Strength of patch | Licensed indication | Frequency of patch application |
5 microgram, 10 microgram, 15 microgram and 20 microgram per hour | Treatment of non-malignant pain of moderate intensity when an opioid is necessary for obtaining adequate analgesia | Replace patch(es) every 7 days. Butec® patches have been accepted by SMC for restricted use in patients over 65 years of age for the treatment of chronic non-malignant pain of moderate intensity when an opioid is necessary for obtaining adequate analgesia. |
35 microgram, 52.5 microgram and 70 microgram per hour | Treatment of moderate to severe cancer pain and severe pain which does not respond to non-opioid analgesics | Either: Apply a new patch every 72 hours (3 days) Or Apply a new patch after up to 96 hours (4 days). SPC suggests bi-weekly dosing, for example Tuesday and Friday. |
Immediate release (quick acting) oral morphine or oxycodone | Apply patch; continue the immediate release opioid 4 hourly for the next 12 hours. |
Modified release (long acting) oral 12 hourly morphine or oxycodone | Apply patch when the last dose of a 12 hourly, modified release opioid is given. |
Subcutaneous infusion of morphine, diamorphine, oxycodone or alfentanil | Apply the patch and continue the infusion for the next 12 hours, then stop the infusion. |
24-hour oral morphine dose | Buprenorphine patch dose (micrograms per hour) | Immediate release oral morphine Suggested breakthrough dose (refer to guidance in dose and administration) | Immediate release oral oxycodone Suggested breakthrough dose (refer to guidance in dose and administration) | Fentanyl patch dose (micrograms per hour) |
12mg | 5 | 2mg | 1mg | 6 |
24mg | 10 | 5mg | 2mg to 3mg | 6-12 |
36mg | 15 | 5mg | 2mg to 3mg | 12 |
48mg | 20 | 10mg | 5mg | 12-18 |