title: Fentanyl Iontophoretic Transdermal System (IONSYS(®)) can be Safely used in the Hospital Environment with X-Rays, Computerized Tomography and Radiofrequency Identification Devices.
abstract: Fentanyl iontophoretic transdermal system (fentanyl ITS, IONSYS(®)) is a patient-controlled analgesia system used for the management of acute postoperative pain, designed to be utilized in a hospital setting. The objective of the two studies was to determine if fentanyl ITS could be safely used with X-rays, computerized tomography (CT) scans and radiofrequency identification (RFID) devices.
  
  
  
  The ITS system has two components: controller and drug unit; the studies utilized ITS systems without fentanyl, referred to as the ITS Placebo system. The first study evaluated the effect of X-radiation on the operation of an ITS Placebo system. Five ITS Placebo systems were exposed to X-rays (20 and 200 mSv total radiation dose-the 200 mSv radiation dose represents a tenfold higher exposure than in clinical practice) while operating in the Ready Mode and five were exposed while operating in the Dose Mode. The second study evaluated the effect of RFID (worst-case scenario of direct contact with an RFID transmitter) on the operation of an ITS Placebo system. During these tests, observations of the user interface and measurements of output voltage confirmed proper function throughout all operational modes (Ready Mode, Dose Mode, End-of-Use Mode, and End-of-Life Mode).
  
  
  
  The ITS Placebo system met all specifications and no functional anomalies were observed during and following X-ray exposure at two radiation dose levels or exposure at six different combinations of RFID frequencies and field strengths.
  
  
  
  The performance of the ITS system was unaffected by X-ray exposure levels well beyond those associated with diagnostic X-rays and CT scans, and by exposure to radiofrequency field strengths typically generated by RFID devices. These results provide added confidence to clinicians that the fentanyl ITS system does not need to be removed during diagnostic X-rays and CT scans and can also be utilized in close proximity to RFID devices.
  
  
  
  The studies and writing of this manuscript were supported financially by The Medicines Company.
authors.affiliation: The Medicines Company, Redwood City, USA.
authors.forename: John
authors.initials: J
authors.lastname: Lemke
authors.affiliation: The Medicines Company, Redwood City, USA.
authors.forename: Edmond
authors.initials: E
authors.lastname: Sardariani
authors.affiliation: The Medicines Company, Redwood City, USA.
authors.forename: Joseph Bradley
authors.initials: JB
authors.lastname: Phipps
authors.affiliation: The Medicines Company, Parsippany, NJ, USA.
authors.forename: Niki
authors.initials: N
authors.lastname: Patel
authors.affiliation: The Medicines Company, Parsippany, NJ, USA. loretta.itri@themedco.com.
authors.forename: Loretta M
authors.initials: LM
authors.lastname: Itri
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: James
authors.initials: J
authors.lastname: Caravelli
authors.affiliation: Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Eugene R
authors.initials: ER
authors.lastname: Viscusi
mesh_terms: D059787:Acute Pain / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D000279:Administration, Cutaneous; D016058:Analgesia, Patient-Controlled / Q000379:methods; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D016503:Drug Delivery Systems / Q000379:methods; D005283:Fentanyl / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D006801:Humans; D007478:Iontophoresis / Q000379:methods; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000517:prevention & control*; D011870:Radiologic Health / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014481:United States
chemical_list: D000701:Analgesics, Opioid; D005283:Fentanyl
keywords: CT scan; Electromagnetic immunity; Fentanyl; IONSYS; Iontophoretic transdermal system; Patient-controlled analgesia; RFID; X-ray