Durogesic Transdermal25mcg/hr

• Breakthrough Pain: Used for management of breakthrough pain in cancer patients who are already receiving and tolerant to opioid therapy.
• Severe Chronic Pain: Used for management of persistent, moderate to severe chronic pain.
• Surgical Anesthesia: Used as part of anesthesia during surgery.

Adult Dose:

• Oral (Breakthrough Pain): Initial: 100 mcg; re-dosing may occur 30 minutes later; titration up to 200 mcg (one tablet in each side of mouth); titrate above 400 mcg by 200 mcg increments.
• Injection (Surgery): Premedicant: 1-2 mL IM 45 minutes before induction; Anesthesia: 2-10 mL IV; max 50 mcg/kg.
• Transdermal Patch (Chronic Pain): 12-100 mcg/hr; replace every 72 hr; opioid-naive: <=25 mcg/hr; dose based on prior opioid use.

Elderly and Debilitated: Reduce dosage.

Common Side Effects:

• Constipation
• Dizziness
• Headache
• Nausea
• Sleepiness
• Vomiting

Serious Side Effects: Respiratory depression, apnoea, muscular rigidity, myoclonic movements, bradycardia.

Precautions:

• Opioid analgesics impair mental and/or physical ability required for potentially dangerous tasks (driving or operating machinery).
• Titrate with caution in patients with chronic obstructive pulmonary disease or pre-existing conditions predisposing to respiratory depression.
• Caution in head injuries and increased intracranial pressure.
• Use with caution in patients with bradyarrhythmias.
• Caution in hepatic or renal disease.