Fentanyl transdermal system

Fentanyl transdermal system Fentanyl transdermal systems contain a high concentration of the potent schedule II opioid agonist, fentanyl. Schedule II opioid substances have the highest potential for abuse and associated risk of fatal overdose due to respiratory depression. Fentanyl can be abused and is subject to criminal diversion. The high content of fentanyl in the patches may be a particular target for abuse and diversion. 

Fentanyl transdermal system is indicated for management of persistent, moderate to severe chronic pain that ... 

Fentanyl transdermal system should only be used in patients who are already receiving opioid therapy, who have demonstrated opioid tolerance, and who require a total daily dose at least equivalent to fentanyl transdermal system 25 mcg/h. 

Do not administer fentanyl transdermal system to children younger than 2 years of age. Administer to children only if they are opioid tolerant and 2 years of age or older. 

Only use in patients who are already receiving opioid therapy, who have demonstrated opioid tolerance, and who require a total daily dose at least equivalent to fentanyl transdermal system 25 meg/h. Patients who are considered opioid tolerant are those who have been taking, for a week or longer, morphine 60 mg/day or more, oral oxycodone 30 mg/day or more, oral hydromorphone 8 mg/day or more, or an equianalgesic dose of another opioid. 

Do not use this table to convert from fentanyl transdermal system to other therapies because this conversion to fentanyl is conservative. Use of this table for conversion to other analgesic therapies can overestimate the dose of the new agent. Overdosage of the new analgesic agent is possible. 

Pediatric patients initiating therapy on a fentanyl transdermal system 25 mcg/h should be opioid-tolerant and receiving oral morphine equivalents 60 mg/day or more. 

If disturbances of gastrointestinal function prevent the use of oral sustained-release morphine, the fentanyl transdermal system (fentanyl patch) can be used over long periods. Furthermore, buccal transmucosal fentanyl can be used for short episodes of breakthrough pain (see Alternative Routes of Administration). Administration of strong opioids by nasal insufflation has been shown to be efficacious, and nasal preparations are now available in some countries. Approval of such formulations in the USA is growing. In addition, stimulant drugs such as the amphetamines have been shown to enhance the analgesic actions of the opioids and thus may be very useful adjuncts in the patient with chronic pain. 

Parenteral (generic, Sublimaze) 50 mcg/mL for injection Fentanyl Transdermal System (Duragesic) 12.5, 25, 50, 75, 100 mcg/h delivery Fentanyl Buccal 100, 200, 400, 600, 800 meg oral lozenge Fentanyl Actiq 200, 400, 600, 800, 1200, 1600 meg lozenge on a stick Patient Controlled Transdermal Iontophoretic Fentanyl System 40 meg per dose for delivery Hydromorphone (generic, Dilaudid)... 

FENTANYL TRANSDERMAL SYSTEM (Duragesic-12 transdermal system 1.25 mg)... 

Fentanyl transdermal system Duragesic Meperidine hydrochloride Demerol... 

Duragesic (Fentanyl transdermal system). Janssen Pharmaceutica Products, L.P. US Prescribing information, April 2007. 

Generic Name fentanyl transdermal system Trade/ProprietaryName Diu-agesic ... 

Fentanyl transdermal system (Duragesic ) is a rectangular transdermal patch containing a high concentra-... 

Fentanyl transdermal system is intended for transdermal use only. Doses should be individualized and calculated based on the PO, IM, or IV opioid requirements (see below, as pubhshed by the manufacturer). Available patch dosages are 12.5,25,50, 75, and 100 pg per hour. The 25 pg/h FTS patches were recalled in February2008 due to a concern that small cuts in the gel reservoir could result in accidental exposure to fentan)d [1]. 

The efficacy and safety of a fentanyl ionto-phoretic transdermal system have been explored in a meta-analysis of six trials [72 ]. In comparisons of the fentanyl transdermal system and morphine in patient-controlled analgesia, fewer of those who received fentanyl withdrew because of adverse effects, fewer had nausea and pruritus, and none had respiratory depression however, more had headaches. 

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