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Fentanyl Patch: Prevention for Chronic Pain

The fentanyl patch is an extended-release formulation of fentanyl for those who need around-the-clock pain relief for severe chronic pain that is unable to be managed with other methods.

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Fentanyl is a potent and powerful synthetic opioid medication designed to treat breakthrough cancer pain in patients who are already opioid tolerant. Fentanyl has a high risk for addiction and overdose, as more than 56,000 people in the United States died from an overdose involving a synthetic opioid drug in 2020. 

The patch can help to prevent overdose by delivering only therapeutic amounts of fentanyl to the body in a controlled manner, which can avoid overwhelming the system or taking too much as the pain stays better managed. Other methods of fentanyl administration, like a tablet or lozenge, need to be taken more often and can potentially result in an accidental overdose by taking too much too soon or in too high of a dose. 

The fentanyl patch is not designed to treat acute pain. The patches have a potential for misuse, addiction, and overdose. They should be used only as directed, when other methods are ineffective, under the supervision of a medical professional.

What Are Fentanyl Patches?

Fentanyl patches are transdermal release systems of the potent synthetic opioid prescribed to cancer patients who are opioid tolerant or often already taking opioid drugs. The goal is to manage breakthrough and extreme pain around the clock. 

The transdermal fentanyl patch is worn on the skin for a period of three days while it slowly and continually releases fentanyl in the bloodstream to keep pain under control. 

The brand-name transdermal fentanyl patch, Duragesic, is available in doses that release the following amount of fentanyl per hour:

  • 12 mcg
  • 25 mcg
  • 37.5 mcg
  • 50 mcg
  • 75 mcg
  • 100 mcg

Benefits of Using Fentanyl Patches for Chronic Pain

Fentanyl is a powerful synthetic opioid that acts on opioid receptors in the brain to block pain sensations and provide an analgesic effect. It is available in lozenge, sublingual tablet, buccal tablet, injection, and transdermal patch formulations. 

The fentanyl patch is optimal for controlling chronic pain that needs to be managed continuously. It can be a more convenient form of pain management, as it can remain in place and active for up to 72 hours without needing to take additional doses. 

Fentanyl is a fast-acting opioid with a short half-life. The fentanyl patch provides a controlled-release distribution system that keeps the medication active and effective in the bloodstream over a period of time. This can help to prevent accidental overdose through taking too much at once or taking another dose too early. 

You can put the patch on and forget about it for three days instead of having to try and stay ahead of your pain and remember to take medication more frequently. It greatly simplifies the pain management process for those in need.

How Do You Use Fentanyl Patches?

It is important to follow the prescribing information on how to properly use a fentanyl patch and stick to all of your doctor’s specific instructions for use. General details for using the fentanyl patch are as follows:

  1. Clean the area where you will apply the patch with clear water. Avoid use of soaps, oils, alcohols, or oils, as these can prevent the patch from adhering correctly. Pat the area completely dry.
  2. Start at the slit, and tear along the dotted line. Carefully remove the patch from the packaging.
  3. Peel off the protective liner on the patch. Be careful not to touch the sticky part.
  4. Press the patch sticky side down to the clean and dry part of your body. Apply it with the palm of your hand.
  5. Hold the patch in place for 30 seconds. Be sure all of the edges are firmly pushed down.
  6. You can use first aid tape around the edges if it is not sticking well or Tegaderm or Bioclusive see-through dressings. Do not use any other form of tape or bandage to cover the patch.
  7. Wash your hands immediately after placing the patch.
  8. Leave the patch on your skin for 72 hours.
  9. If the patch falls off prematurely, properly dispose of it, replace it with a new patch, and leave that in place for 72 hours from the time of application.
  10.  When removing the patch, peel it off, fold it in half (sticky side in), and flush down the toilet.
  11.  Replace the old patch with a new one, and follow the above steps for reapplication in a new skin area.

Where Can I Find Fentanyl Patches?

Fentanyl is a Schedule II controlled substance by the DEA (Drug Enforcement Administration) that can only be prescribed by a qualified medical professional. 

Your doctor will only prescribe a fentanyl patch if other methods for managing chronic pain are not working and you are tolerant to opioids. Ask your doctor about fentanyl patch prescription and use.

How Much Do These Patches Cost?

Prices for a box of fentanyl patches, which typically contains five patches, start around $25, with prices ranging up to over $200 based on the pharmacy, whether the patch is brand name or generic, and insurance coverage. Costs can vary based on where you live and your insurance policy and copay amount for prescription medications.

Are There Side Effects to Using Fentanyl Patches?

As a potent synthetic opioid, fentanyl can have serious side effects. It is extremely habit-forming. Even when used as directed, the fentanyl patch can cause opioid dependence. Therefore, you should not stop using the fentanyl patch suddenly, or “cold turkey,” as this can cause difficult and potentially dangerous withdrawal symptoms. 

The risk for opioid overdose is still possible with the fentanyl patch, especially if it is misused, taken with other central nervous system depressant medications, or used in a way outside of the prescribing information. Trouble breathing, changes in heartbeat, hallucinations, seizures, chest pain, nausea and vomiting, agitation, and sexual dysfunction are serious side effects of the fentanyl patch that should be immediately addressed.

Additional side effects of the fentanyl patch can include the following:

  • Dry mouth
  • Stomach pain
  • Headache
  • Mood changes
  • Depression
  • Drowsiness
  • Tremors or shaking
  • Sleep difficulties
  • Indigestion
  • Back pain
  • Tingling feeling in the hands or feet
  • Itching
  • Problems urinating
  • Skin irritation in patch location

Are These Patches Addictive?

Fentanyl is an extremely addictive opioid drug, and the fentanyl patch can be addictive. Even if you take the medication exactly as directed, it is possible to develop opioid dependence and addiction. 

Addiction leads to compulsive drug use and cravings. It requires specialized treatment and professional help to manage. 

Duragesic, the brand name of the fentanyl patch, has an FDA black box warning for its potential for overdose, misuse, and addiction. While opioid addiction is serious, it can be effectively managed through a comprehensive fentanyl addiction treatment program. Treatment may involve the use of both medications and therapy.

Profile image for Dr. Alison Tarlow
Medically Reviewed By Dr. Alison Tarlow

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More

Updated December 18, 2023
Resources
  1. Synthetic Opioid Overdose Data. (June 2022). Centers for Disease Control and Prevention.
  2. Duragesic. (March 2021). U.S. Food and Drug Administration.
  3. Fentanyl Transdermal Patch. (January 2021). National Library of Medicine.
  4. Drug Scheduling. Drug Enforcement Administration.
  5. Duragesic. (2003). Janssen.
  6. Multiple Risks for Patients Using the Transdermal Fentanyl Patch. (Spring 2014). Anesthesia Progress.
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