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Duragesic-100
Duragesic-100 is a transdermal patch containing fentanyl, a potent opioid analgesic used to manage severe chronic pain in opioid-tolerant patients who require continuous, around-the-clock pain relief. It is typically prescribed when other forms of pain management are ineffective or inadequate. The 100 mcg/hour dose provides the highest strength available in the Duragesic patch series, designed for patients with significant opioid tolerance due to its powerful and long-lasting effects.
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Frequently Asked Questions
How long does it take for the Duragesic-100 patch to start working?
It may take up to 24 hours for the fentanyl patch to reach full effectiveness after the initial application.
Can I shower or swim while wearing the Duragesic patch?
Yes, the patch is water-resistant and can be worn while showering or swimming. However, avoid prolonged exposure to water, as this may cause the patch to loosen.
What should I do if my patch falls off early?
If the patch falls off before the 72 hours are complete, apply a new one and notify your healthcare provider, as it may be necessary to adjust the dosage or application technique.
Is Duragesic-100 safe for long-term use?
Yes, but it requires careful monitoring by your healthcare provider due to the risks of addiction, dependence, and potential side effects.
Can I use a heating pad or hot water bottle while wearing the Duragesic patch?
No, applying external heat to the patch area can increase the absorption of fentanyl and lead to a dangerous overdose. Avoid saunas, heating pads, and hot baths while wearing the patch.
Comprehensive Drug Guide
How Does Duragesic-100 Work?
Fentanyl, the active ingredient in Duragesic-100, binds to opioid receptors in the brain and spinal cord, inhibiting pain signals and reducing the sensation of pain. The transdermal patch allows for continuous release of fentanyl into the bloodstream, providing consistent pain control over 72 hours. This long-acting delivery method is especially beneficial for chronic pain management.
Common Dosages
- 12 mcg/hour
- 25 mcg/hour
- 50 mcg/hour
- 75 mcg/hour
- 100 mcg/hour (Duragesic-100)
Typical Dosing
FDA Approved Indications
- Severe chronic pain in opioid-tolerant patients who require long-term, continuous opioid treatment and for whom alternative treatments are insufficient.
Who Shouldn't Take Duragesic-100?
- Patients who are opioid-naïve or have not developed tolerance to opioids.
- Severe respiratory conditions, such as asthma or chronic obstructive pulmonary disease (COPD), as fentanyl can further depress breathing.
- Known hypersensitivity to fentanyl or other components of the patch.
- Acute pain, post-operative pain, or pain that is mild or short-term.
Advice From The Pharmacist
- Apply the patch to clean, dry, non-irritated skin, and avoid contact with broken or damaged skin.
- Do not cut the patch or apply heat (heating pads, hot baths) to the patch area, as heat can increase fentanyl absorption and raise the risk of overdose.
- Store patches in a safe place away from children, pets, and other people to avoid accidental exposure.
- Properly dispose of used patches by folding them in half, sticky sides together, and flushing them down the toilet.
Side Effects of Duragesic-100
Common Side Effects
- Nausea and vomiting
- Drowsiness and sedation
- Constipation
- Sweating
- Dizziness
Uncommon/Severe Side Effects
- Respiratory depression (slowed or shallow breathing)
- Severe allergic reactions
- Fentanyl overdose, especially if patches are used improperly or if the patient is opioid-naïve
- Physical dependence and addiction with long-term use
Risks and Warnings of Duragesic-100
- Respiratory Depression: Duragesic-100 may cause severe respiratory depression, which can be life-threatening. This risk is especially high in opioid-naïve patients or if the patch is exposed to heat.
- Addiction and Misuse: As a strong opioid, Duragesic-100 carries a high risk of addiction, misuse, and abuse, even when used as directed. Always follow dosing instructions carefully.
- Overdose Risk: An overdose of fentanyl can result in coma or death, especially if multiple patches are applied, or the patch is exposed to heat. Signs of overdose include extreme drowsiness, slow or shallow breathing, and unresponsiveness.
- Accidental Exposure: Keep the patch out of reach of children and pets, as even a used patch contains enough fentanyl to cause fatal overdose if ingested or absorbed through the skin.Other CNS depressants: Combining Duragesic-100 with other CNS depressants such as benzodiazepines, alcohol, or muscle relaxants can increase the risk of severe sedation, respiratory depression, and coma.
- MAO inhibitors: These drugs can interact with fentanyl and increase the risk of serotonin syndrome or exaggerated opioid effects.
- Anticholinergic drugs: Can increase the risk of severe constipation, urinary retention, and sedation when used alongside opioids.
Interactions with Duragesic-100
Common Drug Interactions
- Other CNS depressants: Combining Duragesic-100 with other CNS depressants such as benzodiazepines, alcohol, or muscle relaxants can increase the risk of severe sedation, respiratory depression, and coma.
- MAO inhibitors: These drugs can interact with fentanyl and increase the risk of serotonin syndrome or exaggerated opioid effects.
- Anticholinergic drugs: Can increase the risk of severe constipation, urinary retention, and sedation when used alongside opioids.
Alternatives to Duragesic-100
- Morphine ER (extended-release): Another long-acting opioid used for managing chronic pain in opioid-tolerant patients.
- OxyContin (oxycodone ER): Extended-release oxycodone used for moderate to severe chronic pain.
- Butrans (buprenorphine patch): A lower-strength opioid patch option for patients needing continuous relief.
- Non-opioid pain management: For some patients, options like gabapentin, NSAIDs, or duloxetine may be explored for chronic pain relief.
