[Transdermal opioid administration: the pain plaster].
A new method of administration of an opioid was recently registered: fentanyl transdermal (brand name: Durogesic), intended particularly for the indication range 'pain in cancer'. Fentanyl is lipid-soluble so that deposition in the skin takes place and the biological half-life is approximately 20 hours after removal of the plaster. It is safe to start on a basis of an equianalgesic conversion of 100:1 in relation to oral morphine, although this may entail some risk of fentanyl under dosage. The dose adjustment time is 12-24 hours before a constant fentanyl level is reached; therefore, after attaching the first sticking plaster, the original morphine dose should be continued for another 12 hours. In addition, the patient may, if necessary, be given supplementary morphine preferably as a short-acting drug. There seems to be no clear indication for transdermal fentanyl either in neuropathic pain or in chronic benign pain.
Vecht
C J
CJ
Academisch Ziekenhuis Rotterdam-Daniel den Hoed Kliniek, afd. Neuro-oncologie en Pijn-polikliniek, Rotterdam.
Sillevis Smitt
P A
PA
D000279:Administration, Cutaneous; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D009020:Morphine / Q000008:administration & dosage; D010146:Pain / Q000188:drug therapy*; D010148:Intractable Pain / Q000188:drug therapy
D000701:Analgesics, Opioid; D009020:Morphine; D005283:Fentanyl