3-day fentanyl transdermal patch / Generic mfg. 
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  • ||||||||||  midazolam hydrochloride / Generic mfg.
    Trial completion:  Compare Propofol to Fentanyl and Midazolam for Colonoscopy (clinicaltrials.gov) -  May 23, 2023   
    P=N/A,  N=289, Completed, 
    Trial completion date: Aug 2024 --> Jul 2026 | Trial primary completion date: Aug 2023 --> Jul 2026 Unknown status --> Completed
  • ||||||||||  Trial completion date, Trial primary completion date:  Paravertebral Nerve Blocks in Neonates (clinicaltrials.gov) -  Jan 20, 2023   
    P4,  N=30, Recruiting, 
    Trial completion date: Aug 2023 --> Aug 2024 | Trial primary completion date: Aug 2022 --> Aug 2023 Trial completion date: Dec 2022 --> Dec 2024 | Trial primary completion date: Dec 2022 --> Dec 2024
  • ||||||||||  Enrollment open:  Paravertebral Nerve Blocks in Neonates (clinicaltrials.gov) -  Feb 9, 2022   
    P4,  N=30, Recruiting, 
    Trial completion date: Dec 2022 --> Dec 2024 | Trial primary completion date: Dec 2022 --> Dec 2024 Suspended --> Recruiting
  • ||||||||||  Trial completion date, Trial primary completion date:  Paravertebral Nerve Blocks in Neonates (clinicaltrials.gov) -  Feb 9, 2021   
    P4,  N=30, Suspended, 
    Active, not recruiting --> Completed Trial completion date: Dec 2020 --> Dec 2022 | Trial primary completion date: Dec 2020 --> Dec 2022
  • ||||||||||  Duragesic (fentanyl) / J&J
    Clinical, Review, Journal:  Opioid rotation from transdermal fentanyl to continuous subcutaneous hydromorphone in a cachectic patient: A case report and review of the literature. (Pubmed Central) -  Jan 27, 2021   
    Opioid toxicity eventually resolved with downward titration of hydromorphone to only 30% of the initially estimated equianalgesic dose. This case highlights the need for close follow-up of all patients undergoing opioid rotation from transdermal fentanyl and reinforces the need to reduce the initial dose of the new opioid by 30%-50% of the calculated MEDD, especially when rotating from a high dose of transdermal fentanyl, or if there are factors potentially impairing absorption from the patch such as age, cachexia and weight loss, or if rotation is performed for reasons other than uncontrolled pain.
  • ||||||||||  Duragesic (fentanyl) / J&J
    Journal:  Cancer Cachexia May Hinder Pain Control When Using Fentanyl Patch. (Pubmed Central) -  Jan 21, 2021   
    Subsequently, to investigate whether dry skin was involved in poor pain control in the cancer cachexia group, transepidermal water loss (TEWL) was compared between 15 additional patients classified into cancer cachexia and non-cancer cachexia groups; the mean TEWL in the cancer cachexia group was found to be significantly lower. Our data suggest that cancer cachexia may be a risk factor for poor pain control in patients receiving FP treatment, and that uncontrolled pain in FP treatment may be caused by the inhibition of fentanyl transdermal absorption due to dry skin.
  • ||||||||||  Duragesic (fentanyl) / J&J
    [VIRTUAL] Evaluation of fentanyl patch utilization in cancer patients with compromised renal function () -  Dec 26, 2020 - Abstract #ASHP2020ASHP_4635;    
    A comparison was made of therapy duration, patient pain scores, and quality of life (QoL) outcomes between the two groups. The Wilcoxon sign-rank statistical test was utilized to analyze the difference between two groups on pain intensity prior to and post fentanyl patch administration for each individual.
  • ||||||||||  Duragesic (fentanyl) / J&J
    [VIRTUAL] Evaluation of the appropriateness of fentanyl patch use in the inpatient setting () -  Dec 26, 2020 - Abstract #ASHP2020ASHP_3969;    
    Primary endpoints are the appropriateness of fentanyl dose initiation and titration. Secondary endpoints include appropriate indication, concomitant opioid use (for bridging), safety events (i.e., naloxone administration, rapid response team call) associated with the use of fentanyl, and prescribing patterns between disciplines.
  • ||||||||||  Duragesic (fentanyl) / J&J
    [VIRTUAL] Evaluation of transdermal fentanyl patch utilization in a community hospital setting () -  Dec 26, 2020 - Abstract #ASHP2020ASHP_2104;    
    Patients receiving, for one week or longer, at least 60 mg oral morphine per day, 25 mcg transdermal fentanyl per hour, 30 mg oral oxycodone per day, 8 mg oral hydromorphone per day, 25 mg oral oxymorphone per day, 60 mg oral hydrocodone per day, or the equianalgesic dose of another opioid are determined to be opioid tolerant. Data will be collected on baseline demographics, indication for fentanyl patch, prescriber specialty, documented adverse effects, administration of naloxone, nursing documentation of fentanyl patch application and removal, and concomitant administration of other central nervous system depressants, such as benzodiazepines, skeletal muscle relaxants, and other opioids.
  • ||||||||||  Duragesic (fentanyl) / J&J
    [VIRTUAL] Analysis of opioid-related harms associated with inpatient fentanyl patch administration () -  Dec 26, 2020 - Abstract #ASHP2020ASHP_1121;    
    Several patterns of risk were identified including: (1) Fentanyl patch use in a patient that is not opioid tolerant [taking >/= 60MME for >/= 7 days]; (2) Incorrect patch strength selection for first-time patch patient; (3) Incorrect patch strength selection for patch dosage increases; (4) Inappropriately shortened trial period of up titrated fentanyl patch strength; (5) Use of every 48 hour dosing interval rather than every 72 hour dosing interval; (6) Patch dose decrease occurring prior to the patient’s next scheduled change date, inadvertently increasing the patient’s opioid dose; (7) Lack of documentation/reporting of previous adverse effects or hypersensitivities to fentanyl patch; (8) Overestimation of appropriate fentanyl patch dose respective to patient’s history of adverse events; (9) Inconsistent dosing and administration times of fentanyl patch; (10) Presence of a drug-drug interaction with a CYP3A4 inhibitor; (11) Concomitant opioid and sedative medication use, particularly benzodiazepines; (12) Renarcotizaion likely accounting for the need of multiple naloxone administrations; (13) Presence of fever potentially contributing to a temperature-dependent increase in fentanyl release from the patch system; (14) Fentanyl patch use in patients with a history of IV drug abuse; (15) Alteration in pH levels may affect drug distribution between plasma and the central nervous system; (16) Lack of appropriate monitoring upon presentation with adverse effects secondary to opioids; (17) Forgetting to remove the fentanyl patch after dose discontinuation; (18) Presence of pre-existing respiratory disease and baseline decreased respiratory reserve; (19) Presence of renal or hepatic dysfunction leading to unpredictable pharmacokinetic properties of fentanyl patch; (20) Fentanyl patch use in a patient with pancreatic/biliary tract disease; (21) Fentanyl patch use in a patient with a brain tumor; (22) Fentanyl patch use in a geriatric patient. Institutions should evaluate the fentanyl patch medication use process to identify potential gaps related to the risk patterns described in this analysis.
  • ||||||||||  Duragesic (fentanyl) / J&J
    Journal:  Fentanyl patches: Use and Misuse. (Pubmed Central) -  Dec 1, 2020   
    It is also an opioid that is widely abused. Acute clinicians need to be aware of the methods by which fentanyl patches may be used both therapeutically and illicitly as well as the impact this can have in managing a patient's period of intoxication.
  • ||||||||||  Duragesic (fentanyl) / J&J
    Journal:  Assessment of Potentially Inappropriate Prescribing of Opioid Analgesics Requiring Prior Opioid Tolerance. (Pubmed Central) -  Oct 27, 2020   
    Less than half of use episodes (73 117 episodes [47.7%]) involved patients with evidence in claims data of opioid tolerance prior to initiating therapy with an OTO medication, including 31 392 of 101 676 episodes (30.9%) involving transdermal fentanyl, 1561 of 2440 episodes (64.0%) involving transmucosal fentanyl, 36 596 of 43 559 episodes (84.0%) involving extended-release oxycodone, and 3568 of 5710 episodes (62.5%) involving extended-release hydromorphone...Data from EHRs did not contribute substantial additional evidence of opioid tolerance beyond the data found in prescription claims. Future research is needed to understand the clinical rationale behind these observed prescribing patterns and to quantify the risk of harm to patients associated with potentially inappropriate prescribing.
  • ||||||||||  Duragesic (fentanyl) / J&J
    [VIRTUAL] A Case Report Of Alternative Analgesia: Dronabinol () -  Oct 17, 2020 - Abstract #ASA2020ASA_1288;    
    Initial pain regimen included acetaminophen, tramadol, methocarbamol, pregabalin, lidocaine patch and ketorolac for two days before transitioning to celecoxib, which did not control patient's pain. Decision was made to start patient on Dronabinol, which provided significant analgesia.
  • ||||||||||  Duragesic (fentanyl) / J&J
    [VIRTUAL] Emergent Massive Ascending Aortic Pseudoaneurysm Causing Right Ventricular External Compression () -  Oct 17, 2020 - Abstract #ASA2020ASA_612;    
    Induction with etomidate and fentanyl was complicated by hemodynamic instability requiring phenylephrine, norepinephrine, and resuscitation with blood products...The pseudoaneurysm was patched surgically, and inotropes were initiated to wean from CPB due to moderately reduced RV function. The patient was admitted to the ICU for post-operative management and discharged on POD 18.
  • ||||||||||  Duragesic (fentanyl) / J&J
    [VIRTUAL] DEXMEDETOMIDINE-INDUCED FEVER () -  Oct 12, 2020 - Abstract #CHEST2020CHEST_1368;    
    High degree of clinical suspicion is required to evaluate and consider this as a potential etiology of fever in an ICU setting. Individualized assessment of each patient with history, and physical examination is important to avoid invasive and costly investigations and interventions.
  • ||||||||||  Duragesic (fentanyl) / J&J, Targin (oxycodone/naloxone ER) / Shionogi, Purdue, Mundipharma
    [VIRTUAL] Prolonged release (PR) oxycodone/naloxone (OXN) for cancer pain (CP) & its impact on bowel function, safety & quality of life (QoL): Systematic review (On-Demand e-Poster Display) -  Oct 8, 2020 - Abstract #ESMOAsia2020ESMO_Asia_946;    
    Systematic review of literature from PubMed and EMBASE that evaluated analgesia, bowel function, adverse events (AE) and QoL after OXN PR or oral oxycodone (OXY)/morphine/tapentadol PR, or transdermal fentanyl, in adults with moderate-severe CP...Although limited, this meta-analysis confirms existing evidence on OXN’s efficacy and tolerability in patients with moderate-severe CP and highlights that few data on OXN in CP is available. Mundipharma Singapore Holding Pte Ltd.
  • ||||||||||  Duragesic (fentanyl) / J&J, Targin (oxycodone/naloxone ER) / Shionogi, Purdue, Mundipharma
    [VIRTUAL] Prolonged release (PR) oxycodone/naloxone (OXN) for cancer pain (CP) & its impact on bowel function, safety & quality of life (QoL): Systematic review (On-Demand e-Poster Display) -  Oct 8, 2020 - Abstract #ESMOAsia2020ESMO_Asia_580;    
    Systematic review of literature from PubMed and EMBASE that evaluated analgesia, bowel function, adverse events (AE) and QoL after OXN PR or oral oxycodone (OXY)/morphine/tapentadol PR, or transdermal fentanyl, in adults with moderate-severe CP...Although limited, this meta-analysis confirms existing evidence on OXN’s efficacy and tolerability in patients with moderate-severe CP and highlights that few data on OXN in CP is available. Mundipharma Singapore Holding Pte Ltd.
  • ||||||||||  Duragesic (fentanyl) / J&J
    Journal:  Complex Drug Delivery Systems: Controlling Transdermal Permeation Rates with Multiple Active Pharmaceutical Ingredients. (Pubmed Central) -  Oct 1, 2020   
    Compared with the monolith, decreased opioid antagonist permeation while maintaining fentanyl permeation could be achieved using a bilayer design...Bilayer patch performance did not change over an 8-week period in accelerated stability storage conditions. In conclusion, modifying the patch design of a bilayer TDDS achieves an individualized permeation of each API while maintaining constant patch composition.
  • ||||||||||  fentanyl citrate / Generic mfg., Duragesic (fentanyl) / J&J
    Journal:  Transdermal Fentanyl Uptake at Two Different Patch Locations in Swiss White Alpine Sheep. (Pubmed Central) -  Sep 24, 2020   
    The TFP applied on the foreleg allowed a faster fentanyl uptake with higher peaks and a longer time within or above the target concentration of 0.6-1.5 ng/mL, shown to be analgesic in humans, when compared to the one on the thorax. Assuming that the effective plasma concentration described for humans is providing analgesia in sheep as well, the present findings suggest that it should be sufficient to apply the TFP 3-6 h before the painful insult and that its effect should last at least 48 h. Furthermore, when TFP are used to provide postoperative analgesia in sheep, they should be placed on the foreleg rather than on the thorax.
  • ||||||||||  fentanyl citrate / Generic mfg., Duragesic (fentanyl) / J&J
    Clinical, Journal:  Transdermal Fentanyl patch: An approach to enhance tolerance of conscious proning in COVID-19 patients. (Pubmed Central) -  Sep 12, 2020   
    Cough and myalgia are the common and most distressing symptoms seen in conscious COVID-19 patients which can impair tolerance to awake proning. Modified awake proning with application of transdermal fentanyl patch (TFP) can improve the compliance to conscious proning in COVID-19 patients.