The FDA has issued a public health advisory on the use of fentanyl patches.

The brand name for the fentanyl patch in the US is Duragesic; generic versions of the patch (by Mylan and Sandoz) are also available.

The alert deals in part with doctors inappropriately prescribing the patch for problems as simple as a headache(!), but also notes that applications of heat near the patch (such as a heating pad, an electric blanket or even a hot shower) can cause an overdose.

-- Leslie

Thanks Leslie,

We can always count on you to keep us up to date on anything that hits the news that's related to oral cancer.

Jerry

The FDA has a good point that Fentanyl is a "long term" opioid and should only be prescribed as such. But it is also the ultimate synthetic narcotic pain killer - 100X more potent than pure heroin (which is 10 times more potent the Morphine). Without it I doubt I would (or many others here) have survived the pain. I also took many showers with it on and never had a problem. It can cause an overdose if the patch is cut or damaged however so the user instructions must be followed VERY carefully. If is a safe and very effective drug when used properly. My neighbor, who recently died from pancreatic cancer was taking 5-100mcg patches - that IS the maximum dose. If you are using it just make sure that you follow the labeling to the letter and make NO changes in your dose rate without direct medical supervision or approval. Never quit this drug abruptly or "cold turkey" - it can cause convulsions and death. When it becomes time to stop taking it, you should get a phase out, tapering off, plan from your doctor.

The delivery mechanism is a permeable membrane that allows small amounts to be released transdermally (absorbed into the skin) and hence into the blood. It takes 24 hours to initiate a therapeutic level of the drug. After the first patch the pain management effect is very consistent.

It is not uncommon for other "short term" narcotics, such as Morphine to be used for "breakthrough" pain with it as well.

Morphine is the fastest acting, short term, pain killer. IV instantaneous, liquid about 4 minutes, oral about 30 minutes. Everything else takes at least an hour. If you are having to take Morphine frequently then they will increase the Fentanyl dosage, typically in 25 mcg increments.

Do NOT let the FDA advisory scare you if you are taking Fentanyl. On the home page there is a link to the NCCN Oncology Practice Guidelines and there is a special section on managing adult cancer pain if you are interested in the details.

Thanks Leslie and Gary for this valuable information.

My Dad is on Fentanyl (50 mcg's with Percocet for the break through pain - about every 3 hours). While the doctors can explain how to use this drug, I think Gary's post put it into the simplest of laymans terms. I plan to call Mom here in a bit and read it to her. Thanks for putting it into words that we can all understand. I really liked how you did the comparison to other drugs.

Merry Christmas!

Joy