Use of Transdermal Fentanyl
Fentanyl patches that deliver the narcotic transdermally are often used to treat patients with chronic pain from metastatic cancer and other conditions. Some factors to be considered when considering this drug via this route:
1. Fentanyl patches come in doses of 25, 50, 75, and 100 mcg/hr.
2. Fentanyl patches are relatively expensive when compared to other narcotics.
3. Fentanyl patches are should be changed every three days for most patients. About 20% of patients require patches to be changed after 48 hours.
4. Fentanyl patches should never be used in patients who are beginning opioid therapy.
5. An increase in body or ambient temperature increases Fentanyl drug effect.
6. Coverage with an oral or intravenous opioid should be initiated for the first 15-20 hours until the patch “kicks in.”
7. A short-acting opioid should be prescribed for rescue doses for breakthrough pain.