Direct rotation from a fentanyl patch to a buprenorphine patch in a patient with chronic pain
DOI:
https://doi.org/10.5055/jom.0865Keywords:
fentanyl, buprenorphine, opioid rotation, chronic painAbstract
Transitioning a patient with chronic pain from a fentanyl patch to a buprenorphine patch has not been well described in the literature. Even after a patient removes their fentanyl patch, the residual fentanyl in the skin continues to be absorbed for hours. Due to the risk of precipitated withdrawal when initiating buprenorphine, this transition is a more challenging opioid rotation to plan safely. We report a case of a patient who had been using a fentanyl patch for over 10 years and was successfully rotated directly to a buprenorphine patch.
References
Health Canada: An action plan for pain in Canada. 2021. Available at https://www.canada.ca/content/dam/hc-sc/documents/corporate/about-health-Canada/public-engagement/external-advisory-bodies/canadian-pain-task-force/report-2021-rapport/report-rapport-2021-eng.pdf. Accessed August 1, 2023.
HQO Quality Standards: Chronic pain: Care for adults, adolescents, and children. Available at https://www.hqontario.ca/Portals/0/documents/evidence/quality-standards/qs-chronicpain-quality-standard-en.pdf. Accessed August 1, 2023.
Murphy L, Babaei-Rad R, Buna D, et al.: Guidance on opioid tapering in the context of chronic pain: Evidence, practical advice and frequently asked questions. Can Pharm J. 2018; 151(2): 114-120. DOI: https://doi.org/10.1177/1715163518754918
Chen KY, Chen L, Mao J: Buprenorphine-naloxone therapy in pain management. Anesthesiology. 2014; 120(5): 1262-1274. DOI: https://doi.org/10.1097/ALN.0000000000000170
Jorgenson D, Halpape K: Evaluation of a pharmacist-led interprofessional chronic pain clinic in Canada. Can Pharm J. 2023; 156(5). DOI: 10.1177/17151635231188334. DOI: https://doi.org/10.1177/17151635231188334
Steenhof N, Flannery J, Lee J: Acute pain management for a patient with chronic pain stabilized on buprenorphine-naloxone. NP Curr. 2022; 3: 21-22.
Lee J, Steenhof N: The development of a buprenorphine/ naloxone induction clinic in a tertiary pain clinic. In Canadian Pain Society's 39th Annual Scientific Meeting, Montreal, QC, Canada. 2018.
Center for Effective Practice: Opioid manager, Toronto. 2017. Available at http://cep.health/clinical-products/opioidmanager/. Accessed August 1, 2023.
Chen L, Vo T, Seefeld L, et al.: Lack of correlation between opioid dose adjustment and pain score change in a group of chronic pain patients. J Pain. 2013; 14(4): 384-392. DOI: https://doi.org/10.1016/j.jpain.2012.12.012
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