When can the 24 hour subcutaneous infusion start after the removal of a Durogesic DTrans patch?
This information relates to circumstances where the patient's prognosis is relatively good and it is not an end of life situation.
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Remove the patch (Note time of removal)
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Calculate appropriate breakthrough analgesia dose and ensure that this is available. It may be needed more frequently during the first 12 hours after the patch is removed. Do not prescribe any regular strong opiod analgesia.
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12 hours after patch removal start the 24 hour subcutaneous infusion of morphine
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Make arrangements for regular observation / pain assessment throughout this period
It is clear from the above advice that it may be best, where possible, for such changes in medication to be carried out in a well supported environment preferably as an in-patient until pain control is once again stable or if necessary at home with community or Macmillan nurse involvement.
How to convert?
