A pain patch is a transdermal medication used to manage acute (short-term) and chronic (long-term) pain. Common prescription pain patches include:
- Flector (diclofenac epolamine): A nonsteroidal anti-inflammatory drug (NSAID)
- Lidoderm (lidocaine): A local anesthetic
- Duragesic (fentanyl): An opioid pain medication
The patch has an adhesive back that sticks to the skin. It slowly releases the medication into the bloodstream.
This article discusses pain patches, how they work and what they are used to treat. It also explains how to use a pain patch, doses, and side effects.
Pain Patch Uses
Pain patches are prescribed by healthcare providers for patients with various medical conditions. They are commonly used to treat back pain, knee pain, nerve pain, and other types of pain.
For minor injuries, such as muscle sprains and strains, a healthcare provider may prescribe a patch with diclofenac epolamine, an NSAID in the same group of medicines as aspirin and ibuprofen. Also known by the brand name Flector, it can be applied near the area of pain if there’s no broken or damaged skin.
In 2010, a study found that the diclofenac pain patch was associated with significant pain relief for soft-tissue injuries like strains, sprains, and bruises with few adverse effects.
Lidocaine, also known by the brand name Lidoderm, is available in a prescription pain-relief patch. It’s often prescribed for patients suffering from the pain of shingles (postherpetic neuralgia), which can last for months or years after an infection.
Lidocaine is a local anesthetic that works by stopping nerves from sending pain signals. The topical lidocaine 5% patch starts acting quickly, usually in less than four hours, and is generally well-tolerated, other than mild skin reactions at the application site.
Healthcare providers may prescribe fentanyl patches for severe, chronic pain, also known by the brand name Duragesic. Fentanyl patches should be used only by patients who can tolerate opioids and those with long-term, severe pain who can’t be treated with other medications.
A 2018 study found that fentanyl patches were as effective as oral morphine in managing moderate to severe cancer pain with fewer side effects, such as nausea and vomiting.
Before Using Pain Patches
Prescription pain-relief patches may be prescribed for patients who are unable to take drugs orally because of stomach irritation or other conditions.
Precautions and Contraindications
Before using a prescription pain-relief patch, talk with your healthcare provider about any allergies you have and if you’re taking any other medications or supplements. Also tell your healthcare provider if you’re pregnant, plan to become pregnant, or are breastfeeding.
Some drugs may be safer for you to use than others depending on your medical history and the cause of your pain. Your healthcare provider can help you weigh the pros and cons of a medication, including its ability to manage pain and the risk of side effects.
Because fentanyl is a strong opioid, it can be addictive. As such, tell your healthcare provider if you or anyone in your family has abused alcohol, street drugs, or prescription medications, or if you have ever had depression or another mental illness.
Fentanyl patches should only be used by patients who have previously taken and tolerated opioid medications.
Tell your healthcare provider if you have asthma or any condition with slowed breathing, as you may be advised not to use fentanyl patches. Also tell your healthcare provider if you’ve ever had lung disease, a head injury, or any condition that increases pressure in your brain.
Pain Patch Dosage
All listed dosages are according to the drug manufacturers. Check your prescription and talk to your healthcare provider to make sure you’re taking the right dose for you.
For the Flector patch with 1.3% diclofenac epolamine, the manufacturer’s recommended dose is one patch applied to the most painful area twice a day.
The Lidoderm patch with 5% lidocaine is applied once a day to the painful area for up to 12 hours. Check with your healthcare provider on the number of patches that can be used at once.
The fentanyl patch is typically applied to the skin once every 72 hours. Your healthcare provider may start you on a low dose of fentanyl and gradually increase it, if needed.
How to Take and Store
The adhesive side of the transdermal patch is placed firmly on the skin per label and healthcare provider instructions. Never place a patch in an area for which it is not prescribed, and never use more than one patch at a time unless approved by your healthcare provider.
Patients should wash their hands before and after touching a patch to avoid contaminating the drug and to keep the drug from being applied to an unsafe area such as the eyes or mouth.
Pain-relief patches should only be used on skin that is not broken, cut, or scraped. Do not use a pain-relief patch that has been cut, torn, or damaged unless directed to do so by your healthcare provider.
Store all pain patches at room temperature and away from excess heat. Like all medicines, pain-relief patches should also be stored away from children and pets. The best way to dispose of a patch is to fold it in half, so the adhesive side sticks to itself. A used patch should be thrown away where children and pets won’t come into contact with it.
Fentanyl Overdose Warnings
Using a fentanyl patch that has been cut or damaged may cause you to receive the medication too quickly rather than slowly over time and could lead to overdose or death.
Heat can increase the dose of fentanyl delivered by the patch, which can have the same consequences. While the patch can be worn while bathing, avoid long, hot showers and baths. Likewise, avoid hot tubs, electric blankets, and heating pads.
Pain Patch Side Effects
Prescription pain patches may have side effects depending on the type used. Check with your healthcare provider or pharmacist about what symptoms should warrant discontinuing the medication or seeking medical attention. If you are using a fentanyl patch, your healthcare provider will closely monitor you during treatment to check for any serious side effects.
Common Side Effects
In some cases, a patch can cause minor irritation, redness, blisters, or a burning sensation where it is applied. These symptoms are usually minor and go away within a few hours. Check with your healthcare provider if symptoms are severe or don’t go away.
Severe Side Effects
Severe side effects are associated with the different types of patches.
NSAIDs can increase the risk of heart attack, stroke, and bleeding in the stomach or elsewhere in the gastrointestinal tract. Seek medical attention if you have shortness of breath, slurred speech, nausea, weakness, diarrhea, yellow skin or eyes, indigestion, stomach pain, vomiting blood, blood in bowel movement, or swelling.
Side effects from the lidocaine patch may include allergic reactions, such as hives, skin rash, itching, difficulty breathing, difficulty swallowing, swelling, hoarseness, fast pulse, fast breathing, unusual thirst, nausea, vomiting, confusion, weakness, dizziness, or fainting.
Symptoms of an overdose can include lightheadedness, nervousness, blurred vision, ringing in the ears, twitching or shaking, seizures, slow heartbeat, or loss of consciousness.
The fentanyl patch can cause severe side effects such as changes in heartbeat, agitation, hallucinations, fever, sweating, confusion, severe muscle stiffness or twitching, seizures, hives, swelling, hoarseness, or difficulty breathing or swallowing.
While you are using fentanyl patches, you may be told to have a rescue medication called naloxone available in case of overdose. Symptoms of an overdose include difficulty breathing, extreme sleepiness, difficulty talking, trouble with walking, small eye pupils, faintness, dizziness, confusion, and coma (loss of consciousness).
If you experience any severe side effects or signs of an overdose from any medication, remove the patch and call 911.
Warnings and Interactions
Be sure your healthcare provider is aware of any other medical conditions you have, including liver or kidney problems and high blood pressure, and any medications and supplements you’re taking.
Diclofenac Epolamine Patch
The diclofenac epolamine patch can interfere with the effects of other medications or cause drug interactions. Let your healthcare provider know if you’re using anticoagulants, aspirin, ACE inhibitors, angiotensin receptor blockers (ARB), beta-blockers, diuretics, or digoxin.
Tell your healthcare provider if you are using any medications, including Norpac (disopyramide), Tambocor (flecainide), medications applied to the skin or mouth to treat pain, Mexitil (mexiletine), Ethmozine (moricizine), Procanabid, Pronestyl (procainamide), Rhythmol (propafenone), Quinidex (quinidine), and Tonocard (tocainide).
When using a fentanyl patch, do not drink alcohol or take street drugs, as it can increase the risk of severe side effects or death. Tell your healthcare provider about any other medications you’re using to avoid life-threatening interactions.
Drugs that can cause a serious interaction include benzodiazepines such as Xanax (alprazolam), Klonopin (clonazepam), Valium (diazepam), and Ativan (lorazepam); medications for mental illness, depression, and nausea; other medications for pain; muscle relaxants; sedatives; sleeping pills; and tranquilizers.
Not all drug interactions are listed here, so always let your healthcare provider know about any medicines or supplements you're taking before you start using a fentanyl patch.
Fentanyl patches can be dangerous in the wrong hands or if applied improperly. The U.S. Food and Drug Administration (FDA) has issued warnings about fentanyl patch safety after a number of accidental overdoses were reported.
Overdoses have occurred when more than one patch is used at a time when a patient applies heat to the patch and when a non-patient—such as a child—accidentally comes into contact with a patch. According to the FDA, young children have died from accidental exposure when putting it in their mouth or applying it to their skin.
In 2013, the FDA required color changes on the writing of Duragesic (fentanyl) patches. The change was made so patients could more easily see the patches and notice when they fall off to avoid accidental exposure to kids and pets.
The FDA also reminded that fentanyl patches are dangerous even after being used because they still contain high amounts of opioids. Used fentanyl patches should be folded with the sticky sides together and flushed down the toilet.
If you or someone you know has had accidental exposure to a fentanyl patch, call 9-1-1 or Poison Control at 1-800-222-1222.
A Word From Verywell
If you have any questions about pain patches' use, efficacy, or safety, please discuss these concerns with your healthcare provider. Although pain patches can be effective, they need to be used safely, properly, and under the guidance of your healthcare provider. Take safety warnings seriously to protect both yourself and others.
Frequently Asked Questions
Do patches work for pain relief?
Yes, pain patches are an effective method of delivery for pain relieving medication. When used correctly, they help to relieve pain.(Video) How to Apply the Kailo Pain Patch Adhesive
What patch is used for pain?
Pain relief patches can contain different medications. Patches can be used to deliver NSAIDs, local anesthetics, or opioids. Common pain patches include Flector (diclofenac epolamine), Lidoderm (lidocaine), and Duragesic (fentanyl).
Where is the best place to put a pain relief patch?
It depends on the patch. Lidocaine patches should be placed over the largest area of skin that has pain. Fentanyl and diclofenac patches do not need to be placed on top of the area of pain.
Apply patches to clean and dry skin. Choose a flat area, such as the upper arm, chest, or back.
How do you deal with uncontrollable pain? ›
- Get some gentle exercise. ...
- Breathe right to ease pain. ...
- Read books and leaflets on pain. ...
- Counselling can help with pain. ...
- Distract yourself. ...
- Share your story about pain. ...
- The sleep cure for pain. ...
- Take a course.
Untreated or undertreated pain can rob people of the ability to function and can cause depression, irritability, sexual dysfunction and disruptions in sleeping, eating and mobility, according to Strassels and Dr. Eun-Ok Im of the School of Nursing. Proper treatment can help return people to their lives.What patches are used for pain management? ›
Buprenorphine patches are used to relieve severe pain in people who are expected to need pain medication around the clock for a long time and who cannot be treated with other medications. It is in a class of medications called opiate (narcotic) analgesics.Do pain relief patches work? ›
Yes, pain patches are an effective method of delivery for pain relieving medication. When used correctly, they help to relieve pain.What is it called when you are in constant pain? ›
Chronic or persistent pain is pain that carries on for longer than 12 weeks despite medication or treatment.Is chronic pain considered a disability? ›
The SSA does not consider chronic pain to be a disability, so there is no listing for it in the SSA's Blue Book. Chronic pain, even if it is severe and disabling, does not qualify unless you can prove it is caused by a verifiable condition that lasts for at least 12 months.What happens to people with chronic pain? ›
Chronic pain may be "on" and "off" or continuous. It may affect people to the point that they can't work, eat properly, take part in physical activity, or enjoy life. Chronic pain is a major medical condition that can and should be treated.What happens to the level of pain as the pain becomes chronic? ›
The brain reads these signals as pain. But when someone has chronic pain, the nerves that carry pain signals to the brain, or the brain itself, are behaving in an unusual way. The nerves might be more sensitive than usual, or the brain might be misreading other signals as pain.How long can you keep pain patches on? ›
The patch is usually applied to the skin once every 72 hours. Change your patch at about the same time of day every time you change it. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Apply fentanyl patches exactly as directed.Do prescription lidocaine patches work better than over the counter? ›
Data from a comparison study found that over-the-counter (OTC) transdermal lidocaine with menthol patches proved noninferior to prescription (Rx) lidocaine patches for efficacy, safety, and quality of life.
Can you wear 2 pain patches at once? ›
Do not wear more than one Fentanyl transdermal system patch at a time unless your healthcare provider tells you to do so. Before applying a new Fentanyl transdermal system patch, remove the patch you have been wearing. on the skin such as soaps, lotions, oils, or alcohol before the patch is applied. 3.Do pain patches work for arthritis? ›
Lidocaine patches are another alternative pain remedy for arthritis joint pain. Lidocaine is a drug that blocks transmission of nerve messages. It acts as an anesthetic, an agent that reduces sensation or numbs pain.Where is the best place to put a pain patch on your body? ›
Apply the patch to a dry, flat skin area on your upper arm, chest, or back. Choose a place where the skin is not very oily and is free of scars, cuts, burns, or irritation. Do not apply this medicine to areas that have received radiation treatment.What is the most common cause of chronic pain? ›
Chronic pain is usually caused by an initial injury, such as a back sprain or pulled muscle. It's believed that chronic pain develops after nerves become damaged. The nerve damage makes pain more intense and long lasting. In these cases, treating the underlying injury may not resolve the chronic pain.What is the most common chronic pain? ›
Joint pain, typically caused by injury, infection, or advancing age, is one of the leading types of chronic pain among American adults.What is considered a permanent disability? ›
Permanent disability (PD) is any lasting disability from your work injury or illness that affects your ability to earn a living. If your injury or illness results in PD you are entitled to PD benefits, even if you are able to go back to work.How do you make a doctor believe you are in pain? ›
- Get descriptive: use metaphor and memoir.
- Describe your day.
- Talk about function, not feeling.
- Share your treatment history.
When it intensifies to level 8, pain makes even holding a conversation extremely difficult and your physical activity is severely impaired. Pain is said to be at level 9 when it is excruciating, prevents you speaking and may even make you moan or cry out. Level 10 pain is unbearable.
You've been referred as a red flag because your GP or dentist feels your symptoms need further investigation as soon as possible and has referred you to a specialist. There are many common conditions that these symptoms could be linked to, including the possibility of cancer.Can you live a long life with chronic pain? ›
The concept of living well while living with chronic pain can sound impossible, but you can thrive despite chronic pain. Living well with your chronic pain isn't just about managing your pain, but rather about finding ways to live a happy, fulfilled life in spite of your symptoms.
Can chronic pain change your personality? ›
“The study shows people with chronic pain experience disruptions in the communication between brain cells. This could lead to a change in personality through a reduction of their ability to effectively process emotions.Why do I have so much pain in life? ›
It's natural to feel that it hurts to live this way. Or, perhaps you live with a mental health condition, like clinical depression or bipolar disorder, and how you feel is part of your symptoms. In any case, when emotional pain is too much, the way you see yourself, others, and life in general, may change.What are the 10 most common conditions that have chronic pain? ›
- Low back pain.
- Arthritis, especially osteoarthritis.
- Multiple sclerosis.
- Nerve damage (neuropathy)
Disease can also be the underlying cause of chronic pain. Rheumatoid arthritis, osteoarthritis and fibromyalgia are well-known culprits, but persistent pain may also be due to such ailments as cancer, multiple sclerosis, stomach ulcers, AIDS, and gallbladder disease.Does chronic pain get worse with age? ›
Aging creates a double whammy, however, when you add chronic pain to the mix. Untreated chronic pain worsens over time, although to what degree is unpredictable and depends upon many unknowns. Most chronic pain results in loss of function in the spine, joints or extremities.Why does pain need to be controlled? ›
Managing pain is key to improving quality of life. Pain keeps people from doing things they enjoy. It can prevent them from talking and spending time with others. It can affect their mood and their ability to think.Why is pain control important for healing? ›
In addition to keeping you comfortable, pain control can help speed your recovery and may reduce your risk of developing certain complications after surgery, such as pneumonia and blood clots.