Duragesic

Overview

About Duragesic

Extended use of Duragesic can lead to physical and psychological dependence, but may be necessary to control chronic pain. Your doctor will take this into account when prescribing this drug.

If your breathing is already impaired by chronic pulmonary disease, Duragesic's tendency to reduce respiration can be especially dangerous. The doctor will determine your dosage with extra caution.

Duragesic is not recommended for people with head injuries and other conditions that increase pressure on the brain, or for those who are semi-conscious or in a coma. It should be used with caution by people with brain tumors.

Use Duragesic with caution if you have an irregular heartbeat; Duragesic can make the problem worse. Caution is also advised if you have kidney or liver disease.

When wearing the Duragesic patch, be careful when touching others; hugging, helping in patch positioning, or accidentally touching the patch may result in serious medical problems for the other person. If the gel does come into contact with your skin, or your caregiver's skin, wash immediately with water only. Do not use soap or alcohol?these may increase the gel's absorption into the skin.

Possible food and drug interactions when taking Duragesic

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Remember to check with your doctor before taking any other drugs that slow the nervous system. (See "Most important fact about this drug.") The dose of such drugs should be reduced by at least half.

Certain other drugs can increase the effects of Duragesic, triggering the need for a dosage reduction. They include:

Antifungal medications such as fluconazole, itraconazole, and ketoconazole
HIV drugs classified as protease inhibitors, including amprenavir, indinavir, lopinavir, nelfinavir, ritonavir, and saquinavir,
Macrolide antibiotics such as azithromycin, clarithromycin, and erythromycin

Some drugs may have the opposite impact, decreasing the effects of Duragesic. They include:

Carbamazepine
Phenytoin
Rifampin

Special information if you are pregnant or breastfeeding

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The effects of Duragesic during pregnancy have not been adequately studied. Make sure the doctor knows if you are pregnant or planning to become pregnant.

The active ingredient fentanyl does make its way into breast milk; and Duragesic is not recommended for nursing women.

Recommended dosage for Duragesic

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The Duragesic patch comes in four sizes: Duragesic-25, 50, 75, and 100. If you have not been taking a narcotic painkiller prior to Duragesic, the doctor will start with the smallest size. If this proves inadequate, the size will be increased after the first 3 days. If necessary, further increases can be made every 6 days thereafter.

For people who are already taking a narcotic painkiller, the dosage of Duragesic is determined by the type of painkiller they've been using, its potency, and the size of the dose. Older adults and the debilitated generally receive a smaller dose of Duragesic.

When Duragesic is to be discontinued, the doctor will reduce the dose gradually to avoid withdrawal symptoms.