Administration of TTS fentanyl every 72 hours provides a sustained serum fentanyl concentration more conveniently than intravenous or subcutaneous opioids.
Fentanyl TTS is composed of 4 layers plus a removable protective lining.
The first titration should be at least 3 days after initial patch application.
Subsequent titration at 3- to 6-day intervals.
Upward titration increments should be based on the daily supplementary analgesia requirements; a ratio of 25μg/h fentanyl TTS to 90 mg/24 hours of oral morphine is recommended.
Durogesic® Conversion of patients from other opiods to fentanyl TTS
Durogesic® Dosage
Adequate rapid-onset, short-action rescue medication, such as immediate release oral morphine, should be available in all patients who receive long-acting opioids.
Not all patients will achieve acceptable analgesia on he 72-hour administration regimen; some may require more frequent (i.e. 48-hour) patch replacement.
The maximum number of patches is determined by the area of suitable skin available for application.
Durogesic ® Increase absorption rate
Changes of skin - erythema,... - trauma (i.e. after shaving)
Changes of body temperature - fever (>39°C) - sauna - heat lamps - heat pads
Durogesic ® Interaction with other agents
Conclusions
Pain is a significant health problem currently undertreated.
Opioids are the mainstay in pharmacological treatment of chronic, moderate-to-severe pain.
Choosing an appropriate opioid and delivery route is important for optimal pain relief.
Fentanyl TTS is clinically proven to be effective in treating different types of chronic non-cancer pain.
