II. Precautions: Transdermal Patch
-
Patch is heat sensitive
- Increases absorption and decreases duration
- Affected by fever, Sun Exposure, heating pads, saunas
- Could dangerously increase levels (e.g. Fentanyl)
- Avoid cutting patches unless specifically allowed
- Patches with evenly distributed medication may be cut (e.g. Lidoderm, Capsaicin)
- Cut before removal of their liner
- Avoid cutting patches with drug reservoir (e.g. Androderm, Nicoderm CQ)
- May release toxic, high doses
- Avoid cutting patches for which exact dosing must be maintained (e.g. Fentanyl, Contraceptive Patch)
- Serious toxicity has occurred when patches have been cut, esp. in children (e.g. Clonidine)
- If patch is found to have been cut inappropriately (e.g. by provider, patient's family):
- Remove patch and wash with soap and water, and observe for adverse effects
- May leave part of backing on some patches to reduce overall dose (e.g. Scopolamine patch)
- Patches with evenly distributed medication may be cut (e.g. Lidoderm, Capsaicin)
- Remove patches before entering MRI
- Many patches have a metallic backing
- Patch disposal
III. Precautions: Water Exposure
- Apply Topical Medications and patches after bath, shower or swimming
- Wait at least 15-30 minutes or until medication dries prior to any water exposure
- Avoid reapplying medications after water exposure (if already applied prior to water exposure)
- Applying medication to moist skin may increase absorption (risk of adverse effects)
- Heat may affect topicals as well as patches (see above)
- Some patches may allow for water exposure, but the patch adhesive may be reduced
- May require medical tape along edges or across the surface to keep secured to skin
- Apply patch in regions that are less easily rubbed off
IV. References
- (2017) Presc Lett 24(7)
- (2021) Presc Lett 28(8): 46-7
- (2025) Presc Insights, issue 3/2025