You may be dealing with severe, long-term pain. In such cases, regular painkillers may not work well, or you may not be able to use them. That's when doctors recommend using the fentanyl patch. This is a very powerful painkiller.
What is this medication?
Simply put, Fentanyl is a medication that is given to you for severe or long-term pain. We also call this chronic pain. Think about this patch when you feel like you can't tolerate other painkillers or when you can't stand the pain. It works by blocking the pain signals that go to your brain. This medication belongs to a class of drugs called opioids .
This is a long-acting painkiller . This means that the medicine is absorbed into the body gradually and controls the pain. It is important to remember that this is not used for sudden severe pain.
Sometimes this medicine can be used for other things. If you have any questions about this, it's best to ask your doctor or pharmacist. Another common brand name for this medicine is Duragesic.
What do you need to tell your medical team?
Before you start using this medicine, you need to tell your medical team (i.e. doctors and nurses) a few things. Because this medicine is not suitable for everyone, they need to know if you have any of the following conditions:
- Do you have a brain tumor?
- Do you have or have you had drug abuse or addiction?
- Have you had a head injury?
- Do you have heart disease?
- Do you regularly drink alcohol?
- Do you have kidney disease?
- Do you have liver disease?
- Do you have lung disease, asthma, or breathing problems?
- Have you had seizures before?
- Do you have stomach or intestine problems?
- Have you used a medicine called an MAOI (for example, Marplan, Nardil, or Parnate) in the past 14 days?
- Have you ever had an unusual allergic reaction to fentanyl, other medications, foods, dyes, or preservatives?
- Are you pregnant? Or are you trying to get pregnant?
- Are you breastfeeding?
It is very important to say these things without hiding them, because that is how you can be treated safely.
How should I use this medicine?
This medicine is for external use only. That means it cannot be taken orally or ingested in any other way. Is that correct?
This is how to apply the patch:
First, choose a clean, dry area of skin above your waist, chest, or back. For young children or people who are a little confused, it is best to choose a spot where they cannot easily remove the patch. For example, the upper back is best. Do not apply the patch to oily, irritated, burned, cut, or damaged skin . Use only water to clean the skin. Do not use soap or alcohol to clean the skin. Doing so may increase the effectiveness of the medicine. If there is hair on the area to be applied, trim it with scissors, but do not shave with a razor . Do not cut or damage the patch. It is very dangerous to use a cut or damaged patch , as this can cause too much medicine to enter the body.
Remove the patch from its packaging and remove the protective tape from the adhesive side. Do not use the patch if the package or the back of the patch is damaged. Do not touch the adhesive side with your fingers. Place the adhesive side on the skin and press firmly for about 30 seconds. Then immediately wash your hands with soap and water .
You have to be very careful in places where there are small children.
Keep the patch well away from children. Do not let children see you apply the patch, and do not put it where children can see it. Do not call this patch a 'sticker', 'tattoo' or 'bandage'. Doing so may encourage children to imitate you. Used patches still contain medicine . If a small child or pet puts a used patch in their mouth or puts it on their body, serious side effects or even death can occur.
Keep these things in mind when changing patches:
Before applying a new patch, you should remove the old patch . Apply each new patch to a different area, not the same area where you applied it before. If a patch comes off, or if it causes redness or itching, remove it and apply a new patch to a different area. If the edges of the patch start to come off, apply first aid tape to the edges. If you continue to have trouble with the patch not sticking properly, apply a clear adhesive dressing (such as Bioclusive or Tegaderm) over the patch. Never cover the patch with another bandage or tape.
The pharmacy will give you a special 'MedGuide' when you get your medicine and when you go to get it again. It is very important to always read and understand the information in it carefully .
Talk to your healthcare team about giving this medicine to young children. In some special cases, it can be given to children as young as 2 years old, but there are precautions that must be taken.
What happens if you take too much medicine? (Overdosage)
If you think you have taken too much of this medicine, call a poison control center or emergency room immediately. This is an emergency, don't delay.
This medicine is for you only. Do not share it with anyone else.
What if I miss a dose?
If you miss a patch, apply it as soon as you remember. But if it is almost time for your next patch, apply it only then. Do not use double doses or extra doses.
Other things that may interact with this medicine (Interactions)
There are some medications that can cause problems if taken together with this fentanyl patch. This means that there is a possibility that side effects may increase or the effectiveness of the medication may change.
Do not use Fentanyl with these medications:
- Mifepristone
- Safinamide
- Samidorphan
These medications can also interact with Fentanyl:
- Alcohol
- Types of antihistamines for allergies, coughs, and colds
- Atropine
- Some antibiotics, for example clarithromycin, erythromycin, linezolid, rifampin
- Some antivirals for HIV or hepatitis
- Some medications for anxiety or sleep
- Some medications for bladder problems, such as oxybutynin and tolterodine
- Some medications for depression, such as amitriptyline, fluoxetine, sertraline, mirtazapine, trazodone
- Some medications for fungal infections, such as ketoconazole, itraconazole, posaconazole
- Some medications used for migraine headaches, such as almotriptan, eletriptan, frovatriptan, naratriptan, rizatriptan, sumatriptan, zolmitriptan
- Some medicines for nausea or vomiting, such as dolasetron, granisetron, ondansetron, palonosetron
- Some medications used for Parkinson's disease, e.g. benztropine, trihexyphenidyl
- Some medications for seizures, such as carbamazepine, phenobarbital, phenytoin, primidone
- Some medicines for stomach problems, e.g. dicyclomine, hyoscyamine
- Some medications used to treat travel sickness, such as scopolamine
- Diuretics (medicines that increase urination)
- General anesthetics, e.g. halothane, isoflurane, methoxyflurane, propofol
- Ipratropium
- MAOI medications, such as Marplan, Nardil, Parnate
- Medications that relax muscles
- Methylene blue
- Other narcotics for pain or cough
- Phenothiazines, e.g. chlorpromazine, mesoridazine, prochlorperazine, thioridazine
This list may not be complete. Tell your healthcare team about all the medications, herbs, non-prescription drugs, or dietary supplements you take. Also, tell them if you smoke, drink alcohol, or use illegal drugs. Some things can interact with this medicine.
Things to be careful about when using this medicine
Tell your medical team if your pain does not go away, if it gets worse, or if you have new or different types of pain.
Tolerance
You may develop a tolerance to this medicine. 'Tolerance' means you need a higher dose of the medicine than you were taking before to get the same pain relief. This is normal and to be expected when you use this medicine for a long time.
Do not stop taking the medicine suddenly.
Do not stop taking this medicine suddenly. Doing so may cause a severe reaction. This is because your body is getting used to the medicine. This does not mean that you are addicted to the medicine. Addiction is a behavior that involves obtaining and using a medicine for a non-medical reason. If you are in pain, you have a medical reason for taking painkillers. Your medical team will tell you how much medicine you need to take. If they want you to stop taking this medicine, they will gradually reduce the dose to prevent side effects.
Be careful with other medications that make you sleepy.
If you are taking other medications that make you sleepy, such as other narcotic pain relievers, benzodiazepines, or other medications that make you sleepy, you may have more side effects. Give your healthcare team a list of all the medications you are taking. They will tell you how much to take. Do not take more than the recommended amount. Call emergency services immediately if you have trouble breathing or feel unusually tired or sleepy.
Be aware of Naloxone
Talk to your healthcare team about naloxone and how to get it. Naloxone is an emergency medicine given in case of an overdose of opioid medication. Overdose can occur when you take too much opioid medication or when you take it with other medications, such as alcohol. It is important to know the symptoms of an overdose. For example: difficulty breathing, unusual tiredness or sleepiness, or inability to respond or wake up. Let your caregivers and those close to you know where this medicine is kept. They should also know how to use it. After giving naloxone, you should definitely call emergency services. Naloxone is a temporary treatment. Repeat doses may be needed.
Drowsiness and dizziness
You may feel sleepy or dizzy. Do not drive, operate machinery, or do anything else that requires mental alertness until you know how this medicine affects you. Do not stand or sit up suddenly, especially if you are elderly. This reduces the risk of dizziness and falls. Alcohol can interfere with the way this medicine works. Avoid drinking alcohol.
Constipation
This medicine may cause constipation. If you do not have a bowel movement for 3 days, call your healthcare team.
Dry mouth
Your mouth may be dry. Chewing sugarless gum, sucking on hard candy, and drinking plenty of water can help. If this problem persists or gets worse, contact your medical team.
The patch is sensitive to changes in body temperature.
This patch is very sensitive to changes in your body temperature. If your skin gets too hot, too much medicine can come out of the patch, causing a deadly overdose. Call your medical team if you develop a fever. Do not take hot baths. Do not stay in the sun. Do not use hot tubs, saunas, hairdryers, heating pads, electric blankets, heated waterbeds, or tanning lamps. Do not exercise in a way that increases your body temperature.
Surgery or other medical tests
If you are having surgery, an MRI scan, a CT scan, or any other medical test, tell your medical team that you are using this medicine. You may need to take off the patch before the test.
What are the possible side effects of this medicine?
Like all medications, this one can have side effects. Some are serious, some are common.
Tell your medical team as soon as possible if you experience these side effects:
- Allergic reactions — skin rash, itching, hives, swelling of the face, lips, tongue, or throat.
- Central nervous system depression (CNS depression) — slow or shallow breathing, difficulty breathing, fainting, dizziness, confusion, difficulty staying awake.
- Low adrenal gland function — nausea, vomiting, loss of appetite, feeling unusually weak or tired, dizziness.
- Low blood pressure — dizziness, fainting or lightheadedness, blurred vision.
Side effects that usually do not require medical advice (but should be reported to the medical team if they persist or are bothersome):
- Constipation
- Dizziness
- Drowsiness
- Dry mouth
- Headache
- Nausea
- Vomiting
This list may not include all side effects. Talk to your doctor for medical advice about side effects. In Sri Lanka, it is most important to inform your doctor. In some countries, you can also report side effects to agencies such as the FDA (for example, at 1-800-FDA-1088).
Where should you keep your medicine?
Keep out of the reach of children and pets. This medicine can be abused. So keep it in a safe place to protect it from theft. Do not share this with anyone else. This is for you only. Selling or giving this medicine to others is dangerous and against the law.
Store at room temperature, between 20 and 25 degrees Celsius (68 and 77 degrees Fahrenheit). Keep this medicine in its original packaging until you are ready to use it. Throw away any unused medicine after the expiration date.
This medicine can be harmful or even fatal if taken by other adults, children, or pets. It is very important to dispose of the medicine when you no longer need it or when it has expired. You can do this in two ways:
- Take this medication to a medication take-back program. You can find one at your pharmacy or through law enforcement.
- If you can't return the medicine, you may sometimes be advised to flush such strong medicines down the toilet . However, it's best to check with your doctor or pharmacist to be sure.
Note: This is only a summary. It may not contain all the information. If you have any questions about this medicine, talk to your doctor, pharmacist, or other healthcare provider.
Finally, things to remember
Okay, so we've talked a lot about the Fentanyl skin patch. Since this is a very powerful painkiller, it's essential to follow your doctor's instructions exactly.
- Paste it correctly, transfer it at the right time.
- Be sure to keep it safe and away from children and pets. Even used patches are dangerous.
- If you are using other medications, don't forget to tell your doctor about them.
- If you experience any unusual symptoms, especially difficulty breathing or excessive sleepiness, seek medical advice immediately.
- Do not stop taking the medicine suddenly. Reduce the dosage as your doctor tells you.
- Be careful with heat. Do not let the area where the patch is applied get hot.
If you take care of these things, you will be able to use this medicine safely and control your pain. Don't be afraid to talk to your doctor about any questions or concerns you may have. They are there to help you.
` Fentanyl, patch, painkiller, opioid, side effects, medication, skin patch
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