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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Lot Of Pain, Groggy, Trying To Regulate With Morphine, Stage 4 Lung Cancer. Should I Go For Fetnyl Patch For Pain Management ?

I am trying to help my mother in law with stage 4 lung cancer. She was diagnosed 14 months ago. She did not receive chemo. She is on Hospice now. She is in a lot of pain. She has had a lot of issues trying to regulate with morphine. She is groggy and forgets to take the timed dosages. I was wondering if I should suggest a fetnyl patch for more time released break through pain management. Do they use that patch for that reason?
Mon, 2 Sep 2013
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General & Family Physician 's  Response
Hello,
I understand your mother in law's status. Usually in a hospice the tabs are given by the nurses only. Fentanyl is approximately 100 times more potent than morphine. The patch dosage is based on the size of the patch, since the transdermal absorption rate is generally constant at a constant skin temperature. Fentanyl patches are often prescribed with another opiate (such as morphine or oxycodone) to handle breakthrough pain.
Best wishes
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Oncologist Dr. Monish De's  Response
Fentanyl patch is six times more potent than oral morphine.
Should only be used in patients who are already receiving opioid therapy, who have demonstrated opioid tolerance, and who require a total daily dose at least equivalent to fentanyl 25 mcg/hr. Patients who are considered opioid-tolerant are those who have been taking, for a week or longer, at least 60 mg of morphine daily, or at least 30 mg of oral oxycodone daily, or at least 8 mg of oral hydromorphone daily or an equianalgesic dose of another opioid.
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Lot Of Pain, Groggy, Trying To Regulate With Morphine, Stage 4 Lung Cancer. Should I Go For Fetnyl Patch For Pain Management ?

Hello, I understand your mother in law s status. Usually in a hospice the tabs are given by the nurses only. Fentanyl is approximately 100 times more potent than morphine. The patch dosage is based on the size of the patch, since the transdermal absorption rate is generally constant at a constant skin temperature. Fentanyl patches are often prescribed with another opiate (such as morphine or oxycodone) to handle breakthrough pain. Best wishes