Durogesic

Generic Name: Fentanyl
Product Name: Durogesic

Indication

Durogesic is a pain patch used to relieve chronic or long-lasting pain, which requires strong painkillers. The patches contain a medicine called fentanyl. This strong pain reliever belongs to a group of medicines known as opioid analgesics.

Action

Fentanyl relieves pain by blocking the nerves that recognise pain messages from the body.

Dose advice

Durogesic is available in five different sizes. The doctor will decide which pain patch, or combination of patches, is suitable to control an individual’s pain.

The pain patch is designed so that a certain amount of medication is released each hour to make sure that you get a controlled relief for pain throughout the time you have the patch on.

The five different sizes available and how much is released per hour is shown below:

• Each patch is applied onto the skin and lasts for three days (72 hours).
• After three days, remove the patch and apply a new patch to the skin at a different place.

Using Durogesic for the first time

The first pain patch may take up to a day to take effect after it is applied onto the skin. This is because fentanyl is slowly absorbed through the skin into the blood. The doctor may prescribe additional medicines to control the pain for the first day.

Applying the patch

1. Find an intact and hairless spot of skin on the upper part of your body or on your upper arm. The skin should be healthy and undamaged. Do not place the patch onto skin that is red, burnt or damaged.
2. Trim any excess hair with scissors. Do not shave the hair off since this may affect the skin. If you need to wash the skin before applying the patch, use clean water only. Do not use soap, oils or lotions. The skin should be completely dry before applying the patch.
3. To open the pouch, locate the pre-cut notch indicated by the scissors. Make a small cut and fold at the notch. Carefully tear the pouch along the edge and then fully open the pouch by folding it open like a book.
4. Remove the Durogesic patch from the sealed pouch.

Do not apply the patch if it looks damaged in any way. Never cut or divide the patch.

• Each Durogesic patch has a clear plastic protective (release) liner that can be peeled off in two pieces. After folding the patch in the middle, peel off each part of the protective liner separately.

Avoid touching the adhesive side of the patch.

• Apply the patch to the skin and press with the palm of the hand for about 30 seconds. Make sure all of the patch is in contact with skin and the corners are stuck tightly.
• Wash hands after applying or removing the patch.

You can now leave the patch on the skin for three days (72 hours). You may have a bath, shower or swim.

Always write the date and time you applied the patch on the pack. It will help you to use Durogesic correctly and remember when the next patch is due.

Your doctor may prescribe additional pain relievers to control occasional outbreaks of pain.

Changing the patch

• After three days (72 hours), remove the patch.
• Fold the used patch in half so that the adhesive side sticks to itself. Wrap the folded patch and carefully dispose of it in the garbage.
• Apply a new patch straight away to a different area of the skin, following the steps under ‘Applying the patch’.

If your pain continues, see your doctor who may prescribe additional medicines to help control the pain or change the dose of Durogesic.

Schedule

Schedule 8

Durosgesic is restricted benefit under the PBS and may currently only be prescribed for “chronic severe disabling pain not responding to non-narcotic analgesics”.⁴

Common side effects

All medicines have side effects. Some side effects can be serious, but the most common ones are mild. Common side effects occurring in more than 10% of patients prescribed Durogesic include:

• Nausea
• Vomiting
• Constipation
• Somnolence
• Dizziness
• Dry mouth
• Confusion
• Skin rashes (local redness and itch at the site of the patch is usually mild and resolves when the patch is removed).

Uncommon side effects

The following side effects are less common but still occur frequently. They are demonstrated by 1-10% of patients:

• Insomnia
• Sleepiness
• Anxiety
• Excessive sweating
• Feeling of body temperature change
• Fatigue
• Skin rash or hives
• Palpitations
• Reduced appetite

Consult your doctor if you experience any of the above symptoms, or any other unusual or abnormal symptoms that concern you.

References

1. Australian Medicines Handbook. [online]. Fentanyl. January, 2007. Available from: [URL Link] (last accessed 03/04/07)
2. Janssen-Cilag. (2006). Durogesic Consumer Information. North Ryde: Janssen-Cilag.
3. Janssen-Cilag. (2006). Durogesic Product Information. North Ryde: Janssen-Cilag.
4. MIMS Australia. [online] Durogesic. 2006. Available from: [URL Link] (last accessed 3/04/07)

For further information talk to your doctor.