Fentanyl (also called Duragesic®) is a medicine called an opioid or a narcotic. It is used to reduce pain. The fentanyl patch is a way of giving your child this pain medicine. When the patch is put on your child's skin, a small amount of the fentanyl is absorbed continuously through the skin.
The best thing about giving medicine this way is that your child will receive his medicine continuously without having to swallow it or have an intravenous (IV) line.
These patches are made with different dosages. Your child will have the dosage patch of ________. You will need to change the patch every 72 hours (every 3 days). After 72 hours the patch stops giving enough of the fentanyl through the skin to relieve your child’s pain.
How to put on a patch
- Obtain the package of fentanyl patches. Each patch is sealed in its own protective pouch. Do not remove it from the pouch until you are ready to apply it.
- Choose the area of skin where you will place the patch. It is not necessary to put the patch over the area of pain. The best site for the patch is where your child will not have a lot of movement, such as the upper back or chest. Only put the patch on an area of normal skin. Do not put the patch on skin that is red, swollen, or sore, or on skin that has been treated with radiation.
- Remove the old patch and try not to touch the gel. Fold the patch in half so the sticky side sticks to itself, and flush it down the toilet. Wash hands thoroughly after handling the patch.
- Inspect the skin where the patch was attached. Any redness in this area should go away within 1 to 2 days after removing the patch. If this redness does not go away in that period of time, report it to your child’s doctor as soon as possible.
- Use only water if you need to clean the skin before you put on the new patch. Soaps or lotions may irritate the skin under the patch. The skin should be allowed to dry completely before putting on the patch.
- When you are ready to put on a new patch, tear open the pouch at the small notch found on the edge of the pouch. A paper liner protects the part of the patch that will stick to the skin.
- Pull the liner from the patch by holding the liner at the tab that sticks out from the patch. Try not to touch the sticky edges or the gel on the patch.
- Press the patch firmly in place with the palm of your hand for 10 to 20 seconds, making sure that there are no gaps in the edges. Throw the liner away.
- Write the date and time on a small piece of white tape. Put the tape on the new patch. This will help you remember when to change the patch.
- You should put a new patch on a new area of skin every 72 hours. Change the patch at about the same time of day each time to give your child better pain control.
- If you get some of the gel from the patch on your skin, wash your skin with running water. Do not use soap or alcohol to remove the gel because that may make it easier for your skin to absorb the medicine. If you have any concerns about the medicine getting on your skin, call 901-595-3300 and ask to speak to the pharmacist, or your primary clinic doctor or nurse.
Some effects of the patch will continue for 18 hours after it is removed since the medicine has already been absorbed into the skin.
Side effects of a fentanyl patch
All medicines have side effects. Some mild side effects of the fentanyl patch include:
- Feeling drowsy
- Pupils of the eyes may appear smaller than usual
- Dry mouth
Side effects that need to be reported quickly to the doctor include:
- Hallucinations (seeing things that are not there)
- Nausea and vomiting
- Trouble urinating
- Feeling dizzy, especially if standing up or sitting up quickly
- Constipation (ask your doctor about a stool softener)
Some side effects need emergency medical care right away:
- Breathing problems
- Quick shallow breaths
- Trouble breathing
- A slow breathing rate (less than ____/min)
- A change from being alert; becoming drowsy or being hard to wake up
If your child has any of these side effects, call your Emergency Medical Services number (911). Then take the fentanyl patch off your child's skin.
Being exposed to fentanyl by accident can lead to harm or even death. Young children are at greatest risk because they are mobile and curious. Be sure to follow these guidelines to protect everyone from fentanyl dangers:
- Keep used and unused patches out of the reach of children.
- Throw away any patches that are left over from your child’s prescription as soon as he no longer needs this medicine. Remove the leftover patches from their protective pouches. Remove the protective liners and fold the patches in half. Flush them down the toilet. Do not flush the pouch or the protective liner. Throw them in the trash.
- If anyone touches the gel of a loose patch, have them wash their skin right away with running water. Replace any loose patch using the guidelines above.
- For unexpected increases in pain, a short-acting pain medicine, such as morphine or oxycodone, will be prescribed along with the fentanyl patch.
- Because skin absorbs fentanyl slowly, your child's pain may not be relieved during the first few hours the first patch is in place. During this time you will need to give your child the other pain medicines prescribed by the doctor.
- Never cut the patch before applying it to the skin. Only whole patches should be applied to the skin.
- Do not use a heating pad over the patch area.
- Do not give your child the following medicines while he is wearing a fentanyl patch without first talking to your child's doctor:
- Any narcotics (morphine, hydromorphone, meperidine, codeine) other than the short-acting pain medicine prescribed by your child’s doctor.
- Sedatives (medicines to help your child sleep)
- Muscle relaxants
- Antihistamines (such as Benadryl®)
- Cold medicines (may contain alcohol)
- Fentanyl or the medicines listed above may impair your child’s ability to drive or operate heavy machinery. Your child should not do either if he is even slightly sleepy, drowsy, or not feeling alert.
- This medicine can increase the risk of falls.
- Fever may increase the absorption of fentanyl. Inform your doctor if your child has fever to see if any change of pain medicine is needed.
- If the fentanyl patch falls off before the time to change it (72 hours), replace it with a new patch. Be sure to fold over the old patch and flush it down the toilet.
- If the area of skin on which you need to place the patch is hairy, you can clip the hair close to the skin with scissors. Do not shave the hair.
- Your child may take a bath or shower while wearing a fentanyl patch. Try to avoid very warm or hot water. Be careful not to rub the skin around the patch so strongly that the patch comes off while washing.
- You need to talk to the doctor first before letting your child swim. Do not allow your child to use a hot tub because this will lead to a large amount of drug being released from the patch into your child’s blood stream. This could cause an overdose.
- Since your child uses this medicine for a few days, he will need to be tapered off the dose over a few days using other opioids. This will prevent symptoms of withdrawal. Let your doctor know if these symptoms occur:
- Stomach cramping
- The box of fentanyl patches does not need to be refrigerated. However, do not store the box in hot places such as a car in the summer.
If you have questions about fentanyl patches, please talk to your child’s doctor, nurse, or pharmacist. If you are inside the hospital, dial 0. In the local area, call 901-595-3300. If you are outside the Memphis area, dial toll-free 1-866-2STJUDE (1-866-278-5833), and press 0 after the call is connected.
This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.
St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
ATTENTION: If you speak another language, assistance services, free of charge, are available to you. Call 1-866-278-5833 (TTY: 1-901-595-1040).
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-278-5833 (TTY: 1-901-595-1040).
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