Title: Recommendations

Context:
Although some patients may prefer either transdermal or buccal opioid delivery for opioids, there is  significant potential for harm from OT with these delivery mechanisms, with no evidence of benefit over  traditional opioid delivery systems in patients with chronic pain. Clinicians need to be especially aware of  the risks associated with a fentanyl transdermal delivery system (or patch) (Appendix D) including its: Unique pharmacokinetic profile, Continuous delivery, even after the patch is removed due to depot effect, Increased rate of delivery, Unpredictable variation in rate of delivery  - Due to alterations in temperature due to external heat, skin integrity, and amount of  adipose tissue, Among patients with fever, skin damage, or cachexia.

Question: What are the risks associated with a fentanyl transdermal delivery system (or patch)?

Answer: Unique pharmacokinetic profile, Continuous delivery, even after the patch is removed due to depot effect, Increased rate of delivery, Unpredictable variation in rate of delivery  - Due to alterations in temperature due to external heat, skin integrity, and amount of  adipose tissue, Among patients with fever, skin damage, or cachexia