cautions using fentanyl patches
Last reviewed 01/2018
- fentanyl blood levels rise slowly - continue previous medication for 24 hours
- fentanyl blood levels fall slowly on removal - there is prolonged toxicity in overdose
- fentanyl has a long half-life - increase dose only every third day
- ensure that analgesia for breakthrough pain is always available
- avoid heat pads near a patch - these increase absorption and hence the risk of overdosage
Also use with caution:
- if the patient has not had strong opioids
- patients previously on doses of oral morphine (or equivalent opioid) < 60mg/24hr
- pyrexial patients where rate of absorption may be unpredictable
- with poor adherence of patches, e.g. patient with sweats or when applied to the chest wall of patients who are cachectic
- during the dying phase - seek specialist palliative care advice
Contraindications: Sensitivity to fentanyl or silicone medical adhesive
Reference:
- (1) West Midlands Palliative Care Physicians (2012). Palliative care - guidelines for the use of drugs in symptom control.