Fentanyl Versus Lidoderm Patches, What’s the Difference?

I’ve seen numerous mistakes involving these two pain medications that come in a patch formulation.  Between drug diversion (fentanyl – Duragesic), inappropriate time intervals for changing (lidocaine – Lidoderm), as needed use (fentanyl), and lost patches (both), there are plenty of easy mistakes and misconceptions about these two pain patches that I’ve seen folks from every profession make.

I figured that a nice table with a few comparisons would help educate those of you who may not be up too familiar on the differences of fentanyl versus Lidoderm patches.

Medication or Patch Use Application Site How often to Switch Can we use As Needed? Mistakes or Problems Can I cut it?
Fentanyl(Duragesic) Pain (opioid) chronic, systemic Usually chest, back, flank, upper arm (systemic effects, not local!) Usually every 72 hours (have seen every 48 hours occasionally) No (time to peak is 20-72 hours) also many short acting opioids available! Cutting patch, Drug Diversion, Used as needed or increased too quickly, not for acute pain, placed at site of pain (i.e. knee) No
Lidocaine (Lidoderm) PainLocalized, postherpetic neuralgia Site of Pain! Usual dosing on 12 hours then off for 12 hours Yes, but can take a little while to work (about 4 hours to onset) Leaving   on for 24 hours(Keep both patches away from kids/pets!), it is NOT a controlled substance Yes

I hope you find this table helpful!  For more medication mistakes and real world info from my practice as a clinical pharmacist, please check out the 30 medication mistakes PDF – a free resource for subscribers!

Written By Eric Christianson

July 12, 2015

Free PDF – Top 30 Medication Mistakes

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