Medication patches
Some medication may be given to you in patch form to be placed on the skin; this page provides information about the most commonly found versions which are used for pain relief, frequently asked questions and how to apply and remove the patches.
To apply
- Tear open the envelope and remove the patch
- Peel off the stiff plastic liner and avoid touching the sticky side
- Apply the patch on a flat, dry area of the skin above your waist on your chest, back or upper arms. It does not need to be applied to the painful area. Clip any hair before applying
- Press hand firmly over the entire patch for 30 seconds, paying particular attention to the edges
- Should the patch loosen, tape the edges down with first aid tape
- If wearing more than one patch then apply next to each other but not touching or on top of each other
To remove
- The patch needs to be renewed regularly, depending on the type of patch as above. Take it off gently and fold the sticky side down over itself. Put it back in its pouch then into the bin
- If you touch the sticky side accidentally, wash your hands
- Make a note of what day you change your patch on your calendar or diary
- Place the next patch on a different application site and not the same place for two patch applications in a row
Never increase your patch dose without consulting your doctor or specialist nurse.
Keep it out of reach of children, even used patches have a residual amount of drug present.
Common types of patches
Fentanyl patches
Your Fentanyl patch (which may be called by brand name) is another way of giving you pain relief. It is slowly absorbed through the skin at a dose which has been calculated specifically for you. Fentanyl is a strong painkiller and can be as effective as Morphine for severe pain.
The patches are available in a variety of strengths:
- 12 micrograms/hour
- 25 micrograms/hour
- 50 micrograms/hour
- 75 micrograms/hour
- 100 micrograms/hour
Fentanyl patches are usually changed every 72 hours (3 days). It is possible for you to wear more than one fentanyl patch at a time, as directed by your doctor or specialist nurse.
If you do wear several patches, it is simpler for you to change them all in the same day, at the same time. They should be worn next to, but not touching or on top of, each other. Your patch should be worn at all times.
Buprenorphine
Buprenorphine patches contain another strong painkiller, similar to fentanyl and morphine. Your doctor or specialist nurse will advise which is most appropriate for you and discuss the reasons.
Buprenorphine patches come in two different types which are changed every few days depending on the type of patch.
Butrans – change every 7 days
- 5 micrograms/hour
- 10 micrograms/hour
- 20 micrograms/hour
Transtec – change every 96 hours (4 days)
- 35 micrograms/hour
- 52.5 micrograms/hour
- 70 micrograms/hour
It is possible for you to wear more than one buprenorphine patch at a time, as directed by your doctor or specialist nurse.
If you do wear several patches, it is simpler for you to change them all in the same day, at the same time. They should be worn next to, but not touching or on top of, each other. Your patch should be worn at all times.
It is not usual to use a combination of fentanyl and buprenorphine patches at the same time.
Lidocaine Plasters
Lidocaine is a local anaesthetic which may be given to you in patch/plaster form if you have severe nerve pain in a small area of your body. It may be recommended for you after specialist assessment by your doctor or nurse. The plasters are usually sited directly over the painful area or on the nerves leading to that area – please ask your doctor or specialist nurse if you are unsure where to apply the plaster. Up to 3 plasters per patient may be used at one time. The plaster may be cut if needed to make an optimal size.
Do not apply the plaster close to the eyes or mouth, or on broken skin or wounds. Usually the plasters are applied for 12 hours and then removed for 12 hours to reduce the risk of skin reactions. The medication should still be present under the skin for the hours that the patch is off. The plaster should be replaced daily.
It may be that you are advised to use a lidocaine plaster at the same time as a fentanyl or buprenorphine patch – if you have any questions about the use of any of these medications please speak with your doctor or specialist nurse.
Frequently asked questions
Can I take painkillers when I have a patch on?
When you are wearing your first patch, you will be advised whether you need to take other painkillers until the maximum level of pain-relief is built up in your system.
If you continue to have pain, you may take fast acting painkillers prescribed by your doctor or specialist nurse (this may be Morphine or Oxycodone liquid or tablets). The dose is usually adjusted according to your patch strength.
What if I still continue to have pain?
If your pain persists or intensifies and you are continually taking extra pain relief, you should speak with your doctor or specialist nurse. The patch dose may need to be increased.
What if my skin is sensitive?
You should not apply a patch to any area of your body that has had radiotherapy within the past few weeks or is particularly irritated or fragile. Clip any hair before applying (shaving may cause irritation). Use of lotions, soap or solutions containing alcohol may also irritate the skin. Use plain water to cleanse the skin.
If the patch appears to be causing skin irritation, contact your doctor or specialist nurse for advice as it may be possible to use a steroid spray under the patch to help reduce this.
What are the side effects?
- Some patients experience nausea or vomiting when they first start strong painkillers such as Fentanyl or Buprenorphine. This can be prevented by anti-sickness tablets – please ask your doctor or specialist nurse
- Constipation is a common side effect and can usually be prevented by taking regular laxatives
- Mild sleepiness or confusion may occur for a few days after starting or increasing the dose of Fentanyl or Buprenorphine, and should wear off
- Severe drowsiness or breathing problems are rare but potentially serious side effects. Should they occur, you should seek urgent advice from your GP, district nurse or specialist nurse and they may advise you to remove the patch(es)
Can I still have a shower, bathe or swim whilst wearing my patch?
Yes – if the patch is securely adhered to the skin, but be careful not to rub vigorously so that the patch comes off. Also avoid prolonged exposure to heat such as a sauna or steam room as it may cause an increase release of the drug into the skin and give you a higher dose, and therefore more side effects.
Are there any special instructions?
You should avoid exposing the patch to direct heat, e.g. heat pads, electric blankets, hot water bottles, very hot baths, heat lamps. Similarly, if you have a very high temperature, there is a potential for an increased release of the medication. If you think you have a temperature – call your doctor or specialist nurse.
An old patch leaves my skin very sticky. How do I get this off?
Baby oil, mineral oil or even peanut butter! Remember not to use the oil on the skin area when you are just about to apply a new patch. Your patch may leave your skin a little red, but this usually resolves.