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Duragesic Drug Center

Duragesic (fentanyl) is an opioid analgesic that is used for patients with chronic pain that is persistent, not managed by other opioids or non-steroidal analgesics, and are opioid-tolerant (patients who have been taking opioids daily for at least a week in relatively high concentrations such as 60 mg morphine, 30 mg of oxycodone or 8 mg of oral hydromorphone daily). Duragesic format should not be used in patients that are not opioid-tolerant or in patients that need short-term pain control as the side effect of hypoventilation can be serious enough to cause brain damage or death.

Duragesic is available in transdermal patches (patches impregnated with Duragesic that is absorbed through the skin) of various sizes that deliver about 25 micrograms per hour per every 10.5 cm₂ of patch (23 mcg/h/10.5 cm₂). Each patch lasts for about 72 hours. The patches are available in 12, 25, 50, 75 and 100 mcg/h sizes. Initial dosages can be equated to morphine and other opioids by tables available in the medical literature (Dose Conversion Tables). Patients should not alter the dosage of Duragesic without discussing changes with the physician that prescribed the drug. Patches should be placed on normal, unshaven skin, usually on the back or side. Do not use any Duragesic patch that has been opened previously or is damaged in any way. Safe use in children below age 2 is not established, and above age two, Duragesic is used only in those children known to be opioid-tolerant. While women who are breastfeeding infants transfer very small amounts of the drug to their infants, the American Academy of Pediatrics consider Duragesic patches on the mother compatible with breastfeeding. Studies done on pregnant women are less clear so the treating physician and patient should realize there may be some fetal and maternal risks if this drug is used. Duragesic should not be used with monoamine oxidase inhibitors (MAOIs), other opioids, sedatives, or any respiratory depressants because its respiratory depression may be enhanced. Duragesic, like other opioids, can and is easily abused (sometimes causing unexpected death in otherwise healthy individuals, including a few physicians); it also can lead to drug dependence. Duragesic use, like other opioids, can be complicated by the situation that opioid users should not have the drug stopped suddenly; they can develop an opioid withdrawal syndrome (patients can develop anxiety, restlessness, nausea, abdominal pain, rapid heartbeats, high blood pressure, increased respiratory rate and other symptoms).

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