transdermal fentanyl (Durogesic D Trans 12mcg/hr)

Following an abbreviated submission.

transdermal fentanyl (Durogesic D Trans patches) 12 mcg/hour is accepted for restricted use within NHS Scotland for patients with chronic intractable pain due to non-malignant conditions.

It should be considered as a second-line alternative, reserved for patients whose pain has initially been controlled by oral means, the pain being stable. Its use should focus on patients who have difficulty swallowing or have problems with opiate-induced constipation.

The new strength allows greater flexibility in dose titration without a substantial impact on price compared with the range of patches previously available. However, it remains significantly more expensive than oral therapy.

SMC has not assessed transdermal fentanyl in its original indication for intractable pain due to cancer.