Fentanyl patches for pain

This leaflet is about the use of fentanyl patches to reduce severe long-lasting pain. This might be pain from an injury, after an operation or due to an illness.

Fentanyl can be dangerous if used incorrectly. Accidental use, particularly by young children, can result in death.

This leaflet has been written specifically about the use of this medicine in children. The information may differ from that provided by the manufacturer. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.

Name of drug

Fentanyl

Common brands: Durogesic DTrans^® , Tilofyl^®, Matrifen^®

Why is it important for my child to take this medicine?

Fentanyl patches will help to control your child’s pain.

What doses are available?

Patches come in different sizes that release fentanyl at different rates; these are described as ‘12’, ‘25’, ‘50’, ‘75’ and ‘100’ patches.

When should I use fentanyl patches?

Fentanyl patches are used to provide constant pain relief.

Each patch releases fentanyl slowly for 72 hours. You will need to replace the patch every 72 hours (3 days). Try to do this at about the same time of day each time.

Write down when you change the patch, to help you remember.

How much fentanyl should I give?

Your doctor will work out the amount of fentanyl (the dose) that is right for your child and which size patch provides this amount. The dose will be shown on the medicine label.

You will probably start with a low-dose patch and increase the dose bit by bit by using bigger patches. Your doctor may also show you how to cover some of the patch so that less fentanyl is released.

It is important that you follow the instructions from your doctor.

How do I apply the patch?

Stick the patch on to an area of skin that is dry, not hairy, sore or broken, and has not been exposed to radiotherapy. The upper arm or main part of the body are good places. For young children, the patch can be stuck on the back, so that they can’t peel it off.
After you have removed a patch, do not stick another patch to the same area of skin for a few days. Stick the next patch somewhere else on the body.
Do not rub the patches.
Do not apply anything tight over a patch.
Do not allow patches to come into contact with direct heat, such as a hot-water bottle or heat pad, as the medicine will be released too quickly.
Do not apply more than one patch at a time, unless your doctor has told you to.
Do not tear or cut patches.
Wash your hands after applying a patch.

When should the medicine start working?

The first patch may take up to a day to work properly. Your doctor will provide other pain relief for this period. After this, the patches should keep your child’s pain under control all the time.

What if my child is sick (vomits)?

If your child is sick at any time, do not worry, as the patch will continue to work.

What if I forget to replace a patch?

If you forget to replace a patch, do so as soon as you remember. Make a note of when you do this. Leave the new patch on for 72 hours (3 days) as usual.

What if I give too much?

It can be dangerous to give your child too much fentanyl.
If there is any possibility that your child may have had too much fentanyl, contact your doctor or take your child to hospital straight away. Tell the doctor that your child may have had too much fentanyl. Take the medicine with you, so that the doctor can see what has been taken.

Are there any possible side-effects?

We use medicines to make our children feel better, but sometimes they cause effects that we don’t want (side-effects).

Side-effects that you must do something about

If your child has difficulty breathing, stops breathing or seems very sleepy, they may have had too much fentanyl. Telephone for an ambulance or take your child to hospital straight away.
If your child gets a fever (high temperature), contact your doctor for advice, as the fentanyl may be released from the patch too quickly.

Other side-effects that you need to know about

Your child may feel sick or be sick (vomit) during the first few days of using fentanyl patches. Your doctor may prescribe another drug to help with this.
Most children get constipation (have difficulty doing a poo) when using fentanyl patches. You can help by giving your child plenty to drink. Your doctor will probably suggest that your child also takes laxatives – medicines that will help them go to the toilet. It is important that your child doesn’t strain on the toilet.
Your child may get headaches, feel dizzy, have little energy, or get a rash. Contact your doctor if you are worried.

Can other common medicines be given at the same time as fentanyl?

Do not give your child any medicines that contain codeine or dihydrocodeine, as these make the side-effects of fentanyl worse. Some painkillers and cough medicines contain codeine or dihydrocodeine (you can find this information on the label).
Fentanyl should not be taken with some common drugs that you get on prescription. It is important to tell your doctor and pharmacist that your child is using fentanyl patches.
You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.
Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal or complementary medicines.

Is there anything else I need to know about this medicine?

Do not stop using fentanyl patches suddenly, as your child may get withdrawal symptoms.
Only use these patches for your child. Never use them for anyone else, even if they seem to have the same condition, as this is dangerous.
If you think someone else may have used a fentanyl patch by accident, remove the patch and take the person to hospital straight away.
Fentanyl is particularly dangerous for young children. Store patches where children cannot see or reach them. Ideally this should be in a locked container.
Fold used patches in half with the sticky sides together. Dispose of old patches in a bin where young children cannot get them.
The patches are waterproof, so your child can have a shower or bath.
Do not give your child grapefruit juice, as this affects the way fentanyl is broken down by the body.

General advice

If the fentanyl patches do not seem to be helping your child’s pain, contact your doctor for advice. Do not apply extra patches.
Make sure that you always have enough patches. Order a new prescription at least 2 weeks before you will run out.
Make sure that the patches are not older than the ‘use by’ date on the packaging. Give out-of-date or unused patches to your pharmacist to dispose of.

Where should I keep this medicine?

Keep all medicines where children cannot see or reach them. This is vital with fentanyl, which is very dangerous for young children. If possible, keep fentanyl patches in a locked container.
Keep the patches somewhere cool and dry, away from direct heat and light. They do not need to be kept in the fridge.
Keep the patches in the container they came in.