Some varied information on the Duragesic (fentanyl) patch

[Guest guest]

Patch problems

A patient complained to her physician that the fentanyl patch he had

prescribed for her pain was not working. After talking with her, he found

out that she was putting the patch on her upper chest and holding it in

place with tape. Problem solved! Patches are just like Band-aid® bandages.

They have a backing that you have to peel off, and then you put on the

patch. The patient in this case was not peeling off the backing, and as a

result, the drug inside the patch was not being released into her body.

And for those of you who do use patches, when you remove them, be sure to

cut them in half with scissors, wrap them in toilet paper, and flush them

down the toilet. This prevents small children and pets from getting into

them and getting poisoned.

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FENTANYL PATCH IS RATED HIGHER IN OVERALL PATIENT SATISFACTION COMPARED TO

MORPHINE TO CONTROL CANCER PAIN

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April, 1998

The largest study comparing quality-of-life ratings for two powerful pain

medications, oral morphine and transdermal fentanyl, has shown that

overall, patients are more satisfied with fentanyl, which produced fewer

patient-reported side effects, even though morphine allowed for easier

performance of physical activities.

In the non-randomized study, researchers from the University of Texas M.D.

Cancer Center evaluated 504 patients with advanced cancers,

including breast, lung and prostate. 295 patients received

sustained-release oral forms of morphine, and 209 received transdermal

fentanyl. The results of a patient-completed questionnaire were analyzed

for patient functioning, pain level, ability to sleep, side effects, and

overall satisfaction.

While ability to sleep and pain measurements were similar for both groups,

fentanyl, administered via a skin patch, had fewer side effects such as

constipation and daytime drowsiness. Though patients reported that morphine

provided greater ability to carry out physical activities such as walking

and dressing, this finding may be a function of the slight demographic

differences between the fentanyl and morphine groups; patients receiving

fentanyl were significantly older and in poorer health, and thus may have

entered the study with decreased mobility.

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" Quality of Life and Cancer Pain: Satisfaction and Side Effects With

Transdermal Fentanyl Versus Oral Morphine, " Payne, MD, et al.,

University of Texas M.D. Cancer Center, Houston, TX; Technology

Assessment Group, San Francisco, CA; Immunex Corporation, Seattle, WA; and

Janssen Pharmaceutica, Titusville, NJ.

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Patch Helps Control Chronic Low Back Pain

HOUSTON--(Oct. 16, 1997)--A medicated patch offers another treatment option

for people with chronic low back pain according to a new study.

" The majority of patients felt the patch was more effective and liked it

better than the oral pain therapies they were taking, " said Dr.

Simpson, associate professor of neurosurgery at Baylor College of Medicine.

" Patients testing the patch reported less pain and significantly less

disability. "

The patch, effective for 72 hours, delivers a continuous dose of fentanyl,

a strong opioid therapy, through the skin and into the bloodstream. It is

placed on a flat skin surface such as the chest, back, side or upper arm.

" The standard oral opioid medications have to be taken every four to six

hours, so there are generally peaks and valleys in the level of medication

within the system, " said Simpson, who is on The Methodist Hospital

neurosurgery staff. " The fentanyl patch is convenient and keeps the

medication level constant. "

The 50 study participants had suffered from chronic low back pain for a

minimum of six months and had been taking prescription pain medications for

at least six months More than half of the participants had experienced low

back pain for three to seven years, and all had at least one back surgery.

" These patients had tried everything from physical therapy and surgery to

acupuncture and biofeedback, " he said. " Oral medication had been their only

option to alleviate pain. "

For the study, patients tested the fentanyl patch for one month. Minor side

effects typical of all opioid medications were reported, including mild

nausea and constipation. However, the study reported these side effects

were easily managed.

Upon completion of the study, close to half of the study participants chose

to remain on the fentanyl patch.

" This treatment already has proven to be effective for chronic pain related

to cancer, and now it can provide an option for chronic low back pain

patients taking oral medications, " Simpson said.

The results are published in the October 1997 issue of the Journal of Pain

and Symptom Management.