The duragesic transdermal system patch is used for the management of persistent, moderate to severe chronic pain in opioidtolerant patients when a continuous, aroundtheclock opioid analgesic is needed for an extended period of time. Patches conversion doses drug name drug dose equivalent oral morphine dose fentanyl 25 patch 25microgramshour 30mg to 4mg24hours fentanyl 50 patch 50 microgramshour 5mg to 224mg24hours fentanyl 75 patch 75 microgramshour 225mg to 314mg24hours fentanyl 100 patch 100 microgramshour 315mg to 404mg24hours transtec 52. See the section below disposing ofa duragesic patch. Option for converting final output into an equivalent fentanyl patch strength as long as published guidelines exist for the current dose. Morphine milligram equivalent mme calculator nyc health. Duragesic fda prescribing information, side effects and uses. Duragesic is a brand name for the narcotic pain medicine fentanyl. For each opioid, select the strength from the drop down menu and enter the number of tablets per day for fentanyl transdermal, see instructions below. Find out what health conditions may be a health risk when taken with duragesic transdermal. Opioid conversion calculator morphine equivalents advanced. The web page will automatically calculate the total morphine equivalents per day. Fentanyl is also available as a sustained release transdermal patch which when applied to a fleshy nonbony region of the body functions as a basal pain medication for 72 hours. The duragesic cii patch is manufactured by alza corporation and distributed by janssen pharmaceutica products, l. Strength per unit x number of units days supply x mme conversion factor daily med example.
Dispose of the unused part of the patch safely as described in the fentanyl patch care section. Treatment with oxycontin can be initiated after the transdermal fentanyl patch has been removed for at least 18 hours. So by applying the patch with the last dose of the oral morphine the chances of increasing pain during the drug transition can be avoided. Calculate total dose oral morphine over 24 hours, 2 x 90 mg 180 mg. This calculator, which is based roughly on information provided by janssen pharmaceuticals inc. Quickwhat dose of the transdermal fentanyl patch duragesica is equianalgesic to a 3 mghr morphine continuous infusion. The conversion ratio of certain opioids can be dependent on the dose of the original opioid.
The 50, 75, and 100 mcghr patches should only be used in patients already on and tolerant to opioid therapy. The table is based on oral dosing for chronic noncancer pain. In the iv form fentanyl is often used in icus for pain control due to its rapid onset of action and due to the minimal histamine release associated with fentanyl in comparison to morphine. The conversion doses in these tables are only for the conversion from one of the listed oral or parenteral opioid analgesics to duragesic. Converting from oral morphine to fentanyl transdermal patch. Instructions for use duragesic instructions for applying a.
Fentanyl is also used as a recreational drug, often mixed with heroin or cocaine. Converting to transdermal fentanyl palliative care. Duragesic fentanyl transdermal dosing, indications. Duragesic label page 1 full prescribing information for. John smith, a terminally ill lung cancer patient has pain that is well controlled on morphine sustained action, 90mg every 12 hours. An alternative algorithm for dosing transdermal fentanyl for. Opioid opiate equianalgesia conversion calculator 12 mar 2017 online calculator to convert equianalgesic doses of opioid narcotic because transdermal fentanyl has a delayed onset and onset of peak oral opioid dosing equivalents and conversions university ofhydrocodone vicodin, norco, lorcet morphine to methadone conversion each 2 mg po morphine approximately equivalent to 1. So, you use that and add 15mg for your breakthrough dose and there you have it.
This is especially important for fentanyl and methadone conversions. Methadone and fentanyl are generally safe and considered good options in patients with renal insufficiency. The larger the dose of fentanyl delivered, the larger the patch as of the skins surface area has to be covered to ensure that. Withdrawal symptoms, drug interactions, dosage, and pregnancy and breastfeeding safety are provided. Each 2 mg po morphine approximately equivalent to 1 mcghr fentanyl patch e.
Webmd provides common contraindications for duragesic transdermal. For mild pain, the starting regimen should be a nonsteroidal antiinflammatory drug nsaid or acetaminophen. Made by orthomcneil, duragesic patches are nearly 100 more potent than morphine and can provide up to 72 hours 3 days of pain relieve when used as directed. For moderate pain, an opioid agonist eg, hydrocodone. Fentanyl patch converter globalrph conversion from other.
Jan 29, 2018 methadone and fentanyl are generally safe and considered good options in patients with renal insufficiency. This calculator should not be used to determine doses when converting a patient from one opioid to another. Instead of increasing the dosage of the patch, he gave me ultracet to handle the breakthrough pain. Oct 15, 2019 the conversion doses in these tables are only for the conversion from one of the listed oral or parenteral opioid analgesics to duragesic. Apply 75 microgram fentanyl patch concurrently with the last dose of long acting oral morphine 90mg.
Opioid conversion calculator for morphine equivalents. The duragesic fentanyl patch is used to treat chronic pain by supplying a steady dose of fentanyl a powerful opioid pain medication over an extended period of timeusually up to 72 hours. Transdermal and parenteral fentanyl dosage calculations. Duragesic label page 1 full prescribing information for use.
In the case of converting morphine to methadone, methadone has a relative potency of 4. Do not apply the new patch to the same place as the last one. Stronger dosed duragesic patches may be available for particularly severe cases of chronic pain. Remove a duragesic patch after wearing it for 3 days 72 hours. I have been on the duragesic patch for about a year and a half now. Fentanyl is a lipophilic opioid that is hundred times as strong as morphine. Oral morphine milligram equivalent conversion table updated 8. Conversion from morphine or equivalent to fentanyl transdermal calculate the total 24hour morphine dose or morphineequivalent. Butrans contains buprenorphine, a schedule iii controlled substance. Equianalgesic dose ratios are only approximations and do not account for genetic factors, incomplete crosstolerance, and pharmacokinetics. Calculates total daily morphine milligram equivalents. Because extendedrelease products such as butrans deliver the opioid over an extended period of time, there is a greater risk for overdose and death, due to the larger amount of buprenorphine present. Duragesic patches typically come in the following doses. Smith is now unable to swallow and so the morphine needs to be converted into a transdermal fentanyl patch.
Online calculator to convert equianalgesic doses of opioid narcotic analgesics. Enter 24hour total doses below, then click the convert button to display 24hour equianalgesic doses. Fentanyl patch conversions package insert recommendations. Fentanyl transdermal patch is a prescription medication thats used to treat chronic pain in opioidtolerant people. There is no completely safe opioid dose, and this calculator does not substitute for clinical judgment. Side effects may include profuse sweating, coughing, nausea, diarrhea, and tearing. This calculator is intended for calculating the morphine equivalent dose med dose for a patient taking one or more opioid medications. Fentanyl patch converter globalrph conversion from other opiates. The total daily morphine milligram equivalents mme will be displayed. Convert the iv dose to the equianalgesic oral morphine dose using a ratio.
Caution should be used in older adults or patients with cachexiafentanyl is lipid soluble and requires subcutaneous fat for proper absorption. Some experts use this conversion in cancer patients. It should not be used to determine doses when converting a patient from one opioid to another. Duragesic fentanyl transdermal drugs requiring prior authorization drugs requiring prior authorization label name gcn duragesic 12 mcghr patch 24635 duragesic 25 mcghr patch 19200 duragesic 50 mcghr patch 19201 duragesic 75 mcghr patch 19202 duragesic 100 mcghr patch 19203 fentanyl 12 mcghr patch 24635.
Durogesic 100 mcg 100mcg1patch 1 patch fentanyl citrate drug information. Duragesic is used to treat moderate to severe chronic, constant pain. Most of the above oral opioids are available as generics. The fentanyl in the patch diffuses through the skin and depots in the adipose tissue and provides sustained pain relief. This table should not be used to convert from duragesic to other. Although there has been no systematic assessment of such conversion, start with a conservative conversion. Methadone conversion algorithm including the ability to edit equianalgesic conversion factors if necessary in order to reflect any changes in the literature. Converting to transdermal fentanyl palliative care network of. Fentanyl accumulates to form a depot in the skin below the. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease.
Opioid oral morphine milligram equivalent mme conversion. Repeat steps 2 through 6above when applying a new duragesic patch. Generic fentanyl is covered by some medicare and insurance plans, but some pharmacy coupons or cash prices may be lower. Fentanyl, also spelled fentanil, is an opioid used as a pain medication and together with other medications for anesthesia. Fentanyl patches durogesic for chronic pain nps medicinewise. Canadian guideline for safe and effective use of opioids for. Demystifying opioid conversion calculations 83 chapter 5 transdermal and parenteral fentanyl dosage calculations and conversions objectives after reading this chapter and completing all practice problems, the participant will be able to. The duragesic patch is an adhesive patch containing narcotic pain medicine typically narcotic analgesics or opioid analgesics. Duragesic s skin patch form is used to treat aroundtheclock pain chronic pain that is moderate to severe and expected to last for weeks or longer. Didnt know where else to put this, but i was recently switched from morphine 60mg er to the fentanyl duragesic patch. Fentanyl patch dosing determination based on current opioid therapy.
Remember to enter all opioids the patient is taking. Duragesics skin patch form is used to treat aroundtheclock pain chronic pain that is moderate to severe and expected to last for weeks or longer. Stop long acting oral morphine after applying patch. Several companies manufacture a generic duragesic fentanyl patch product, including actavis u. Duragesic fentanyl transdermal system cii pain patch. Duragesic is a longacting extendedrelease opioid pain medicine narcotic that can put you at risk for overdose and death. What are the steps for converting from morphine or. My doctor refuses to increase my dosage of the patch even though i dont feel it is effective as it was. Do not change fentanyl patches to another opioid in a dying patient, continue the fentanyl patch and use an additional opioid as required via csci.
The transdermal patch is a longacting formulation with a delayed onset of effect initially and a prolonged duration of action. Duragesic patch fentanyl patch rationale for inclusion in pa. In clinical trials, these ranges of daily oral morphine doses were used as a basis for conversion to duragesic. Medically, fentanyl is used by injection, as a patch on the skin, as a nasal spray, or in the mouth.
In other words, the conversion factor not accounting for days of use would be 6025 or 2. Serious or lifethreatening breathing problems that can lead to death can. Equianalgesic dosing of opioids for pain management. The united states food and drug administration has determined that the generic versions of duragesic are equivalent to the brandname drug. However, since the fentanyl patch remains in place for 3 days, we have multiplied the conversion factor by 3 2. Use caution when prescribing opioids at any dosage, and prescribe the lowest effective dose. Select microgram per hour dose of transdermal fentanyl based. Describe the pharmacokinetics of transdermal fentanyl, and variables that can influence dosing. I will run out of fentora 2 days early and am wondering if i could stick on an extra patch to avoid withdrawals i am prescribed the fentora. Fentanyl is also available as a sustained release transdermal patch which when. Even if you take your dose correctly as prescribed you are at risk for opioid addiction, abuse, and misuse that can lead to overdose or death. Morphine milligram equivalent mme calculator instructions. I will run out of fentora 2 days early and am wondering if i could stick on an extra patch to avoid withdrawals. Duragesic fentanyl transdermal system is a skin patch that belongs to a group of medicines called narcotic analgesics or opioid analgesics.
Conversions to and from fentanyl transdermal are notoriously tricky, requiring knowledge of the published conversion data, general opioid pharmacology, and a generous dose of common sense. The content on this site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. Dose conversion tool butrans buprenorphine transdermal. Is there a conversion for going from fentora to duragesic patch i am currently on 50mcg duragesic patch every 3days and 400mcg fentora. Aug 18, 2012 the duragesic fentanyl patch is used to treat chronic pain by supplying a steady dose of fentanyl a powerful opioid pain medication over an extended period of timeusually up to 72 hours. Eligible patients using commercial or private insurance can save on outofpocket costs for duragesic. Conversion oraliv opioids to fentanyl transdermal each transdermal system is worn continuously for up to 72 hr see administration tables found in prescribing information cannot be used to convert from fentanyl transdermal to another opioid because conversions will result in an overestimation of the dose of new opioid and may result in fatal. Scottish palliative care guidelines fentanyl patches. People who are on the 25ughr patch feel they are on the lowest dose, so they can just drop off right from there. Fentanyl duragesic is a moderately priced drug used to treat chronic pain. Canadian guideline for safe and effective use of opioids.
Fentanyl patch converter globalrph conversion from. Duragesic patch dose duragesic patches are fentanyl transdermal systems that deliver extremely potent pain medication to patients via patches placed on the skin. Read the medication guide and, if available, the instructions for use provided by your pharmacist before you start using. Transdermal and parenteral fentanyl dosage calculations and. I thought the weird flu like symptoms might be a result of the new drug, but apparently it has to be withdrawal from the morphine.
Morphine milligram equivalents mme calculator mdcalc. Using damaged or cut duragesic patches can lead to the rapid release of the contents of the duragesic patch and absorption of a potentially fatal dose of fentanyl. Choose a different skin site to apply a new duragesic patch. Converting to transdermal fentanyl palliative care network. Round up or down based on patient factors and available patch sizes. Current breakthrough opioid entered to be what the patient is actually taking rather than what has been prescribed.
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