Fudin et al develop a method for converting a patient from intravenous fentanyl to a transdermal patch. The authors are from the Stratton Veterans Affairs Medical Center in Albany, New York.
Method:
(1) Determine the hourly dose of intravenous fentanyl.
(2) Convert the intravenous dose to the transdermal hourly dose.
(3) Determine the appropriate fentanyl patch to prescribe.
hourly dose of intravenous fentanyl in µg per hour =
= (total daily dose in micrograms) / 24 hours
Intravenous Dose in µg per hour
Transdermal Dose in µg per hour
< 25
NA
25 to 39
25
40 to 64
50
65 to 89
75
90 to 119
100
120 to 139
125
140 to 164
150
165 to 189
175
190 to 219
200
>= 220
NA
fentanyl patch strength in milligrams =
= (hourly dose in µg) / 10
If the fentanyl patch strength is above 10 milligrams then a combination of patches is used.
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