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Is It Safe To Increase The Dose Of Fentanyl 50 Mg To 75mg?

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Posted on Tue, 26 Mar 2013
Question: My fentanyl 50 mg patch quits after 48 hours.My Dr. wants to up dosage to 75mg.How will that solve the patch quitting early? She also did not what the up the dosage of BT meds..to help me the last 24 hours.I did not like the answer of increasing the dosage to solve the time problem so I did nothing
doctor
Answered by Dr. dr. Jawahar Ticku (1 hour later)
Dear XXXXXXX,

Your doctor is increasing the dose because the original 50 mg lasts for only 48 hrs. Increasing the dose to 75 mg will give initial higher analgesia and after the expiry of 48 hrs analgesia will persist but with lower intensity as you would get during first 48 hrs with 50 mg dosage. Normally the effect lasts for 72 hrs but in your case, pain intensity must be higher so 50 mg dosage must be giving just tolerable analgesia which also fades after 48 hrs. In my opinion you should give a trial to 75 mg. fentanyl and if it doesn't help additional additive therapy in consultation with your doctor can be thought of.

Hope I have addressed your concern. Let me know if I can assist you further.

Truly,
Dr. J. Ticku,
Oncologist

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. dr. Jawahar Ticku (7 hours later)
At the 50 mg level I am tolerating the side effects(slight itching and mild nausea) and have two good days without BT meds.I really hate to upset that by putting more narcotics into my system. With the increased dosage will the itching and nausea feeling increase? If so how can I reduce those symptoms.
doctor
Answered by Dr. dr. Jawahar Ticku (2 hours later)
Dear,

If the pain is of low intenssity and you feel better without it, then it is better to avoid this narcotic. If the intensity of pain is high then you better give it a trial.

It is possible that the side effects may be same as with 50mg dosage.

Why have unnecessary medication if they can be avoided. Take medicines only when it is a must.

Truly,
Dr. Ticku
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. dr. Jawahar Ticku (2 hours later)
How do you feel about changing the 50mg fentanyl patch every 48 hours to help with the last day of pain.If you do approve of changing every 48hours ,which method do you prefer best ,increasing the dosage or changing @ 48 hour interval and WHY.
doctor
Answered by Dr. dr. Jawahar Ticku (8 hours later)
Hi,

Thanks again.

The use of fentanyl patches - dose and frequency is guided by patients need and tolerance limit. Accordingly we could either use 75 mg every 72 hours or 50 mg every 48 hours - the total dosage remains the same at the end of time.

Therefore there is no harm if you change it every 48 hrs.

Truly,
Dr. J. Ticku
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
Dr.
Dr. dr. Jawahar Ticku

Oncologist

Practicing since :1979

Answered : 490 Questions

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Is It Safe To Increase The Dose Of Fentanyl 50 Mg To 75mg?

Dear XXXXXXX,

Your doctor is increasing the dose because the original 50 mg lasts for only 48 hrs. Increasing the dose to 75 mg will give initial higher analgesia and after the expiry of 48 hrs analgesia will persist but with lower intensity as you would get during first 48 hrs with 50 mg dosage. Normally the effect lasts for 72 hrs but in your case, pain intensity must be higher so 50 mg dosage must be giving just tolerable analgesia which also fades after 48 hrs. In my opinion you should give a trial to 75 mg. fentanyl and if it doesn't help additional additive therapy in consultation with your doctor can be thought of.

Hope I have addressed your concern. Let me know if I can assist you further.

Truly,
Dr. J. Ticku,
Oncologist