Cutting Nitro patches?

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Is it okay to cut Nitro patches in half? Some nurses at my facility do this, but I was taught that this is not proper practice.

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Specializes in Medical and general practice now LTC.

Personally I would say not because how accurate can you be in cutting something in half which would more than likely be done by eye and not proper measurement. I am sure Pharmacy whether hospital or community can send the right one up for the client

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Specializes in Oncology; medical specialty website.

No, it's not OK. It's not OK to cut fentanyl patches in half, either. (Just saying.)

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Specializes in OB.

No it is NOT okay! The patches are designed so that a limited amount of the medication passes through the material of the patch at a known rate. When you cut the patch you create a large opening through which the medicine passes at an unmetered rate potentially giving the patient a large immediate overdose.

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So if the person has 0.2 mg Nitro patch ordered, and all we have is 0.4 mg patches for her, is it acceptable to remove the backing from half the patch and apply this, without cutting? I am told the family will not pay for the 0.2 mg patch, because cutting the 0.4 patch in half lasts twice as long.

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No, no, no. You need the correct dose. Period. What does her script say, and why is she being given the wrong amt by the pharmacy?

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I have to agree that this is not ok. If the pharmacy does not have the correct dose, then I would call the doctor to inform and suggest that they change the order to the paste where at least it can be measured more accurately. I find it odd that the pharmacy would knowingly send the wrong dose...

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Specializes in ER/ICU/STICU.
So if the person has 0.2 mg Nitro patch ordered, and all we have is 0.4 mg patches for her, is it acceptable to remove the backing from half the patch and apply this, without cutting? I am told the family will not pay for the 0.2 mg patch, because cutting the 0.4 patch in half lasts twice as long.

And what happens when the other half of the backing comes of and now the patient is getting TWICE the dose? They need the right dose. Cutting a patch in half is NOT the same as cutting a pill in half.

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Specializes in ER, ICU.

I agree that cutting a patch is not the right thing, although I disagree you can't cut a patch in half as accurately as cutting a pill. I would say they both are approximate. I would worry how the cut edge would affect absorption, and it seem it might also be more likely to fall off. That said, I would rather do that than not give the drug at all. Why can't people just do the right thing and give us what we need?

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I think it was a fentanyl or clonidine patch, but we were told by pharmacy that for a 1/2 dose, fold 1/4 of it back on to the next 1/4, so 1/2 is stuck to itself, the other 1/2 is stuck to the patient.

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Ok, so I'm back with a little update on my question.

Last night I reviewed this particular order and it says:

Nitro patch 0.4 mg. Apply 1/2 patch in the morning.

So it actually specifies to apply HALF. Hmmmmm......

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Just do like I said above, fold sticky side to sticky side so that half of the patch is left to stick to the patient, and the other half is stuck to itself, even is kind of nice, makes it easy to get off since there's now a tab to pull. :)

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