Fentanyl skin patches should only be used to control moderate to severe chronic (around-the-clock, long-lasting) pain that cannot be controlled by the use of other pain medications in people who are tolerant (used to the effects of the medication) to narcotic pain medications because they have taken this type of medication for at least 1 week. Fentanyl skin patches should not be used to treat mild pain, short-term pain, pain after an operation or medical or dental procedure, or pain that can be controlled by medication that is taken as needed.
Fentanyl skin patches may cause serious or life-threatening breathing problems, especially during the first 72 hours of your treatment. Tell your doctor if you have or have ever had breathing difficulties, asthma, chronic obstructive pulmonary disease (COPD; a group of diseases that affect the lungs and airways), or other lung disease. Your doctor may tell you not to use fentanyl skin patches. Also tell your doctor and pharmacist if you are taking or plan to take any of the following medications: certain antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral); clarithromycin (Biaxin, in Prevpac); nefazodone; nelfinavir (Viracept); ritonavir (Norvir, in Kaletra) and troleandomycin (TAO) (not available in the United States). If you have any of the following symptoms, call your doctor immediately: difficulty breathing; extreme drowsiness with slow breathing; heartbeat that is slower than normal; cold clammy skin; difficulty thinking, talking, or walking normally; dizziness; confusion; extreme tiredness; fainting; or loss of consciousness.
Do not apply fentanyl skin patches to skin that is irritated, broken out, burned, cut, or damaged in any way. Do not use a fentanyl skin patch that is cut, damaged, or changed in any way. If you use cut or damaged patches, you may receive most or all of the medication at once, instead of slowly over 3 days. This may cause serious problems, including overdose and death.
Fentanyl skin patches can be habit-forming. Tell your doctor if you or your family drink or have ever drunk large amounts of alcohol; have overused prescription medications; have used street drugs; or have or have ever had depression or mental illness.
Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with fentanyl skin patches and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs) or the manufacturer's website to obtain the Medication Guide.
Fentanyl skin patches should not be used in children less than 2 years of age. Talk to your child's doctor about the risks of applying fentanyl skin patches to your child.
Talk to your doctor about the risks of using this medication.
Fentanyl skin patches are used to relieve moderate to severe pain that is expected to last for some time, that does not go away, and that cannot be treated with other pain medications. Fentanyl skin patches are only used to treat people who are tolerant (used to the effects of the medication) to narcotic pain medications because they have taken this type of medication for at least 1 week. Fentanyl is in a class of medications called opiate (narcotic) analgesics. It works by changing the way the brain and nervous system respond to pain.
Transdermal fentanyl comes as a patch to apply to the skin. The patch is usually applied to the skin once every 72 hours. Change your patch at about the same time of day every time you change it. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Apply fentanyl patches exactly as directed.
Your doctor may start you on a low dose of fentanyl skin patches and gradually increase your dose, not more often than once every 3 days at first, and then not more often than once every 6 days.
Fentanyl skin patches are only for use on the skin. Do not place patches in your mouth or chew or swallow the patches.
The medication in fentanyl patches is contained in a gel that is sealed between layers of the patch. If this gel leaks from the patch, remove the patch right away without touching the gel. If you or a caregiver touches the gel, immediately wash the area with large amounts of clear water. Do not use soap, alcohol, or other cleansers.
Fentanyl skin patches may be habit forming. Do not apply more than one patch at a time unless your doctor tells you that you should, and do not apply fentanyl skin patches more often, or for a longer period of time than prescribed by your doctor.
Do not stop using fentanyl skin patches without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop using fentanyl skin patches you may have symptoms of withdrawal. Call your doctor if you experience any of these symptoms of withdrawal: restlessness, teary eyes, runny nose, yawning, sweating, chills, hair standing on end, muscle aches, large pupils (black circles in the center of the eyes), irritability, anxiety, backache, pain in the joints, weakness, stomach cramps, difficulty falling asleep or staying asleep, nausea, loss of appetite, vomiting, diarrhea, fast heartbeat, or rapid breathing.
While you are wearing a fentanyl patch, protect the patch from direct heat such as heating pads, electric blankets, heat lamps, saunas, hot tubs, and heated water beds. Do not take long, hot baths or sunbathe while you are wearing the patch.
You may bathe, swim, or shower while you are wearing a fentanyl skin patch. If the patch falls off during these activities, dry your skin completely and apply a new patch.
Choose a flat, hairless area of skin on your chest, back, upper arm, or sides of your waist. If you are applying the patch to a child or person who is unable to think clearly, choose an area on the upper back to make it more difficult for the person to remove the patch and place it in his or her mouth. Avoid areas that move a lot, that are sensitive, that have been exposed to radiation (x-ray treatment), or where you have recently applied a skin patch. If there is hair on the skin, clip the hair as close to the skin as possible with scissors, but do not shave it.
Clean the area with clear water and pat dry. Do not use any soaps, lotions, alcohols or oils.
Tear open the pouch containing the fentanyl skin patch along the dotted line, starting at the slit. Remove the skin patch from the pouch and peel off the protective liner from the back of the patch. Try not to touch the sticky side of the patch.
Immediately press the sticky side of the patch onto the chosen area of skin with the palm of your hand.
Press the patch firmly for at least 30 seconds. Be sure that the patch sticks well to your skin, especially around the edges.
If the patch does not stick well or comes loose after it is applied, tape the edges to your skin with first aid tape.
When you are finished applying the patch, wash your hands with only clear water right away.
When it is time to change your patch, peel off the old patch and apply a new patch to a different skin area.
After you remove your patch, fold it in half with the sticky sides together and flush it down a toilet. Used patches may still contain some medication and may be dangerous to children, pets, or adults who have not been prescribed fentanyl skin patches.
If a patch accidentally comes off or if the skin under the patch becomes irritated, remove the patch and replace it with a new one in a different area, following the steps above.
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
Talk to your doctor about eating grapefruit and drinking grapefruit juice while using this medication.
If you forget to apply or change a fentanyl skin patch, apply the patch as soon as you remember it. Be sure to remove your used patch before applying a new patch. Wear the new patch for the period of time prescribed by your doctor (usually 3 days) and then replace it. Do not wear two patches at once unless your doctor has told you that you should.
headache
mood changes
nervousness
depression
confusion
memory problems
hallucinations (seeing things or hearing voices that do not exist)
weakness
dizziness
difficulty falling asleep or staying asleep
uncontrollable shaking of a part of the body
pain, burning, tingling, or numbness in the hands or feet
dry mouth
hiccups
stomach pain
indigestion
gas
diarrhea
constipation
nausea
vomiting
loss of appetite
back pain
difficulty urinating
itching
skin irritation, redness, itching, swelling, or blisters in the area where you wore the patch
sweating
heartbeat that is faster than normal
chest pain
rash
seizure
coughing up blood
Fentanyl skin patches may cause other side effects. Call your doctor if you have any unusual problems while you are using fentanyl skin patches.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].
Keep this medication in the protective pouch it came in, tightly closed, and out of reach of children and pets. Store fentanyl skin patches in a safe place so that no one can take them accidentally or on purpose. Keep track of how many patches are left so you will know if any are missing. Store the patches at room temperature and away from excess heat and moisture (not in the bathroom). Do not store fentanyl skin patches inside your car.
Throw away any patches that are outdated or no longer needed by carefully removing the adhesive backing, folding the sticky sides of each patch together so that it sticks to itself, and flushing the patches down the toilet. Throw away the pouches and protective liners in the trash. Wash your hands well with water after throwing away fentanyl patches. Do not put unneeded or used fentanyl skin patches in a garbage can.
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
difficulty breathing
extreme sleepiness or tiredness
difficulty thinking, talking, or walking normally
small, pinpoint pupils (black circles in the center of the eye)
faintness
dizziness
confusion
coma (loss of consciousness for a period of time)
Keep all appointments with your doctor.
This prescription is not refillable. Be sure to schedule appointments with your doctor on a regular basis so that you do not run out of medication.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
Last Reviewed - 09/01/2010
AHFS® Consumer Medication Information. © Copyright, 2012. The American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.