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Duragesic, Ionsys, |Duragesic

Duragesic

Generic Name: fentanyl topical (FEN ta nil TOP ik al)
Brand Names: Duragesic, Ionsys

What is fentanyl topical?

Fentanyl is a narcotic (opioid) pain medicine.

The Duragesic fentanyl skin patch is used to treat moderate to severe chronic pain. The Ionsys fentanyl transdermal device is used only in a hospital to treat acute pain after surgery.

Fentanyl topical may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about fentanyl topical?

Before using fentanyl topical, tell your doctor if you have a breathing disorder such as chronic obstructive pulmonary disease (COPD). You should not use fentanyl topical if you have had an allergic reaction or severe side effects when using any narcotic pain medicine.

Avoid drinking alcohol, or using other medicines that make you sleepy (such as cold medicine, other pain medication, muscle relaxers, and medicine for seizures, depression or anxiety). They can add to sleepiness caused by fentanyl and may cause extreme drowsiness or breathing problems.

What should I discuss with my healthcare provider before using fentanyl topical?

• a breathing disorder such as chronic obstructive pulmonary disease (COPD);

• a history of head injury or brain tumor;

• a heart rhythm disorder;

• liver disease; or

• kidney disease.

If you have any of these conditions, you may not be able to use fentanyl topical, or you may need a dosage adjustment or special tests during treatment.

How should I use fentanyl topical?

Use this medication exactly as it was prescribed for you. Do not use the medication in larger or smaller amounts, or use it for longer than recommended by your doctor. Using too much fentanyl can be very harmful or fatal.

Duragesic skin patches may be used at home. Read all patient instructions carefully before using the patches. Ask your doctor or pharmacist if you have questions.

If the skin must be washed before fentanyl topical is applied, use clear water only. Allow the skin to dry completely before applying the medicine.

Apply the skin patch to a flat, dry, hairless area of the chest, back, side, or outer side of your upper arm. To remove any hair from these areas, clip the hair short but do not shave it. Press the patch firmly with the palm of your hand for 30 seconds. Make sure the patch is sticking firmly, especially around the edges. You may wear the patch for up to 72 hours. Do not wear more than 1 patch at a time.

After removing a skin patch fold it in half, sticky side in, and flush the patch down the toilet. Apply a new patch to a different skin area on the chest, back, side, or upper arm. Do not use the same skin area twice in a row.

The transdermal device will be applied where you can reach it, such as your chest or the outer side of your upper arm. The device is worn for 24 hours or until the device has delivered 80 doses of fentanyl.

To release the medicine from the transdermal device, press the dosing button twice. The device will sound a beep when the dose starts, and a red light will come on for 10 minutes while the dose is delivered. The light will also flash between doses to let your caregivers know how many doses are left in the device. Tell your care provider if the patch comes loose or falls off.

Keep each skin patch in its foil pouch until you are ready to use it. If the pouch seal is already broken, do not use the patch. After removing a patch from the foil pouch, apply the patch to your skin right away.

Do not use a fentanyl topical skin patch or device if the patch or device has been cut or damaged. Doing so could expose you to too much fentanyl, which can cause a life-threatening overdose.

Keep track of how many skin patches have been used from each new package of this medicine. Fentanyl is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

What happens if I miss a dose?

Since fentanyl topical is used as needed, you may not be on a dosing schedule. If you are using the skin patches regularly, apply the missed patch as soon as you remember. Continue wearing the patch for up to 72 hours and then apply a new one if needed for pain. Do not wear extra patches to make up a missed dose.

What happens if I overdose?

What should I avoid while using fentanyl topical?

Avoid using other medicines that make you sleepy (such as cold medicine, other pain medication, muscle relaxers, and medicine for seizures, depression or anxiety). They can add to sleepiness caused by fentanyl topical.

Avoid exposing a fentanyl topical skin patch to heat while you are wearing it. This includes a hot tub, heating pad, sauna, or heated water bed. Heat can increase the amount of drug you absorb through your skin and may cause harmful effects.

Fentanyl topical side effects

• weak, shallow breathing;

• severe weakness, feeling light-headed or fainting;

• cold, clammy skin; or

• pale skin, easy bruising or bleeding.

Continue using fentanyl topical and talk with your doctor if you have any of these less serious side effects:

• nausea, vomiting, stomach pain, constipation, gas;

• dizziness, drowsiness, anxiety, sleep problems (insomnia);

• muscle stiffness, back pain;

• itching, blistering, redness, or swelling where the patch or device was worn; or

• increased sweating, urinating less than usual.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect fentanyl topical?

Before using this medication, tell your doctor if you are using any of the following drugs:

• carbamazepine (Tegretol, Carbatrol);

• phenytoin (Dilantin);

• St. John"s wort;

• rifampin (Rifater, Rifamate, Rimactane);

• antibiotics such as clarithromycin (Biaxin), erythromycin (E-Mycin Ery-Tab, E.E.S.), itraconazole (Sporanox), or ketoconazole (Nizoral); or

• HIV medicines such as amprenavir (Agenerase), tipranavir (Aptivus), indinavir (Crixivan), saquinavir (Invirase), lopinavir/ritonavir (Kaletra), fosamprenavir (Lexiva), ritonavir (Norvir), atazanavir (Reyataz), or nelfinavir (Viracept).

There may be other drugs not listed that can affect fentanyl topical. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist has additional information about fentanyl topical written for health professionals that you may read.

What does fentanyl topical look like?

Fentanyl topical is available with a prescription under the brand names Duragesic and Ionsys. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Duragesic 25 micrograms (mcg) per hour

• Duragesic 50 mcg per hour

• Duragesic 75 mcg per hour

• Duragesic 100 mcg per hour

• Ionsys 40 mcg per activation

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ("Multum") is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum"s drug information does not endorse drugs, diagnose patients or recommend therapy. Multum"s drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.