Reviewed August 7, 2023 (revised November 5, 2024)
Catapres-TTS (transdermal therapeutic system) patches contain the medicine clonidine, which is used to treat high blood pressure. The patch is applied to the skin where it slowly releases the medicine into the body over a specific period of time.
Once a week the patch needs to be removed and replaced with a new one. Confusion can occur because of the way the patch is supplied by the manufacturer. The medicine is on a tan, square, adhesive patch. However, it is packaged with a white, round, adhesive patch cover to use over the tan patch. This white cover helps keep the tan medicine patch in place, but is not necessary to use. There is a warning on the pouch that contains the white cover patch saying it does not contain medicine (Figure 1). However, if the warning is missed, the white cover patch may be applied by itself without the tan medicine patch underneath. Therefore, no medicine will be given.
Catapres-TTS medicine patches and adhesive covers come in a carton that contains four of each (Figure 2). However, in hospitals or long-term care facilities, the medicine patches and the covers are not usually provided in the carton. So, the pharmacist dispensing the patch or the nurse administering the patch may not realize that only the tan patch contains the medicine and an error can occur.
This is exactly what happened in a nursing home. For 2 weeks in a row, a nurse only applied the white cover patch to a patient, thinking it contained the medicine. It wasn’t until the third week when a different nurse was caring for the woman that the mistake was recognized. The nurse noticed extra tan medicine patches in the woman’s medicine drawer. When she removed the white cover patch from the woman’s arm, a tan medicine patch was not underneath, which was why there were extra tan patches in the drawer.
Here’s what you can do: Make sure you understand how to use medicine patches correctly. Talk to your pharmacist when you pick up your prescription. Ask questions if you are not sure how or where to apply the patch. Know how often the patch needs to be changed. Read the medicine pamphlet that is given to you when you pick up your prescription. If you receive a carton (Figure 2) from your pharmacy, look for the package insert that describes how to use the medicine. The graphic in Figure 3 is an example of instructions shown on a package insert showing how to apply the medicine patch and the adhesive cover. If you experience any side effects, contact your healthcare provider.
