How do you convert oral morphine to fentanyl patch?
How do you convert oral morphine to fentanyl patch?
Answer
- Calculate the total 24-hour morphine dose (or morphine-equivalent).
- Select microgram per hour dose of transdermal fentanyl based on Table 2.
- Decrease new dose 30-50% to allow for incomplete cross-tolerance.
- Manage breakthrough pain with morphine/short-acting opioid PRN.
- Titrate patch to effect every 72 hours.
How much morphine is in a fentanyl patch?
A 25micrograms/hour fentanyl patch is equivalent to about 60mg to 90mg of oral morphine in 24 hours. Frail or elderly patients may need lower doses and slower titration.
When to use a 50 mcg / HR fentanyl patch?
The 50, 75, and 100 mcg/hr patches should only be used in patients already on and tolerant to opioid therapy. This calculator, which is based roughly on information provided by ©Janssen Pharmaceuticals Inc., computes a conservative estimate of the equivalent fentanyl patch based on the patient’s current opioid therapy.
When to use fentanyl transdermal patch for Pati Ents?
Scope All medical and nursing staff This guideline is for use in Palliative Care ONLY. Fentanyl patches are not appropriate for opioid naïve patients or for pati ents whose pain is unstable/highly variable 2. Presentation Fentanyl Transdermal Patch 12.5 microgram/hr, 25 microgram/hr, 50 microgram/hr, 75 microgram/h, 100microgram/hr.
Can a morphine patch be converted to a fentanyl patch?
Mr. John Smith, a terminally ill lung cancer patient has pain that is well controlled on Morphine Sustained Action, 90mg every 12 hours. Mr. Smith is now unable to swallow and so the Morphine needs to be converted into a transdermal fentanyl patch.
How much Transdermal fentanyl to take for pain?
He was then on 150 microg/hr transdermal fentanyl. Adjuvant therapy with amitriptyline 50 mg/day and dexamethasone 4 mg/day was added, but it did not relieve his pain. The dose of transdermal fentanyl was increased gradually to 1000 microg/hr with good pain control (verbal pain scale of 1 to 4/10 most of the time).
The 50, 75, and 100 mcg/hr patches should only be used in patients already on and tolerant to opioid therapy. This calculator, which is based roughly on information provided by ©Janssen Pharmaceuticals Inc., computes a conservative estimate of the equivalent fentanyl patch based on the patient’s current opioid therapy.
Are there any transdermal fentanyl patches for chronic pain?
Transdermal fentanyl patches were designed to provide long-lasting opioid therapy (three days) for patients with stable chronic pain. Because fentanyl has a low molecu- lar weight and high solubility in both fat and water, the drug is a good candidate for transdermal administration. There are 5 patch strengths currently available: 12 mcg/h
How to calculate the dosage of transdermal fentanyl?
1. Describe the pharmacokinetics of transdermal fentanyl, and variables that can influence dosing. 2. Recommend an appropriate dose of transdermal fentanyl when switching from other opioids, including rescue opioid dosing. The participant will be able to describe the appropriate tim- ing of this conversion. 3.
How much morphine can you take in a transdermal patch?
TRANSDERMAL PATCH: -Due to the risk of respiratory depression, the transdermal patch is for use in opioid-tolerant patients only; opioid tolerant patients have been taking at least: morphine 60 mg daily, oral oxycodone 30 mg daily, oral hydromorphone 8 mg daily, or an equianalgesic dose of another opioid for 1 week or longer.