To prevent overdose it is recommended that opioid-naïve patients receive low doses of immediate-release opioids (e.g.
Alternative routes of administration (oral, parenteral) should be considered. Generally, the transdermal route is not recommended in opioid-naïve patients. The dosage may subsequently be titrated upwards or downwards, if required, in increments of either 12 or 25 mcg/h to achieve the lowest appropriate dosage of Matrifen depending on response and supplementary analgesic requirements. To convert opioid-tolerant patients from oral or parenteral opioids to Matrifen refer to Equianalgesic potency conversion below. Other factors to be considered are the current general condition and medical status of the patient, including body size, age, and extent of debilitation as well as degree of opioid tolerance. It is recommended that Matrifen be used in patients who have demonstrated opioid tolerance. The appropriate initiating dose of Matrifen should be based on the patient's current opioid use.
The patches are designed to deliver approximately 12, 25, 50, 75, and 100 mcg/h fentanyl to the systemic circulation, which represent about 0.3, 0.6, 1.2, 1.8, and 2.4 mg per day respectively. The lowest effective dose should be used.
Matrifen doses should be individualised based upon the status of the patient and should be assessed at regular intervals after application.
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