What Is A Fentanyl Patch Made Of
According to the CDC, law enforcement submitted 426 more fentanyl to the DEA for testing between 20, while deaths from synthetic opioids. Matrifen Transdermal patch Summary of Product Characteristics SPCPosology. Matrifen doses should be individualised based upon the status of the patient and should be assessed at regular intervals after application. The lowest effective dose should be used. The patches are designed to deliver approximately 1. Initial dosage selection The appropriate initiating dose of Matrifen should be based on the patients current opioid use. It is recommended that Matrifen be used in patients who have demonstrated opioid tolerance. Other factors to be considered are the current general condition and medical status of the patient, including body size, age, and extent of debilitation as well as degree of opioid tolerance. Adults Opioid tolerant patients. To convert opioid tolerant patients from oral or parenteral opioids to Matrifen refer to Equianalgesic potency conversion below. The dosage may subsequently be titrated upwards or downwards, if required, in increments of either 1. Matrifen depending on response and supplementary analgesic requirements. Pouch.jpg' alt='What Is A Fentanyl Patch Made Of' title='What Is A Fentanyl Patch Made Of' />Opioid naive patients. Generally, the transdermal route is not recommended in opioid nave patients. Alternative routes of administration oral, parenteral should be considered. To prevent overdose it is recommended that opioid nave patients receive low doses of immediate release opioids eg, morphine, hydromorphone, oxycodone, tramadol, and codeine that are to be titrated until an analgesic dosage equivalent to Matrifen with a release rate of 1. Patients can then switch to Matrifen. What Is A Fentanyl Patch Made Of' title='What Is A Fentanyl Patch Made Of' />Q I was prescribed fentanyl patch 25 for excruciating back pain, but after reading all of the side effects from the included pamphlet, I am actually afraid to use it. In the circumstance in which commencing with oral opioids is not considered possible and Matrifen is considered to be the only appropriate treatment option for opioid nave patients, only the lowest starting dose ie, 1. In such circumstances, the patient must be closely monitored. The potential for serious or life threatening hypoventilation exists even if the lowest dose of Matrifen is used in initiating therapy in opioid nave patients see sections 4. Equianalgesic potency conversion. In patients currently taking opioid analgesics, the starting dose of Matrifen should be based on the daily dose of the prior opioid. To calculate the appropriate starting dose of Matrifen, follow the steps below. Calculate the 2. 4 hour dose mgday of the opioid currently being used. Convert this amount to the equianalgesic 2. Table 1 for the appropriate route of administration. To derive the Matrifen dosage corresponding to the calculated 2. Table 2 or 3 as follows a. Table 2 is for adult patients who have a need for opioid rotation or who are less clinically stable conversion ratio of oral morphine to transdermal fentanyl approximately equal to 1. Table 3 is for adult patients who are on a stable, and well tolerated, opioid regimen conversion ratio of oral morphine to transdermal fentanyl approximately equal to 1. Table 1 Conversion Table Multiplication Factors for Converting the Daily Dose of Prior Opioids to the Equianalgesic 2. Oral Morphine Dose mgday Prior Opioid x Factor Equianalgesic 2. Oral Morphine DosePrior Opioid. Route of Administration. Multiplication Factor. Morphine oral. 1a parenteral. Buprenorphine sublingual. Codeine oral. 0. 1. Diamorphine oral. Fentanyl oral parenteral. Hydromorphone oral. Ketobemidone oral. Levorphanol oral. Methadone oral. 1. Oxycodone oral. 1. Oxymorphone rectal. Pethidine oral parenteral. Tapentadol oral. 0. Tramadol oral. 0. The oralIM potency for morphine is based on clinical experience in patients with chronic pain. Based on single dose studies in which an IM dose of each active substance listed was compared with morphine to establish the relative potency. Oral doses are those recommended when changing from a parenteral to an oral route. Table 2 Recommended starting dosage of Matrifen based upon daily oral morphine dose for patients who have a need for opioid rotation or for clinically less stable patients conversion ratio of oral morphine to transdermal fentanyl is approximately equal to 1. Oral 2. 4 hour morphinemgdayMatrifen. Dosagemcghlt 9. In clinical studies these ranges of daily oral morphine doses were used as a basis for conversion to Matrifen. Table 3 Recommended starting dosage of Matrifen based upon daily oral morphine dosage for patients on stable and well tolerated opioid therapy conversion ratio of oral morphine to transdermal fentanyl is approximately equal to 1. Oral 2. 4 hour morphinemgdayMatrifen Dosagemcghlt 4. Initial evaluation of the maximum analgesic effect of Matrifen cannot be made before the patch is worn for 2. This delay is due to the gradual increase in serum fentanyl concentration in the 2. Previous analgesic therapy should therefore be gradually phased out after the initial dose application until analgesic efficacy with Matrifen is attained. Dose titration and maintenance therapy. The Matrifen patch should be replaced every 7. The dose should be titrated individually on the basis of average daily use of supplemental analgesics, until a balance between analgesic efficacy and tolerability is attained. Dosage titration should normally be performed in 1. Matrifen 1. 22. 5 mcgh and pain status of the patient should be taken into account. After an increase in dose, it may take up to 6 days for the patient to reach equilibrium on the new dose level. Therefore after a dose increase, patients should wear the higher dose patch through two 7. More than one Matrifen patch may be used for doses greater than 1. Patients may require periodic supplemental doses of a short acting analgesic for breakthrough pain. Some patients may require additional or alternative methods of opioid administration when the Matrifen dose exceeds 3. If analgesia is insufficient during the first application only, the Matrifen patch may be replaced after 4. If the patch needs to be replaced e. Ammyy Admin For Windows Xp there. This may result in increased serum concentrations see section 5. Discontinuation of Matrifen. If discontinuation of Matrifen is necessary, replacement with other opioids should be gradual, starting at a low dose and increasing slowly. This is because fentanyl levels fall gradually after Matrifen is removed. It may take 2. 0 hours or more for the fentanyl serum concentrations to decrease 5. In general, the discontinuation of opioid analgesia should be gradual in order to prevent withdrawal symptoms see section 4. Opioid withdrawal symptoms are possible in some patients after conversion or dose adjustment. Tables 1, 2, and 3 should only be used to convert from other opioids to Matrifen and not from Matrifen to other therapies to avoid overestimating the new analgesic dose and potentially causing overdose. Special populations Elderly patients Elderly patients should be observed carefully and the dose should be individualised based upon the status of the patient see section 4. In opioid nave elderly patients, treatment should only be considered if the benefits outweigh the risks. In these cases, only Matrifen 1. Renal and hepatic impairment Patients with renal or hepatic impairment should be observed carefully and the dose should be individualised based upon the status of the patient see section 4. In opioid nave patients with renal or hepatic impairment, treatment should only be considered if the benefits outweigh the risks. In these cases, only Matrifen 1. Paediatric population. Children aged 1. 6 years and above. Follow adult dosage. Children aged 2 to 1. Matrifen should be administered only to those opioid tolerant paediatric patients ages 2 to 1.