Cautions using fentanyl patches

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Fentanyl patches

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fentanyl blood levels rise slowly - continue previous medication for 24 hours

fentanyl blood levels fall slowly on removal - there is prolonged toxicity in overdose

fentanyl has a long half-life - increase dose only every third day

ensure that analgesia for breakthrough pain is always available

avoid heat pads near a patch - these increase absorption and hence the risk of overdosage

if the patient has not had strong opioids

patients previously on doses of oral morphine (or equivalent opioid) < 60mg/24hr

pyrexial patients where rate of absorption may be unpredictable

with poor adherence of patches, e.g. patient with sweats or when applied to the chest wall of patients who are cachectic

during the dying phase - seek specialist palliative care advice

Contraindications: Sensitivity to fentanyl or silicone medical adhesive

(1) West Midlands Palliative Care Physicians (2012). Palliative care - guidelines for the use of drugs in symptom control.

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Cautions using fentanyl patches

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