Fentanyl Patch Overdose & Death

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Fentanyl patches (Duragesic, etc) are causing deaths...still.

Recent FDA warnings are not stopping the problem.

Many overdoses are due to inappropriate use. Watch for Rxs for acute or

post-op pain...or for patients not tolerant of opioids.

In general, patients should be on at least 60 mg/day of oral morphine or an

equivalent for a week or longer before starting a fentanyl patch.

Dosing errors also cause problems. Be careful when initial doses are over

25 mcg/hr...or other opiates are also given.

Contact the prescriber if you suspect a wrong indication or dose...and

document the outcome of the call.

Remind patients that heat can increase fentanyl absorption. Warn against

extended exposure of the patch to heating pads, hot tubs, sunbathing, high

fever, etc.

Warn patients NOT to cut fentanyl patches or remove just part of the

backing to titrate a dose. This is especially a bad idea with reservoir patches

like Duragesic and some of its generics. Cutting these allows the liquid to leak

out and cause toxicity.

Advise people NOT to put used fentanyl patches in the trash. Explain that

this is one of the few drugs that should still be flushed...to avoid accidental

use, ingestion, or diversion.

Keep in mind this isn't just a problem with fentanyl PATCHES. Recent deaths

with Fentora (fentanyl buccal tablets) underscore the need for caution with all

fentanyl dosage forms

--

Life should not be a journey to the grave with the intention of arriving safely

in an attractive and well-preserved body, but rather to skid in sideways,

champagne in one hand, strawberries in the other, body thoroughly used up,

totally worn out and screaming " WOO HOO - what a ride! "