Therapeutic Group

Indication Dosage

Chronic Intractable Malignant And Non-malignant Pain For Patients Who Have Not Previously Received A Strong Opioid Analgesic: 

• Adult: Initially 25mcg/hour Every 72 Hours, When Starting, Evaluation Of The Analgesiceffect Should Not Be Made Before 24 Hours Of Application (to Allow For The Gradual Increase In Plasma-fentanyl Concentration), Dose Should Be Adjusted At48-72 Hour Intervals In Steps Of 12-25 Mcg/hour If Necessary, More Than Onepatch May Be Used At A Time (but Applied At The Sametime To Avoid Confusion), Consider Additional Oralternative Analgesic Therapy If Dose Required Exceeds300 Mcg/hour. Apply To Dry, Non-Irritated, Non-Irradiated, Non-hairy Skin On Torso Or Upper Arm, Removing After 72 Hr And Sitting Replacement Patch On A Different Area 

Chronic Intractable Pain Currently Treated With A Strong Opioid Analgesic: 

By Transdermal Application: 

• Adult: Initial Dose Based On Previous 24-hr Opioid Requirement (oral Morphine Sulphate 90 Mg Over 24 Hr Is Approximately Equivalent To One 25 Mcg/hr Patch). Apply to Dry, Non-irritated, Non-irradiated, Non-hairy Skin On Torso Or Upper Arm, Removing After 72 Hr And Sitting Replacement Patch On A Different Area 
• Children 2-17 Yrs: Initial Dose Based On Previous 24-hour opioid Requirement (consult Product Literature), For Evaluating Analgesic Efficacy And Dose Increments 

Breakthrough Pain In Patients Receiving Opioid Therapy For Chronic Cancer Pain: 

Oral: 

• Adult & Children 16 Yrs: Initially 100 Mcg Repeated If Necessary After 15-30 Min; Adjust Dose According To Response, No More Than 2 Dose Units, 15-30 Min Apart, For Each Pain Episode; Max 800 Mcg Per Episode Of Breakthrough Pain. Consult Product Literature. 

Spontaneous Respiration: Analgesia And Enhancement Of Anaesthesia, During Operation: 

By Slow IV Inj: 

• Adult & Children 12 Yrs: Initially 50-100 Mcg (max. Per Dose200 Mcg), Then 25-50 Mcg As Required 
• Children 1 Month-12 Yrs: Initially 1-3 Mcg/kg, Then 1 Mcg/kg As Required; Slow IV Injection Over At Least 30 Sec 

By IV Infusion: 

• Adult: 3-4.8 Mcg/kg/hour, Adjusted According To Response 

Assisted Ventilation: Analgesia And Enhancement Ofanaesthesia During Operation: 

By Slow IV Inj: 

• Adult: Initially 300-3500 Mcg, Then 100-200 Mcg As Required 
• Children Neonate: Initially 1-5 Mcg/kg, Then 1-3 Mcg/kg As Required; 
• 1 Month-12 Yr: Initially 1-5 Mcg/kg, Then 1-3 Mcg/kg As Required; 
• 12-18 Yrs: Initially 1-5 Mcg/kg, Then 50-200 Mcg As Required. 

By IV Infusion: 

• Adult: Initially 10 Micrograms/kg, Dose To Be Given Over10 Minutes, Then 6 Mcg/kg/hour, Adjusted According To Response, May Require Up To180 Mcg/kg/hour During Cardiac Surgery 

Assisted Ventilation: Analgesia And Respiratory Depression In Intensive Care: 

By Slow IV Inj: 

• Adult: Initially 300-3500 Mcg, Then 100-200 Mcg As Required 
• Children: Neonate: Initially By IV Injection 1-5 Mcg/kg, Then By IV Infusion 1.5 Mcg/kg/hr Adjusted According To Response
• 1 Month-18 Yrs: Initially By IV Injection 1-5 Mcg/kg, Then By IV Infusion, 1-6 Mcg/kg/hr Adjusted According To Response. 

By IV Infusion: 

• Adult: Initially 10 Mcg/kg, Dose To Be Given Over10 Minutes, Then 6 Micrograms/kg/hour, Adjusted According To Response, May Require Up To180 Mcg/kg/hour During Cardiac Surgery

Content

Pregnancy

Risk Of Respiratory Depression And Withdrawal Symptoms In The Neonate And Risk Of Gastric Stasis And Inhalation Pneumonia In The Mother If Opioidanalgesics Are Used During Labour And Delivery

Stability

Contra Indications

Precautions

Lactation

Side Effects