Medicines

Fentanyl patches for pain

This leaflet is for parents and carers about how to use this medicine in children. Our information may differ from that provided by the manufacturers, because their information usually relates to adults. Read this leaflet carefully. Keep it somewhere safe so that you can read it again.

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

Name of medicine

Fentanyl

Common brands: Durogesic DTrans, Tilofyl, Matrifen, Fencino, Fentalis, Mezolar, Opiodur, Osmanil

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. 

Why is it important for my child to take Fentanyl?

Fentanyl patches will help to control your child’s 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.

What is Fentanyl available as?

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 give Fentanyl

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

How much 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 should I give Fentanyl?

Patches on the skin

  • 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 give it?

If you forget to replace a patch, do it 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.

Are there any possible side effects?

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

Side effects you must do something about

If your child has difficulty breathing, stops breathing or seems very sleepy, they may have had too much Fentanyl. Remove the patch and take your child to hospital or telephone for an ambulance 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 you need to know about

  • Your child is likely to feel sick or be sick (vomit) for the first few days of taking Fentanyl. Your doctor may prescribe another medicine to help with this.

  • Most children get constipation (have difficulty doing a poo) when taking Fentanyl. You can help by encouraging them to drink plenty of fluid. 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.

There may sometimes be other side effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side effects to a UK safety scheme at www.mhra.gov.uk/yellowcard

Can other medicines be given at the same time as Fentanyl?

  • Do not give your child any medicines that contain codeine or dihydrocodeine, as these will make the side effects of Fentanyl worse. Some painkillers and cough medicines contain codeine or dihydrocodeine (you can find this information on the label).
  • The 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 taking Fentanyl.
  • 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 and complementary medicines.

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

Do not stop using Fentanyl patches suddenly – unless your child may have had too much Fentanyl – as they 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 about medicines

  • If you are not sure a medicine is working, contact your doctor but continue to give the medicine as usual in the meantime. Do not give extra doses, as you may do harm.
  • Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
  • Make sure that the medicines you have at home have not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

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 in a locked container.

Where should I keep this medicine?

  • 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.

Who to contact for more information?

Your doctor or pharmacist will be able to give you more information about Fentanyl and other drugs or methods for pain relief.

England: NHS 111

Tel 111

www.nhs.uk

Scotland: NHS 24

Northern Ireland: NI Direct

Wales: NHS Direct

Tel 111 (free) or 0845 46 47 (2p per minute)

111.wales.nhs.uk/

Copyright disclaimer

Version [2]. © NPPG, RCPCH and WellChild, all rights reserved. Review by February 2017.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.