Increase in Fentanyl Patch Strength to Adjust for Frequent Episodes of Breakthrough Pain

Description

One cause of breakthrough pain for a patient with chronic pain is too low a dose of the analgesic being used. The strength of a fentanyl patch can be increased based on the type and dose of breakthrough medication used.

Parameters:

(1) type of opiate used for breakthrough pain

(2) oral dose used for breakthrough pain in mg

Opiate	Oral Dose Equivalent to 25 µg per hour Fentanyl Patch
codeine	300
hydromorphone	12
morphine	90
oxycodone	45

target increase in fentanyl dose in µg per hour =

= 25 * ROUNDDOWN(24 hour oral dose of breakthrough medication) / (equivalence factor))

new patch strength in mg =

= ((previous dose in µg/h) + (increased dose in µg/h)) / 10

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Description

Specialty

ICD-10