Meds and you

27 September 2013

Fentanyl (Transdermal)

Fentanyl is an analgesic. Analgesics are drugs used to relieve pain.


Fentanyl (Transdermal) is the active ingredient of Durogesic patches (Nappi code: 711169001, 814008-003, 814016-006, 819425-001, and 814024-009).

General information

Fentanyl is an analgesic. Analgesics are drugs used to relieve pain.

In South Africa fentanyl (transdermal patches) is registered for the treatment of the management of chronic pain requiring the use of opioid analgesics.

Although most patients who receive this drug for the treatment of chronic pain do not develop psychological dependence, prolonged use may lead to physical and psychological dependence and tolerance. Do not change your dose, take more than has been prescribed, or discontinue treatment without talking to your doctor.

Fentanyl medication does not cure the underlying condition, but simply keeps the symptoms under control. It reduces a patient's perception of pain without altering the cause of the pain.

Be careful if you drive or do anything that requires you to be alert. Avoid any other dangerous activities until you know how this medication affects you.

How does fentanyl work?

Fentanyl binds to pain receptors in the central nervous system, thereby altering the response to, and the perception of, pain.

Fast facts

Drug schedule: schedule 6

Available as: fentanyl is available as patches.

What does it do? Fentanyl reduces pain.

Overdose risk: medium

Dependence risk: high

Is transdermal fentanyl available as a generic? no

Is transdermal fentanyl available on prescription only? yes

User information

Onset of effect: within 6 hours

Duration of action: up to 72 hours

Dietary advice: avoid drinking grapefruit juice.

Stopping this medicine: it is advised that you decrease your dose gradually as directed by your doctor - preferably over 7 - 14 days.

Special precautions

Consult your doctor before using this drug if:

  • you are allergic to opioid medicines
  • you have difficulty breathing
  • you have liver disease
  • you have kidney disease
  • you have acute pain
  • you have a CNS tumor
  • you are suffering from head trauma
  • you have increased intra-cranial pressure
  • you have ulcerative colitis
  • you have a history of drug addiction

Pregnancy: avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.

Breastfeeding: avoid. This medication is passed through breastmilk and may affect your baby adversely. Consult your doctor before use.

Porphyria: this medication is safe for use.

Infants and children: this medication is not intended for use in children under the age of 2 years.

The elderly: caution is advised in the elderly, as side effects are more likely to occur.

Driving and hazardous work: caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how this medication affects you.

Alcohol: avoid concomitant use of alcohol with this medication.

Possible side effects

Side effect Frequency
Consult your doctor

Common Rare Only in severe cases In all cases
sedation x
confusion x
dizzieness x
x x
dry mouth x
nausea/vomiting x
appitite loss x
breathing difficulties
muscle rigidity
skin reaction


Drug interactions

cimetidine inceased risk of fentanyl side-effects
erythromycin increased risk of fentanyl side-effects
ketoconazole increased risk of fentanyl side-effects
rivastigmine increased risk of fentanyl side-effects
alcohol increased risk of fentanyl side effects
grapefruit juice increased risk of fentanyl side effects
fluconazole increased risk of fentanyl side-effects
verapamil increased risk of fentanyl side-effects
monoamine-oxidase-inhibitor antidepressants increased risk of hypertensive crisis
anitdepressants increased CNS depression
antihistamines increased CNS depression
sedatives increased CNS depression
valerian increased CNS depression
chamomile increased CNS depression
tricyclic antidepressants increased risk of fentanyl side-effects

Overdose action

A small overdose is no cause for concern. In case of intentional large overdose, seek emergency medical attention.

Recommended dosage

Adults: starting dose: 25 microgram/h patch every 72 hours


This material is not intended to substitute medical advice, but is for informational purposes only.

Please consult a physician for specific treatment and recommendations.


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