Fentanyl skin patch

July 31, 2020

Fentanyl skin patch

What is this medicine?

FENTANYL (FEN ta nil) is a pain reliever. It is used to treat persistent, moderate to severe chronic pain. It is used only by people who have been taking an opioid or narcotic pain medicine for more than one week.

How should I use this medicine?

Apply the patch to your skin. Do not cut or damage the patch. A cut or damaged patch can be very dangerous because you may get too much medicine. Select a clean, dry area of skin above your waist on your front or back. The upper back is a good spot to put the patch on children or people who are confused because it will be hard for them to remove the patch. Do not apply the patch to oily, broken, burned, cut, or irritated skin. Use only water to clean the area. Do not use soap or alcohol to clean the skin because this can increase the effects of the medicine. If the area is hairy, clip the hair with scissors, but do not shave.

Take the patch out of its wrapper, and take off the protective strip over the sticky part. Do not use a patch if the packaging or backing is damaged. Do not touch the sticky part with your fingers. Press the sticky surface to the skin using the palm of your hand. Press the patch to the skin for 30 seconds. Wash your hands at once with soap and water.

Keep patches far away from children. Do not let children see you apply the patch and do not apply it where children can see it. Do not call the patch a sticker, tattoo, or bandage, as this could encourage the child to mimic your actions. Used patches still contain medicine. Children or pets can have serious side effects or die from putting used patches in their mouth or on their bodies.

Take off the old patch before putting on a new patch. Apply each new patch to a different area of skin. If a patch comes off or causes irritation, remove it and apply a new patch to different site. If the edges of the patch start to loosen, first apply first aid tape to the edges of the patch. If problems with the patch not sticking continue, cover the patch with a see-through adhesive dressing (like Bioclusive or Tegaderm). Never cover the patch with any other bandage or tape.

To get rid of used patches, fold the patch in half with the sticky sides together. Then, flush it down the toilet. Do not discard the patch in the garbage. Pets and children can be harmed if they find used or lost patches. Replace the patch every 3 days or as directed by your doctor or health care professional. Follow the directions on the prescription label. Do not take more medicine than you are told to take.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for children as young as 2 years old for selected conditions, precautions do apply.

If someone accidentally uses a fentanyl patch and is not awake and alert, immediately call 911 for help. If the person is awake and alert, call a doctor, health care professional, or the Poison Control Center.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

  • allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

  • breathing problems

  • confusion

  • signs and symptoms of low blood pressure like dizziness; feeling faint or lightheaded, falls; unusually weak or tired

  • trouble passing urine or change in the amount of urine

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

  • constipation

  • dry mouth

  • itching at the site where the patch was applied

  • nausea, vomiting

  • tiredness

What may interact with this medicine?

Do not take this medication with any of the following medicines:

  • mifepristone

This medicine may also interact with the following medications:

  • alcohol

  • antihistamines for allergy, cough and cold

  • antiviral medicines for HIV or AIDS

  • aprepitant

  • atropine

  • certain antibiotics like erythromycin and clarithromycin

  • certain medicines for anxiety or sleep

  • certain medicines for bladder problems like oxybutynin, tolterodine

  • certain medicines for blood pressure, heart disease, irregular heart beat

  • certain medicines for depression like amitriptyline, fluoxetine, sertraline

  • certain medicines for diabetes like pioglitazone, troglitazone

  • certain medicines for fungal infections like ketoconazole and itraconazole

  • certain medicines for seizures like phenobarbital, phenytoin, primidone

  • certain medicines for stomach problems like dicyclomine, hyoscyamine

  • certain medicines for travel sickness like scopolamine

  • certain medicines for Parkinson's disease like benztropine, trihexyphenidyl

  • cimetidine

  • general anesthetics like halothane, isoflurane, methoxyflurane, propofol

  • grapefruit juice

  • ipratropium

  • local anesthetics like lidocaine, pramoxine, tetracaine

  • MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate

  • medicines that relax muscles for surgery

  • other narcotic medicines for pain or cough

  • phenothiazines like chlorpromazine, mesoridazine, prochlorperazine, thioridazine

  • rifampin

  • St. John's wort

  • steroid medicines like prednisone or cortisone

What if I miss a dose?

If you forget to replace your patch, take off the old patch and put on a new patch as soon as you can. Do not apply an extra patch to your skin. Do not wear more than one patch at the same time unless told to do so by your doctor or health care professional.

Where should I keep my medicine?

Keep out of the reach of children. This medicine can be abused. Keep your medicine in a safe place to protect it from theft. Do not share this medicine with anyone. Selling or giving away this medicine is dangerous and against the law.

Store below 77 degrees F (25 degrees C). Do not store the patches out of their wrappers.

This medicine may cause harm and death if it is taken by other adults, children, or pets. Return medicine that has not been used to an official disposal site. Contact the DEA at 1-800-882-9539 or your city/county government to find a site. If you cannot return the medicine, flush it down the toilet as instructed above. Do not use the medicine after the expiration date.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

  • brain tumor

  • Crohn's disease, inflammatory bowel disease, or ulcerative colitis

  • drug abuse or addiction

  • head injury

  • heart disease

  • if you frequently drink alcohol containing drinks

  • kidney disease or problems going to the bathroom

  • liver disease

  • lung disease, asthma, or breathing problems

  • mental problems

  • skin problems

  • taken isocarboxazid, phenelzine, tranylcypromine, or selegiline in the past 2 weeks

  • an allergic or unusual reaction to fentanyl, meperidine, other medicines, foods, dyes, or preservatives

  • pregnant or trying to get pregnant

  • breast-feeding

What should I watch for while using this medicine?

Tell your health care provider if your pain does not go away, if it gets worse, or if you have new or a different type of pain. You may develop tolerance to this drug. Tolerance means that you will need a higher dose of the drug for pain relief. Tolerance is normal and is expected if you take this drug for a long time.

Do not suddenly stop taking your drug because you may develop a severe reaction. Your body becomes used to the drug. This does NOT mean you are addicted. Addiction is a behavior related to getting and using a drug for a nonmedical reason. If you have pain, you have a medical reason to take pain drug. Your health care provider will tell you how much drug to take. If your health care provider wants you to stop the drug, the dose will be slowly lowered over time to avoid any side effects.

If you take other drugs that also cause drowsiness like other narcotic pain drugs, benzodiazepines, or other drugs for sleep, you may have more side effects. Give your health care provider a list of all drugs you use. He or she will tell you how much drug to take. Do not take more drug than directed. Get emergency help right away if you have trouble breathing, unusually tired or sleepy, or not being able to respond or wake up.

Talk to your health care provider about naloxone and how to get it. Naloxone is an emergency drug used for an opioid overdose. An overdose can happen if you take too much opioid. It can also happen if an opioid is taken with some other drugs or substances, like alcohol. Know the symptoms of an overdose, like trouble breathing, unusually tired or sleepy, or not being able to respond or wake up. Make sure to tell caregivers and close contacts where it is stored. Make sure they know how to use it. After naloxone is given, you must get emergency help right away. Naloxone is a temporary treatment. Repeat doses may be needed.

This patch is sensitive to body heat changes. If your skin gets too hot, more drug will come out of the patch and can cause a deadly overdose. Call your health care provider if you get a fever. Do not take hot baths. Do not sunbathe. Do not use hot tubs, saunas, hairdryers, heating pads, electric blankets, heated waterbeds, or tanning lamps. Do not do exercise that increases your body temperature.

If you are going to need surgery, an MRI, CT scan, or other procedure, tell your health care provider that you are using this drug. You may need to remove the patch before the procedure.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this drug affects you. Do not stand up or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this drug. Avoid alcoholic drinks.

This drug will cause constipation. If you do not have a bowel movement for 3 days, call your health care provider.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy and drinking plenty of water may help. Contact your health care provider if the problem does not go away or is severe.

Updated:  

July 31, 2020