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Durogesic

Durogesic

Ask a doctor about a prescription for Durogesic

This page is for general information. Consult a doctor for personal advice. Call emergency services if symptoms are severe.
About the medicine

How to use Durogesic

B. PATIENT INFORMATION LEAFLET

Leaflet accompanying the packaging: patient information

Durogesic, 12 µg/h, transdermal system, patch
Durogesic, 25 µg/h, transdermal system, patch
Durogesic, 50 µg/h, transdermal system, patch
Durogesic, 75 µg/h, transdermal system, patch
Durogesic, 100 µg/h, transdermal system, patch
fentanyl

You should carefully read the contents of the leaflet before using the medicine, as it contains important information for the patient.

  • You should keep this leaflet so that you can read it again if you need to.
  • If you have any doubts, you should consult your doctor, pharmacist, or nurse.
  • This medicine has been prescribed specifically for you. Do not pass it on to others. The medicine may harm another person, even if their symptoms are the same as yours.
  • If the patient experiences any side effects, including any side effects not listed in this leaflet, they should tell their doctor, pharmacist, or nurse. See section 4.

Table of contents of the leaflet

  • 1. What is Durogesic and what is it used for
  • 2. Important information before using Durogesic
  • 3. How to use Durogesic
  • 4. Possible side effects
  • 5. How to store Durogesic
  • 6. Contents of the packaging and other information

1. What is Durogesic and what is it used for

The name of this medicine is Durogesic.
Durogesic is indicated for the treatment of severe chronic pain:

  • in adults who require continuous opioid treatment
  • in children over 2 years of age who have already used opioid medications and require continuous opioid treatment.

Durogesic contains the active substance fentanyl, which is a strong pain reliever belonging to the opioid group.

2. Important information before using Durogesic

When not to use Durogesic

  • if the patient is allergic to the active substance or any of the other ingredients of this medicine (listed in section 6),
  • for short-term, acute, or post-operative pain,
  • if the patient has severe respiratory depression (significant slowing and shallowing of breathing). Do not use this medicine if any of the above situations apply to the patient. In case of doubt, consult your doctor or pharmacist before using Durogesic.

Warnings and precautions

  • Durogesic may cause life-threatening side effects in people who do not regularly use opioid medications.
  • Durogesic is a medicine that can be life-threatening to children. This also applies to used patches. It should be considered that the appearance of the patch (used or unused) may encourage a child to touch it, stick it to their body, put it in their mouth, etc., which can lead to death.
  • This medicine should be stored in a safe and protected place, inaccessible to other people - more information on this can be found in section 5.

In case of accidental attachment of the Durogesic patch to another person's skin

Patches should only be applied to the skin of the person they have been prescribed for. There have been several reports of accidental attachment of a patch to another person's skin during close physical contact or while sleeping in the same bed with the person using the patches. Accidental attachment of a patch to another person's skin (especially a child) can cause the medicine to be absorbed through the skin and lead to severe side effects, such as respiratory disorders with slow and shallow breathing, which can be life-threatening. If such a situation occurs, the patch should be removed immediately and a doctor should be consulted.

Special caution is required when using Durogesic

You should consult your doctor or pharmacist before using this medicine if

any of the following situations apply- closer monitoring of the patient may be necessary, when:

  • the patient has had lung disease or breathing difficulties,
  • the patient has had heart, liver, kidney, or low blood pressure problems,
  • the patient has had a brain tumor,
  • the patient has had persistent headaches or head injuries,
  • the patient is elderly - may be more sensitive to the effects of this medicine,
  • the patient has "myasthenia gravis", a condition characterized by muscle weakness and fatigue.

If any of the above situations apply to the patient (or the patient is unsure), they should consult their doctor or pharmacist before using Durogesic.

During patch use, you should inform your doctor if you experience

breathing problems during sleep.Opioids, such as Durogesic, can cause sleep apnea (pauses in breathing during sleep) and nocturnal hypoxemia (low oxygen levels in the blood). You should inform your doctor if you, your partner, or caregiver notice any of the following symptoms:

  • pauses in breathing during sleep
  • nighttime awakenings due to shortness of breath
  • difficulty staying asleep
  • excessive daytime sleepiness. Your doctor may decide to adjust the dose of the medicine.

During patch use, you should inform your doctor if you notice a change in

how you feel pain.If you feel that:

  • the pain is no longer relieved after applying the patch
  • the pain is getting worse
  • there is a change in how you feel pain (e.g., you feel pain in a different part of your body)
  • you experience pain when touched, which should not be there. Do not change the dose yourself. Your doctor may decide to change the dose or treatment.

Durogesic side effects

  • Durogesic may cause unnatural fatigue and slowed or shallow breathing. Very rarely, these breathing disorders can be life-threatening or lead to death, especially in people who have not previously used opioid pain medications (such as Durogesic or morphine). If the patient, partner, or caregiver notices that the person using the patches is excessively sleepy and has slow or shallow breathing, they should:
  • remove the patch
  • call a doctor or go to the nearest hospital immediately
  • encourage the patient to move and talk as much as possible.
  • If the patient develops a fever while using Durogesic, they should consult their doctor - an increase in body temperature can significantly increase the absorption of the medicine through the skin.
  • Durogesic may cause constipation; the patient should consult their doctor or pharmacist about how to prevent or alleviate constipation. A full list of side effects can be found in section 4.

Durogesic, like other opioids, may affect the normal production of hormones in the body, such as cortisol, prolactin, or sex hormones, especially with long-term use. The effects of these hormonal changes may include malaise (including nausea), loss of appetite, fatigue, weakness, dizziness, low blood pressure, infertility, or decreased sex drive. Additionally, women may experience changes in their menstrual cycle, and men may experience impotence or breast enlargement. If the patient notices any of these symptoms, they should consult their doctor.
Do not heat the patch application site with external heat sources, such as heated pads, electric blankets, hot water bottles, heated beds, heat lamps, or tanning beds. Do not sunbathe or use prolonged warming baths, saunas, or whirlpool baths. In these situations, there is a risk of increased release of the medicine from the patch.

Long-term use and tolerance

This medicine contains fentanyl, which is an opioid pain reliever. Repeated use of opioid pain relievers can lead to decreased effectiveness of the medicine (the patient becomes accustomed to it, which is known as tolerance to the medicine). During Durogesic use, the patient's sensitivity to pain may also increase. This phenomenon is known as hyperalgesia.
Increasing the patch dose may temporarily reduce the pain, but it can also be harmful. If the patient notices a decrease in the effectiveness of the medicine, they should consult their doctor. The doctor will decide whether it is better for the patient to increase the dose or gradually reduce the use of Durogesic.

Dependence and addictive use

Repeated use of Durogesic can also lead to dependence, abuse, and addictive use, which can result in life-threatening overdose. The risk of these side effects may increase with increasing dose and duration of use. Dependence or addictive use can cause the patient to feel a loss of control over the amount of medicine they use or how often they use it. The patient may feel the need to continue using the medicine, even if it no longer helps relieve their pain.
The risk of dependence or addictive use varies from person to person. The risk of dependence on Durogesic or its addictive use may be higher if:

  • the patient or someone in their family has previously abused or been dependent on alcohol, prescription medications, or illegal substances (addiction);
  • the patient smokes;
  • the patient has previously experienced mood disorders (depression, anxiety disorders, or personality disorders) or has been treated by a psychiatrist for other mental health conditions.

If the patient experiences any of the following symptoms while using Durogesic, it may indicate dependence or addictive use.

  • The patient needs to use the medicine for a longer period than prescribed by the doctor.
  • The patient needs to use a higher dose than prescribed.
  • The patient uses the medicine for reasons other than those for which the doctor prescribed it, such as "to calm down" or "to fall asleep".
  • The patient has repeatedly tried to stop or control the use of the medicine but has been unable to do so.
  • After stopping the use of the medicine, the patient feels unwell and experiences improvement in their condition when they start using the medicine again (withdrawal symptoms).

If the patient notices any of these symptoms, they should discuss the best treatment strategy with their doctor, including determining when it is appropriate to stop the treatment and how to safely stop using the medicine.

Withdrawal symptoms after stopping Durogesic use

Do not stop using this medicine suddenly. Withdrawal symptoms may occur, such as anxiety, difficulty sleeping, irritability, restlessness, anxiety, rapid heartbeat (palpitations), increased blood pressure, nausea, vomiting, diarrhea, loss of appetite, tremors, chills, or sweating. If the patient wants to stop using this medicine, they should first consult their doctor. The doctor will inform them how to do it; usually, it is done by gradually reducing the dose, so that any unpleasant withdrawal symptoms are minimized. See also section 2 "Withdrawal symptoms after stopping Durogesic use".

Durogesic and other medicines

Tell your doctor or pharmacist about all medicines you are currently taking, have recently taken, or plan to take. This includes all over-the-counter medicines and herbal medicines.
When buying other medicines at the pharmacy, tell the pharmacist that you are using Durogesic.
Your doctor knows which medicines can be safely used with Durogesic. You will need close monitoring if you use any of the following medicines or if you stop using any of the following medicines, as it may affect the required strength of Durogesic.
In particular, tell your doctor or pharmacist if you are taking:

  • Other opioid pain relievers (such as buprenorphine, nalbuphine, or pentazocine) and some pain relievers used for neuropathic pain (gabapentin and pregabalin).
  • Sleeping pills (such as temazepam, zaleplon, or zolpidem).
  • Calmatives (such as alprazolam, clonazepam, diazepam, hydroxyzine, or lorazepam) and antipsychotics (such as aripiprazole, haloperidol, olanzapine, risperidone, or phenothiazines).
  • Muscle relaxants (such as cyclobenzaprine or diazepam).
  • Certain antidepressants called SSRIs or SNRIs (such as citalopram, duloxetine, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, or venlafaxine) - see below.
  • Certain antidepressants or medications used to treat Parkinson's disease called MAOIs (such as isocarboxazid, phenelzine, selegiline, or tranylcypromine). Do not use Durogesic for 14 days after stopping these medicines - see below.
  • Certain antihistamines, especially those that cause drowsiness (such as chlorpheniramine, clemastine, cyproheptadine, diphenhydramine, or hydroxyzine).
  • Certain antibiotics (such as erythromycin or clarithromycin).
  • Antifungal medications (such as itraconazole, ketoconazole, fluconazole, or voriconazole).
  • Medications used to treat HIV infection (such as ritonavir).
  • Anti-arrhythmic medications (such as amiodarone, diltiazem, or verapamil).
  • Anti-tuberculosis medications (such as rifampicin).
  • Certain anti-epileptic medications (such as carbamazepine, phenobarbital, or phenytoin).
  • Certain medications used to treat nausea and motion sickness (such as phenothiazines).
  • Certain medications used to treat heartburn and stomach ulcers (such as cimetidine).
  • Certain medications used to treat coronary artery disease (angina pectoris) or high blood pressure (such as nicardipine).
  • Certain medications used to treat blood cancers (such as idelalisib).

Using Durogesic with antidepressants

The risk of side effects increases when used with certain antidepressants. There may be an interaction between Durogesic and these medicines, and the patient may experience changes in their mental state, such as agitation, hallucinations, and other effects, such as changes in blood pressure, rapid heartbeat, high temperature, excessive reflexes, coordination disorders, muscle stiffness, nausea, vomiting, and diarrhea (these may be symptoms of serotonin syndrome). When used together, the doctor may want to closely monitor the patient for these side effects, especially when starting treatment or changing the dose of the medicine.

Using Durogesic with medicines that act on the central nervous system, including alcohol and certain narcotics

Concomitant use of Durogesic and sedatives, such as benzodiazepines or related medicines, increases the risk of drowsiness, breathing difficulties (respiratory depression), coma, and can be life-threatening. Therefore, concomitant use should only be considered when other treatment options are not possible.
If the doctor prescribes Durogesic with sedatives, the dose and duration of concomitant treatment should be limited by the doctor.
Tell your doctor about all sedatives you are taking and follow the doctor's instructions regarding the dose. It may be helpful to inform friends or relatives to be aware of the above symptoms. If such symptoms occur, consult a doctor.
Do not drink alcohol while using Durogesic until you have discussed it with your doctor.

Surgical procedures

If you think you may be having an operation, tell your doctor or dentist that you are using Durogesic.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant, or plan to have a child, consult your doctor or pharmacist before using this medicine.
Durogesic should not be used during pregnancy unless discussed with your doctor.
Durogesic should not be used during the perinatal period, as it may cause respiratory disorders in the newborn.
Long-term use of Durogesic during pregnancy may cause withdrawal symptoms in the newborn (such as loud crying, trembling, seizures, poor feeding, and diarrhea), which can be life-threatening if not recognized and treated. If you suspect that the child may experience withdrawal symptoms, consult a doctor immediately.
Durogesic should not be used during breastfeeding. Do not breastfeed for 3 days after removing the Durogesic patch. The medicine may pass into human milk.

Driving and using machines

Durogesic may affect your ability to drive or operate machines, as it can cause drowsiness and dizziness. If you experience these symptoms, do not drive or operate any machines or tools. Do not drive until you know how the medicine affects you.
Consult your doctor or pharmacist if you are unsure whether you can drive safely while using this medicine.

3. How to use Durogesic

This medicine should always be used exactly as prescribed by your doctor. If you are unsure, consult your doctor or pharmacist.
Your doctor will decide which strength of Durogesic is suitable for you, based on the severity of your pain, your overall condition, and the pain treatment you have been using so far.
Before starting and regularly during treatment, your doctor will also discuss with you what to expect from using Durogesic, when and for how long to use it, when to consult a doctor, and when to stop using the medicine (see also section 2 "Withdrawal symptoms after stopping Durogesic use").

Using and changing patches

  • Each patch contains enough medicine for 3 days (72 hours).
  • You should change the patch every third day, unless your doctor advises otherwise.
  • Always remove the old patch beforeapplying a new one.
  • Always change the patch at the same timeevery 3 days (72 hours).
  • If you use more than 1 patch, you should change all patches at the same time.
  • You should write down the day, date, and time you apply the patch to remember when to change it.
  • The following table shows when to change the patch:

Patch applied on: Patch change on:

Monday
Thursday
Tuesday
Friday
Wednesday
Saturday
Thursday
Sunday
Friday
Monday
Saturday
Tuesday
Sunday
Wednesday

Where to apply the patch

Adults

  • You should apply patches to a flat area of the upper body or arm (avoiding joints).

Children

  • To minimize the risk of the child touching or removing the patch, apply the patch to the upper back.
  • Check frequently to ensure the patch is properly attached to the skin.
  • It is essential that the child does not remove the patch and put it in their mouth, as this can be life-threatening or lead to death.
  • Monitor the child closely for 48 hours after:
  • applying the first patch
  • applying a patch with a higher strength.
  • The action of the patch may be delayed after the first dose is applied. Therefore, before the full effect of the medicine is apparent, the child may need to take additional pain relievers. The doctor will inform you about this.

Adults and children

Do not apply the patch:

  • to the same place twice in a row
  • to moving areas (joints), irritated, or damaged skin
  • to very hairy skin. If there is hair, do not shave it (shaving irritates the skin). Instead, cut the hair as close to the skin as possible.

Applying the patch

Step 1: Preparing the skin

  • Make sure the skin is completely dry, clean, and cool before applying the patch
  • If the skin needs to be cleaned, do so with cold water
  • Do not use soap or other cleansers, oils, creams, lotions, or talcum powder before applying the patch
  • Do not apply the patch immediately after a hot bath or shower.

Step 2: Opening the pouch

  • Each patch is in an individual pouch
  • Tear the pouch at the notch indicated by the arrow
  • Gently, completely tear or cut off one edge of the pouch (if using scissors, cut close to the edge to avoid damaging the patch)
Hand tearing the patch pouch at the notch with an arrow indicating the direction
  • Hold both edges of the opened pouch and stretch
  • Remove the patch and apply it immediately
  • Keep the empty pouch to use later to dispose of the used patch
  • Each patch can only be used once
  • Do not remove the patch from the pouch until you are ready to apply it
  • Check that the patch is not damaged
  • Do not use patches that are cut, broken, or damaged in any way
  • Never divide or cut patches.

Step 3: Removing the backing and applying the patch to the skin

  • Make sure the clothing in the area where the patch will be applied is loose; do not wear tight, elastic bands or bandages
  • Carefully peel off half of the backing from the center of the patch. Avoid touching the adhesive side of the patch
  • Apply the adhesive side of the patch to the skin
  • Remove the other half of the backing and press the entire patch firmly onto the skin with your hand
  • Hold for at least 30 seconds. Make sure the patch is fully attached, especially at the edges.

Step 4: Removing the patch

  • Immediately after removing the patch, fold it in half, adhesive side to adhesive side
  • Put it back in the original pouch and dispose of it according to the pharmacist's instructions
  • Used patches should be kept out of sight and reach of children - even used patches still contain medicine that can be harmful to children and life-threatening.

Step 5: Washing hands

  • Always wash your hands with clean water after applying or removing a patch.

Additional information about using Durogesic

Daily activities while using patches

  • Patches are waterproof
  • You can take a shower or bath, but do not rub the patch
  • You can exercise or play sports while wearing the patch, with your doctor's permission
  • You can also swim while wearing the patch, but:
  • Do not take prolonged warming baths or use a sauna
  • Do not wear tight, elastic bands or bandages over the patch
  • While using the patch, do not heat the patch application site with external heat sources, such as heated pads, electric blankets, hot water bottles, heated beds, heat lamps, or tanning beds. Do not sunbathe or use prolonged warming baths, saunas, or whirlpool baths. In these situations, there is a risk of increased release of the medicine from the patch.

How quickly will the patch work?

  • The maximum effect of the first patch may be delayed.
  • During the initial treatment period, your doctor may prescribe additional pain relievers
  • After the initial treatment period, the patch should provide constant pain relief, so you can stop taking other pain relievers. However, your doctor may occasionally recommend additional pain relievers.

How long will you use the patches?

  • Durogesic patches are used to treat chronic pain. Your doctor will inform you about the expected duration of treatment.

If the pain worsens

  • If the pain suddenly worsens after applying the last patch, check the patch. If it is no longer attached well or has fallen off, replace it (see also the section "If the patch comes off").
  • If the pain worsens over time while using the patches, your doctor may prescribe a patch with a higher strength and (or) additional pain relievers
  • If increasing the patch strength does not improve the pain, your doctor may decide to stop using the patches.

If you use more patches than prescribed or a patch with the wrong dose

If you use too many patches or a patch with the wrong dose, remove the patches immediately and consult your doctor as soon as possible.
Overdose symptoms include breathing disorders or shallow breathing, fatigue, extreme drowsiness, inability to think clearly, difficulty walking or talking, and a feeling of fainting, dizziness, or confusion. Overdose can also cause brain disorders called toxic leukoencephalopathy.

If you forget to change the patch

  • Change the patch as soon as you remember and make a note of the day and time. The next patch should be changed normally after 3 days (72 hours).
  • If it has been longer than the scheduled patch change, consult your doctor, as additional pain relievers may be necessary, but do notapply an extra patch.

If the patch comes off

  • If the patch comes off before the scheduled change, apply a new one in its place and make a note of the day and time. Apply the patch to a different area:
  • On the upper body or arm
  • On the upper back - in children
  • Tell your doctor and leave the patch on for 3 days (72 hours)or as advised by your doctor, until the next scheduled patch change
  • If the patch comes off repeatedly, consult your doctor, pharmacist, or nurse.

Stopping patch use

  • Do not stop using this medicine suddenly. If you want to stop using this medicine, consult your doctor first. Your doctor will inform you how to do it; usually, it is done by gradually reducing the dose, so that any unpleasant withdrawal symptoms are minimized. See also section 2 "Withdrawal symptoms after stopping Durogesic use".
  • When stopping patch use, do not restart treatment without consulting your doctor. In this situation, a different dose than before may be required.

If you have any further doubts about using the medicine, consult your doctor or pharmacist.

4. Possible side effects

Like all medicines, Durogesic can cause side effects, although not everybody gets them.

If the patient, partner, or caregiver notices any of the following symptoms in the person using the patches, they should remove the patch and consult a doctor or go to the hospital immediately. Intensive medical care may be necessary.

Medical care.

  • Feeling overly sleepy, slow, or shallow breathing. Very rarely, these breathing disorders can be life-threatening or lead to death, especially in people who have not previously used strong opioid pain medications (such as Durogesic or morphine). Proceed as advised above and encourage the patient to move and talk as much as possible. (Uncommon, may affect less than 1 in 100 people)
  • Sudden swelling of the face or throat, severe irritation, redness, or blisters on the skin. These may be symptoms of a severe allergic reaction. (Frequency cannot be estimated from the available data)
  • Seizures (Uncommon, may affect less than 1 in 100 people)
  • Decreased consciousness or loss of consciousness (Uncommon, may affect less than 1 in 100 people).

Other reported side effects

Very common side effects (may affect more than 1 in 10 people):

  • nausea, vomiting, constipation
  • drowsiness
  • feeling dizzy
  • headache.

Common side effects (may affect less than 1 in 10 people):

  • allergic reaction
  • loss of appetite
  • insomnia
  • depression
  • feeling anxious or confused
  • seeing, feeling, hearing, smelling things that do not exist (hallucinations)
  • tremors or muscle spasms
  • disorders of sensation, tingling, burning skin (paresthesia)
  • dizziness
  • rapid heartbeat or palpitations
  • high blood pressure
  • shortness of breath
  • diarrhea
  • dry mouth
  • stomach pain or indigestion
  • excessive sweating
  • itching, rash, redness of the skin
  • difficulty urinating or completely emptying the bladder
  • feeling tired, weak, unwell
  • feeling cold
  • swelling of the limbs.

Uncommon side effects (may affect less than 1 in 100 people):

  • agitation or disorientation
  • unusual state of euphoria and increased activity
  • decreased sensation, especially skin (hypoesthesia)
  • memory loss
  • blurred vision
  • slow heartbeat or low blood pressure
  • low oxygen levels (hypoxia)
  • intestinal obstruction (ileus)
  • itchy rash, allergic reaction, or other skin disorders at the patch application site
  • flu-like symptoms
  • feeling changes in body temperature
  • fever
  • muscle tremors
  • erectile dysfunction or sexual function disorders
  • difficulty swallowing.

Rare side effects (may affect less than 1 in 1000 people):

  • pupil constriction
  • periodic breathing pauses (apnea)

Other reported side effects, but the frequency is unknown:

  • male sex hormone deficiency (androgen deficiency)
  • delirium (symptoms may include agitation, anxiety, disorientation, confusion, fear, seeing or hearing things that do not exist, sleep disturbances, nightmares)
  • the patient may become dependent on Durogesic (see section 2).

A rash, redness, or mild itching may occur at the patch application site on the skin. These reactions are usually mild and resolve after the patch is removed. If they do not resolve or the patch causes significant skin irritation, tell your doctor.
Repeated use of patches may lead to decreased effectiveness of the medicine (tolerance to the medicine may develop) or the patient may become dependent on it.
After switching from other pain relievers to Durogesic or suddenly stopping Durogesic use, the patient may experience withdrawal symptoms, such as nausea, vomiting, diarrhea, anxiety, and chills. Tell your doctor immediately if you experience these symptoms.
In newborns whose mothers have used Durogesic for a long time during pregnancy, cases of withdrawal symptoms have been observed.

Reporting side effects

If you experience any side effects, including any side effects not listed in this leaflet, tell your doctor, pharmacist, or nurse. Side effects can be reported directly to the Department of Medicinal Product Monitoring, Urząd Rejestracji Produktów Leczniczych, Wyrobów Medycznych i Produktów Biobójczych
Al. Jerozolimskie 181C
02-222 Warsaw
Phone: +48 22 49 21 301
Fax: +48 22 49 21 309
Website: https://smz.ezdrowie.gov.pl
Side effects can also be reported to the marketing authorization holder.
Reporting side effects will help gather more information on the safety of the medicine.

5. How to store Durogesic

Where to store the patches

Unused and used Durogesic patches should be stored in a place out of sight and reach of children.
Store in the original packaging to protect from light.
No special storage temperature instructions are provided.
The medicine should be stored in a safe and protected place, inaccessible to other people. It can cause serious harm and lead to death if used accidentally or intentionally by someone who has not been prescribed it.

How long can you store Durogesic

Do not use this medicine after the expiration date stated on the patch pouch and outer packaging after EXP. The expiration date refers to the last day of the month stated.
If the expiration date has passed, return unused patches to the pharmacy.
The medicine should be stored in sealed pouches in the original packaging, without special requirements.

How to dispose of used and unused patches

Accidental attachment of a used or unused patch to another person's skin, especially a child, can be fatal.
A used patch should be folded in half, with the adhesive sides together, placed in the original pouch, and then disposed of in a place out of sight and reach of others, especially children, until disposal. Ask your pharmacist how to dispose of medicines that are no longer needed.
Do not throw medicines down the drain or into household waste. This will help protect the environment.

6. Contents of the packaging and other information

What does Durogesic contain

  • The active substance of Durogesic is fentanyl. Durogesic, transdermal system, patch 12 μg/h contains 2.1 mg of fentanyl and releases 12 micrograms of the medicine per hour. Durogesic, transdermal system, patch 25 μg/h contains 4.2 mg of fentanyl and releases 25 micrograms of the medicine per hour. Durogesic, transdermal system, patch 50 μg/h contains 8.4 mg of fentanyl and releases 50 micrograms of the medicine per hour. Durogesic, transdermal system, patch 75 μg/h contains 12.6 mg of fentanyl and releases 75 micrograms of the medicine per hour. Durogesic, transdermal system, patch 100 μg/h contains 16.8 mg of fentanyl and releases 100 micrograms of the medicine per hour.

Other ingredients (excipients) of the patch are:

The outer layer, foil: polyester and ethylene-vinyl acetate copolymer.
The protective layer, foil: silicone-coated polyester.
The layer containing the active substance: acrylic adhesive.
Printing inks (on the outer layer):
Durogesic 12 μg/h also contains orange printing ink.
Durogesic 25 μg/h also contains red printing ink.
Durogesic 50 μg/h also contains green printing ink.
Durogesic 75 μg/h also contains blue printing ink.
Durogesic 100 μg/h also contains gray printing ink.

What Durogesic looks like and contents of the pack

Durogesic 12 μg/h
Durogesic is a semi-transparent, rectangular patch with rounded corners. Each patch has an area of 5.25 cm and has an orange border printed with "DUROGESIC 12 μg fentanyl/h".
Durogesic 25 μg/h
Durogesic is a semi-transparent, rectangular patch with rounded corners. Each patch has an area of 10.5 cm and has a red border printed with "DUROGESIC 25 μg fentanyl/h".
Durogesic 50 μg/h
Durogesic is a semi-transparent, rectangular patch with rounded corners. Each patch has an area of 21.0 cm and has a green border printed with "DUROGESIC 50 μg fentanyl/h".
Durogesic 75 μg/h
Durogesic is a semi-transparent, rectangular patch with rounded corners. Each patch has an area of 31.5 cm and has a blue border printed with "DUROGESIC 75 μg fentanyl/h".
Durogesic 100 μg/h
Durogesic is a semi-transparent, rectangular patch with rounded corners. Each patch has an area of 42.0 cm and has a gray border printed with "DUROGESIC 100 μg fentanyl/h".
The medicine is supplied in cardboard boxes containing 5 individually packaged patches in heat-sealed pouches (made of acrylonitrile or cyclic olefin copolymer).

Marketing authorization holder:

Janssen-Cilag International NV
Turnhoutseweg 30
B-2340 Beerse
Belgium

Manufacturer:

Janssen-Pharmaceutica NV
Turnhoutseweg 30
B-2340 Beerse
Belgium
To obtain more detailed information on this medicine, please contact the local representative of the marketing authorization holder:
Janssen-Cilag Polska Sp. z o.o.
phone: +48 22 237 60 00

This medicine is authorized in the Member States of the European Economic Area

Economically and in the United Kingdom (Northern Ireland) under the following names:

Austria, Belgium, Croatia, Cyprus, Czech Republic, Denmark, Finland, France, Greece, Hungary, Iceland, Italy, Luxembourg, Netherlands, Norway, Poland, Portugal, Slovenia, SwedenDurogesic
GermanyDurogesic SMAT
Ireland, United Kingdom (Northern Ireland)Durogesic DTrans
SpainDuogesic Matrix

Date of the last update of the leaflet: 10/2024

Other sources of information

Detailed information about this medicinal product is available on the website of the Office for Registration of Medicinal Products, Medical Devices and Biocidal Products www.urpl.gov.pl

Alternatives to Durogesic in other countries

The best alternatives with the same active ingredient and therapeutic effect.

Alternative to Durogesic in Spain

Dosage form: SUBLINGUAL TABLET, 800 micrograms
Active substance: fentanyl
Prescription required
Dosage form: SUBLINGUAL TABLET, 600 micrograms
Active substance: fentanyl
Prescription required
Dosage form: NASAL PRODUCT, 1 dose (100 mcl) 50 mcg of Fentanyl
Active substance: fentanyl
Prescription required
Dosage form: NASAL PRODUCT, 1 dose (100 mcl) 50 mcg of fentanyl
Active substance: fentanyl
Prescription required
Dosage form: NASAL PRODUCT, 1 dose (100 mcl) 50 mcg of Fentanyl
Active substance: fentanyl
Prescription required
Dosage form: NASAL PRODUCT, 50 µg
Active substance: fentanyl
Prescription required

Alternative to Durogesic in Ukraine

Dosage form: patch, 75 mcg/hour
Active substance: fentanyl
Manufacturer: Anssen Farmacevtika NV
Prescription required
Dosage form: patch, 50 mcg/hour
Active substance: fentanyl
Manufacturer: Anssen Farmacevtika NV
Prescription required
Dosage form: patch, 25 mcg/hour
Active substance: fentanyl
Manufacturer: Anssen Farmacevtika NV
Prescription required
Dosage form: patch, 100 mcg/hour
Active substance: fentanyl
Manufacturer: Anssen Farmacevtika NV
Prescription required
Dosage form: transdermal, 75 mcg/hour
Active substance: fentanyl
Prescription required
Dosage form: transdermal, 50 mcg/hour
Active substance: fentanyl
Prescription required

Online doctors for Durogesic

Discuss dosage, side effects, interactions, contraindications, and prescription renewal for Durogesic – subject to medical assessment and local rules.

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Andrei Popov

General medicine6 years of experience

Dr. Andrei Popov is a licensed pain management specialist and general practitioner based in Spain. He provides expert online care for adults dealing with both chronic and acute pain, as well as a wide range of everyday health concerns.

He specialises in diagnosing and treating pain conditions that affect quality of life, including:

  • Chronic pain lasting more than 3 months.
  • Migraines and recurring headaches.
  • Neck, back, lower back, and joint pain.
  • Post-traumatic pain following injury or surgery.
  • Nerve-related pain, fibromyalgia, and neuralgia.
In addition to pain management, Dr. Popov helps patients with:
  • Respiratory infections (colds, bronchitis, pneumonia).
  • High blood pressure and metabolic conditions such as diabetes.
  • Preventive care and routine health check-ups.

Online consultations last up to 30 minutes and include a detailed symptom review, personalised treatment planning, and medical follow-up when needed.

Dr. Popov’s approach is rooted in evidence-based medicine, combined with individualised care tailored to each patient’s history, lifestyle, and clinical needs.

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Abdullah Alhasan

General medicine10 years of experience

Dr. Abdullah Alhasan is a physician specialising in cardiology and general medicine, with international clinical experience and a commitment to evidence-based care. He offers online consultations for adults, focusing on both acute symptoms and long-term health management.

Main areas of consultation:

  • Chest pain, shortness of breath, heart palpitations, high blood pressure
  • Hypertension control and cardiovascular disease prevention
  • Interpretation of ECG, blood tests, and Holter monitor results
  • Management of heart failure and coronary artery disease
  • General medical issues: infections, fever, fatigue, gastrointestinal symptoms
  • Guidance on diagnostics, treatment plans, and medication adjustments
Dr. Alhasan’s approach is based on thorough assessment, clear communication, and personalised care – helping patients understand their health and make informed decisions about their treatment.
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Nuno Tavares Lopes

Family medicine17 years of experience

Dr. Nuno Tavares Lopes is a licensed physician in Portugal with 17 years of experience in emergency medicine, family and general practice, and public health. He is the Director of Medical and Public Health Services at an international healthcare network and serves as an external consultant for the WHO and ECDC. He offers online consultations in Portuguese, English, and Spanish — combining global expertise with a patient-centred, evidence-based approach.

  • Emergency care: infections, fever, chest/abdominal pain, minor injuries, paediatric emergencies
  • Family medicine: hypertension, diabetes, cholesterol, chronic disease management
  • Travel medicine: pre-travel advice, vaccinations, fit-to-fly certificates, travel-related illnesses
  • Sexual and reproductive health: PrEP, STD prevention, counselling, treatment
  • Weight management and wellness: personalised weight loss programmes, lifestyle guidance
  • Skin and ENT issues: acne, eczema, allergies, rashes, sore throat, sinusitis
  • Pain management: acute and chronic pain, post-surgical care
  • Public health: prevention, health screenings, long-term monitoring
  • Sick leave (Baixa médica) connected to Segurança Social in Portugal
  • IMT medical certificates for driving licence exchange
Dr. Lopes also provides interpretation of medical tests, follow-up care for complex patients, and multilingual support. Whether for urgent concerns or long-term care, he helps patients act with clarity and confidence.
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Duarte Meneses

Family medicine4 years of experience

Dr. Duarte Meneses is a licensed family medicine and general practice doctor based in Portugal, with additional expertise in occupational health. He provides online consultations for adults, offering medical support for both acute symptoms and chronic health conditions.

  • Common symptoms such as fever, sore throat, cough, fatigue, or digestive issues
  • Chronic conditions including hypertension, diabetes, high cholesterol, and thyroid problems
  • Mental health concerns such as stress, sleep issues, anxiety, and burnout
  • Preventive care: health check-ups, lifestyle advice, and follow-up for existing conditions
  • Work-related health questions, sick leave documentation, and medical guidance for returning to work
Dr. Meneses graduated from the University of Beira Interior and has years of experience working with diverse patient populations. He is fluent in Portuguese, English, Spanish, and French.

His approach is friendly, clear, and focused on delivering practical medical advice tailored to each patient’s needs.

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Ngozi Precious Okwuosa

General medicine5 years of experience

Dr. Ngozi Precious Okwuosa is a Primary Care Physician with over 5 years of clinical experience in Hungary, Sweden, and Nigeria. A graduate of the University of Szeged (cum laude), she offers online consultations for adults in the areas of internal medicine, women’s health, and postoperative care.

Key areas of consultation:

  • Preventive and family medicine
  • Women’s health, including gynaecology and obstetrics
  • Chronic disease management: hypertension, diabetes, and more
  • Mental health support, anxiety, and counselling
  • Postoperative care and lab test interpretation
She has conducted research on the genetic background of stroke and is skilled in communicating with patients from diverse cultural backgrounds. Her approach combines clinical expertise with empathy and clear communication.
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Iryna Reznychenko

Gynecology25 years of experience

Dr Iryna Reznychenko is an obstetrician-gynaecologist, paediatric gynaecologist, and certified lactation consultant. She provides online consultations for women at all stages of life – from adolescence to menopause. Her work combines medical care for gynaecological conditions with dedicated support for breastfeeding challenges, both physical and emotional.

Areas of expertise:

  • interpretation of test results and personalised treatment planning
  • menstrual irregularities, PCOS, endometriosis
  • abnormal uterine bleeding, endometrial hyperplasia, cervical dysplasia
  • care during perimenopause and menopause, hormonal balance, cancer prevention
  • breastfeeding issues: nipple pain, cracked skin, blocked ducts, low milk supply
  • support during the postpartum and lactation period
Dr Reznychenko offers a clear, attentive and professional approach. Her consultations help prevent minor discomforts from developing into more serious concerns – all in a convenient online format.
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Tarek Agami

General medicine10 years of experience

Dr. Tarek Agami is a general practitioner registered in both Portugal and Israel, with broad experience in family and preventive medicine. He offers online consultations for adults and children, providing personalised support for primary care needs, chronic disease management, and everyday health concerns.

Dr. Agami received clinical training and worked in leading medical institutions in Israel (Kaplan Medical Center, Barzilai Medical Center, Wolfson Medical Center) and Portugal (European Healthcare City, Viscura Internacional, Hospital Dr. José Maria Grande, Hospital Vila Franca de Xira). His approach combines international medical standards with individualised attention to each patient.

Main areas of consultation:

  • Diagnosis and treatment of acute and chronic conditions (high blood pressure, diabetes, respiratory infections, cardiovascular symptoms)
  • Evaluation of symptoms and guidance on further diagnostic testing
  • Preventive check-ups and regular health monitoring
  • Medical support during travel or after relocation
  • Treatment adjustments and lifestyle recommendations based on your personal history
Dr. Agami provides medical support for patients using GLP-1 medications (such as Ozempic or Mounjaro) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Portugal and Israel.

Dr. Agami is committed to evidence-based, patient-centred care, ensuring that each person receives trusted medical support tailored to their health goals.

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Roman Raevskii

General medicine6 years of experience

Dr. Roman Raevskii is a licensed general practitioner in Spain, offering online medical consultations with a strong focus on prevention, early diagnosis, and personalized care. He combines evidence-based clinical expertise with a patient-centered approach to deliver comprehensive support.

Dr. Raevskii provides medical care in the following areas:

  • Diagnosis and management of common conditions: hypertension, diabetes, respiratory and digestive disorders.
  • Oncological consultations: early cancer detection, risk evaluation, and treatment navigation.
  • Supportive care for oncology patients – pain control, symptom relief, and side effect management.
  • Preventive medicine and health screenings.
  • Development of tailored treatment plans based on clinical guidelines.

With a patient-centred approach, Dr. Raevskii helps individuals manage both chronic illnesses and complex oncological cases. His consultations are guided by current medical standards and adapted to each patient’s needs.

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Svetlana Kovalenko

Family medicine14 years of experience

Dr Svetlana Kovalenko is a family medicine doctor with over 14 years of experience and a medical degree from Kharkiv National Medical University. She offers online consultations for adults, supporting patients with both acute and chronic conditions, preventive care, and personalised medical advice.

What patients commonly consult her for:

  • High blood pressure, type 2 diabetes, cholesterol management
  • Cold and flu symptoms: fever, cough, sore throat
  • Fatigue, sleep problems, headaches, general discomfort
  • Ongoing care for chronic conditions and medication review
  • Help interpreting test results and lab reports
  • Preventive check-ups and advice on healthy lifestyle habits

Dr Kovalenko combines evidence-based practice with a respectful, patient-centred approach. She takes time to explain, listens attentively, and helps each person make confident, informed decisions about their health.

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€55
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Doctor

Sergio Correa

General medicine7 years of experience

Dr. Sergio Correa is a licensed general practitioner, aesthetic medicine specialist, and trichologist with experience in emergency care and preventive health. He offers online consultations in English and Spanish, supporting adult patients with a wide range of medical concerns – from acute symptoms to chronic condition management.

His areas of focus include:

  • General and urgent care: fever, fatigue, infections, digestive issues, respiratory symptoms, and other common concerns
  • Chronic condition support: hypertension, high cholesterol, diabetes, thyroid issues
  • Aesthetic medicine and dermatology: acne, skin ageing, hyperpigmentation, personalised skincare guidance
  • Trichology: hair loss, scalp conditions, treatment strategies for men and women
  • Preventive care: health check-ups, lifestyle advice, second opinions

Dr. Correa combines medical knowledge with an aesthetic and holistic approach to help patients improve both health and quality of life.

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€40
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