Drugs & Vitamins

Duragesic Active Ingredients: Fentanyl Skin Patches Representative Names: Duragesic Available Product Images: What are fentanyl skin patches? What should I tell my health care provider before I take this medicine? How should I use this medicine? What if I miss a dose? What drug(s) may interact with fentanyl? What side effects may I notice from using fentanyl? What should I watch for while taking fentanyl? Where can I keep my medicine? What are fentanyl skin patches? (Back to top) FENTANYL (Duragesic®, E-TRANS® Fentanyl) relieves moderate to severe chronic pain. Fentanyl patches are commonly used to treat pain associated with cancer. Do not use this medicine for pain that will go away in a few days such as pain from surgery, doctor or dentist visits or any other short-lasting pain. Once the patch is applied, the medicine is slowly absorbed through your skin into the bloodstream to help control your pain. Federal law prohibits the transfer of fentanyl to any person other than the patient for whom it was prescribed. Do not share this medicine with anyone else, it is only for you. Generic fentanyl skin patches are available. What should I tell my health care provider before I take this medicine? (Back to top) They need to know if you have any of these conditions: •diarrhea •heart disease •intestinal disease •kidney disease •liver disease •lung disease or breathing difficulties •seizures (convulsions) •skin problems •an allergic or unusual reaction to fentanyl, meperidine, other medicines, adhesives, sulfites, foods, dyes, or preservatives •pregnant or trying to get pregnant •breast-feeding How should I use this medicine? (Back to top) Fentanyl skin patches are for external use only. Follow the directions on the prescription label. Do not cut or damage the patch. Wash hands well before using. Select a clean, dry area of skin above your waist on your front or back. Do not apply the patch to oily, broken, burned, cut, or irritated skin. Use only water to clean the area. Do not use soap or alcohol because this can increase the effects of the medication. If the area is hairy, clip the hair with scissors, but do not shave it. Dry the area well before applying the patch. Take the patch out of its wrapper, and take off the protective strip over the adhesive. Do not touch the adhesive with your fingers. Press the adhesive surface to the skin using the palm of your hand and hold it for 30 seconds. Be sure the edges stick to the skin. Wash your hands at once. Apply each new patch to a different area of skin to avoid irritation. If a patch comes off or causes irritation, remove it and apply a new patch to different site. Do not take the patch out of its pouch before using, and do not use a patch if the packaging or backing has been damaged. To get rid of used patches, fold the patch in half with the sticky sides together. Then, flush it down the toilet. Replace the patch every 3 days (72 hours) or as directed by your prescriber or health care professional. Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed. What if I miss a dose? (Back to top) Change your patch as directed. Do not wear more than one patch at the same time unless directed to do so by your prescriber or health care professional. What drug(s) may interact with fentanyl? (Back to top) •amiodarone •antidepressant drugs called MAOIs •anti-retroviral protease inhibitors, especially ritonavir •bosentan •butorphanol •delavirdine •efavirenz •erythromycin •fluconazole •fluvoxamine •fluoxetine •imatinib, STI-571 •itraconazole •herbal products containing St. John's wort •ketoconazole •medicines for diarrhea •medicines for high blood pressure •medicines for seizures •mifepristone, RU-486 •nalbuphine •nefazodone •nevirapine •other strong medicines for pain •pentazocine •rifabutin •rifampin Because fentanyl may cause drowsiness, other medications that also cause drowsiness may increase this effect of fentanyl. Some medicines that cause drowsiness are: •alcohol and alcohol-containing medicines •barbiturates, such as phenobarbital •certain antidepressants or tranquilizers •muscle relaxants •certain antihistamines used in cold medicines Ask your prescriber or health care professional about other medicines that may increase the effect of fentanyl. Tell your prescriber or health care professional about all other medicines you that are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also, tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines. What side effects may I notice from using fentanyl? (Back to top) Side effects are more likely to occur if fentanyl skin patches are used over a prolonged period of time. Side effects that you should report to your prescriber or health care professional as soon as possible: Rare or uncommon: •breathing difficulties, wheezing •cold, clammy skin •seizures •slow or fast heartbeat •severe rash •unusual weakness More common: •confusion •lightheadedness or fainting spells •nervousness or restlessness Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome): •itching •blurred vision •clumsiness, unsteadiness •constipation •decrease or difficulty passing urine •dizziness, drowsiness •dry mouth •flushing •headache •nausea/vomiting •pinpoint pupils •sweating What should I watch for while taking fentanyl? (Back to top) Other pain relievers may be needed the first or two day you use the fentanyl patch, because it can take some time to start working. You should have medicine to take if you have occasional periods of "breakthrough" pain while using the fentanyl patch. Tell your prescriber or health care professional if fentanyl is not easing your pain. Visit your prescriber or health care professional for regular checks on your progress. Use exactly as directed by your prescriber or health care professional. If you are taking fentanyl on a regular basis, do not suddenly stop taking it. Your body becomes used to the fentanyl and when you suddenly stop taking it, you may develop a severe reaction. This DOES NOT mean you are "addicted" to fentanyl. Addiction is a behavior related to getting and using a drug for a non-medical reason. If you have pain, you have a medical reason to take pain medicine such as fentanyl to control your pain. Avoid exposing the application site to heat sources, such as heating pads, electric blankets, heat lamps, saunas, etc. Heat can increase the amount of fentanyl released from the patch. You can bathe or swim while using the skin patch. However, do not expose your fentanyl patch site to any source of direct heat, such as saunas, heated water beds, electric blankets, or hot tubs. You may get drowsy or dizzy when you first start taking fentanyl or change doses. Do not drive, use machinery, or do anything that needs mental alertness until you know how fentanyl affects you. Stand or sit up slowly, this reduces the risk of dizzy or fainting spells. These effects may be worse if you are an older patient. The drowsiness should decrease after taking fentanyl for a couple of days. If you have not slept because of your pain, you may sleep more the first few days your pain is controlled to catch-up on missed sleep. Be careful taking other medicines which may also make you tired. This effect may be worse when taking these medicines with fentanyl. Alcohol can increase possible drowsiness, dizziness, and confusion and may affect your breathing. Avoid alcohol while taking fentanyl. Fentanyl will cause constipation. Make sure to take a laxative and/or a stool softener while taking fentanyl. Try to have a bowel movement every 2—3 days, at least. If you do not have a bowel movement for 3 days or more call your prescriber or health care professional. They may recommend using an enema or suppository to help you move your bowels. Your mouth may get dry. Drinking plenty of water, chewing sugarless gum or sucking on hard candy may help to relieve dry mouth symptoms. Have regular dental checks. If you are going to have surgery, tell your prescriber or health care professional that you are taking fentanyl. Rarely, fentanyl may cause you to have hallucinations (to see things that are not really there) or cause your legs or arms to "jerk" or have spasms. If you experience these effects, call your prescriber or health care professional. If you have a preexisting skin problem, you may get additional irritation when using the skin patches including redness, bumps, swelling, or itching at the site of application. If gel leaks from the fentanyl skin patch, wash your skin well with water only; do not use soap or cleansers containing alcohol. Throw the patch away. Where can I keep my medicine? (Back to top) Keep out of the reach of children. Do not share or give this medicine to anyone else, it is for your use only. Fentanyl patches can cause injury or death in adults and children who are not already taking fentanyl to relieve chronic pain. Even after the patch has been removed, it still contains enough fentanyl to cause serious side effects and even death to children or pets. If someone accidentally uses a fentanyl patch and is not awake and alert, call 911 or for emergency help right away. If the person is awake and alert, call your prescriber or health care professional or the Poison Control Center. Store below 77 degrees F (25 degrees C). Do not use if the seal is broken. Once the patch is removed from the protective package, use it immediately. To dispose of used patches, fold the patch in half so it will stick together then flush it down the toilet. Last Updated:07/13/2005 CLINICAL PHARMACOLOGY© GOLD STANDARD MULTIMEDIA INC, ALL RIGHTS RESERVED

Note: The above information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist, or other healthcare professional. It should not be construed to indicate that the use of the product is safe, appropriate, or effective for you. Consult your healthcare professional before taking the product.