Palliative Care Guidelines - NHS Lanarkshire

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Palliative Care Guidelines: Patient information leafletQ. What should I do if I still get pain while using fentanyl?A. When you first start fentanyl or the dose is increased it takes time to work. Yourdoctor will give you extra pain killers to take if you need them until your patch isworking. Some people find that doing certain things like having a bath or going for awalk brings on pain. Your doctor or nurse may suggest you take a quick acting painkiller before you start doing something that brings on pain.If your pain is not well controlled and you need to take more than 2-3 doses of extrapain killer a day, tell your doctor or nurse.Q. How will I know if fentanyl is not going to work for some of my pain?A. Although fentanyl is a very good pain killer, it does not help all types of pain. You maystill have pain despite using bigger doses of fentanyl and may feel unwell if the dose istoo high. The answer below tells you what signs to look for.Tell your doctor or nurse if this happens. Your doctor may need to reduce your doseof fentanyl and suggest other treatments to help the pain.Q. Are there any side effects from using fentanyl?A. Fentanyl is a safe and effective pain killer but can have side effects. It is important toknow when the dose might be too high.• Too high a dose of fentanyl:Contact your doctor or nurse if you:• are more sleepy than usual• become muddled or confused• have more difficulty walking or talking than usualContact a doctor urgently if the patient has:• shallow breathing• marked sleepiness• a slow pulse or cold clammy skin• Heat effects:Heat speeds up the way the fentanyl is released from the patch.• Avoid direct heat on the patch like a hot water bottle, electric blanket, heat pad, orheat lamp.• Do not soak in a hot bath or sunbathe while using fentanyl patches• If you develop a fever, try to keep your temperature down and contact your doctorif your temperature is 39° or higher.• Changing from another pain killer:A few people who change from another pain killer to fentanyl feel unwell in the first 24-48 hours with sickness, shivering, stomach pains or diarrhoea. Contact your doctor ifthis happens.• Constipation:Fentanyl tends to cause less constipation than some other strong pain killers but youmay still need to take a laxative regularly.2 Issue date: January 2009 Review date: March 2012 © NHS Lothian
Palliative Care Guidelines: Patient information leaflet• Skin/rash irritation:If you develop itching or redness under the patch, tell your doctor or nurse.• Patch falls off frequently:Sweating or applying the patch to hairy skin may prevent it sticking well. Your nursecan give you some sticky tape or a dressing to keep the patch on.Clipping or shaving excess hair may be needed in some people – do not use shavingfoam, gel or soap as they affect the way the medicine goes into the skin.Q. Can I drive?A. You may be able to drive but you must discuss this with your doctor.(Patient information leaflet: Strong pain killers and driving).Q. Can I drink alcohol?A. A small glass of wine, beer, sherry or whisky may help you feel better and improveyour appetite. It is best to avoid taking more than this as you may become toodrowsy.(Discuss this leaflet with your doctor or nurse who will answer any questions you may have)© NHS Lothian Issue date: January 2009 Review date: March 20123
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Palliative Care Guidelines - NHS Lanarkshire

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