Fentanyl patch dosing determination based on current narcotic analgesic therapy. Developed by D.McAuley

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Fentanyl Patch dosage determination based on current therapy

Based roughly on the table below this calculator. This document Copyright Š 2005 D.McAuley, GlobalRPh Inc. All Rights Reserved.
	Enter total daily dosage: mg

The 50, 75, and 100 mcg/hr patches should only be used in patients already on and tolerant to opioid therapy. This calculator, which is based roughly on information provided by ŠJanssen Pharmaceuticals Inc., computes a conservative estimate of the equivalent fentanyl patch based on the patient's current opioid therapy. According to the manufacturer, 50% of the patients in clinical trials required a dose increase after initial application using a similar computation. All patients should also be prescribed a short-acting narcotic for breakthrough pain.

All calculations must be confirmed before use. The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgement. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.

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Source:

Ortho-McNeil, Inc. 2006-2008. All rights reserved.
Manufactured by: ALZA Corporation Mountain View, CA 94043 Distributed by: Janssen, L.P.Titusville, NJ 08560 [Add new code post-approval] Revised February 2008
ŠJanssen 2008. http://www.duragesic.com/

How to use this chart: First determine the patient's previous 24 hour regimen for any of the agents listed below. All dosages in the same row are therapeutically equivalent. Example: Patient is receiving Oxycodone 5-10mg po q4h = 30-60 mg/day . Using the table below, the equivalent dose of Fentanyl patch would be 25 mcg.
NOTE: DO NOT use this table to convert to other opiates.
Codeine		Fentanyl Patch	Hydromorphone		Meperidine		Methadone		Morphine		Oxycodone
Oral	IV	(Patch)	Oral	IV	Oral	IV	Oral	IV	Oral	IV	Oral	IV
150-447	104-286	25 mcg	5.6-17	1.2-3.4	-	60-165	15-44	8-22	45-134	8-22	22.5-67	12-33
448-747	287-481	50 mcg	17.1-28	3.5-5.6	-	166-278	45-74	23-37	135-224	23-37	67.5-112	33.1-56
748-1047	482-676	75 mcg	28.1-39	5.7-7.9	-	279-390	75-104	38-52	225-314	38-52	112.5-157	56.1-78
1048-1347	677-871	100 mcg	39.1-51	8-10	-	391-503	105-134	53-67	315-404	53-67	157.5-202	78.1-101
1348-1647	872-1066	125 mcg	51.1-62	10.1-12	-	504-615	135-164	68-82	405-494	68-82	202.5-247	101.1-123
1648-1947	1067-1261	150 mcg	62.1-73	12.1-15	-	616-728	165-194	83-97	495-584	83-97	247.5-292	123.1-147
1948-2247	1262-1456	175 mcg	73.1-84	15.1-17	-	729-840	195-224	98-112	585-674	98-112	292.5-337	147.1-168
2248-2547	1457-1651	200 mcg	84.1-96	17.1-19	-	841-953	225-254	113-127	675-764	113-127	337.5-382	168.1-191
2548-2847	1652-1846	225 mcg	96.1-107	19.1-21	-	954-1065	255-284	128-142	765-854	128-142	382.5-427	191.1-213
2848-3147	1847-2041	250 mcg	107.1-118	21.1-24	-	1066-1178	285-314	143-157	855-944	143-157	427.5-472	213.1-236
3148-3447	2042-2236	275 mcg	118.1-129	24.1-26	-	1179-1290	315-344	158-172	945-1034	158-172	472.5-517	236.1-258
3448-3747	2237-2431	300 mcg	129.1-141	26.1-28	-	1291-1403	345-374	173-187	1035-1124	173-187	517.5-562	258.1-281