Fentanyl

 

Name of the generic: fentanyl transdermal (skin patch)
Name of the brand: Duragesic
Drug class: Narcotic analgesics

What is a Fentanyl?

Fentanyl is an opioid painkiller, sometimes referred to as an Narcotic.

Fentanyl patches are an effective prescription pain medication. These patches are utilized for the treatment of mild to extreme constant pain throughout the day.

Fentanyl patches are prescribed to treat pain when other treatment options like non-opioid pain medication or immediate-release opioid drugs are not able to treat pain effectively enough or can’t tolerate them.

Fentanyl patches should not be used intended to treat mild or intermittent painful or numbness caused by surgery. They are not intended meant to alleviate pain that isn’t continuous.

Fentanyl  is not a treatment for the pain that isn’t related to cancer.¶

Warnings

Fentanyl can cause breathing to slow or stop and can cause dependence. Make sure you only take the dose prescribed by your doctor. Do not give away Fentanyl with a person else.

The misuse of this medication could lead to addiction, overdose or even death, particularly for children or any other user of the medication without prescription.

Side effects that are fatal can be experienced if you take this medication in combination with alcohol or other substances that can cause drowsiness, or slow breathing.

Before taking this medication, following point should be consider in mind.

• A clinically significant respiratory or CNS depressions can be experienced. Check patients regularly for any signs of CNS depression.
• Do not change patients on a mg per mcg basis from a different Fentanyl-based product to Fentanyl.
• Fentanyl containing dosage that could be fatal for a child. Make sure that the product is properly stored and disposed of.
• Combining it together with other CNS depressants as well as powerful Cytochrome P450 3A4 inhibitors can cause depressant-related effects such as hypotension, hypoventilation, and deep sleepiness. Make adjustments to dosage if needed.
• Titrate Fentanyl carefully in patients suffering from chronic obstructive lung disease or other medical conditions that may predispose them to hypoventilation. Also, in patients who are susceptible to CO2 retention effects that affect the intracranial area.

Before taking this medication, you must consult your physician

Do not take Fentanyl unless you’re already taking an opioid medication that is available 24/7 and you are tolerant of this. You should not take Fentanyl when you have an allergy to fentanyl, or you are:

• severe asthma or breathing problems;
• A bowel obstruction or stomach (including an ileus that is paralytic).

To be sure Fentanyl is suitable for you, ask your physician if you’ve previously had:

• breathing issues sleep apnea
• any breathing issue or lung disease
• an injury to the head, a seizures or brain tumors;
• Low blood pressure heartbeats that are slow or other heart rhythm disorders;
• Addiction to alcohol or drugs or schizophrenia or hallucinations;
• kidney disease or liver failure;
• Problems with urination and
• troubles that concern your gallbladder, thyroid or the pancreas.

Inform your doctor whether there are children within the home in which you’ll store this medicine. The quantity of fentanyl present in this medication could be fatal to children.

If you are using Fentanyl during pregnancy the baby may become dependent to the medication. This can cause dangerous withdrawal symptoms for the infant after it is born. Baby’s who become dependent on habit-forming medications could require medical treatment for a period of time. Inform your doctor if are pregnant or are planning to be pregnant.

Do not breastfeed when you take this medication.

 

How should I use Fentanyl?

Apply the patch as directed by your physician. Follow the directions on the prescription label, and be sure to read the entire medication guide. Do not use fentanyl patches greater quantities or for longer than the time prescribed. Inform your doctor if have a strong urge to apply more patches of fentanyl. Do not apply a patch to your skin when it’s been damaged or cut.

Stop making use of other round-the-clock opioids.

Do not share your opioid medication with a person, particularly one who has an history of substance abuse or addiction. A misusing of the medicine can result in addiction or overdose, or even death. Make sure the medication is kept in a location where other people are not able to access it. Giving away or selling opioids is against the law.

Don’t allow the patch of skin to touch your eyes, mouth the nose, lips or the skin of a person.

Follow and read carefully any instructions that are included in your medication. Consult your physician or pharmacist If you don’t understand the instructions.

Wear the fentanyl patch throughout the day, taking out and replacing it every for 72 days (3 jours). Don’t wear more than one patch at a given time unless your physician has advised you to.

If you are putting a patch of skin on a child pick a location that the child is unable to remove the patch without supervision.

Don’t stop taking fentanyl in a hurry otherwise you might experience painful withdrawal signs. Consult your physician about how you can effectively stop using the drug.

Place each patch in the foil pouch at temperatures at room temperature.

Make sure to keep both unused and used patches out of pet’s reach. A high concentration of Fentanyl present in the skin patch used can cause harm to pets or children who chews or sucks at the patches. Seek emergency medical care if this happens.

After you have removed skin patches: fold it in half , putting the sticky side inside, and flush it down the toilet immediately. Don’t put a used skin patch inside a trash container.

Do not store any an empty bottle of opioid. A single dose can cause death for someone who is using this medication improperly or in error. Ask your pharmacist for a disposal program that takes back the drug. If there isn’t a take-back plan, discard the skin patches that are not used in the same way as you fold them. Don’t flush the pouch with foil or patch liner; put them in a trash can far from access of pets and children.

 

 

Dosing information

Usual Adult Dose for Chronic Pain:

Due to the possibility of respiratory depression The transdermal patch is intended for the treatment of patients who have a tolerance to opioids only Patients who are opioid-tolerant are taking at minimum 60 mg of morphine per day oral oxycodone at 30 mg daily, or oral hydromorphone daily 8 mg or an equivalent dose of an alternative opioid for a week or more.
Stop all other extended-release opioids before beginning treatment.

• Initial doses

First dose should be determined individually considering the patient’s previous treatment experience. The dose can be calculated using the dosage conversion guidelines found in the insert to the product’s package or local protocol, or any other reliable source; when calculating, remember that there is a significant inter-patient variation in the relative strength of various opioids and products which is why it is more sensible to underestimate the fentanyl requirement for 24 hours and administer a medication to help in the event of an emergency, rather instead of overestimating that could cause adverse reactions.

• Dose titration

Initial: may increase dosage after 3 days, based on the dose of daily additional opioid analgesics needed from the patient during the second or third day following the first application.
Further titration should be done at least two three-day treatments as it can take up to six days for levels of fentanyl to be at equilibrium. The titration must be based on your daily dosage of additional opioids needed and the following proportion could be used: Increase the transdermal Fentanyl dosage by 12 mg/hour when using oral supplementary dosages of morphine that are up to 45 mg/24 hours.
Dosage for maintenance: adjust dosage to achieve a level of pain relief and adverse reactions related to opioids. When you are on a long-term treatment, it is important to periodically evaluate the necessity to use opioid analgesics.

Comments:
Do not start the patient with the transdermal patch containing fentanyl as your first prescription for opioids.
A few patients may require a 24-hour dosing interval. An increase in dosage should be evaluated prior to changing dosage intervals.

What if I miss a  dose?

If you’re using patches for skin on a regular basis you missed, apply the patch immediately after you have remembered. Wear the patch until 72 hours apply a new patch in case of the pain. Don’t wear additional patches to cover the missed dose.

If I consume too much?

For medical emergencies, seek immediate medical attention or contact emergency medical attention or call the Poison Help line at 1-800-222-1222. Fentanyl overdoses is fatal, especially for children or any other user of the drug without having a prescription. Overdose symptoms may include a slow breathing and heart rate, extreme fatigue and muscle weakness as well as clammy and cold skin, pinpoint pupils and fainting.

What to be aware of when taking fentanyl?

Avoid heat sources during the time you wear this patch. Do not use the heating pad or blanket, tanning bed, waterbed heater or sauna. Don’t sit on hot surfaces, bathe in the sun or increase the temperature of your body with extreme exercise. The heat could increase the amount of substance you absorb through your skin, and could result in an overdose, or even death.

Grapefruit can interact with fentanyl, which can lead to undesirable adverse consequences. Beware of using grapefruit-related products.

Avoid drinking or consume alcohol. Dangerous side effects or even death could happen.

Do not wear a skin patch on your body where children can reach or remove the patch off your skin. Don’t let your children observe the process of putting on the patch. Never inform a child that the fentanyl patch on their skin is just a “bandage.”

Do not drive or operate machinery until you understand how patches containing fentanyl affects your health. Drowsiness or excessive drowsiness may cause accidents or falls.

Fentanyl side effects

Contact a medical professional immediately in the event that you show symptoms that you are experiencing an allergic reaction after a patch of fentanyl: hives or chest pain, trouble breathing, swelling of your lips, face or tongue.

Opioid medicines may slow or stop breathing and the possibility of death can occur. The person who is caring for you must seek urgent medical care if you suffer from prolonged breathing, pauses in your breathing or blue-colored lips or if it is difficult to get up.

Take off the patch of skin and notify your doctor the earliest opportunity if:

• slower heart rate and sighing. It may also cause breath that is shallow or weak (up up to several days following the removal of the patch of skin);
• breathing stops while asleep;
• confusion, severe drowsiness, feeling like you might pass out;
• chest pain, fast or pounding heartbeats; or
• low levels of cortisol Low levels of cortisol – vomiting, vomiting and loss of appetite. dizziness, fatigue that is worsening or weakness.

Get medical attention immediately if you experience signs of serotonin disorder, like: agitation hallucinations, fever, sweating, shivering rapid heart rate stiffness of muscles and twitching, nausea vomiting, as well as vomiting.

Risky side effects are more common in older people and people with overweight or malnourished. disabled.

Common side effects of fentanyl patches could be:

• headache, dizziness, drowsiness, tiredness;
• nausea, vomiting, stomach pain, diarrhea, constipation;
• redness, itching, or rash if patches were worn;
• sleep problems (insomnia); or
• an increase in sweating, or a the feeling of cold.

This is not a comprehensive list of possible side effects, and others could happen. Contact your doctor for advice regarding medical adverse effects. You can report any adverse reactions to the FDA at 1-800-FDA-1088.

What other drugs can have an effect on the effects of fentanyl?

There is a possibility of breathing issues or withdrawal symptoms if take or stop using certain other medications. Talk to your doctor if also take any antibiotic or antifungal medication. blood pressure or heart-related medications, seizures medication or medication for treating HIV as well as Hepatitis C.

Opioid medications can interact with other drugs , causing serious side effects or even death. Be sure your doctor is aware of if you take:

• medications for allergies or colds, asthma bronchodilatorand COPD medication or diuretic (“water pill”);
• medications to treat motion sickness, irritable bowel syndrome medicines for motion sickness, irritable bowel syndrome the overactive bladder;
• other narcotic drugs like opioid pain medication and prescription medicine for cough
• A sedative that is similar to Valium – diazepam alprazolam, Lorazepam, Xanax, Klonopin, Versed and more;
• drugs that can make you feel sleepy or cause breathing to slow such as a sleeping pill, a muscle relaxer, or medicine for treating mental illnesses or mood disorders as well as
• medications that alter serotonin levels within your body. an stimulant or medication to treat Parkinson’s disease, depression migraine headaches, serious infections, nausea, and vomiting.

This list is not comprehensive. Other medications may interact with fentanyl. This includes prescription and over-the counter drugs, vitamins, and herbal products. The interactions of all kinds are not mentioned here.

Additional details

Be sure to keep all medicines away from reach of children. Never let your medications be shared with anyone else and use patches of fentanyl for only the purpose that is prescribed.

Always consult your doctor to make sure the information presented on this site is appropriate to your particular situation.