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Published: September 2010

Fentanyl patches - different brands are not interchangeable

Prescriber Update 31(3): 21
September 2010

Prescribers are advised that a new brand of fentanyl patch has been approved. However, patients should not be changed from one brand of fentanyl patch to another. If for any reason the brand needs to be changed the dose should be re-titrated and the patient's response clinically assessed.

Fentanyl, a potent opioid analgesic, is only recommended for patients who have opioid tolerance due to the risk of developing respiratory depression.

Experience in other countries has shown that patients and caregivers need support and counselling to ensure they are fully informed of the correct use of these patches. Patients and caregivers must be advised to:1,2

Patients wearing fentanyl patches who experience an increase in body temperature or expose the patches to external heat may develop clinically significant increases in fentanyl blood levels. Therefore patients should not use heat sources such as heating pads, electric blankets, heat or tanning lamps, hot water bottles, prolonged hot baths, saunas or hot whirlpool spa baths while wearing fentanyl patches.

Patients and caregivers need to be aware of the signs and symptoms of fentanyl overdose. Patients experiencing any of the following should seek immediate medical attention:

If serious adverse reactions to the patch do occur it should be removed immediately and the patient should be monitored for up to 24 hours.

Further information on the use of fentanyl patches can be found in the product data sheets on the Medsafe website: www.medsafe.govt.nz/profs/Datasheet/dsform.asp

References
  1. FDA- Fentanyl Transdermal Patch- Important Information for the Safe Use of Fentanyl Transdermal System (Patch). Public Health Advisories (Drugs). http://www.fda.gov/Drugs/DrugSafety/ PostmarketDrugSafetyInformationforPatientsand Providers/DrugSafetyInformationforHeathcare Professionals/PublicHealthAdvisories/ucm048721.htm
  2. MHRA. Volume 2, Issue 2. September 2008. Drug safety advice- Fentanyl patches: serious and fatal overdose from dosing errors, accidental exposure, and inappropriate use. http://www.mhra.gov.uk/Publications/Safetyguidance/ DrugSafetyUpdate/CON025631