Fentanyl (transdermal route)
利用可能なブランド
Duragesic, Ionsys, APO-fentaYNL Matrix, CO fentaYNL, Mylan-fentaNYL Matrix Patch, Ran-fentaNYL Matrix, Ran-fentaNYL Transdermal System 100, Ran-fentaNYL Transdermal System 25, Ran-fentaNYL Transdermal System 50, Ran-fentaNYL Transdermal System 75, Sandoz fentaNYL Patch, Teva fentaNYL 100, Teva fentaNYL 12
この薬について
Fentanyl skin patch is used to treat severe pain, including acute pain following surgery.Ionsys®is applied by your healthcare provider in a hospital setting after surgery for the short-term management of acute pain.Duragesic®is used for pain severe enough to require around-the-clock pain relief for a long period of time. Fentanyl skin patch is also used to treat severe and persistent pain that requires an extended treatment period and when other pain medicines did not work well enough or cannot be tolerated. TheDuragesic® skin patchshould not be used if you need pain medicine for just a short time, such as after dental surgery or tonsil surgery. Do not use the patch for mild pain or pain that occurs only once in a while. Fentanyl is a strong opioid analgesic (pain medicine). It acts on the central nervous system (CNS) to relieve pain. When an opioid medicine is used for a long time, it may become habit-forming, causing mental or physical dependence. However, under the close supervision of a healthcare provider, people who have continuing pain should not let the fear of dependence keep them from using opioids to relieve their pain. Mental dependence (addiction) is less likely to occur when opioids are used for this purpose. Physical dependence may lead to withdrawal symptoms if treatment is stopped suddenly. However, severe withdrawal symptoms can usually be prevented by gradually reducing the dose over a period of time before treatment is stopped completely. This medicine is available only under a restricted distribution program called the Opioid Analgesic REMS (Risk Evaluation and Mitigation Strategy) program. This product is available in the following dosage forms:
この薬を使用する前に
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered: Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully. Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of theDuragesic® patchandFentanyl extended-release patchin children 2 years of age and older.However, pediatric patients must be opioid-tolerant before using a fentanyl patch. Safety and efficacy have not been established in children younger than 2 years of age. Appropriate studies have not been performed on the relationship of age to the effects of theIonsys® patchin the pediatric population. Safety and efficacy have not been established. Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of fentanyl skin patch in the elderly. However, elderly patients are more likely to have drowsiness and age-related lung, kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving fentanyl skin patch. There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take. Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines. Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive. Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco. The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
この薬の使用方法
Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to. If too much of this medicine is taken for a long time, it may become habit-forming (causing mental or physical dependence). Thefentanyl skin patch is only used for opioid-tolerant patients. A patient is opioid-tolerant if oral opioids have already been used for severe pain. Check with your doctor if you have questions about this. It is very important that you understand the rules of the Opioid Analgesic REMS program to prevent addiction, abuse, and misuse of fentanyl. This medicine should also come with a Medication Guide and patient instructions. Read and follow these instructions carefully. Read it again each time you refill your prescription in case there is new information. Ask your doctor if you have any questions. You will receive theIonsys® patchwhile you are in a hospital. A nurse or other trained health professional will give you this medicine after surgery. You will be taught how to use this medicine in the hospital, but the patch will be removed by your healthcare provider before you leave the hospital.Do not leave the hospital with the patch on your skin. To use theDuragesic® patch: To use theFentanyl extended-release patch: In young children or persons with decreased mental alertness, the Duragesic® patch should be put on the upper back to decrease the chance that the patch will be removed and placed in the mouth. After a Duragesic® patch is applied, fentanyl passes into the skin a little at a time. A certain amount of the medicine must build up in the skin before it is absorbed into the body. Up to a full day (24 hours) may pass before the first dose begins to work. Your doctor may need to adjust the dose during the first few weeks before finding the amount that works best for you. Even if you feel that the medicine is not working, do not increase the amount of fentanyl skin patch that you apply. Instead, check first with your doctor. You will probably need to take a faster-acting opioid by mouth to relieve pain during the first few days of using fentanyl skin patch. You may also need another opioid while your dose of fentanyl is being adjusted, and to relieve any "breakthrough" pain that occurs later on. Be sure you do not take more of the other opioid, and do not take it more often than directed. Taking 2 opioids together can increase the chance of serious side effects. Do not eat grapefruit or drink grapefruit juice while you are using this medicine. The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so. The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine. If you forget to wear or change a patch, put one on as soon as you can. If it is almost time to put on your next patch, wait until then to apply a new patch and skip the one you missed. Do not apply extra patches to make up for a missed dose. Remove the Duragesic® patch 3 days (72 hours) after applying it. Your healthcare provider will remove the Ionsys® patch before you leave the hospital. The Ionsys® patch is not for use at home. Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing. Keep out of the reach of children. Do not keep outdated medicine or medicine no longer needed. Ask your healthcare professional how you should dispose of any medicine you do not use. Fentanyl can cause serious unwanted effects or a fatal overdose if taken by children, pets, or adults who are not used to strong opioid pain medicines. Make sure you store the medicine in a safe and secure place to prevent others from getting it. Use thepatch-disposal unitthat was provided with your prescription to dispose of the patches. Read and follow the printed instructions on the disposal unit and use one unit for each patch. Peel off the liner of the disposal unit to reveal the sticky surface. Place the sticky side of the used patch on the disposal unit and seal the entire package. If the patch has not been used, take it out of the pouch and remove the liner that covers the sticky side before placing it on the disposal unit. Throw the sealed disposal unit in a trash can. Talk to your pharmacist if you have questions about how to use the disposal unit. Do not flush thepouchor theprotective linerdown the toilet. Put them in a trash can. Your healthcare provider will dispose of theIonsys® patchafter removing it. Drop off any unused opioid medicine at a drug take-back location right away. If you do not have a drug take-back location near you, flush any unused opioid medicine down the toilet. Check your local drug store and clinics for take-back locations. You can also check the DEA web site for locations. Here is the link to the FDA safe disposal of medicines website: www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/safedisposalofmedicines/ucm186187.htm