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What Causes Vomiting After Using Fentanyl Patches?

Posted on Tue, 27 Dec 2016

Question: My 68 year old wife was prescribed Fentanyl for a very painful back nerve issue. She whore the patch for 2 days and began vomiting frequently (a side affect), up to 6 times a day, lost what little appetite she had, as the pain has been plaguing her since early XXXXXXX Tuesday she removed the patch but the vomiting has continued along with extreme sleepiness, an accelerated heart rate with including breathing issues. She has lost 10 lbs in a week, 81 now. At the end of May, she weighed about 105 lbs. Today, she has only vomited 2 times but has slept most of the day. Is this an urgent care or emergency room issue? We haven't been able to get an answer from the nurse practiioner under the doctor who prescribed the patch. She also has been taking 5-325 mg Percocet tab and 100 mg Gabapentin cap. Suggestions?

Answered by Dr. Dr.Arnab (33 minutes later)

Brief Answer:
she needs immediate medical attention, please take her to your nearest ER..

Detailed Answer:
Hello XXXX, Welcome to HCM,
I've gone through your query and understand your concern for your wife,

First of all, I do appreciate your precise observation, good that the patch already removed..

Now nausea, vomiting is a well known adverse effect of any opioids (Fentanyl no different in this regard), however due to excessive vomiting, there's increasing fluid loss in the body thus,causing a hypovolumic state and opioids and analgesics tend to get accumulated in the body..

Respiratory depression is a well known side effect and complication of narcotics like Fentanyl and it comes with statutory warning on the medication level itself..

You shouldn't delay anymore and please don't panic, but take her to your nearest ER/Urgent care for a prompt evaluation, intravenous fluid therapy and few urgent investigations (arterial blood gas analysis, chest X-ray, electrolytes and liver, Renal function assay), along with continuous ambulatory monitoring and breathing supports if needed..

Please keep her head end propped up as much as possible, don't try to give anything per-orally as due to breathing difficulty and improper breathing efforts foods/drinks can easily get aspirated in to the respiratory tract, causing further complication..

My best wishes..

Do let me know how she stays in the due course....

Take Care
Kind Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Dr.Arnab (2 hours later)

Thank you Dr. Banerjee, I appreciate the quick response and advice!
XXXXXXX XXXX

Answered by Dr. Dr.Arnab (15 minutes later)

Brief Answer:
You're always welcome to have my suggestions..

Detailed Answer:
Hello Mr XXXXXXX

Your most welcome

Wish her the best of health..

Take Care
Kind Regards

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

Above answer was peer-reviewed by : Dr. Arnab Banerjee