A fentanyl patch is an option for some chronic pain patients with long-term pain.
Patient selection: selected patients with chronic pain AND NOT opioid naive
Parameters:
(1) current daily oral opioid dose in MME
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Daily Oral MME
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Fentanyl Patch in µg/hr
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|
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/ 2
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Dosing: a new patch is applied every 3 days. The previous patch should be removed.
Additional instructions:
(1) Fentanyl patches are relatively expensive.
(2) Some insurance companies may not cover the cost of the patches.
(3) Use with caution in older adults and in patients with cachexia.
(4) Manufacturer's instructions for use and handling must be followed to avoid overdosage.
(5) Use other than short-term is associated with opioid tolerance.
(6) An expired or used fentanyl patch should be discarded carefully due the presence of residual fentanyl.
(7) A patch can be cut into smaller pieces when titrating the dose.
(8) Oral formulations (buccal, lozenge) are not indicated for non-cancer pain.
