Durogesic DTrans 50 micrograms/hour Transdermal Patch
*Company:
Janssen Sciences IrelandStatus:
No Recent UpdateLegal Category:
Product subject to medical prescription which may not be renewed (A)Active Ingredient(s):
*Additional information is available within the SPC or upon request to the company
Updated on 27 September 2023
File name
Durogesic DTrans 50 mcg_hr-SmPC Ireland-23-Aug-2023-clean_EDMS-RIM-960525_4.0.pdf
Reasons for updating
- Change to section 4.2 - Posology and method of administration
- Change to section 4.4 - Special warnings and precautions for use
- Change to section 4.8 - Undesirable effects
- Change to section 4.9 - Overdose
Legal category:Product subject to medical prescription which may not be renewed (A)
Free text change information supplied by the pharmaceutical company
Changes to sections 4.2, 4.4, 4.8 and 4.9
Updated on 27 September 2023
File name
Durogesic DTrans 12,25,50,75,100 mcg_hr-PIL Ireland-August 2023-clean_EDMS-RIM-960528_4.0.pdf
Reasons for updating
- Change to section 2 - what you need to know - warnings and precautions
- Change to section 3 - how to take/use
- Change to section 4 - possible side effects
Free text change information supplied by the pharmaceutical company
Changes to sections 2, 3 and 4 corresponding to SmPC changes
Updated on 09 May 2022
File name
PI-Durogesic DTrans 50 mcg_hr-Ireland-EN-IA 015-PSUSA 00001370202104 outcome.pdf
Reasons for updating
- Change to section 4.5 - Interaction with other medicinal products and other forms of interaction
Legal category:Product subject to medical prescription which may not be renewed (A)
Free text change information supplied by the pharmaceutical company
- SmPC section 4.5 Interaction with other medicinal products and other forms of interaction and corresponding PIL section, to add additive effect of gabapentinoids on CNS depression
Please note there will be no update to the CCDS in relation to this, since gabapentinoids are already covered by the drug interaction for CNS depressants and therefore would only be another example of a CNS depressant and not a separate drug interaction in the table. The drug interaction table is not meant to be an exhaustive list of CNS depressants, as such it isn’t necessary to update the CCDS with another example of CNS depressants.
Updated on 09 May 2022
File name
PIL-Durogesic DTrans 12,25,50,75,100 mcg_hr-Ireland-EN-IA 015-PSUSA 00001370202104 outcome.pdf
Reasons for updating
- Change to section 3 - how to take/use
- Change to section 6 - date of revision
Free text change information supplied by the pharmaceutical company
- PIL section 3.0 How to use DUROGESIC to add information about lack of efficacy if patch falls off
Please note there will be no update to the CCDS in relation to this, since gabapentinoids are already covered by the drug interaction for CNS depressants and therefore would only be another example of a CNS depressant and not a separate drug interaction in the table. The drug interaction table is not meant to be an exhaustive list of CNS depressants, as such it isn’t necessary to update the CCDS with another example of CNS depressants.
Updated on 16 August 2021
File name
PI-Durogesic Dtrans 50 mcg hr TDP-IE-EN-IA 013.pdf
Reasons for updating
- Change to section 6.5 - Nature and contents of container
- Change to section 10 - Date of revision of the text
- Correction of spelling/typing errors
Legal category:Product subject to medical prescription which may not be renewed (A)
Free text change information supplied by the pharmaceutical company
Changes to sections:
- 6.5 - Nature and contents of container
- 10 - Date of revision of the text
Updated on 16 August 2021
File name
PIL-Durogesic Dtrans 12,25,50,75,100 mcg hr TDP-IE-EN-IA 013.pdf
Reasons for updating
- Change to section 6 - what the product looks like and pack contents
- Change to section 6 - date of revision
- Correction of spelling/typing errors
Free text change information supplied by the pharmaceutical company
The following changes to section 6 were made:
- What the product looks like and pack contents - "The patches come in individually wrapped heat-sealed (acrylonitrile film or cyclic olefin copolymer) pouches, and come in cartons containing 3, 4, 5, 8, 10, 16, 20 or 30 patches."
- Last date of revision of the text
Updated on 26 May 2021
File name
PIL-Durogesic Dtrans-12,25,50,75,100 mcg hr TDP-IE-EN-II 011_II 012-clean.pdf
Reasons for updating
- Change to section 2 - what you need to know - contraindications
- Change to section 2 - what you need to know - warnings and precautions
- Change to section 2 - pregnancy, breast feeding and fertility
- Change to section 4 - how to report a side effect
- Correction of spelling/typing errors
Updated on 26 May 2021
File name
PI-Durogesic Dtrans-50 mcg hr TDP-IE-EN-II 011_II 012_EDMS-RIM-372556_4.0.pdf
Reasons for updating
- Change to section 4.2 - Posology and method of administration
- Change to section 4.4 - Special warnings and precautions for use
- Change to Section 4.8 – Undesirable effects - how to report a side effect
Legal category:Product subject to medical prescription which may not be renewed (A)
Updated on 20 January 2021
File name
PIL-Durogesic DTrans-12,25,50,75,100mcghr-TDP-Ireland-English-NLH3915001-005II007G-clean.pdf
Reasons for updating
- Change to section 2 - what you need to know - warnings and precautions
- Change to section 4 - possible side effects
Updated on 20 January 2021
File name
PI-Durogesic DTrans-50mcghr-TDP-Ireland-English-NLH3915001-005II007G-clean.pdf
Reasons for updating
- Change to section 4.4 - Special warnings and precautions for use
- Change to section 4.5 - Interaction with other medicinal products and other forms of interaction
Legal category:Product subject to medical prescription which may not be renewed (A)
Updated on 04 October 2019
File name
IE_Durogesic DTrans PIL Clean.pdf
Reasons for updating
- Change to section 4 - possible side effects
- Change to section 6 - what the product looks like and pack contents
- Change to section 6 - date of revision
Updated on 04 October 2019
File name
Durogesic-DTrans SPC_50-27-Sep-19 Clean.pdf
Reasons for updating
- Change to section 4.8 - Undesirable effects
- Change to section 6.5 - Nature and contents of container
- Change to section 10 - Date of revision of the text
Legal category:Product subject to medical prescription which may not be renewed (A)
Updated on 30 August 2019
File name
IRE_Durogesic DTrans PIL clean.pdf
Reasons for updating
- Change to section 5 - how to store or dispose
- Change to section 6 - what the product contains
- Change to section 6 - what the product looks like and pack contents
- Change to section 6 - date of revision
Updated on 30 August 2019
File name
Durogesic-DTrans SPC_50-clean.pdf
Reasons for updating
- Change to section 1 - Name of medicinal product
- Change to section 2 - Qualitative and quantitative composition
- Change to section 3 - Pharmaceutical form
- Change to section 6.1 - List of excipients
- Change to section 6.2 - Incompatibilities
- Change to section 6.4 - Special precautions for storage
- Change to section 6.5 - Nature and contents of container
- Change to section 10 - Date of revision of the text
Legal category:Product subject to medical prescription which may not be renewed (A)
Updated on 08 April 2019
File name
IRE_Durogesic DTrans PIL C20_clean.pdf
Reasons for updating
- Change to section 6 - marketing authorisation holder
- Change to section 6 - date of revision
Updated on 08 April 2019
File name
Durogesic-DTrans SPC_50-C22_clean.pdf
Reasons for updating
- Change to section 7 - Marketing authorisation holder
- Change to section 10 - Date of revision of the text
Legal category:Product subject to medical prescription which may not be renewed (A)
Updated on 11 June 2018
File name
Durogesic-DTrans SPC_50-C21_Clean.docx
Reasons for updating
- Change to section 4.4 - Special warnings and precautions for use
- Change to section 4.5 - Interaction with other medicinal products and other forms of interaction
- Change to section 10 - Date of revision of the text
Legal category:Product subject to medical prescription which may not be renewed (A)
Free text change information supplied by the pharmaceutical company
4.4 Special warnings and precautions for use
Respiratory depression
Some patients may experience significant respiratory depression with Durogesic DTrans; patients must be observed for these effects. Respiratory depression may persist beyond the removal of the Durogesic DTrans patch. The incidence of respiratory depression increases as the Durogesic DTrans dose is increased (see section 4.9). Central nervous system depressants may increase the respiratory depression (see section 4.5).
Central Nervous System (CNS) Depressants, including Alcohol and CNS Depressant Narcotic Drugs
Concomitant use of Durogesic DTrans with CNS depressants, including alcohol and CNS depressant narcotic drugs, may increase the undesirable effects of Durogesic DTrans; concomitant use should be avoided (see section 4.5). If concomitant use of Durogesic DTrans with a CNS depressant is clinically necessary, prescribe the lowest effective dosages and minimum duration for both drugs, and follow patients closely for signs of respiratory depression and sedation.
4.5 Interaction with other medicinal products and other forms of interaction
Pharmacodynamic-related interactions
Centrally-acting medicinal products/Central Nervous System (CNS) depressants, includingand alcohol and CNS depressant narcotic drugs
The concomitant use of Durogesic DTrans with other central nervous system depressants (including benzodiazepines and other sedatives/ hypnotics, opioids, sedatives, hypnotics, general anaesthetics, phenothiazines, tranquilisers, sedating antihistamines, and alcoholic beverages and CNS depressant narcotic drugs) and skeletal muscle relaxants may produce additive disproportionately increase the CNS depressant effects such as respiratory depressionhypoventilation, hypotension, profound sedation, coma or death may occur. Therefore, the use of any of these medicinal products concomitantly with Durogesic DTrans requires special patient care and observation.
Cytochrome P450 3A4 (CYP3A4) Inhibitors
Fentanyl, a high clearance active substance, is rapidly and extensively metabolised mainly by CYP3A4.
The concomitant use of Durogesic DTrans with cytochrome P450 3A4 (CYP3A4) inhibitors may result in an increase in fentanyl plasma concentrations, which could increase or prolong both the therapeutic and adverse effects, and may cause serious respiratory depression. The extent of interaction with strong CYP3A4 inhibitors is expected to be greater than with weak or moderate CYP3A4 inhibitors. Cases of serious respiratory depression after coadministration of CYP3A4 inhibitors with transdermal fentanyl have been reported, including a fatal case after coadministration with a moderate CYP3A4 inhibitor. The concomitant use of CYP3A4 inhibitors and Durogesic DTrans is not recommended, unless the patient is closely monitored (see section 4.4). Examples of active substances that may increase fentanyl concentrations include: amiodarone, cimetidine, clarithromycin, diltiazem, erythromycin, fluconazole, itraconazole, ketoconazole, nefazodone, ritonavir, verapamil and voriconazole (this list is not exhaustive). After coadministration of weak, moderate or strong CYP3A4 inhibitors with short-term intravenous fentanyl administration, decreases in fentanyl clearance were generally ≤25%, however with ritonavir (a strong CYP3A4 inhibitor), fentanyl clearance decreased on average 67%. The extent of the interactions of CYP3A4 inhibitors with long-term transdermal fentanyl administration is not known, but may be greater than with short-term intravenous administration.
Cytochrome P450 3A4 (CYP3A4) Inducers
Updated on 11 June 2018
File name
IRE_Durogesic DTrans PIL C19_Clean.pdf
Reasons for updating
- Change to section 2 - interactions with other medicines, food or drink
- Change to section 6 - date of revision
Updated on 25 January 2017
Reasons for updating
- New SPC for new product
Legal category:Product subject to medical prescription which may not be renewed (A)
Updated on 25 January 2017
Reasons for updating
- Change to section 4.1 - Therapeutic indications
- Change to section 4.2 - Posology and method of administration
- Change to section 4.3 - Contraindications
- Change to section 4.4 - Special warnings and precautions for use
- Change to section 4.5 - Interaction with other medicinal products and other forms of interaction
- Change to section 4.6 - Pregnancy and lactation
- Change to section 4.8 - Undesirable effects
- Change to section 5.1 - Pharmacodynamic properties
- Change to section 5.2 - Pharmacokinetic properties
Legal category:Product subject to medical prescription which may not be renewed (A)
Free text change information supplied by the pharmaceutical company
Change due to harmonisation of Summary of Product Characteristics in Europe (implementation of the outcome of a referral procedure under Article 30 of Directive 2001/83/EC).
Updated on 25 January 2017
Reasons for updating
- Change to section 4.1 - Therapeutic indications
- Change to section 4.2 - Posology and method of administration
- Change to section 4.3 - Contraindications
- Change to section 4.4 - Special warnings and precautions for use
- Change to section 4.5 - Interaction with other medicinal products and other forms of interaction
- Change to section 4.6 - Pregnancy and lactation
- Change to section 4.8 - Undesirable effects
- Change to section 5.1 - Pharmacodynamic properties
- Change to section 5.2 - Pharmacokinetic properties
Free text change information supplied by the pharmaceutical company
Change due to harmonisation of Summary of Product Characteristics in Europe (implementation of the outcome of a referral procedure under Article 30 of Directive 2001/83/EC).
Updated on 24 January 2017
File name
PIL_10567_425.pdf
Reasons for updating
- New PIL for new product
Updated on 11 September 2015
Reasons for updating
- Change to section 10 - Date of revision of the text
Legal category:Product subject to medical prescription which may not be renewed (A)
Free text change information supplied by the pharmaceutical company
Updated on 11 September 2015
Reasons for updating
- Change to section 10 - Date of revision of the text
Free text change information supplied by the pharmaceutical company
Updated on 22 July 2015
Reasons for updating
- New individual SPC (was previously included in combined SPC)
Legal category:Product subject to medical prescription which may not be renewed (A)
Free text change information supplied by the pharmaceutical company
Durogesic DTrans combined SmPC is no longer published, SmPC for each strength is now available
Changes to the SmPC
Section 4.4: Special warnings and precautions for use
Gastrointestinal tract
Opioids increase the tone and decrease the propulsive contractions of the smooth muscle of the gastrointestinal tract. The resultant prolongation in gastrointestinal transit time may be responsible for the constipating effect of fentanyl. Patients should be advised on to take measures to prevent constipation and prophylactic laxative use should may be considered in some situations. Extra caution should be used in patients with chronic constipation. If paralytic ileus is present or suspected, treatment with Durogesic DTrans should be reviewed taking into account the overall risk-benefit for the patient.
Updated on 22 July 2015
Reasons for updating
- New individual SPC (was previously included in combined SPC)
Free text change information supplied by the pharmaceutical company
Durogesic DTrans combined SmPC is no longer published, SmPC for each strength is now available
Changes to the SmPC
Section 4.4: Special warnings and precautions for use
Gastrointestinal tract
Opioids increase the tone and decrease the propulsive contractions of the smooth muscle of the gastrointestinal tract. The resultant prolongation in gastrointestinal transit time may be responsible for the constipating effect of fentanyl. Patients should be advised on to take measures to prevent constipation and prophylactic laxative use should may be considered in some situations. Extra caution should be used in patients with chronic constipation. If paralytic ileus is present or suspected, treatment with Durogesic DTrans should be reviewed taking into account the overall risk-benefit for the patient.