Duragesic

Duragesic is a transdermal fentanyl patch designed for managing persistent, moderate to severe chronic pain. It is specifically indicated for use in opioid-tolerant patients who require continuous, around-the-clock opioid administration for an extended period. The patch contains a high concentration of fentanyl, a potent Schedule II opioid agonist, which can be abused and is subject to criminal diversion.

Duragesic is available in various strengths, including 12.5 mcg/hour, 25 mcg/hour, 50 mcg/hour, 75 mcg/hour, and 100 mcg/hour. Each patch is a rectangular transparent unit with four functional layers: a backing layer of polyester film, a drug reservoir containing fentanyl and alcohol gelled with hydroxyethyl cellulose, an ethylene-vinyl acetate copolymer membrane that controls the rate of fentanyl delivery, and a fentanyl-containing silicone adhesive.

Before use, the protective liner covering the adhesive layer is removed and discarded. The actual rate of fentanyl delivery to the skin varies over the 72-hour application period, but each system is labeled with a nominal flux representing the average amount of drug delivered per hour. This allows for individual titration of dosage for a given patient.

Fentanyl is absorbed through the skin, forming a depot in the upper skin layers that gradually releases the medication into the systemic circulation. Central nervous system effects increase with increasing serum fentanyl concentrations, and peak levels occur between 24 and 72 hours of treatment.

Duragesic should only be used in patients who are already receiving opioid therapy and have demonstrated opioid tolerance. It is contraindicated for use as an as-needed analgesic in non-opioid tolerant patients due to the risk of respiratory depression, profound sedation, coma, and death. Concomitant prescribing should be reserved for patients where alternative treatment options are inadequate, and dosages and durations should be limited to the minimum required.

For more information, consult the prescribing information or consult with a healthcare professional.