Fentanyl patches contain a very strong painkiller, so misuse can be deadly


Fentanyl is a very powerful pain reliever. It is only supposed to be prescribed for people with long-term (chronic) pain who have already been taking high doses of prescription opioid (narcotic) pain medicine for at least a week. Serious harm or death has resulted when this drug was taken in high doses by people who have not been taking other prescription opioid pain medicine for 7 days or more.

In one case, a young man died after a well-meaning but misinformed doctor prescribed a starting dose fentanyl patch that was too high (50 mcg/hour). The man had been given a prescription for fentanyl patches to help reduce pain after surgery. Use of this medicine to treat pain related to the surgery itself is not safe. The man stopped breathing during his first night home after surgery.

Another patient who had surgery was given a prescription for a very high dose of fentanyl patches (75 mcg/hour). This man received morphine--another powerful pain medicine--right after surgery, and then he was sent home the same day with a prescription for fentanyl patches. He was also given a prescription for an oral pain medicine, oxycodone, to be taken as needed. The nurse placed a fentanyl patch on the patient before he left the hospital. Upon arriving home, the young man took one dose of the oral pain medicine, oxycodone. Sadly, the man died within 12 hours of leaving the hospital. He was not used to taking high doses of pain medicine, so he stopped breathing. He also had been treated for sleep apnea: a condition in which breathing repeatedly stops and starts during sleep. Fentanyl patches should not be prescribed for patients with sleep apnea or other serious breathing disorders.

The US Food and Drug Administration (FDA) and companies that make fentanyl patches have sent out numerous warnings to doctors about incorrectly prescribing this drug to patients after surgery. Pain after an operation is acute pain, or short-term pain. Fentanyl should only be prescribed for patients who have long-term chronic pain. Patients with chronic pain have often taken other powerful pain medicines for at least 1 week and are more tolerant to the powerful pain reliever, fentanyl. People who are tolerant to other prescription pain relievers are much less likely to suffer from breathing problems when using a properly prescribed fentanyl patch.

Follow the suggestions in Check it out! if your doctor prescribes fentanyl patches for you or a family member. Rest assured, this pain medicine works extremely well--but you want to make sure you are using the medicine patches safely.

Check it out!
If your doctor prescribes fentanyl patches for you or a family member:

  • Ask for education. Talk to a pharmacist when picking up your prescription so you can learn how to use the medicine safely. Be sure to tell your pharmacist the type of pain for which the patch was prescribed, and be sure to mention any other pain medicines you have been taking.
  • Use as directed. The directions for using the fentanyl patch must be followed exactly to prevent serious side effects from overdosing. Do not use more patches than prescribed or use them longer than directed. Take off the old patch before applying a new patch.
  • Don't warm patches. Do not expose the patch site to heat from a heating pad, electric blanket, saunas, hot tubs, heated waterbeds, or excessive sunlight. Also avoid tight coverings over the patch and strenuous exercise, which can heat the body. Heat increases the absorption of the medicine through the skin, which could lead to an overdose.
  • Don't wear during MRI. Remove your fentanyl patch before entering the exam room for an MRI. The metal in some patches is attracted by the MRI magnet and may cause burns at the site if left on during the procedure.
  • Report signs of an overdose. Signs of a fentanyl overdose include trouble breathing or shallow breathing; tiredness, extreme sleepiness, or drowsiness; inability to think, talk, or walk normally; and feeling faint, dizzy, or confused. If these signs occur, seek medical attention right away.
  • Store safely. Keep new patches far from the reach or discovery of children. Do not let children see you apply patches or call them stickers, tattoos, or Band-Aids. This could attract children and encourage them to mimic your actions.
  • Dispose safely. Dispose of used or unneeded fentanyl patches by folding the sticky side together and flushing it down the toilet. (This is one of only a few medicines that the FDA suggests flushing rather than throwing in the trash.) Even after a patch is used, a lot of the medicine remains in the patch.
Created on July 25, 2009

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