Fentanyl patch and opioid tolerant question

PLEASE NOTE:   Posts made to this forum should not be considered as the expressed opinions of, nor should be considered endorsed by, the Medication Safety Officer’s Society (MSOS) or the Institute for Safe Medication Practices (ISMP). 

Make sure your email is up-to-date
In order to continue to receive updates from MSOS, as well as forum posts and other valuable information as a member of MSOS, please be sure to update your email address with us, whenever it changes. If you need assistance doing so, please send an email to cmichalek@ismp.org. 

3 posts / 0 new
Log in or register to post comments
Last post
Mon, 09/22/2025 - 11:26
#1
Amy Logan
Amy Logan's picture
Offline
Last seen: 2 weeks 5 days ago
Joined: 12/04/2022 - 15:37
Fentanyl patch and opioid tolerant question

Hi everyone,
I am seeking input to query if any of your institutions allow fentanyl patches to be ordered on patients that do not have 7 days of documented opioid doses: at least 60 mg oral morphine per day, 25 mcg transdermal fentanyl per hour, 30 mg oral oxycodone per day, 8 mg oral hydromorphone per day, 25 mg oral oxymorphone per day, 60 mg oral hydrocodone per day, or an equianalgesic dose of another opioid?
i.e. do you allow palliative care to approve the ordering of fentanyl patches on patients without yet reaching the 7 days of documented above opioid doses? Or do you have a policy in place that allows exceptions to this black box warning?
Thanks in advance!

Top