As with all medications, risks are associated with the use of pain-relief patches, and they should be used only as prescribed by a qualified healthcare professional.
How To Use Pain-Relief Patches
Patients should wash their hands before and after touching a patch to avoid contaminating the drug and to keep the drug from being applied to an unsafe area such as the eyes or mouth.
Pain-relief patches should only be used on skin that is not broken, cut or scraped. In some cases, a patch can cause irritation, blisters or a burning sensation where it is applied. These side effects are usually mild and go away after a few hours.
Problems have been reported with the use of patches that have been cut to apply a smaller dose of the drug. Patches should not be cut, and patients should not use a pain-relief patch that has been cut, torn or damaged unless directed to do so by their doctor.
Like all medicines, patches should be stored away from children and pets. The best way to dispose of a patch is to fold it in half so the adhesive side sticks to itself. It should be thrown away where children and pets cannot come into contact with it.
Types of Pain-Relief Patches
Flector (diclofenac epolamine): Of the three widely used prescription pain-relief patches, only Flector is a nonsteroidal anti-inflammatory drug (NSAID), a class of painkiller that includes aspirin, Advil and Motrin (ibuprofen), and Aleve and Naprosyn (naproxen). This medicine is prescribed for pain from sprains, muscle strain or other minor injuries. The patch can be applied near the area that is injured if there is no broken skin. Like other NSAIDs, there is some risk of cardiovascular problems -- including heart attack or stroke -- in patients using Flector. There is also the risk of irritation, inflammation or bleeding in the stomach or elsewhere in the gastrointestinal tract, although there may be less risk of that with Flector than with oral NSAIDs.
Lidoderm (lidocaine): This medicine is a local anesthetic often prescribed for patients suffering from the pain of shingles (post-herpetic neuralgia). It should be applied near the area where the pain is greatest, as long as the skin is intact. Lidoderm is also used by some patients for arthritis pain. The patch can be applied directly over the joint causing the pain.
Duragesic (fentanyl): This medicine is used to treat moderate to severe chronic pain. Also available as a generic drug, fentanyl is a strong opioid pain medication and should only be used by patients with long-term, chronic pain after other pain-relief drugs, including other opioids, have been tried. It is not intended for short-term pain, headaches, or pain after surgery or dental procedures.
There is the potential that the patient's body may develop a tolerance to fentanyl; there is also the potential for addiction, although when used properly, fentanyl can provide safe and effective pain relief. The doctor prescribing fentanyl should educate the patient in its safe use and should monitor patients using it.
In 2005, the FDA issued a warning about fentanyl patch safety. Another warning was issued in 2007 after an increasing number of accidental overdoses were reported. Overdoses have occurred when more than one patch is used at a time and when a nonpatient -- such as a child -- accidentally comes into contact with a patch.
Heat can also increase the dose of fentanyl delivered by the patch. Although the patch can be worn when bathing, long, hot showers or baths can increase the risk of overdose; hot tubs, electric blankets, prolonged sun exposure and heating pads should also be avoided.
"Fentanyl: Patient drug information." UpToDate for Patients. 2009. 19 Feb. 2009 http://www.uptodate.com/online/content/topic.do?topicKey=pat_drug/82724&selectedTitle=3~150&source=search_result. (subscription)
"Flector Patch." fda.gov. Jul. 2005. Food and Drug Administration. 19 Feb. 2009 <http://www.fda.gov/cder/foi/label/2007/021234lbl.pdf>.
"Lidoderm." fda.gov. Apr. 2006. Food and Drug Administration. 19 Feb. 2009 <http://www.fda.gov/medwatch/SAFETY/2006/Apr_PIs/Lidoderm_PI.pdf>.
"Proper Use of Fentanyl Pain Patches." fda.gov. Mar. 2006. Food and Drug Administration. 19 Feb. 2009 <http://www.fda.gov/fdac/features/2006/206_fentanyl.html>.
"Transdermal Patches: To Cut or Not Cut." Oregon DUR Board Newsletter 10.8Nov. 2008 19 Feb. 2009 <http://pharmacy.oregonstate.edu/drug_policy/pages/dur_board/newsletter/articles/volume10/DURV10I8.pdf>.