Fentanyl belongs to a group of medications called opioids. Fentanyl is used to treat persistent chronic (long-term) severe pain for those who need constant pain relief and are currently taking other opioid (narcotic) medications. It acts on the brain to increase pain tolerance.

Sandoz Fentanyl Patch (Fentanyl-transdermal) may be available under multiple brand names and/or in several different forms. Any specific brand name of Sandoz Fentanyl Patch (Fentanyl-transdermal) may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of Sandoz Fentanyl Patch (Fentanyl-transdermal) may not be used for all of the conditions discussed here.

Your doctor may have suggested Sandoz Fentanyl Patch (Fentanyl-transdermal) for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are using Sandoz Fentanyl Patch (Fentanyl-transdermal), speak to your doctor. Do not stop using Sandoz Fentanyl Patch (Fentanyl-transdermal) without consulting your doctor.

Do not give Sandoz Fentanyl Patch (Fentanyl-transdermal) to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use Sandoz Fentanyl Patch (Fentanyl-transdermal) if their doctor has not prescribed it

The dose of fentanyl transdermal patch must be individualized and is based on many factors, including the dose of opioid medication that a person is currently using before starting Sandoz Fentanyl Patch (Fentanyl-transdermal).

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.

Apply the patch to non-irritated and non-irradiated (not exposed to radiation) skin on a flat surface such as the chest, back, flank (side of the body between the upper abdomen and back), or upper arm. Hair at the application site should be clipped (not shaved) before applying a patch.

Clean the area with water only; do not use soaps, oils, lotions, alcohol, or any other agent that might irritate the skin. Using soap, alcohol, or other chemicals to clean the skin may cause the fentanyl to be absorbed faster, causing unwanted side effects. After cleaning, allow the skin to dry completely before applying the patch.

Apply the patch immediately after removing it from the protective packaging. This reduces the opportunity for someone who is not using the medication to come into contact with the patch. It is a good idea to apply the patch out of sight of children, to prevent "mimicking" behaviour.

The patch should be pressed firmly in place with the palm of the hand for 30 seconds. Make sure the contact is complete – especially around the edges. The patch should not be folded so that only part of the patch is exposed. If the patch does not stick to the skin properly, tape the edges of the patch with first-aid tape.

Each patch may be worn continuously for 72 hours. A new patch should be applied on a different skin site after removal of the previous one. This helps to prevent skin irritation, which may increase the speed that the fentanyl is absorbed through the skin. If the patch falls off before 72 hours have passed, you may apply a new patch to a new site. Wash your hands immediately with water only, after applying or removing the patch. Consult the package insert, your doctor, or your pharmacist for additional instructions on how to use the medication.

Do not use the patch if it is cut, damaged, or altered in any way.

After 72 hours, there is still enough medication in the patch to cause serious harm to someone who is not using the fentanyl patch for pain control. Accidental exposure to the fentanyl patch may cause death or serious medical problems. When you remove the patch, fold it in half and keep it in a secure place until you can return it to your pharmacy for proper disposal.

Maximum pain relief may not occur for up to 72 hours after first starting Sandoz Fentanyl Patch (Fentanyl-transdermal). Your doctor may give you a short-acting pain control medication during this period.

Sandoz Fentanyl Patch (Fentanyl-transdermal) may be habit-forming if taken for long periods of time. Do not stop taking Sandoz Fentanyl Patch (Fentanyl-transdermal) without talking with your doctor. If Sandoz Fentanyl Patch (Fentanyl-transdermal) is stopped suddenly, you may experience withdrawal symptoms such as:

• anxiety
• Diarrhea
• hallucinations
• nausea
• shakiness
• sweating
• tremors
• trouble sleeping
• vomiting

If you plan on stopping the medication, your doctor may want you to reduce the dose gradually to reduce the severity of withdrawal effects.

Do not change the dose of the patch you are using or the way you are applying the patch without direction from your doctor. If you experience any of the following side effects of too much fentanyl in the body, seek immediate medical help:

• cold or clammy skin
• confusion
• dizziness
• feeling faint
• hallucinations
• seizure
• severe sleepiness
• slow heartbeat
• slow or shallow breathing
• trouble breathing
• unable to think, walk, or talk normally

It is important to use Sandoz Fentanyl Patch (Fentanyl-transdermal) exactly as prescribed by your doctor. If a patch is left on for more than 3 days, change the patch as soon as you remember. Do not apply 2 patches to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store Sandoz Fentanyl Patch (Fentanyl-transdermal) at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is used in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes Sandoz Fentanyl Patch (Fentanyl-transdermal). If you are concerned about side effects, discuss the risks and benefits of Sandoz Fentanyl Patch (Fentanyl-transdermal) with your doctor.

The following side effects have been reported by at least 1% of people using Sandoz Fentanyl Patch (Fentanyl-transdermal). Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• confusion
• Constipation
• diarrhea
• difficulty concentrating
• difficulty sleeping
• dizziness or lightheadedness
• drowsiness
• Dry Mouth
• feeling anxious
• flushing
• headache
• loss of appetite
• memory loss
• nausea
• skin itchiness or irritation at the site of application
• sweating
• vomiting
• weakness

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• bowel blockage (e.g., abdominal pain, severe constipation, nausea)
• confusion
• decreased coordination
• fainting
• hallucinations (seeing, hearing, or feeling things that are not actually there)
• fast, slow, pounding, or irregular heartbeat
• signs of Depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• skin rash
• vision changes

Seek immediate medical attention if any of the following occur:

• signs of a serious allergic reaction (e.g., rash, fever, swelling, tightness in chest, shortness of breath)
• signs of a severe skin reaction (e.g., blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort)
• signs of breathing problems (e.g., shortness of breath, troubled breathing, wheezing, or tightness in chest, fast or irregular breathing)
• signs of getting too much medication
• cold, clammy skin
• trouble breathing
• extreme drowsiness with slowed breathing
• slow shallow breathing
• feeling faint
• dizziness
• confusion
• inability to think, talk, or walk normally
• hallucinations
• seizure

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking Sandoz Fentanyl Patch (Fentanyl-transdermal).

Sandoz Fentanyl is a skin patch that gradually delivers fentanyl through the skin into the bloodstream for 72 hours. The amount of fentanyl released per hour from each rectangular transparent patch is directly related to the surface area of the patch. The remaining components of the patch are pharmacologically inactive.

12 µg per hour
Each 5.25 cm² matrix-based transdermal patch contains 2.1 mg of fentanyl. It provides fentanyl at a rate of 12 µg per hour delivered through the skin into the bloodstream. Nonmedicinal ingredients: acrylic-vinylacetate copolymer adhesive, polyethylene terephthalate backing foil, and siliconized polyethylene terephthalate release liner.

25 µg per hour
Each 10.5 cm² matrix-based transdermal patch contains 4.2 mg of fentanyl. It provides fentanyl at a rate of 25 µg per hour delivered through the skin into the bloodstream. Nonmedicinal ingredients: acrylic-vinylacetate copolymer adhesive, polyethylene terephthalate backing foil, and siliconized polyethylene terephthalate release liner.

37 µg per hour
Each 15.75 cm² matrix-based transdermal patch contains 6.3 mg of fentanyl. It provides fentanyl at a rate of 37 µg per hour delivered through the skin into the bloodstream. Nonmedicinal ingredients: acrylic-vinylacetate copolymer adhesive, polyethylene terephthalate backing foil, and siliconized polyethylene terephthalate release liner.

50 µg per hour
Each 21 cm² matrix-based transdermal patch contains 8.4 mg of fentanyl. It provides fentanyl at a rate of 50 µg per hour delivered through the skin into the bloodstream. Nonmedicinal ingredients: acrylic-vinylacetate copolymer adhesive, polyethylene terephthalate backing foil, and siliconized polyethylene terephthalate release liner.

75 µg per hour
Each 31.5 cm² matrix-based transdermal patch contains 12.6 mg of fentanyl. It provides fentanyl at a rate of 75 µg per hour delivered through the skin into the bloodstream. Nonmedicinal ingredients: acrylic-vinylacetate copolymer adhesive, polyethylene terephthalate backing foil, and siliconized polyethylene terephthalate release liner.

100 µg per hour
Each 42 cm² matrix-based transdermal patch contains 16.8 mg of fentanyl. It provides fentanyl at a rate of 100 µg per hour delivered through the skin into the bloodstream. Nonmedicinal ingredients: acrylic-vinylacetate copolymer adhesive, polyethylene terephthalate backing foil, and siliconized polyethylene terephthalate release liner.

Do not use Sandoz Fentanyl Patch (Fentanyl-transdermal) if you:

• are allergic to fentanyl, the adhesives used in the patch, or any ingredients of the medication
• are not already using opioid (narcotic) painkillers to manage your pain
• have acute or severe bronchial Asthma
• have acute pain or pain following surgery, including outpatient surgery
• have mild or intermittent pain that can otherwise be managed
• have or are suspected to have paralytic ileus (a condition of the intestine that does not allow material to pass through the intestine) or any other conditions that block the intestine, narrow the intestine, or slow down movement through the intestine
• have or may have "surgical abdomen" (conditions of the abdomen, such as Appendicitis, that need urgent surgery)
• have severe difficulty breathing
• have delirium tremens (e.g., confusion, diarrhea, shaking, Fever, hallucinations, disorientation) associated with alcohol withdrawal
• have acute Alcoholism
• have Epilepsy and other conditions that can cause seizures
• are taking or have taken (within the last 14 days) MAO inhibitors (e.g., Phenelzine, Tranylcypromine)
• have increased intracranial pressure (increased pressure inside the head), cerebrospinal pressure (increased pressure inside the head and spine), or head injury
• are pregnant, in labour or delivering, or breastfeeding

There may be an interaction between fentanyl transdermal patch and any of the following:

• Abiraterone
• aclidinium
• alcohol
• alpha agonists (e.g., Clonidine, methyldopa)
• alpha/beta agonists (e.g., Epinephrine, norepinephrine)
• Amiodarone
• amphetamines (e.g., Dextroamphetamine, lisdexamphetamine)
• anti-Hepatitis C virus combinations ombitasvir/paritaprevir/ritonavir/dasabuvir
• antihistamines (e.g,. cetirizine, doxylamine, Diphenhydramine, Hydroxyzine, Loratadine)
• antipsychotics (e.g., Chlorpromazine, Clozapine, Haloperidol, Olanzapine, Quetiapine, Risperidone)
• antiseizure medications (e.g., Clobazam, Ethosuximide, felbamate, Levetiracetam, Phenobarbital, Phenytoin, primidone, Topiramate, Valproic acid, zonisamide)
• Aprepitant
• atropine
• azelastine
• "azole" antifungals (e.g., fluconazole, itraconazole, ketoconazole, posaconazole)
• barbiturates (e.g., butalbital, phenobarbital)
• belladonna
• benzodiazepines (e.g., Clonazepam, Diazepam, Lorazepam)
• Benztropine
• beta-adrenergic blockers (e.g., Atenolol, Propranolol, Sotalol)
• Bicalutamide
• Bosentan
• brimonidine
• Buspirone
• calcium channel blockers (e.g., Amlodipine, Diltiazem, Nifedipine, Verapamil)
• cannabis
• chloral hydrate
• Cobicistat
• conivaptan
• Cyclosporine
• Desmopressin
• Disopyramide
• diuretics (water pills; e.g., Furosemide, Hydrochlorothiazide, triamterene)
• dofetilide
• Domperidone
• Dronedarone
• Enzalutamide
• ergot-containing medications (e.g., diydroergotamine, ergonovine, ergotamine, methylergonovine)
• Flavoxate
• Gabapentin
• glycopyrrolate
• grapefruit juice
• HIV non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., delavirdine, efavirenz, etravirine, nevirapine)
• HIV protease inhibitors (e.g., atazanavir, indinavir, ritonavir, saquinavir)
• ipratropium
• ketotifen
• lithium
• macrolide antibiotics (e.g., clarithromycin, erythromycin, telithromycin)
• mifepristone
• Mirtazapine
• monoamine oxidase inhibitors (M.O.S. e.g., Moclobemide, phenelzine, Rasagiline, Selegiline, tranylcypromine)
• Modafinil
• muscle relaxants (e.g., Cyclobenzaprine, Baclofen)
• Nabilone
• nalbuphine
• Naloxone
• Naltrexone
• nefazodone
• Octreotide
• Olopatadine
• other opioid medications (e.g., Meperidine, Morphine, Codeine, Oxycodone, Hydromorphone)
• Oxybutynin
• Pramipexole
• Pregabalin
• rifabutin
• rifampin
• Ropinirole
• Rotigotine
• St. John's wort
• scopolamine
• seizure medications (e.g., Carbamazepine, clobazam, levetiracetam, phenobarbital, phenytoin, primidone, topiramate, valproic acid, zonisamide)
• selective serotonin reuptake inhibitors (SSRI; e.g., Fluoxetine, Paroxetine, Sertraline)
• serotonin antagonists (anti-emetic medications; e.g., Granisetron, Ondansetron)
• serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., Desvenlafaxine, Duloxetine, Venlafaxine)
• thalidomide
• tiotropium
• Tolterodine
• Trazodone
• tricyclic antidepressants (e.g., Amitriptyline, Clomipramine, Desipramine, Trimipramine)
• "triptan" migraine medications (e.g., Sumatriptan, Zolmitriptan)
• tyrosine kinase inhibitors (e.g., Crizotinib, Lapatinib, Nilotinib, Sunitinib)
• Tryptophan
• umeclidinium
• Zolpidem
• Zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with Sandoz Fentanyl Patch (Fentanyl-transdermal). Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.