Doses - FENTANYL, TRANSDERMAL
Dogs & Cats: 
The following dosage regimen is used at the University of Minnesota Veterinary Teaching Hospital and is adapted from a presentation by Dr. Lynelle Graham:
In acutely painful patients provide alternative analgesia (injectable opioids, epidural opioids orconstant rate infusion of opioids) until "lag" phase is completed (usually 6 hours in cats anda minimum of 12 hours in dogs). Patch Size:
** Small dogs and cats may be dosed with 1/2 patch, but the patch should not be cut in half! Cover 1/2 the gel membrane with tape. "Half-patch dosing" is suggested for pediatric, geriatric and systemically ill cats and small dogs.
Patch may be placed either at dorsal or lateral cervical area, the lateral thorax or the inguinal area.
If the neck is used, collars/leashes cannot be placed over the patch. Thorax is easily used andcontact maximized (especially in cats), but can be difficult to bandage and the bald spot andchange in hair growth/color may bother some clients. Inguinal area may be difficult to see andassess and some patients can lick/chew at the area. Regardless of site chosen, it must be cleanand dry at the time of application and while the patch is attached. Do not place where a heatingpad may come into contact. Site should be closely clipped with at least a 1 cm margin aroundthe patch. Do not shave as cuts, abrasions or wounds can alter the absorption of fentanyl. Afterclipping, wipe with damp cloth to remove small hairs and skin debris; do not scrub orsurgically prepare the site. Allow to completely dry.
Remove occlusive membrane from patch by folding back the edge and gently tear away themembrane to expose the sticky surface. Be careful not to expose your skin to the gel surface.
Place patch over clipped area and hold it in place for 2-3 minutes to maximize adherence. Usea slightly padded bandage or transparent dressing used with medical adhesive spray to assureadherence and to keep it dry. Check every few hours to ensure proper placement andadherence.
Dispose of used patches in a safe and effective manner.
Monitoring Parameters - 1) analgesic efficacy 2) heart rate and respiratory rate
Client Information - Explain carefully to clients how to apply (if applicable), remove and disposeof patches. Should accidental human skin contact occur, wash with water (only; no soap, etc.).
Consider making application, removal and disposal an outpatient procedure, thereby bypassingconcerns with clients.
Dosage Forms/Preparations/FDA Approval Status/Withholding Times - Veterinary-Approved Products: None:
Human-Approved Products:
Transdermal: 2.5 mg (10 cm2; 25 mcg/hr); 5 mg (20 cm2; 50 mcg/hr); 7.5 mg (30 cm2; 75mcg/hr); 10 mg (40 cm2; 100 mcg/hr); Duragesic®-25 (etc.), (Janssen); (Rx) C-IIAll fentanyl products are Class-II controlled substances.