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Duragesic-50

Duragesic-50 is a transdermal patch containing fentanyl, a powerful opioid analgesic used for managing severe chronic pain in patients who require continuous, around-the-clock pain relief and are opioid-tolerant. The 50 mcg/hour dose is designed for patients who need consistent pain management and have developed opioid tolerance due to prolonged opioid therapy. Fentanyl provides potent pain relief, and the transdermal delivery system allows for slow, sustained release of the medication over 72 hours.



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Frequently Asked Questions

How long does it take for the Duragesic-50 patch to start working?
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It can take up to 24 hours for the full effects of the fentanyl patch to be felt after the initial application.

Can I shower or swim while wearing the Duragesic patch?
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Yes, the patch is water-resistant and can remain in place while showering or swimming. However, avoid prolonged water exposure, as this may loosen the patch.

What should I do if my patch falls off early?
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If your patch falls off before 72 hours, apply a new one and inform your healthcare provider. Avoid applying it to the same area to prevent irritation.

Is Duragesic-50 safe for long-term use?
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Yes, Duragesic-50 can be used for long-term pain management, but it requires close monitoring by a healthcare provider to manage side effects, prevent addiction, and adjust dosages as needed.

Can I use a heating pad while wearing the patch?
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No, do not use heating pads or expose the patch to external heat, as this can increase the absorption of fentanyl and raise the risk of overdose.

Comprehensive Drug Guide

How Does Duragesic-50 Work?

Fentanyl, the active ingredient in Duragesic-50, binds to opioid receptors in the brain and spinal cord, blocking the transmission of pain signals and altering the perception of pain. The transdermal patch allows for the slow and consistent absorption of fentanyl into the bloodstream, providing long-lasting relief from chronic pain over a 72-hour period. This delivery system helps maintain steady drug levels, avoiding the peaks and troughs associated with other forms of pain medication.



What is Duragesic-50 Used For?

  • Management of severe chronic pain in patients who are opioid-tolerant and require continuous, long-term opioid analgesia when other pain treatments are inadequate.


Common Dosages

  • 12 mcg/hour
  • 25 mcg/hour
  • 50 mcg/hour (Duragesic-50)
  • 75 mcg/hour
  • 100 mcg/hour


Typical Dosing

Off-Label Uses


Who Shouldn't Take Duragesic-50?

  • Opioid-naïve patients or individuals who are not already receiving opioids.
  • Acute or post-operative pain, mild or intermittent pain that does not require continuous opioid therapy.
  • Patients with severe respiratory issues, such as asthma or chronic obstructive pulmonary disease (COPD).
  • Known hypersensitivity to fentanyl or components of the transdermal system.

Advice From The Pharmacist

  • Apply the patch to a flat, non-irritated area on the upper body and avoid touching the sticky side. Do not cut or alter the patch.
  • Avoid exposing the patch to direct heat (such as heating pads, hot baths, or saunas), as heat can increase fentanyl absorption, leading to an overdose.
  • Be sure to rotate the application site with each new patch to avoid skin irritation.
  • Store the patches in a safe place, out of reach of children and pets, as even used patches contain enough fentanyl to be potentially lethal.
  • 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-50

Common Side Effects

  • Nausea or vomiting
  • Drowsiness or sedation
  • Constipation
  • Sweating
  • Dizziness or lightheadedness


Uncommon/Severe Side Effects

  • Respiratory depression (shallow or slow breathing)
  • Severe allergic reactions (swelling, rash, or difficulty breathing)
  • Fentanyl overdose, which can be life-threatening
  • Dependence and addiction with long-term use

Risks and Warnings of Duragesic-50

  • Respiratory Depression: Duragesic-50 can cause serious respiratory depression, especially in opioid-naïve patients or if exposed to heat. Monitoring for signs of overdose is essential, particularly in the first 72 hours of use or when increasing the dose.
  • Addiction and Abuse: Fentanyl is highly addictive, and Duragesic-50 carries a high risk of abuse and misuse. It should only be used as prescribed and never shared with others.
  • Overdose Risk: An overdose of fentanyl can result in life-threatening respiratory depression, coma, or death. Signs of overdose include extreme drowsiness, slow or shallow breathing, and inability to respond.
  • Accidental Exposure: Be cautious of accidental exposure, especially in children and pets, as the fentanyl from the patch can be fatal even in small amounts.

Interactions with Duragesic-50

Common Drug Interactions

  • Other CNS depressants: Combining Duragesic-50 with benzodiazepines, alcohol, or other CNS depressants can increase the risk of severe sedation, respiratory depression, and death.
  • MAO inhibitors: Combining MAO inhibitors with fentanyl can result in serious drug interactions, including serotonin syndrome.
  • Anticholinergic drugs: These can increase the risk of constipation, urinary retention, and sedation when used alongside opioids.

Alternatives to Duragesic-50

  • Morphine ER (extended-release): A long-acting opioid for managing severe chronic pain in opioid-tolerant patients.
  • OxyContin (oxycodone ER): Extended-release oxycodone for chronic pain relief.
  • Butrans (buprenorphine patch): A lower-strength opioid patch for continuous pain relief.
  • Non-opioid pain management: Other options may include gabapentin, NSAIDs, or duloxetine for chronic pain, depending on the patient's condition.