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FENTANYL, 25μg/hour, transdermal patch

https://unicat.msf.org/cat/product/34707
NST DEXTFENT4TP

Valid Article

Former Code(s): DEXTZFR0061 DEXTZNL0213
2.2 - Opioid analgesics
Classification of the medicines in groups and subgroups according to their therapeutic use. The classification used by MSF is based on the WHO Model List of Essential Medicines.
N02AB03
Anatomical Therapeutic Chemical Classification according to WHOCC
PE
The order of this product needs to be justified and is only acceptable under certain conditions.
N1
Substance listed as Narcotic Drug or Psychotropic Substance, and as precursors. Other substances may be subject to restrictions according to national regulations. These substances require an import permit from the country of destination when ordering.
1525
Thermosensitive codes are defined for storage and transportation temperature requirements of the products.
OC subscriptions: included in supply or field order tools (e.g. UniField)
SC subscriptions: included in supply or field tools
OC validations: approved for procurement and use by an OC for international or local orders specifying context and activity in Medical Standard Lists (MSL)
https://unicat.msf.org/web/image/product.template/580748/image_1920?unique=e7ba65e

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FENTANYL transdermal patch - NST

Please always consider the MSF STD before ordering a NST.

Therapeutic Action

Strong opioid analgesic

Indications

Moderate to severe pain in patients whose pain is previously controlled with morphine or another opioid.

Prolonged opioid therapy in patients with severe renal impairment or when oral administration is not possible (dysphagia or frequent vomiting).

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Instructions for use

The patches deliver 12 or 25 µg (mcg) fentanyl per hour:

  • a 12 µg/hour patch (2.1 mg of fentanyl) is approx. equivalent to 30-45 mg morphine over 24 hours.
  • a 25 µg/hour patch (4.1-5.1 mg of fentanyl) is approx. equivalent to 60-90 mg morphine over 24 hours.

Other patches deliver 50 or 100 µg (mcg) fentanyl per hour:

  • a 50 µg/hour patch (8.4.mg of fentanyl) is approx. equivalent to 120-180 mg morphine over 24 hours.
  • a 100 µg/hour patch (16.8 mg of fentanyl) is approx. equivalent to 240-360 mg morphine over 24 hours.

Dosage:

  • Patients should be on an opioid regimen before initiating the fentanyl patch, with a relatively controlled level of pain.
  • The dose of fentanyl should be calculated based on a 24-hour morphine equivalent.
  • In case of paroxysmal pain attacks, administer immediate-release morphine orally (fentanyl PO does not exist). Calculate the dose by converting the fentanyl TD to oral morphine and then calculate the appropriate unit dose.
  • Monitor efficacy, side effects, and signs of overdose.

Method of administration:

  • Transdermal use
  • Apply to clean, dry, intact skin on a flat surface of the torso or upper arms.
  • Choose an area where the skin is not oily and is free of scars, cuts, burns or irritations.
  • Hair at the application site should be clipped (not shaved) before the application (a non-hairy area is preferable).
  • Do not remove the patch from the sealed package until ready to apply.
  • Press the patch firmly in place with the palm of the hand for at least 30 seconds. Ensure that the entire adhesive surface adheres properly to the skin, particularly the edges.
  • Wash hands.
  • Replace the patch every 72 hours, choosing a different skin site after removing the previous patch.

Remark:

After removal of the patch, the effects of fentanyl can persist for 12 to 18 hours (monitor for signs of opioid toxicity). Systematically order naloxone (specific opioid antagonist) together with fentanyl.

Distribution to be controlled: narcotics register or supervision of amounts in and out, and storage under lock and key. (CF Introduction: Narcotic and psychotropic medicines under international control)

Image

Precautions for Use

Avoid touching the adhesive side when handling the patch.

Do not use soap, oils, lotions, or any other products that might irritate the skin.

Do not administer to children under 2 years of age.

In patients with a fever, fentanyl absorption may be increased due to enhanced skin permeability (risk of opioid overdose).

In patients in the terminal phase using transdermal fentanyl, keep the patch in place and administer emergency doses by another route if necessary.

The TD patch should only be used when the patient's pain is controlled with morphine or another opioid. Since it takes 24 hours for the patch to reach a therapeutic steady state, rapid titration is not possible.

Storage

  • Below 25°C - Protect from sunlight
  • Store in the original pouch.

Description updated and validated by A. Lamrous (EMACC WG) on 05/04/2023.