Can Fentanyl Patches Be Replaced Sooner to Improve Pain Control?

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Specializes in PICU, NICU, L&D, Public Health, Hospice.

Yes, it is appropriate and beneficial in some cases to dose Q48hr with Duragesic rather than Q72hr. While it is true that the manufacturer recommends 72hr we all know that people are different, circumstances are different, and there are times when we must be creative to meet the needs of our patients. There is good evidence that a practice of changing the patches every 48hr improves pt pain control with no increase in adverse events for some patients. Clearly in hospice the option of 48hr dosing is considered if our patients are experiencing increased pain prior to the normal schedule.

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Specializes in Holistic and Aesthetic Medicine.

I've also heard a lot of complaints about the generic patches. I've had complaints about Mylan and Sandoz both. It seems that the Mylan patches stick better than the gel filled Sandoz patches but for some people don't provide as much pain relief. The Mylan patches are smaller than Sandoz or Watson.

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Specializes in PICU, NICU, L&D, Public Health, Hospice.

to echo the sentiments of my fellow hospice nurses...evidence based practice allows for a 48hr schedule with the patches because it improves pain control for some people.

yes, that is expensive...but it is worth it when it works.

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Specializes in Maternity, med & Surg Onc, Hospice, Med.

I work in hospice, if a patch isn't holding for the 72 hrs then we assess that the pt needs a higher dose or something for break-thru if the patch is already a high dose. Over 200 mcg/hr we D/C the patch and we do a SQ dilaudid or MS PCA, but as I said that is Hospice.

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