IMPORTANT WARNING:  

Why is this medication prescribed?     

Fentanyl skin patches are used to relieve moderate to severe pain that occurs constantly. Fentanyl skin patches contain fentanyl inside.The medication is released from the patch continuously over a period of time and is absorbed through the skin into the bloodstream. Fentanyl is in a class of medications called opiate (narcotic) analgesics. It works to treat pain by changing the way the brain and nervous system respond to pain.

How should this medicine be used?     

Fentanyl skin patches are placed on the skin. The patch usually is changed every 3 days. Change your patch at about the same time of day on the days you are supposed to change the patch. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Apply fentanyl patches exactly as directed. Read the patient information that is given to you with your prescription before you start using fentanyl skin patches.

Your doctor may start you on a low dose of fentanyl skin patches and gradually increase your dose, not more often than once every 3 days after the first patch and every 6 days thereafter, based upon your level of pain control. If your pain is not controlled by this medication, call your doctor.

Fentanyl skin patches should never be placed in the mouth, chewed, or swallowed, or used in any way other than directed by your doctor or pharmacist. Do not try to open the patch or allow someone to have your patch (new or used) for this purpose. If the fentanyl gel leaks from the patch at any time, try not to touch the gel as you remove and throw away the patch according to the directions below. If you or a caregiver touch the gel, immediately wash the area with only large amounts of water. Using soap, alcohol, or other cleansers to remove the gel may actually increase the amount of medication that goes through the skin.

Accidental exposure to the medication inside the fentanyl skin patch can cause serious harm. This may occur through transfer of a patch from an adult's body to a child while hugging, accidentally sitting on a patch, accidental exposure of a caregiver's skin to the medication in the patch when applying or removing a patch, or in other ways. If the patch comes off the person for whom it was prescribed and sticks to the skin of another person, take the patch off that person right away, wash the area with water only, and seek immediate medical attention by calling your doctor, emergency room, or the poison control center. Accidental exposure of children to fentanyl skin patches is a medical emergency. It is important to store and handle this medication carefully to prevent accidental exposure to fentanyl skin patches.

Do not apply more than one patch at a time unless your doctor tells you to, and do not apply fentanyl skin patches more often, or for a longer period of time than your doctor tells you to. Do not stop using fentanyl skin patches without talking to your doctor. Your doctor will probably decrease your dose gradually when you are to stop using this medication. If you suddenly stop using fentanyl skin patches or use the patches less often than your doctor told you to, you may have symptoms of withdrawal. Call your doctor if you experience any of these symptoms of withdrawal: restlessness, tearing from your eyes, runny nose, yawning, sweating, chills, feeling that your hair stands on end, muscle aches, large pupils (black circles in the center of the eyes), irritability, anxiety, backache, pain in the joints, weakness, stomach cramps, difficulty falling asleep or staying asleep, upset stomach, loss of appetite, vomiting, diarrhea, fast heartbeat or rapid breathing.

To apply the patch, follow the directions provided by the manufacturer and these steps:

• Select a clean, dry area of skin on your chest, back, upper arm, or side above the waist. You should choose an area of your body which is flat and hairless. Avoid areas that move a lot, areas where the skin is sensitive, an area of the skin that has been exposed to radiation (x-ray treatment); or an area where you have recently applied a skin patch. If the area is hairy, clip hair as close to the skin as possible with scissors, but do not shave it.
• Clean the skin area, using only clear water. Pat the skin completely dry. Do not put anything on the skin (including soap, lotion, alcohol, or oil) before applying the patch.
• Tear open the pouch containing the fentanyl skin patch along the dotted line, starting at the slit. Remove the skin patch from the pouch and peel off the protective liner from the back of the patch exposing the adhesive (sticky) surface. Try not to touch the sticky side.
• Immediately press the adhesive side of the patch onto the skin with the palm of your hand.
• Press the patch firmly, for at least 30 seconds. Be sure that the patch sticks well to your skin, especially around the edges.
• If the patch does not stick well or comes loose after it is applied, tape the edges down to your skin with first aid tape.
• When you are finished applying the patch, wash your hands promptly with only clear water.
• Apply each new patch to a different skin area to avoid irritation. Remove the old patch before applying another one.
• Fold used patches in half with the sticky sides together and flush down a toilet. Used patches may still contain some medication and may be dangerous to children, pets, or adults who have not been prescribed fentanyl skin patches.

If a patch accidentally comes off or if the skin under the patch becomes irritated, remove the patch and replace it with a new one in a different area, following the steps above.

Do not remove a skin patch from its protective pouch or remove the protective backing until just before applying it. Do not use a patch if the pouch or backing has been broken or damaged.

If fentanyl has been prescribed for a person who is unable to think well or for a child, the patch should be placed on his or her upper back so it is less likely that the patch could be removed and put in their mouth.

Other uses for this medicine     

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

What storage conditions are needed for this medicine?     

Keep this medication in the protective pouch it came in, tightly closed, and out of reach of children and pets. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Do not store fentanyl skin patches inside your car.

Throw away any medication that is outdated or no longer needed by carefully removing the adhesive backing, folding the sticky sides of the patch together (until it sticks to itself), and flushing the patch down the toilet. Throw away the pouch and protective liner in the trash. Wash your hands well with water after throwing away fentanyl patches. Do not put used fentanyl skin patches in a garbage can. Used fentanyl patches still contain some medication after they are removed from the skin.

Store fentanyl skin patches in a safe place so that no one can take it accidentally or on purpose. Keep track of how many patches are left so you will know if any are missing.

In case of emergency/overdose     

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

• difficulty breathing
• extreme sleepiness or tiredness
• difficulty thinking, talking, or walking normally
• small, pinpoint pupils (black circles in the center of the eye)
• faintness
• dizziness
• confusion
• coma

What other information should I know?     

Keep all appointments with your doctor.

You may bathe, shower, and swim while wearing a fentanyl skin patch.

This prescription is not refillable. Be sure to schedule appointments with your doctor on a regular basis so that you do not run out of medication if your doctor wants you to continue using fentanyl skin patches.

Brand names