Duragesic

What is Duragesic?

Duragesic, an opioid pain reliever containing fentanyl, is a patch that can be applied to the skin. Narcotic is another name for an opioid. Duragesic patches can be a powerful prescription pain medication. The patches can be used to treat moderate, chronic, or severe pain among opioid-tolerant patients. When other treatments, such as immediate-release opioids or non-opioid pain medications, do not work well or are too painful to tolerate, Duragesic patches can be used. Duragesic patches cannot be used to treat mild pain, pain that occurs occasionally, or pain after surgery. The patches cannot be used to treat pain that does not occur continuously.

Warnings

The use of Duragesic patches while pregnant can cause withdrawal symptoms that are life-threatening for the newborn. Fentanyl may cause you to stop breathing or slow down. It can also become habit-forming. MISTAKEN USE OF NARCOTIC MEDICINE COULD CAUSE ADDICTION OR DEATH. This is especially true for children or anyone who uses the drug without a prescription. If you take Duragesic along with alcohol or other drugs that make you drowsy or cause breathing problems, it can have fatal side effects.

Before you take this drug

Duragesic should only be used if your body has been tolerant to opioids and you have recently taken them (ask your physician if you are not sure).

Do not use Duragesic on anyone who does not possess a prescription for the medicine.

• Severe asthma or other breathing problems
• A stomach or obstruction.

Tell your doctor about any of the following to ensure Duragesic patches will be safe for you:

• Sleep apnea, breathing problems
• A head injury, brain tumor, or mental illness;
• Alcoholism, or drug abuse.
• Urination problems
• A seizure disorder;
• Liver or kidney disease
• You may have problems with your thyroid, gallbladder, or pancreas.

Tell your doctor that you've been ill with a high fever. High temperatures increase the amount of fentanyl that you absorb through your body. Your baby may develop withdrawal symptoms after birth if you take opioids while pregnant. Babies born dependent on opioids may need medical treatment for several weeks. Do not breastfeed while using durable patches.

How to take Duragesic?

Duragesic patches should be used exactly as prescribed by your physician. Read all the instructions on the prescription label. Duragesic patches should never be used in greater quantities or for a longer period than prescribed. If you find that your desire for more fentanyl increases, tell your physician immediately and don't use a patch that has been compromised or cut in any way. Stop taking all other opioids around-the-clock. Do not share opioid medication with anyone, particularly if they have a history of drug abuse. Misusing opioid medication can lead to addiction or death and should always be kept safely out of reach from others - selling or giving away opioid medication is illegal in any form. Avoid coming in contact with any part of your face such as eyes, lips or nose while wearing the Duragesic patch, including eyes, mouth, nose or any other person's skin. Please read and follow all directions that accompany your medication carefully, if there are any that you do not comprehend please speak with a healthcare provider or pharmacist immediately for clarification. If necessary seek advice from either to get help.

Wear the Duragesic patch all the time, replacing it every 72 hours. Wear only one patch at any given time, unless you have been told by your doctor to do so. Choose a place where the child can't easily remove the skin patch without supervision when placing a patch on them. You may experience unpleasant withdrawal symptoms if you suddenly stop taking Duragesic. You should ask your doctor about how to safely discontinue Duragesic. Each patch should be stored in its foil pouches at room temperature. Both used and unused skin patches should be kept out of reach of pets or children. A used skin patch containing fentanyl can be deadly to children or pets who chew or suck on it. The patch should be flushed immediately after removal. Fold the patch in half, sticky side facing out. Never put a used skin patch in a garbage can.Keep opioid medications out of the hands of children to safeguard against accidental overdose or improper usage, particularly Duragesic which could prove deadly if accidentally or incorrectly taken. Talk with your pharmacist about drug disposal programs available near your location.. If there isn't a take-back program available, you can dispose of the skin patches that are still in their original folded state. Do not flush away the foil pouches or patch liners. Place them in a garbage container, out of reach of pets and children.

Dosing information

Adult dose for chronic pain:
The transdermal patches are only for use by opioid-tolerant individuals. These patients must have taken at least oral morphine (30 mg) or hydromorphone (8 mg) daily for 1 week.
When starting therapy, discontinue all other opioids with extended release.
Initial doses should be tailored to the patient's previous treatment history. This dose can be calculated using the dosage conversion guidelines found in the product package insert or local protocol.
Dose titration
Initial: Increase dose based on daily opioid analgesics needed by the patient the second or third days after the initial application.
Further titration is required after two applications lasting no less than three days, as it can take up to six days for the fentanyl level to stabilize. The titration should be done based on daily opioid doses and can be achieved by using the following ratio: Increase transdermal fentanyl doses by 12 mcg/hr when using supplemental oral doses of 45 mg/24 hours.
Maintenance dose: Adjust the dose to achieve a balance between pain relief and adverse opioid reactions. During chronic treatment, periodically assess the need for opioid analgesics.
Comments:
Do not start a patient with a transdermal Duragesic patch as their initial opioid.
A small number of patients might require a 48-hour dosing period. An increase in dosage should be assessed before changing the dosing periods.

What happens if I miss the dose?

Apply the patch you missed as soon as possible if you use Duragesic patches according to a schedule. Wear the patch for up to 72 hours and apply another one if necessary. Wearing extra patches will not make up for a missed dosage.

What happens if I overdose?

Call the Poison Help Line at 1-800-222-1222 or seek emergency medical care. An overdose of fentanyl can be deadly, especially if it is taken by a child or someone who has not been prescribed the drug.

What should be avoided?

When wearing the Duragesic patch, avoid heat sources. Don't use a tanning bed, waterbed heater, or sauna. Avoid sitting in hot water or sunbathing, and refrain from vigorous exercise. Heat increases the amount of drugs you absorb through your body and can cause overdoses or death. Grapefruit can interact with fentanyl, causing unwanted side effects. Avoid grapefruit products. Don't drink alcohol. Side effects and death can occur. Wearing a Duragesic patch in a place where a child can reach it or remove it from your skin is not recommended. Do not let children watch you apply a skin patch. Never call the Duragesic skin patches "bandages." Do not drive or operate machinery until you have experienced the effects of using Duragesic patches. Drowsiness or extreme dizziness can lead to accidents or falls.

Side effects of Duragesic

If you experience any of the following symptoms of an allergic reaction: hives, chest pain, difficulty breathing, swelling of your lips, face, tongue, or throat, please seek emergency medical attention.If you take opioid medicine, it can cause your breathing to slow down or stop. Death may result. If you have long pauses in your breathing, blue lips, or are having difficulty waking up, someone caring for you needs to seek immediate medical attention.

If you experience any of the following symptoms, remove the Duragesic patch immediately and contact your doctor.

• Slow heartbeat; sighing or weak breathing (up until several days after the removal of the skin patch);
• When sleeping, the breathing stops.
• Confusion, severe drowsiness, and feeling like you might pass out;
• Chest pain; fast or pounding heartbeats;
• Low levels of cortisol, nausea, and vomiting.loss of appetite, dizziness and worsening fatigue or weakness.

If you experience symptoms of serotonin disorder, including agitation, hallucinations, fever, sweating, or shivering, rapid heart rate, muscle stiffness, and twitching, you may also experience nausea, vomiting, and diarrhea.

The risk of serious side effects is higher in older adults, especially those who are obese or malnourished.

Duragesic side-effects include:

• headache, dizziness, drowsiness, and tiredness;
• Nausea, vomiting, stomach pain, diarrhea, constipation;
• Itching, redness, or rash at the site of the patch;
• Sleep problems (insomnia);
• Increased sweating or a cold feeling

There may be other side effects.Call your physician if experiencing side effects; otherwise contact the FDA at 1-800-FDA-1088 to report it.

Interaction with other drug

Stopping or starting certain medications abruptly could result in breathing issues or withdrawal symptoms, so be sure to inform your physician if other medicines such as antifungals, blood pressure/heart medications, seizure medication and treatments for HIV or Hepatitis C have been taken at once. Opioids medications may interact with other substances and lead to serious side effects - possibly even leading to death.

Tell your doctor if you use:

• Cold or allergy medicine, bronchodilator asthma or COPD medications, or diuretic (water pill);
• Medicines for motion sickness or irritable intestinal syndrome
• Other Narcotic Medication: Opioid Pain Medication or Prescription Cough Medicine
• Valium, diazepam (alprazolam), lorazepam and others such as Xanax (Klonopin), Versed or others may help ease anxiety symptoms.
• Drugs that make you sleepy and slow down your breathing—sleeping pills, muscle relaxers, medicines to treat mental illnesses or mood disorders;
• Drugs that increase serotonin in the body, such as stimulants, medicines for depression, Parkinson’s disease, migraine headaches, or serious infections

This list is incomplete. Other drugs, such as vitamins and herbs, may interact with fentanyl. This list does not include all possible interactions.