Fentanyl Transdermal Patch

Vile and syringe of fentanyl sitting on a piece of gauze

Fentanyl is a strong opioid that was created to help people who need potent pain relief. One of its dosage forms is a topical patch that can be worn on the skin for up to three days to manage pain. Over the years, the fentanyl patch helped many people control their pain. However, fentanyl is also a deadly drug at the center of the opioid epidemic. Learning about appropriate uses of fentanyl is important to accurately understand the dangers of using the drug.

Prescribed Uses

Fentanyl patches are sold under the brand name Duragesic. They are prescribed for severe pain. The drug is so strong that it can only be used in people who are currently taking opioids. Someone who uses fentanyl and is not used to opioids can easily overdose. Because the patch lasts for 72 hours, it is not meant to be used for mild pain, or for pain that comes and goes. All other opioids should be stopped as soon as the patch is used due to the risk of an overdose.

The Cost of Fentanyl Patches

Fentanyl patches may be covered by health insurance. Someone may have a copay depending on their plan. Although drug prices can fluctuate, the full retail price of a carton of five fentanyl patches, a 15-day supply, ranges from nearly $150 to almost $200. Because fentanyl patches may be used in hospice as well, they may be fully covered under a hospice program.

Unfortunately, because it is an addictive drug, fentanyl patches have street value. They can range from $15 to $40 each.

Dosage and Administration

Fentanyl patches come in several different strengths, from 12.5 mcg per hour to 100 mcg per hour of drug released from the patch.

The patch should be applied so that it lies flat on intact skin. If the skin has hair, it should be clipped short. The skin should not be shaved, which could irritate the skin and impact absorption.

The patch needs to be applied whole and should not be cut. If placing the patch on someone else, a person should strongly consider wearing gloves, since fentanyl can be absorbed through the skin. If gloves are unavailable, people should make sure to wash their hands as soon as they apply the patch. The patch should be pressed down for 30 seconds and it should be checked to ensure it is sticking to the skin, especially around the edges. If the patch is not sticking, it can be reinforced with first-aid tape.

When applied to the skin, a fentanyl patch takes anywhere from two to five hours to kick in fully.

Side Effects

Like any medication, fentanyl patches have side effects. The patch itself can cause side effects like redness or irritation. Additionally, fentanyl itself can lead to side effects like:

  • Nausea
  • Vomiting
  • Constipation
  • Sleepiness
  • Dizziness

Precautions and Interactions

Fentanyl patches can have drug interactions with certain medications including:

  • Certain antibiotics, like erythromycin
  • Antifungal drugs, like fluconazole
  • Protease inhibitors, like ritonavir

These drugs can increase the amount of fentanyl in a person’s system. If someone is regularly using fentanyl patches in combination with one of those drugs and they suddenly stop using that drug, the amount of fentanyl in their body can decrease and cause withdrawal symptoms.

Even if someone wears the fentanyl patch as prescribed, they need to be careful about making sure that other people are not exposed to the drug. Several instances of accidental fentanyl exposure from the patches have occurred. They include:

  • Hugging someone, and the patch attaching to the other person
  • Sharing a bed with someone
  • Sitting on the patch
  • Touching the patch without gloves when putting on or taking off the patch

It is important to make sure to avoid putting heat on the fentanyl patch site because this can increase the amount of drug released from the patch by around 30%. Certain objects to avoid while wearing a fentanyl patch include:

  • Heating pads
  • Electric blankets
  • Heat lamps
  • Tanning lamps
  • Sunbathing
  • Hot baths and hot tubs
  • Saunas
  • Heated water beds

It is also important to be careful when taking off the patch. Even after 72 hours, the patch has some fentanyl left in it. The amount left may not be enough to provide pain relief, but it is enough drug to still be deadly to someone who is not used to the effects of opioids.

When taking off the patch, the adhesive pad’s side should be folded together so that no adhesive is exposed. The patch should then be flushed down the toilet. Although flushing is not recommended for most drugs, because of the danger of fentanyl exposure to animals and people, it is recommended to flush them.

Signs of Abuse

Fentanyl patches can be abused. Some people scrape out the fentanyl-containing gel from the patch. The gel is then injected or swallowed. Other people freeze the fentanyl patches, cut them and put them in their mouths. Sometimes when people start using drugs, their behavior changes. Signs of fentanyl abuse can include symptoms such as:

  • Being socially withdrawn
  • Spending less time with family and friends
  • Spending more time with new friends
  • Having less interest in hobbies
  • Mood swings
  • Irritability
  • Sleep problems
  • Problems with appointments or deadlines
  • School or work problems
  • Personal or family problems
  • Reckless behavior
  • Legal problems

What to Do if an Overdose Occurs

If you think someone has overdosed on fentanyl, you should immediately call 911. If you have naloxone available, you should administer it. However, it is important to seek emergency medical attention even if the person seems regain consciousness after getting naloxone. Although naloxone starts to work within three minutes, it wears off within 90 minutes, so the person may stop breathing again after that time.

Signs of a fentanyl overdose include:

  • Slow breathing
  • Excessive sleepiness
  • Stupor
  • Coma
  • Flaccid muscles
  • Cold or clammy skin
  • Small pupils
  • Slow heartbeat
  • Low blood pressure

Treatment for Fentanyl Addiction

If you or a loved one struggle with a fentanyl addiction, contact The Recovery Village Ridgefield today to speak with a representative about how professional addiction treatment can help. Take the first step toward a healthier future, call today.

Drug Enforcement Administration. “Drugs of Abuse.” 2017. Accessed September 20, 2019.

GoodRX. “Fentanyl Prices, Coupons & Patient Assistance.” Accessed September 20, 2019.

Connecticut State Department of Consumer Protection. “Fentanyl C-II/Synthetic Opioids.” Accessed September 20, 2019.

U.S. National Library of Medicine. “Duragesic (fentanyl system) – fentanyl patch.” November 2, 2018. Accessed September 21, 2019.

National Institute on Drug Abuse. “What are Some Signs and Symptoms of Someone with a Drug Use Problem?” Accessed July 13, 2019.

Anne Arundel County Department of Health. “Naloxone: Frequently Asked Questions.” September 19, 2018. Accessed June 23, 2019

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.