WARNING

Fentanyl transdermal patches carry several risks, including:

• Overdose: Fentanyl is a potent opioid, and incorrect use or accidental exposure to the patch can lead to overdose, causing respiratory depression and potentially death.
• Respiratory Depression: Like other opioids, fentanyl can depress breathing, especially in individuals with respiratory conditions or those taking other medications that depress the central nervous system.
• Addiction and Dependence: Fentanyl, being an opioid, carries a high risk of addiction and dependence, particularly when used long-term or at high doses.
• Withdrawal Symptoms: Abrupt discontinuation of fentanyl can lead to withdrawal symptoms, including nausea, vomiting, diarrhea, sweating, muscle aches, and insomnia.
• Drug Interactions: Fentanyl can interact with other medications, particularly those that also depress the central nervous system, increasing the risk of respiratory depression and other adverse effects.
• Skin Irritation: The patch itself can cause skin irritation or allergic reactions at the application site.
• Accidental Exposure: There is a risk of accidental exposure to fentanyl patches, especially in households with children or pets, which can lead to overdose and serious health complications.

It’s crucial to use fentanyl transdermal patches only as prescribed by a healthcare professional and to follow all instructions carefully to minimize these risks. Additionally, proper disposal of used patches is essential to prevent accidental exposure to others.

Why is this medication prescribed?

Fentanyl transdermal patches are typically prescribed for the management of chronic severe pain that requires round-the-clock opioid treatment and for which alternative treatment options are inadequate. This can include conditions such as cancer pain or severe chronic pain syndromes.

How should this medicine be used?

When using fentanyl transdermal patches, it’s crucial to follow the prescribing doctor’s instructions carefully. Here are general guidelines for proper use:

• Applying the Patch: The patch should be applied to clean, dry, intact skin, usually on the upper arm, chest, back, or upper torso. Avoid areas with hair, cuts, irritation, or scars.
• Rotate Application Sites: To prevent irritation and improve absorption, rotate the application site with each new patch. Wait at least a week before using the same site again.
• Handling the Patch: Handle the patch with clean, dry hands. Do not cut the patch or expose it to excessive heat or sunlight, as this can increase the rate of fentanyl release.
• Avoiding Water: Avoid exposing the patch to water, such as swimming or bathing, as it can loosen the adhesive and affect drug delivery. However, brief showers are usually acceptable.
• Monitoring: Keep track of when you apply and remove each patch. This is important for maintaining a steady level of medication in the body and avoiding accidental overdose.
• Disposal: After use, fold the patch in half with the adhesive side inward, then dispose of it safely out of reach of children and pets. Many pharmacies offer disposal programs for used patches.
• Dosage Adjustments: Do not adjust the dosage or stop using the patch without consulting your doctor. Changes in dosage should be made under medical supervision to avoid withdrawal symptoms or other complications.
• Seek Medical Help: If you experience severe respiratory depression, overdose symptoms, or any other serious side effects, seek medical attention immediately.

It’s essential to use fentanyl transdermal patches exactly as prescribed and to communicate any concerns or difficulties with your healthcare provider. Misuse or improper use can lead to serious health risks, including overdose and death.

Other uses for this medicine

However, there are instances where healthcare providers might prescribe fentanyl patches for off-label uses, such as:

• Non-cancer Chronic Pain: While fentanyl patches are primarily indicated for cancer-related pain, they may be prescribed off-label for severe chronic non-cancer pain in certain situations.
• Pain in Palliative Care: Fentanyl patches may be used in palliative care to manage severe pain in patients with advanced illnesses beyond cancer.
• Neuropathic Pain: In some cases of severe neuropathic pain, where other treatments have failed, healthcare providers may consider using fentanyl patches off-label.

What special precautions should I follow?

Special precautions should be taken when using fentanyl transdermal patches due to their potency and potential for misuse and adverse effects. Here are some important precautions to follow:

• Prescription: Fentanyl patches should only be used under the direct supervision and prescription of a qualified healthcare professional who has experience in opioid therapy.
• Dosage: Use the lowest effective dose for the shortest duration possible to minimize the risk of addiction, tolerance, and overdose.
• Monitoring: Patients using fentanyl patches should be closely monitored for signs of respiratory depression, sedation, and other opioid-related side effects. Regular follow-up appointments with healthcare providers are essential to assess the effectiveness and safety of treatment.
• Drug Interactions: Inform your doctor about all medications, supplements, and herbal products you are taking before starting fentanyl patches, as they can interact with other drugs, particularly those that depress the central nervous system.
• Misuse and Abuse: Store fentanyl patches securely out of reach of children, adolescents, and individuals with a history of substance abuse. Misuse or abuse of fentanyl patches can lead to addiction, overdose, and death.
• Disposal: Properly dispose of used fentanyl patches by folding them in half with the adhesive sides together and flushing them down the toilet. This prevents accidental exposure and ingestion by others.
• Pregnancy and Breastfeeding: Use of fentanyl patches during pregnancy or breastfeeding should be carefully considered, as the drug can pass through the placenta and into breast milk, potentially causing harm to the fetus or newborn.
• Skin Irritation: Monitor the application site for any signs of skin irritation, such as redness, itching, or rash. If irritation occurs, consult your healthcare provider.
• Emergency Situations: In case of overdose or respiratory depression, have naloxone (Narcan) readily available for emergency use, and know how to administer it. Naloxone can reverse the effects of opioid overdose temporarily and can save lives when administered promptly.

Following these precautions can help ensure the safe and effective use of fentanyl transdermal patches in managing chronic pain while minimizing the risk of adverse effects and complications.

What special dietary instructions should I follow?

Regarding dietary instructions, there are no specific dietary restrictions associated with fentanyl transdermal patches. However, maintaining a balanced diet and staying hydrated can contribute to overall health and well-being, which may indirectly support pain management efforts.

What should I do if I forget a dose?

If you forget to apply a dose of the fentanyl patch at the scheduled time, apply it as soon as you remember, unless it is almost time for your next scheduled dose. In that case, skip the missed dose and resume your regular dosing schedule. Do not apply extra patches to make up for a missed dose, as this can increase the risk of overdose. If you are unsure about what to do, consult your healthcare provider or pharmacist for guidance.

What side effects can this medication cause?

Fentanyl transdermal patches can cause various side effects, ranging from mild to severe. Common side effects may include:

• Nausea and vomiting: Gastrointestinal upset, including nausea and vomiting, is a common side effect of fentanyl patches, especially when starting treatment or increasing the dose.
• Constipation: Opioids like fentanyl can slow down bowel movements, leading to constipation. Adequate hydration, dietary fiber, and stool softeners may help manage this side effect.
• Drowsiness and dizziness: Fentanyl can cause drowsiness, sedation, and dizziness, impairing mental and physical abilities. Avoid driving or operating heavy machinery until you know how fentanyl affects you.
• Headache: Some individuals may experience headaches while using fentanyl patches.
• Skin Irritation: Irritation or redness at the application site is possible, although less common. Rotating application sites and proper patch placement can help minimize this side effect.
• Itching or Rash: Skin itching or rash may occur at the patch site in some individuals.
• Sweating: Excessive sweating, particularly at the application site, can occur with fentanyl patches.
• Respiratory Depression: In high doses or with improper use, fentanyl can depress breathing, leading to respiratory depression, which can be life-threatening.
• Hypotension: Fentanyl can cause low blood pressure, leading to dizziness or fainting.
• Adverse Reactions: Rarely, severe allergic reactions, including anaphylaxis, can occur in response to fentanyl.
• Opioid Withdrawal: Abrupt discontinuation of fentanyl patches can lead to withdrawal symptoms, such as sweating, agitation, anxiety, muscle aches, and insomnia.
• Serotonin Syndrome: Fentanyl can interact with other medications to cause serotonin syndrome, characterized by symptoms such as confusion, agitation, rapid heart rate, elevated blood pressure, dilated pupils, and sweating.

It’s essential to report any side effects to your healthcare provider promptly. Additionally, seek immediate medical attention if you experience severe side effects or signs of overdose, such as shallow breathing, extreme drowsiness, confusion, or unconsciousness.

What should I know about storage and disposal of this medication?

Storage and disposal of Fentanyl transdermal Spray:

• Storage: Store fentanyl patches in a secure location out of reach of children, adolescents, pets, and anyone else who may accidentally use them. Keep them in their original packaging to prevent confusion with other medications. Store at room temperature away from heat, moisture, and light.
• Disposal: After use, fold the patch in half with the adhesive side together and flush it down the toilet immediately. This helps prevent accidental exposure and ingestion by others. Do not dispose of patches in the trash where they could be accessed by children or pets. Many pharmacies also offer medication disposal programs for safe disposal.

In case of emergency/overdose

In case of emergency or overdose involving fentanyl transdermal patches, take the following steps:

• Call Emergency Services: If you suspect someone has overdosed on fentanyl, call emergency services (e.g., 911) immediately. Time is critical in overdose situations, and prompt medical attention can save lives.
• Administer Naloxone: If naloxone (Narcan) is available, administer it according to the instructions provided. Naloxone can reverse the effects of opioid overdose temporarily, restoring breathing and consciousness.
• Provide Support: Stay with the person until emergency medical help arrives. Keep them calm and monitor their breathing and vital signs.
• Follow Medical Instructions: Follow any instructions provided by emergency responders or healthcare professionals. Be prepared to provide information about the individual’s medical history and the circumstances of the overdose.

What other information should I know?

• Avoid Alcohol: Avoid consuming alcohol while using fentanyl patches, as it can increase the risk of side effects such as drowsiness, dizziness, and respiratory depression.
• Avoid Driving or Operating Machinery: Fentanyl can impair cognitive and motor function, so avoid driving or operating heavy machinery until you know how it affects you.
• Medical Alert: Wear a medical alert bracelet or carry a card indicating that you are using fentanyl patches, especially when traveling or in emergency situations.
• Regular Monitoring: Attend regular follow-up appointments with your healthcare provider to monitor the effectiveness and safety of fentanyl treatment. Report any concerns or changes in symptoms promptly.
• Avoid Suddenly Stopping: Do not abruptly stop using fentanyl patches without consulting your healthcare provider. Sudden discontinuation can lead to withdrawal symptoms.
• Keep Track of Doses: Keep a record of when you apply and remove each patch to ensure proper dosing and to prevent accidental overdose.

By following these guidelines and being informed about the safe use, storage, disposal, and management of fentanyl transdermal patches, you can help minimize risks and ensure safe and effective pain management.