1\. Skin Areas Where the Fentanyl Transdermal System May Be Applied:

For adults:

  * Put the patch on the chest, back, flank (sides of the waist), or upper arm in a place where there is no hair (see Figures 1-4).



For children (and adults with mental impairment):

  * Put the patch on the upper back (see Figure 2). This will lower the chances that the child will remove the patch and put it in their mouth.



For adults and children

  * Do not put a fentanyl transdermal system on skin that is very oily, burned, broken out, cut, irritated, or damaged in any way.
  * Avoid sensitive areas or those that move around a lot. If there is hair, do not shave (shaving irritates the skin). Instead, clip hair as close to the skin as possible (see Figure 5).



  * Talk to your doctor if you have questions about skin application sites.



2\. Prepare to Apply a Fentanyl Transdermal System:

  * Choose the time of day that is best for you to apply fentanyl transdermal system. Change it at about the same time of day (3 days or 72 hours after you apply the patch) or as directed by your doctor.
  * Do not wear more than one fentanyl transdermal system at a time unless your doctor tells you to do so. Before putting on a new fentanyl transdermal system, remove the patch you have been wearing.
  * Clean the skin area with clear water only. Pat skin completely dry.  Do not use anything on the skin such as soaps, lotions, oils, or alcohol before the patch is applied.



3\. Open the Pouch: Fold and tear at slit, or cut at slit taking care so as not to cut the patch, and remove the fentanyl transdermal system. Each fentanyl transdermal system is sealed in its own protective pouch. Do not remove the fentanyl transdermal system from the pouch until you are ready to use it (see Figure 6).

4\. Peel: Peel off the protective liner from the patch. Each fentanyl transdermal system has a clear plastic backing that can be peeled off. This covers the sticky side of the patch. Carefully peel this backing off. Throw the clear plastic backing away. Touch the sticky side of a fentanyl transdermal system as little as possible (see Figure 7).

5\. Press: Press the patch onto the chosen skin site with the palm of your hand and hold there for at least 30 seconds (see Figure 8). Make sure it sticks well, especially at the edges.

  * Fentanyl transdermal system may not stick to all patients. You need to check the patches often to make sure that they are sticking well to the skin.
  * If the patch falls off right away after applying, throw it away and put a new one on at a different skin site (see “Disposing a Fentanyl Transdermal System”).
  * If you have a problem with the patch not sticking
    * Apply first aid tape only to the edges of the patch.
    * If you continue to have problems with the patch sticking, you may cover the patch with Bioclusive™. This is a special see-through adhesive dressing. Never cover a fentanyl transdermal system with any other bandage or tape. Remove the backing from the Bioclusive™ dressing and place it carefully over the fentanyl transdermal system, smoothing it over the patch and your skin.
  * If your patch falls off later, but before 3 days (72 hours) of use, discard it properly (see “Disposing a Fentanyl Transdermal System”) and put a new one on at a different skin site. Be sure to let your doctor know that this has happened, and do not replace the new patch until 3 days (72 hours) after you put it on (or as directed by your doctor).



6\. Wash your hands when you have finished applying a fentanyl transdermal system.

7\. Remove a fentanyl transdermal system after wearing it for 3 days (72 hours) (see “Disposing a Fentanyl Transdermal System”). Choose a different place on the skin to apply a new fentanyl transdermal system and repeat Steps 2 through 6. Do not apply the new patch to the same place as the last one.