Durogesic is a local opioid narcotic analgesic used to relieve non-oncological and oncologic pain syndrome.
Release form and composition
Durogezik is produced in the form of a transdermal therapeutic system (TTS) - a hermetically sealed translucent rectangular patch with rounded corners, containing a transparent gel. 1 pc each in packages from the combined material, on 5 packages in cardboard packs.
The composition of the patch includes the active substance - fentanyl in the amount of:
- 2.5 mg (pink with inscription 25 µg / h);
- 5 mg (light green with 50 μg / h);
- 7.5 mg (blue with an inscription of 75 μg / h);
- 10 mg (gray with the inscription 100 μg / h).
Auxiliary components that are part of TTC: hydroxyethyl cellulose, ethyl alcohol, purified water.
Indications for use
Durogesic is prescribed for chronic pain syndrome of moderate and severe severity:
- Pains caused by cancer;
- Pain syndrome of non-oncological genesis requiring analgesia with narcotic analgesics, including neuropathic pains (pain in case of nerve injuries, diabetic polyneuropathy, multiple sclerosis, syringomyelia, shingles) and phantom pain arising after amputation of extremities.
The use of Durogezika is contraindicated in:
- Inhibition of the respiratory center;
- Acute pain or postoperative pain requiring a short period of treatment;
- Hypersensitivity to fentanyl or to the adhesive components that make up the system.
The drug is not prescribed:
- Children under 18;
- Pregnant women (except in cases of acute need);
- For women during lactation (the active substance is excreted in breast milk and may cause respiratory depression and sedation in children).
The patch should not be applied to irradiated, damaged or irritated skin.
Durogezik should be used with caution:
- Patients with chronic lung diseases, bradyarrhythmias, arterial hypotension, renal and hepatic insufficiency, hepatic colic in history, increased intracranial pressure, incl. with brain tumors;
- Elderly patients;
- Simultaneously with the intake of insulin, glucocorticosteroids and antihypertensive drugs;
- In acute surgical diseases of the abdominal organs (before diagnosis);
- During cesarean section and other obstetric operations (before fetching).
Dosing and Administration
The doctor selects the dosage of Dyurogezika individually based on the patient's condition and regular assessment of changes after the application of TTC.
The plaster is applied to the flat surface of the skin of the upper arms or torso. For the application, you should choose a place with the smallest hairline. Before use, the hair on the site of application must be cut (not shave). If the skin needs to be washed before applying, do not use soaps, oils, lotions or other means to avoid irritating the skin or changing its properties. Before application, the skin should be completely dry.
Dyurogezik is glued immediately after removal from the sealed bag, firmly pressing the palm for 30 seconds at the site of application. You need to make sure that the patch fits tightly on the skin, especially at the edges.
Durogezik is designed for continuous use for 72 hours. A new system can be glued to another area of the skin only after removing the previously pasted. On the same skin patch can be glued only with a break of several days.
When first used, the dosage (system size) is selected based on the patient's condition, previous use of opioid analgesics and the degree of tolerance. If opioids have not been previously prescribed, a 25 μg / hr patch should be used as the starting dose. The same dose is prescribed if the patient previously received promedol.
In patients with tolerance to opioids, when switching from parenteral or oral forms of opioids to Durogesic, the dosage is calculated based on the previous 24-hour need for analgesia.
For a successful transition from one drug to another, the previous anesthetic treatment should be canceled gradually after the application of the initial dosage of Durogezika.
If, after application of the initial dose, adequate anesthesia is not achieved, after 3 days the dosage can be increased by 25 µg / h, however, the patient’s condition and the need for additional anesthesia should be taken into account (oral dosage of morphine 90 mg / day is approximately 25 µg / h of Durogesika) . To achieve a dose of more than 100 µg / h, several TTCs can be used simultaneously.
In the event of "breaking through" pain, patients may require additional doses of short-acting analgesics. Some patients may require alternative or additional methods of administering opioid analgesics when using a dosage of more than 300 μg / h.
When using Durogezika, the development of disorders on the part of some body systems is possible, manifested as:
- Headache, hallucinations, drowsiness, depression, confusion, anorexia, anxiety, rarely - euphoria, agitation, insomnia, tremor, amnesia, paresthesia (nervous system);
- Hypoventilation, with an overdose - respiratory depression and bronchospasm, in rare cases - shortness of breath (respiratory system);
- Dyspepsia, nausea, constipation, vomiting, dry mouth, biliary colic (in patients with a history of them), rarely - diarrhea (digestive system).
Also during therapy, tachycardia, increased sweating, bradycardia, hypertension, lowering blood pressure, itching, urinary retention, transient muscle rigidity, tolerance, mental and physical dependence can develop. In rare cases, asthenia, sexual dysfunction and withdrawal syndrome may occur.
Sometimes there are local reactions such as skin rash, itching and erythema at the site of application. Typically, these reactions are resolved within days after removal of the drug.
In the transition to the use of dyurogezika from previously taken narcotic analgesics or in case of a sudden cessation of treatment, symptoms characteristic of opioid withdrawal are possible (vomiting, nausea, anxiety, diarrhea, chills). Slow decrease in dosage helps to reduce the severity of these symptoms.
Overdose may develop:
- Lower blood pressure;
- Muscle stiffness;
- Oppression of the respiratory center;
Patients who have developed severe side effects should be under close medical supervision for a day after the removal of Durogezika.
The drug, both before and after use, must be kept out of the reach of children.
The patch should not be damaged in any way and be divided into parts or cut, as this can cause uncontrolled release of fentanyl.
If it is necessary to stop using DuroGesic, its replacement with other opioids should be gradual to avoid the development of withdrawal syndrome.
The drug can have an impact on the mental and physical functions required when performing such potentially dangerous work as driving a car or working with equipment. During therapy, one should refrain from driving vehicles and performing potentially hazardous types of work requiring the patient to have a high concentration of attention and quickness of psychomotor reactions.
After use, the plaster must be folded in half with a sticky side and returned to the doctor for further destruction in the prescribed manner. Unused patches should also be returned to the doctor for disposal.
Analogs of DuroGesics
- By active substance - Durogezik Matrix, Lunaldin, Fendivia;
- By the mechanism of action - Bupranal, Ultiva, Prosidol, Dipidolor, Morphine, Palexia, Nopan, Promedol, Skanan, Fentanyl and other opioid narcotic analgesics.
Terms and conditions of storage
Keep out of the reach of children, at a temperature of 15-25 ° C.
The shelf life of the drug - 2 years.