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Long Term Side Effects of Duragesic Fentanyl

By Adam Cloe Ph.D./M.D. ; Updated August 14, 2017

Duragesic fentanyl is also known as the fentanyl patch. Fentanyl is an extremely powerful narcotic pain reliever and is often prescribed to help patients manage severe, chronic pain. Duragesic fentanyl is typically taken for an extended period of time. Because of the potency of fentanyl, Duragesic fentanyl is designed to slowly release a steady amount of fentanyl that can then be absorbed through the bloodstream.

Opioid Tolerance

Duragesic fentanyl is an extremely potent opioid. One of the long-term side effects of any sort of opioid use is tolerance. Essentially, over time, the brain becomes accustomed to the effects that opiates generate. This is because neurons naturally adapt to their environment, and in the case of Duragesic fentanyl, this environment involves a constant level of fentanyl surrounding the neurons. As a result, the neurons will become less sensitive to the effects of fentanyl and other opiate pain relievers. This means that over time, other narcotic pain relievers will becomes less effective. As a result, Duragesic fentanyl is only indicated for patients who already have developed opioid tolerance.

Addiction

Duragesic fentanyl can also cause opioid addiction. Opioid addiction is related to opioid tolerance because they both result from the effects of long-term fentanyl use on the brain. As neurons become more tolerant of fentanyl, some patients will lose the sense of euphoria and pleasure that fentanyl use can cause. This can cause some patients to engage in "drug-seeking" behavior, in which the patient begins to abuse fentanyl and other narcotic pain relievers for their euphoric effects. Although Duragesic fentanyl is released over an extended period of time to help prevent opioid addiction, it is a potential side effect of long-term use.

Overdose

Duragesic fentanyl can cause hypoventilation (slowed breathing), which can be fatal when it is present in abnormally high levels in the blood. The fentanyl patch releases low enough quantities of medication so that this will not happen. However, fentanyl is metabolized by the liver using an enzyme called cytochrome p450. Some medications inhibit the activity of this enzyme, which can lead to increased levels of fentanyl, causing hypoventilation. Consequently, patients using Duragesic fentanyl must avoid certain medications, including many antibiotics and heart medications, as well as grapefruit juice.

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