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!