FDA is investigating reports of death and other serious side effects
from overdoses of fentanyl in patients using Fentanyl transdermal
(skin) patches for pain control. Deaths and overdoses have occurred
in patients using both the brand name product Duragesic and the
generic product. The directions for using the Fentanyl skin patch
must be followed exactly to prevent death or other serious side
effects from overdosing with fentanyl.
Some patients and health care providers may not be fully aware of the dangers
of this very strong narcotic painkiller. Therefore, FDA is issuing this public
health advisory to alert patients and their caregivers and health care professionals
by highlighting the following important safety information:
- Fentanyl skin patches are very strong narcotic (opioid) painkillers that
may cause death from overdose. The Fentanyl skin patch should always
be prescribed at the lowest dose needed for pain relief.
- Fentanyl skin patches should not be used to treat short-term pain, pain that
is not constant, or for pain after an operation. Fentanyl skin patches should
only be used by patients who are already taking other narcotic painkillers (opioid
tolerant), and who have chronic pain that is not well controlled with shorter-acting
painkillers.
- Patients who are using the Fentanyl skin patch and their caregivers should
be told about the directions for safe use of the patch and should
follow the directions exactly.
- Patients who are using the Fentanyl skin patch and their caregivers
should be told about safe methods for storage and disposal of used,
unneeded or defective Fentanyl skin patches. Fentanyl skin patches
should be stored in a safe place and kept out of the reach of children.
Safely dispose of used, unneeded or defective Fentanyl skin patches
by folding the sticky side of the patch together (until it sticks
to itself) and flushing it down the toilet.
- Health care professionals who prescribe the Fentanyl skin patch
and patients who use the patch and their caregivers should be aware
of the signs of Fentanyl overdose. Signs of Fentanyl overdose include
trouble breathing or shallow breathing; tiredness, extreme sleepiness
or sedation; inability to think, talk or walk normally; and feeling
faint, dizzy or confused. If these signs occur, patients or their
caregivers should get medical attention right away.
- A patient using the Fentanyl skin patch may have a sudden and
possible dangerous rise in their body level of Fentanyl or have
a stronger effect from Fentanyl if they: use other medicines that
affect brain function; drink alcohol (beer, wine or distilled spirits);
have an increase in body temperature or are exposed to heat; or
use other medicines that affect how Fentanyl is broken down in the
body. These factors are described further in the product label.
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