Duragesic

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.

Possible food and drug interactions when taking Duragesic

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 Diflucan, Nizoral, and Sporanox
HIV drugs classified as protease inhibitors, including Agenerase, Crixivan, Fortovase, Invirase, Kaletra, Norvir, and Viracept
Macrolide antibiotics such as erythromycin, Biaxin, and Zithromax

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

Carbamazepine (Tegretol)
Phenytoin (Dilantin)
Rifampin (Rifadin)

Special information if you are pregnant or breastfeeding

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

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.

Overdosage

An overdose of Duragesic can severely impair breathing. If you suspect an overdose, seek emergency medical attention immediately.