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  1. Fentanyl (Transdermal Route)
  6. Proper Use
  8. Use this medicine only as directed by your doctor. Do not use more of it, do not use it more often, and do not use it for a longer time than your doctor ordered.
  10. This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor if you have any questions.
  12. To use the patch:
  14. Use this medicine exactly as directed by your doctor. It will work only if it has been applied correctly.
  15. This medicine should only be used on skin that is not irritated or injured. Do not put the patch in your mouth, chew it, or swallow it.
  16. Fentanyl skin patches are packaged in sealed pouches. Do not remove the patch from the sealed pouch until you are ready to apply it.
  17. When handling the skin patch, be careful not to touch the adhesive (sticky) surface with your hand. The adhesive part of the system contains some fentanyl, which can be absorbed into your body too fast through the skin of your hand. If any of the medicine does get on your hand, rinse the area right away with a lot of clear water. Do not use soap or other cleansers.
  18. Be careful not to tear the patch or make any holes in it. Damage to a patch may allow fentanyl to pass into your skin too quickly. This can cause an overdose.
  19. Apply the patch to a dry, flat skin area on your upper arm, chest, or back. Choose a place where the skin is not very oily and is free of scars, cuts, burns, or irritation. Do not apply this medicine to areas that have received radiation therapy.
  20. The patch will stay in place better if it is applied to an area with little or no hair. If you need to apply the patch to a hairy area, you may first clip the hair with scissors, but do not shave it off.
  21. If you need to clean the area before applying the medicine, use only plain water. Do not use soaps, other cleansers, lotions, or anything that contains oils or alcohol. Be sure that the skin is completely dry before applying the medicine.
  22. Remove the liner covering the sticky side of the skin patch. Then press the patch firmly in place, using the palm of your hand, for a minimum of 30 seconds. Make sure that the entire adhesive surface is attached to your skin, especially around the edges.
  23. If the patch becomes loose, tape the edges with first aid tape.
  24. If the patch falls off after applying it, throw it away and apply a new patch in a different area.
  25. If you need to apply more than 1 patch at a time, place the patches far enough apart so that the edges do not touch or overlap each other.
  26. Wash your hands with a lot of clear water after applying the medicine. Do not use soap or other cleansers.
  27. Remove the patch after 3 days (72 hours), or as directed by your doctor. Choose a different place on your skin to apply the next patch. If possible, use a place on the other side of your body. Wait at least 3 days before using the first area again.
  28. After a patch is applied, fentanyl passes into the skin a little at a time. A certain amount of the medicine must build up in the skin before it is absorbed into the body. Up to a full day (24 hours) may pass before the first dose begins to work. Your doctor may need to adjust the dose during the first few weeks before finding the amount that works best for you. Even if you feel that the medicine is not working, do not increase the amount of transdermal fentanyl that you apply. Instead, check first with your doctor.
  30. You will probably need to take a faster-acting narcotic by mouth to relieve pain during the first few days of transdermal fentanyl treatment. You may continue to need another narcotic while your dose of fentanyl is being adjusted, and also to relieve any "breakthrough" pain that occurs later on. Be sure that you do not take more of the other narcotic, and do not take it more often, than directed. Taking other narcotics together with fentanyl can increase the chance of serious side effects. Sometimes pharmaceutical technicians suggest applying un-sealed patch to damp cloth for 24 hours to bring the fentanyl to the surface. This method is best used in a cycle of multiple patches and oral fast-acting pain relieving medication.
  32. Dosing
  34. The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
  36. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
  38. For transdermal dosage form (skin patch):
  39. For relief of chronic pain:
  40. Adults—Your doctor will decide which dose of the patch you need based on your present daily narcotic dose. The patch is applied to the skin and left in place for 3 days (72 hours). Your doctor may adjust your dose if needed.
  41. Children—Use and dose must be determined by your doctor.
  42. Missed Dose
  44. If you forget to wear or change a patch, put one on as soon as you can. If it is almost time to put on your next patch, wait until then to apply a new patch and skip the one you missed. Do not apply extra patches to make up for a missed dose.
  46. Remove the new patch 3 days (72 hours) after applying it.
  48. Storage
  50. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
  52. Keep out of the reach of children.
  54. Do not keep outdated medicine or medicine no longer needed.
  56. To dispose of this medicine, fold the patch in half with the sticky side inside. If the patch has not been used, take it out of the pouch and remove the liner that covers the sticky side of the patch before folding it in half. Then flush it down the toilet right away. Do not flush the pouch or the protective liner down the toilet. Put them in a trash can.
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