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Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Fentanyl patch cutting

Fentanyl is a strong opioid analgesic that is usually used in palliative care. Recently, the manufacturers of Durogesic Patches® changed the product from a reservoir patch to a matrix patch.

The reservoir patch is still available from generic manufacturers and this is causing a small number of problems. This is because some palliative care teams are recommending cutting the patches to provide more tailored doses.

Cutting either of the patches before application is outside the product license. More importantly, cutting the patches is likely to be harmful with the reservoir patches because the gel contents may leak.

There are some suggestions that to avoid this problem, Fentanyl and other controlled drugs should be prescribed by brand. It would seem more sensible however to avoid cutting these patches wherever possible and to only prescribe by brand where cutting is absolutely necessary.

Action: Clinicians who prescribe Fentanyl should not routinely recommend cutting patches. Where this practice is deemed absolutely necessary the appropriate brand should be prescribed and the half dose specified to highlight this practice to the dispensing pharmacist.

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