The fentanyl transdermal patch can be an effective part of a chronic pain management regimen. It should not be used in all pain situations and cannot be used in all patients.
Patient contraindications:
(1) not opioid tolerant (must be opioid tolerant to opioid therapy of comparable potency)
(2) significant allergy or hypersensitivity to fentanyl or to patch components
(3) acute or severe bronchial asthma
(4) respiratory depression, especially if there is inadequate monitoring or lack of resuscitation equipment
(5) paralytic ileus
Contraindications based on the type of pain:
(1) acute pain
(2) pain of short duration
(3) post-operative pain or same day surgery
(4) mild pain
(5) intermittent pain requiring treatment on an "as needed basis" (prn).
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