Abruptly stopping the drug in patients can precipitate a withdrawal reaction.

Symptoms of withdrawal include:

Fentanyl can cause respiratory depression (decreased rate or depth of breathing), muscle rigidity, and slow heart rate. Nausea or vomiting, constipation, and itching can occur during treatment with fentanyl. Transdermal fentanyl can cause a variety of skin reactions. Commonly, redness occurs at the site of application and can last for 6 hours following removal of the patch.

Other side effects include:

Possible serious side effects include:

The FDA is investigating reports of deaths and other serious side effects from the use of the fentanyl transdermal system as well as overdoses.

Exposing the patch to heat can increase the amount of fentanyl released and may lead to an overdose. Some patches may cause burns of the skin if worn during an MRI (magnetic resonance imaging) scan. Patients should tell their health-care professional that they are using a medication patch prior to receiving an MRI scan.

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What is the dosage for fentanyl transdermal system?

  • 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.

Which drugs or supplements interact with fentanyl transdermal system?

The use of fentanyl with other central nervous system depressants can increase the ability of fentanyl to depress breathing, depress the brain, sedate, and lower blood pressure.

Other drugs that may result in slow heart rates in patients when used with fentanyl, and therefore, should be used cautiously include:

Cimetidine (Tagamet) when used with fentanyl can cause confusion, disorientation, or seizures due to impairment in breathing and brain function.

Is the fentanyl patch safe to use while pregnant or breastfeeding?

The fentanyl transdermal system is not recommended for use during pregnancy; it may harm a fetus.

Fentanyl from the patch passes into breast milk and may cause undesirable side effects in a nursing infant. Breastfeeding is not recommended while using it.

What else should I know about fentanyl transdermal system?

What preparations of fentanyl transdermal system are available?

Transdermal systems labeled as delivering 12, 25, 50, 37.5, 62.5, 75, 87.5, or 100 mcg/hour.

How should I keep fentanyl transdermal system stored?

  • Patches should be stored at room temperature below 30 C (86 F). Used patches should be folded in half with the sticky sides together, and then flushed down the toilet.
  • Patients must avoid exposing the patches to excessive heat as this promotes the release of fentanyl from the patch and increases the absorption of fentanyl through the skin which can result in fatal overdose.

Summary

Fentanyl transdermal patch (Duragesic) is a synthetic narcotic prescribed for severe pain in patients, for example, with cancer pain. Side effects may include yawning, nasal discharge, twitching muscles, nausea, diarrhea, and coughing. Drug interactions, dosage, and pregnancy and breastfeeding safety information should be reviewed prior to using this medication.

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Medically Reviewed on 7/10/2019
References
FDA Prescribing Information
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