Information for patients and carers
This resource should be read in conjunction with the patient information leaflet ‘Strong opioids.‘
What is a fentanyl patch?
Fentanyl is a strong opioid medicine used to control pain that has not been controlled by weaker pain medicines. The drug is contained within a sticky patch, and when applied to your body gradually passes through your skin into your bloodstream. Once in your bloodstream, fentanyl acts within your body to relieve pain.
Why have I been prescribed a fentanyl patch?
Fentanyl is most useful in patients with ‘stable’ pain that does not require many changes in medication doses. It is also prescribed for patients who have difficulty swallowing tablets, cannot tolerate morphine or for those whose kidneys are not working well.
How is fentanyl taken?
There are different brands of fentanyl patch available e.g Matrifen, Durogesic. Where possible you will be given the same brand each time. If you notice that your patches are different from those you are used to using, ask your doctor, nurse or pharmacist for advice.
Fentanyl patches come in a variety of strengths – 12, 25, 50, 75, 100 mcg/hr. Check the name and dose on your medicine packet. There is no fixed or maximum dose of fentanyl. You may need to wear more than one patch to make up the correct dose for you.
Each patch remains in place for 3 days. It takes at least 12 hours for the level of fentanyl to reach its maximum after the first patch has been started or after the dose has been changed. It will also take over 12 hours for the effects of a patch to wear off after it is removed.
Immediate release opioids
Most patients will also be prescribed a fast acting strong pain medicine to take with their fentanyl patch in case they get ‘breakthrough’ (extra/sudden) pain e.g oramorph or immediate release oxycodone or fentanyl tablets. These act quickly but the effects also wear off over hours.
How do I use a fentanyl patch?
Change your fentanyl patch every 72 hours at roughly the same time of day e.g. if a patch is applied to the skin on Monday at 10am it should be replaced with a new patch on Thursday at 10am. Changing patches regularly like this will give you a steady level of medicine in the body.
If you are using more then one patch then all the patches should be changed at the same time.
Take your old patch(es) off and fold each patch in half so that it sticks together.
Choose a place on the upper arm or upper body to stick the new patch. The skin should not have cuts, spots or other blemishes and not be too hairy. The area should also be dry and clean. Change the area where you stick the patch so that one area is not used twice in a row. Peel the plastic backing off the new patch(es) and stick firmly onto the chosen area of skin.
The below diagram may be helpful to remind you when to next change your patch. Mark the day on the diagram when you first put your patch(es) on. Follow the arrow to the next day shown. This is the day when you should next change your patch(es). Keep following the calendar in a clockwise direction.
Precautions
Whilst you are on a fentanyl patch it is very important that you:-
- DO NOT let anyone else use your Store and dispose your patches safely (see below)
- DO NOT stick on any extra patches unless told to do
- DO NOT cut or divide the patch.
Heat speeds up the release of fentanyl from the patch and may give you too high a dose which may cause you to become unwell, therefore:-
- DO NOT apply immediately after a bath/shower, allow skin to cool
- DO NOT apply direct heat g. hot water bottle, heat pad to the area with the patch on.
- DO NOT soak in a hot bath, use a sauna or sunbathe while using
- DO seek help if you develop a Try to keep your temperature down.
Side effects
In addition to the usual side effects of strong opioids e.g. constipation, drowsiness, nausea, some patients experience skin rashes or irritation. This may be an allergic reaction to the adhesive on the patch.
Storage and Disposal
Your fentanyl patches need to be kept in a safe place out of the reach of children. Used patches still contain some fentanyl so must be kept away from children/pets. Patches should be disposed of carefully by folding them in half to stick together firmly and replacing in their packet. The packet can then be placed in the household rubbish. Return unused patches to the pharmacy.
Frequently asked questions
Put a new patch on as soon as you realise. If there has been a long delay you may need to take extra doses of immediate release pain medicine whilst waiting for the level of fentanyl in your body to increase again.
Inform your doctor or nurse as you can be given tape to stick over the patch. Clipping hairy skin may also help but do not use shaving gel/foam or soap.
Yes. Patches are waterproof.