An Introduction to Your Dosage of the Fentanyl Patch
The dose of the
fentanyl patch (
Duragesic®) your healthcare provider recommends will vary depending on a number of factors, including:
- The type and severity of your pain
- The type and dosage of other pain medications you have taken
- How you respond to the medication
- Other medications you are taking
- Other medical conditions you may have.
As is always the case, do not adjust your dosage unless your healthcare provider specifically tells you to do so.
Fentanyl Patch Dosing Guidelines
Fentanyl patches should only be used in people who are already using an opioid pain medication, at a dose equivalent to at least fentanyl patch 25 mcg. Each initial dosage is highly individualized. The initial dosage your healthcare provider recommends will mostly depend on the type and dose of the other opioids you have been taking.
After calculating the dosage of your other opioid medications, your healthcare provider will convert that to an initial dose of the fentanyl patch. It is best to underestimate the dose initially, in order to avoid dangerous potential side effects.
Your healthcare provider may also recommend a short-acting pain medication, to be used on an "as needed" basis, for when your pain is especially severe (sometimes called "breakthrough pain"). You may find you need more of the breakthrough pain medication when you first start using fentanyl patches. This is because it can take several days to feel the full effects of the patch.
Because initial dosages are often underestimated, many people find they will need a dose increase from the initial amount. If your pain is not adequately controlled after three days, your healthcare provider may increase your fentanyl patch dosage. The increase will be based on the amount of short-acting pain medication you needed in the two to three days after starting this skin patch.
It may take up to six days after your first dose increase to feel maximum pain relief. Therefore, additional dose increases should be made after at least six days have passed, or after two patches have been worn.
Very rarely, some people may require patch changes every 48 hours (every two days), as opposed to every 72 hours (three days), for adequate pain relief. However, 48-hour dosing is not recommended in children.
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