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Duragesic-25
Duragesic-25 is a transdermal patch containing fentanyl, a potent opioid analgesic used to treat severe chronic pain in patients who require continuous, long-term opioid therapy and are opioid-tolerant. The patch delivers 25 mcg of fentanyl per hour over a 72-hour period, providing consistent pain relief for patients who need around-the-clock management of pain that cannot be controlled by other medications. It is typically prescribed to patients who have developed opioid tolerance due to previous opioid use.
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Frequently Asked Questions
How long does it take for the Duragesic-25 patch to start working?
It may take up to 24 hours for the full effect of the fentanyl patch to be felt after the initial application.
Can I shower or swim while wearing the Duragesic patch?
Yes, the patch is water-resistant and can stay on while showering or swimming. However, avoid prolonged exposure to water, as this may cause the patch to loosen.
What should I do if the patch falls off early?
If your patch falls off before the 72 hours are up, apply a new patch and contact your healthcare provider. Be sure to rotate the application site to avoid skin irritation.
Is Duragesic-25 safe for long-term use?
Yes, Duragesic-25 can be used for long-term pain management, but it requires close monitoring by your healthcare provider to manage side effects and adjust dosages as necessary.
Can I use a heating pad while wearing the Duragesic patch?
No, avoid using heating pads or exposing the patch to any form of external heat, as this can increase fentanyl absorption and raise the risk of overdose.
Comprehensive Drug Guide
How Does Duragesic-25 Work?
Fentanyl, the active ingredient in Duragesic-25, works by binding to opioid receptors in the brain and spinal cord, which blocks the transmission of pain signals and alters the perception of pain. The transdermal patch system provides a slow and steady release of fentanyl into the bloodstream, offering continuous pain relief over 72 hours. This delivery system ensures consistent pain control without the peaks and troughs seen with short-acting opioids.
Common Dosages
Duragesic is available in the following strengths:
- 12 mcg/hour
- 25 mcg/hour (Duragesic-25)
- 50 mcg/hour
- 75 mcg/hour
- 100 mcg/hour
Typical Dosing
FDA Approved Indications
- Management of severe chronic pain in patients who are opioid-tolerant and require continuous, long-term opioid therapy when other treatments are inadequate.
Who Shouldn't Take Duragesic-25?
- Opioid-naïve patients or individuals not previously taking opioids.
- Acute or intermittent pain that does not require continuous opioid therapy.
- Patients with severe respiratory depression, including asthma or chronic obstructive pulmonary disease (COPD).
- Known hypersensitivity to fentanyl or components of the patch.
Advice From The Pharmacist
- Apply the patch to a flat, non-irritated area on the upper body and avoid placing it on areas with cuts or irritated skin. Do not cut the patch, as it could result in rapid release of fentanyl.
- Avoid exposing the patch to heat sources such as heating pads, hot baths, or direct sunlight, as heat can increase the absorption of fentanyl and raise the risk of overdose.
- Rotate the application site with each new patch to avoid skin irritation.
- Keep patches away from children and pets, as even used patches contain enough fentanyl to be dangerous if ingested or touched.
- Properly dispose of used patches by folding them in half with the sticky sides together and flushing them down the toilet.
Side Effects of Duragesic-25
Common Side Effects
- Drowsiness or sedation
- Nausea and vomiting
- Constipation
- Dizziness
- Sweating
Uncommon/Severe Side Effects
- Respiratory depression (slow or shallow breathing)
- Severe allergic reactions (swelling, rash, difficulty breathing)
- Overdose, especially if the patch is not used as directed
- Physical dependence and addiction with long-term use
Risks and Warnings of Duragesic-25
- Respiratory Depression: Fentanyl can cause life-threatening respiratory depression, particularly in opioid-naïve patients or if the patch is exposed to heat, which increases the absorption rate.
- Addiction and Abuse: Duragesic-25 carries a high risk of addiction, abuse, and misuse. It should be used only as prescribed and never shared with others.
- Overdose Risk: An overdose of fentanyl can result in death, especially if multiple patches are applied or if the patch is exposed to heat. Signs of overdose include extreme drowsiness, slow or shallow breathing, and loss of consciousness.
- Accidental Exposure: Keep the patch away from children, pets, and others who may accidentally come into contact with it, as fentanyl can be absorbed through the skin and lead to overdose.
Interactions with Duragesic-25
Common Drug Interactions
- Other CNS depressants: Using Duragesic-25 with alcohol, benzodiazepines, or other CNS depressants can increase the risk of severe sedation, respiratory depression, coma, or death.
- MAO inhibitors: Combining fentanyl with MAO inhibitors can cause dangerous drug interactions, including serotonin syndrome.
- Anticholinergic drugs: Using these with Duragesic-25 may increase the risk of constipation, urinary retention, and other side effects.
Alternatives to Duragesic-25
- Morphine ER (extended-release): A long-acting opioid for managing severe chronic pain in opioid-tolerant patients.
- OxyContin (oxycodone ER): Extended-release oxycodone for long-term pain management.
- Butrans (buprenorphine patch): A lower-strength opioid patch for continuous pain relief.
- Non-opioid pain management: Options like gabapentin, NSAIDs, or duloxetine may be considered for managing chronic pain, depending on the patient's condition.
