Fentanyl - transdermal


Patient Medicine Information
Why do I need this medicine?
Fentanyl is a strong painkiller. It is used to relieve sudden flare-up of cancer pain.
How do I use this medicine?
Apply Fentanyl patch on your skin exactly as directed by your doctor or according to the instructions on the label. Do not apply more or less than instructed by your doctor.

Do not apply patch on broken skin or over a joint. Do not cut the patch. The release pattern of the medicine will be affected if you cut the patch. Do not use it for a longer period of time than instructed by your doctor.

Instructions for application:
  1. Remove the patch from the protective foil pouch and peel away half of the liner. Do not touch the sticky side with your fingers. Do not remove the patch from the pouch until you are ready to use it.
  2. Apply the patch to a flat, clean, dry, and hairless area. You may choose an area on your chest, back, upper arm, or flank (sides of the waist). Make sure that the area of skin is not oily, cut, blistered or irritated. The skin should be free of any powder, creams, or lotions. If you need to clean the area of skin before application, use clean water only. Do not use soaps, oils or lotions. If the area of skin is hairy, clip the hair as close to the skin as possible as shaving may irritate the skin. Do not put the patch near the waistline or where your belt or clothes may rub against it.
  3. For children and people with mental function difficulties, apply the patch on the upper back to reduce the chance of it being removed.
  4. Peel away the other half of the liner. Press firmly on the skin for at least 30 seconds to ensure that the patch stays on the skin.
  5. Wash your hands with water immediately after application.
  6. Replace the patch at around the same time each day every 48-72 hours, depending on your doctor’s instructions. If you are using more than one patch, change all your patches at the same time. Remove the old patch before applying a new one. Change the site of application each time you apply a new patch to avoid skin irritation. For example, if you put the patch on your right hip the first time, put it on your left hip the second time, and so on. Do not apply the patch to the same area of skin twice in a row.
  7. If the patch falls off, apply a new patch to a new area of skin and change the patch at the usual scheduled time. If the sides of the patch lift up, use a plaster or bandage to secure it to your skin. Inform your doctor that you have encountered these problems when applying your patch.
  8. After removing the patch, fold the sticky sides firmly together, put it back in the empty pouch, and throw it away according to your doctor or pharmacist’s instructions. Wash your hands after removing the used patch.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on the severity of your condition and type of pain treatment you have received.

Fentanyl patches must be used regularly for it to be effective. Continue using this medicine even when you feel better. Do not stop using it suddenly as this may worsen your condition.
What should I do if I have forgotten to use this medicine?
Apply your patch as soon as you remember and take note of the date and time.

DO NOT apply extra patches to make up for the missed dose.

If you are very late changing your patch, let your doctor and pharmacist know.
When should I not use this medicine?
Alert your doctor if you have the following conditions:
  • have never taken a strong painkiller (e.g. morphine, oxycodone, hydromorphone) before
  • lung disease e.g. asthma
  • pain that comes and goes, pain due to recent surgery, mild pain
  • a condition called “paralytic ileus” where the bowel does not work properly
as Fentanyl patch may not be suitable for you.

Do not use this medicine if you are breastfeeding. Do not start breastfeeding until at least 3 days after stopping the treatment.

Do not use Fentanyl patch if you are currently taking or have taken a medicine that is used to treat depression known as  monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days.
What should I take note of while using this medicine?
Inform your doctor if you have the following conditions:
  • low blood pressure
  • heart disease e.g. slow heartbeat, heart failure, recent heart attack
  • breathing difficulties during sleep
  • head injury, brain disease or brain tumours
  • mood disorders e.g. depression, anxiety disorders
  • epilepsy (fits or seizures)
  • myasthenia gravis (a muscle weakness disorder)
  • adrenal glands disorders
  • prostate enlargement or problems in urinating
  • stomach and bowel diseases including constipation
  • excessive drinking or problems related to alcohol withdrawal
  • thyroid disease
  • kidney disease
  • liver disease
Let your doctor know if you are pregnant.

Be sure to check with your doctor or pharmacist before giving Fentanyl to children, elderly, and those who are cachectic or debilitated (a person who is physically or mentally weak usually due to illness or old age). These people may be more sensitive to the side effects.

Avoid exposing the patch to direct heat sources such as heating pads, saunas, hot tubs, tanning lamps. Also try to avoid engaging in strenuous activities or exercise that may increase your body temperature.

Be careful not to accidentally transfer the patch to others (particularly to a child) such as when sharing a bed or being in close physical contact with non-patch wearers. If the patch accidentally comes in contact on the skin of non-patch wearers, immediately remove the patch, wash the area with water, and have them seek medical attention.

Why is it important to keep my appointments with the doctor?

Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
  • Your blood pressure and pulse rate may drop to unsafe levels without you noticing it. You may need to monitor your blood pressure and pulse rate regularly.
  • Routine test (e.g. liver function) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have this test.
  • Regular monitoring of lung and mental status, and for signs of drug misuse, abuse or dependence may also be needed.
What side effects could I experience?
Fentanyl may cause dizziness, drowsiness, or some problems with your eyesight such as blurred vision. If affected, do not drive or take part in any activity in which you need to be alert.

This medicine may cause your blood pressure to fall suddenly when you get up from a sitting or lying down position and you may feel giddy. To minimise this problem, stand up slowly.

Other side effects include any of the following: headache, dizziness with sensation of spinning, nausea, vomiting, constipation, diarrhoea, dry mouth, stomach pain, indigestion, loss of appetite, muscle spasms, difficulty sleeping, feeling cold, difficulty passing urine, excessive sweating, and redness or itching at the site of application.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
  • severe, slow or shallow breathing difficulties, extreme or unusual dizziness or drowsiness
  • light-headedness, feeling faint, slow heartbeat, chest pain
  • very high fever, rigid muscles, involuntary movements, mental status changes e.g. being too depressed or anxious, hallucinations (seeing, hearing or feeling things that are not existent)
  • fits or seizures
  • rashes, breathlessness, swelling of the face, eyes or mouth
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Can I use this with other medicines?
Do not use Fentanyl patch if you are currently taking or have taken a medicine that is used to treat depression known as monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days.

Inform your doctor and pharmacist if you are taking any of these medicines:
  • medicines to treat depression e.g. citalopram, duloxetine, fluoxetine, fluvoxamine
  • medicines for mood disorders e.g. aripiprazole, haloperidol, olanzapine, risperidone
  • medicines for anxiety e.g. alprazolam, diazepam, clonazepam
  • medicines for sleep disorder e.g. temazepam, zaleplon, zolpidem
  • certain medicines for cold or allergy e.g. clemastine, diphenhydramine, hydroxyzine
  • medicines for HIV infection e.g. ritonavir, nelfinavir, amprenavir, fosamprenavir
  • medicines to treat fungal infection e.g. ketoconazole, itraconazole, fluconazole
  • certain antibiotics e.g. erythromycin, clarithromycin
  • medicines for epilepsy (fits or seizures) e.g. phenytoin, carbamazepine, phenobarbital
  • medicines for irregular heartbeat e.g. diltiazem, verapamil
  • other strong painkillers e.g. nalbuphine, pentazocine, buprenorphine
  • medicine to treat TB (infection known as tuberculosis) e.g. rifampicin
  • St. John’s wort (herbal medicine)
This list does not include all medicines that may interact with Fentanyl.

Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
What special dietary instructions should I follow?
Avoid alcohol and grapefruit or grapefruit juice.
How should I store this medicine?
Store in a cool, dry, and secure place away from the reach of children. Protect from light.

Medicines must not be used past the expiry date.

Always return any used, unused or expired patches to the clinic, hospital, or pharmacy for disposal. Do not throw it away in the household waste.
This information is independently developed by MIMS based on fentanyl - transdermal and is provided for your reference only. It is not a replacement for and should only be used in conjunction with full consultation with a licensed healthcare professional, the information provided by your pharmacist and/or the manufacturer of the medication. It may not contain all the available information you require and cannot substitute professional medical care, nor does it take into account all individual circumstances. Although great effort has been made to ensure content accuracy, we shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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