What it Fentanyl (Duragesic®)? What is it used for?
Fentanyl is an opioid (narcotic) commonly used to control
persistent, moderate to severe chronic pain. Fentanyl patches, such
as Duragesic® (fentanyl transdermal system), are designed to be
worn on the skin. The adhesive layer of the patch, the layer that
sticks to your skin, is made of a special material that allows
fentanyl to be absorbed through your skin into your bloodstream.
The fentanyl is absorbed very slowly over a 72 hour period. The
patch starts to work 12-18 hours after it is applied to your skin
and continues working for up to 24 hours after the patch has been
removed from the skin.
Fentanyl patches, such as the Duragesic patch, should be used
only when a person is considered to be "opioid-tolerant." An
"opioid-tolerant" person is someone who has been taking opioids
daily for at least one week. Using opioids for this period of
time allows your health care provider to monitor your usage and
allows him/her to determine the proper dosage.
Fentanyl patches are to be used for persistent, moderate
to severe chronic pain only and should never be used "when
necessary."
Using Fentanyl (Duragesic®) Patches Safely
Keep an accurate, up-to-date medication list or card with you at
all times. This list should include the names and dosages of all
medications you are taking. Share your medication list with your
health care provider. Be sure that he/she has reviewed your
medication list before issuing a prescription for fentanyl
(Duragesic) patches because many drugs are broken down by common
pathways in the liver, which increases the risk for side
effects.
Never use a patch that is damaged or cut. Damaged patches should
be disposed of properly.
To properly dispose of a used or damaged patch:
- Fold the patch in half so that the sticky side sticks to
itself.
- Flush the folded patch down the toilet.
Always apply the patch to clean, dry skin. Do not use soaps,
lotions, oils, or alcohol on the skin where the patch will be
applied. These products may prevent the patch from sticking and/or
may increase the rate at which the fentanyl is absorbed. If the
skin must be cleansed prior to applying the patch, do so with plain
water. Allow the skin to dry completely before to apply the patch
to the skin.
The patch should be applied to intact, non-irritated skin only.
Applying the patch to open or abraded skin may increase the rate of
fentanyl absorption.
Duragesic patches may be worn for 72 hours. After removing a
patch, the next patch should be applied to a different skin site
from the previous patch to prevent skin irritation. Always remove
the old patch when a new patch is applied.
Write the date the patch was applied on a piece of tape that can
be applied to the top of the patch. Do not write on the patch.
To apply the patch:
- Choose a flat skin site on which to apply the patch, such as
the back, chest, flank (sides of the waist), or upper arm.
- If there is hair on the application site, clip the hair. DO NOT
SHAVE the application site.
- Remove the clear protective liner from the patch. The patch
must be applied immediately after the liner is removed.
- Avoid touching the sticky side of the patch as much as
possible.
- With the palm of your hand press the sticky side of the patch
to the desired skin site.
- Hold your hand on the patch for at least 30 seconds to ensure
the patch edges seal properly.
- Wash your hands.
If gel from the patch leaks out onto the skin, rinse skin well
with plain water. Do not use soap, alcohol, etc.
to rinse the skin.
Do not expose the patch skin site and the area around the patch
site to direct heat (e.g., heating pads, electric blankets, hot
tubs, tanning lamps, etc.). Heat increases the rate of fentanyl
absorption, which could lead to an overdose.
Side Effects/Adverse Effects
Be sure you share your medication list with all of your health
care providers. Many medications interact when taken with
other medications. If you are taking other medications along with
fentanyl, you may be at risk for drug interactions.
Opioids can cause constipation; therefore, it is important for
you to drink at least two quarts of non-alcoholic liquids per day,
unless your health care provider tells you not to do so. Eat
a balanced diet consisting of five servings of fruits and
vegetables a day to help combat constipation. You may also need a
stimulant laxative, such as senna, to relieve constipation.
Ask your health care provider which laxative is best for you.
Another way to help reduce constipation is to get some form of
exercise each day. A regular walking regimen -- even 10 to 15
minutes several times a day -- can help your body and your
digestive system function optimally. Consult your health care
provider before starting any vigorous exercise program.
Do not drink alcohol while using fentanyl
patches. Alcohol may increase the blood level of fentanyl
and put you at risk for respiratory depression (breathing that has
slowed so much that the body is not able to supply the oxygen they
need to survive).
Watch for signs of oversedation. Oversedation
will always precede respiratory depression. Some signs of
over sedation are:
- Falling asleep in the middle of a sentence
- Unable to arouse
Other Information
You may experience "breakthrough" pain while using fentanyl
patches. Breakthrough pain is pain that occurs because of an
activity or pain that comes on suddenly. Breakthrough pain
should be controlled with an immediate release opioid. An Immediate
release opioid is a pain medication that works very quickly.
You and your health care provider can decide what immediate release
opioid is best for you. If you need more than two doses of
immediate release pain medication a day, talk to your health care
provider about increasing the dose of your fentanyl patch.
Other family members should never use your
fentanyl patches.
Be sure your patches are stored out of the reach from children.
Do not let children handle fentanyl patches. There have been
reports of children dying from fentanyl overdoses. Children may
think that the patches are stickers or temporary tattoos.
When to Call Your Health Care Provider
Call your HCP if:
- You are falling asleep in the middle of a sentence during a
conversation.
- Your breathing is shallow.
- Your skin becomes red, irritated, or itchy.
- You have not moved your bowels for three days.
- You are vomiting.
- Your pain is not well-controlled.
Call 911 immediately if you find someone who cannot be
awakened or aroused.
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