The Magic Bullet Fund

PAIN CONTROL


Why Not Fentanyl?


Fentanyl is a pain medication available as a transdermal patch from Duragesic.
It is referred to as the fentanyl patch, the pain patch or the Duragesic patch.

Fentanyl is an opioid (a synthetic version of an opiate). When used properly and safely, the patch is prescribed for chronic pain -- never for short-term or post-surgery pain. Here's why:

After the patch is applied, the therapeutic blood level is reached after about 14 hours (for humans). Every three days, a new patch is applied and the old patch removed, to maintain the amount of medication in the blood stream.

When the patch will be discontinued because of adverse side effects or reactions (which can be terminal), a patch is removed and a new one is not applied. The amount of medication in the bloodstream decreases gradually but remains effective (and will continue to produce adverse side effects) for many hours.

But don't take my word for it! Here are the manufacturer's guidelines for safe and effective use:

The following cautions are provided by the manufacturer on the product label
and should be heeded by veterinarians!

DURAGESIC® (fentanyl transdermal system) is contraindicated [is not safe to use]:

  • in patients who are not opioid-tolerant
  • in the management of acute pain or in patients who require opioid analgesia for a short period of time
  • in the management of post-operative pain
  • in the management of mild pain
  • in the management of intermittent pain
Veterinarians are permitted by law to prescribe medications that have not been FDA approved for veterinary use.
They may prescribe medications for uses other than the use for which they were developed (off-label use).
In other words, they can do pretty much whatever they want when it comes to prescribing medications for pets.

I first read about the use of fentanyl to control post-surgery pain for pets about 10 years ago.
At that time I was wearing a fentanyl patch myself and I was dismayed about its misuse by veterinarians.

It has since become quite popular among veterinarians - I don't know why. Is the manufacturer giving discounts? Promoting fentanyl for pets, in hopes of seeking FDA approval for human use for post-surgery pain?

Regardless of "why," I remain firmly against the off-label use of the fentanyl patch for pets after surgery.

Please ask your veterinarian to provide an alternate plan for pain medication if your pet has surgery.

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