Strong opioid patches for pain relief

This page explains what strong opioid patches are and how they help to relieve pain. You may be experiencing pain because of your illness or the treatment you are having.

What are strong opioid patches?

Strong opioid patches deliver a continuous level of pain relief over three or seven days, depending on the patch. They come in different types and strengths. It can sometimes take a while to find the right type or dose for you.

Your doctor or nurse might prescribe you a strong opioid patch if you have difficulties swallowing or taking tablets or capsules.

When you first start to use a patch, it can take up to 24 hours to reach an effective level of pain relief. For this reason you may need to take some short-acting morphine during that time.

How to use a strong opioid patch

• Patches need changing every three or seven days, depending on the type of patch you have. They also need changing at the same time of the day. It’s a good idea to write the date and time on the patch to help you remember when it needs to be changed.
• Choose an area on your upper arm or upper body where the skin is clean, dry, cool,
• healthy and hair-free. You’ll need to pick a new area each time you change your patch because it can irritate the skin.
• Patches look like a waterproof plaster. Peel off the plastic backing and place firmly onto your skin.
• Take off the old patch before putting on the new one. Fold it in half before throwing it away.
• If you have two patches, make sure you change both at the same time.
• Don’t cut or divide the patch.
• Don’t put a patch on immediately after a bath or shower. Allow the skin to cool first.
• Don’t apply heat to the patch (for example a hot water bottle).
• If you forget to change your patch on time, do it as soon as you remember.
• If your patch falls off, start a new one as soon as possible.

Please note:

• Addiction to opioid medicines is very unlikely if you take them as advised.
• Being prescribed an opioid medicine does not necessarily mean you are reaching
• the end of your life.
• Being prescribed an opioid medicine now does not mean you won’t be prescribed
• additional pain medication if your pain gets worse in the future.

Types of strong opioid patches

There are two types of patches that are commonly prescribed:

Fentanyl. Fentanyl patch comes in different strengths and delivers a continuous level of pain relief over three days.

Buprenorphine. Buprenorphine is usually called a BuTrans or Transtec patch and comes in different strengths. The patches will need changing every three or seven days, depending on which one you are using.

You might still experience breakthrough pain even if you are wearing an opioid patch. If that happens, you will need a short-acting opioid to help with this.

If you are experiencing breakthrough pain more than three times per day, let your doctor or nurse know. This is because you may need to increase the dose of your opioid(s).

Side effects of opioids

• Opioids can cause constipation so drink plenty of water and include lots of fruit, vegetables and fibre in your diet. If needed, your doctor or nurse may suggest a laxative.
• Opioids can also make you feel drowsy. This can happen when you first start taking them and often wears off after a few days. If you are still feeling drowsy after a few days, let your doctor or nurse know.
• You may also feel drowsy if the dose is too high.
• Opioids can make you feel sick or nauseous. This often settles down after a few days, but your doctor or nurse may prescribe you an anti-sickness tablet to help relieve this.
• Patches can sometimes cause skin to become red, itchy or sore. Tell your doctor or nurse if you experience this.

Please seek advice from your doctor or nurse if you drive or drink alcohol and are
taking an opioid medicine.

If you have any questions about the medicine(s) you have been prescribed, or if you think your medicines are not helping, please talk to your doctor or nurse, or contact the Enhanced Supportive Care team.

Macmillan Support and Information Service

The Macmillan Support and Information Service is located on the ground floor of the University College Hospital Macmillan Cancer Centre. The support and information specialists based in the service provide emotional support, practical advice and information to anyone affected by cancer or a blood condition. They can see patients, their families and friends at any stage of their care. You don’t need an appointment to visit the Macmillan Support and Information Service. The team will see you as quickly as possible.

Tel: 020 3447 8663

Email: uclh.supportandinformation@nhs.net

Contact us

Enhanced Supportive Care team

Tel: 020 3447 3412

Email: ESC.UCLH@nhs.net