Ionsys

Generic Name: fentanyl topical (FEN ta nil TOP ik al)
Brand Names: Duragesic, Ionsys

What is Ionsys?

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Fentanyl (Ionsys) is a narcotic pain medicine.

The Duragesic fentanyl skin patch is used to treat moderate to severe chronic pain. The Ionsys fentanyl transdermal device is used only in a hospital to treat acute pain after surgery.

Ionsys may be used for other purposes not listed in this medication guide.

Important information about Ionsys

MISUSE OF THIS MEDICATION CAN CAUSE HARMFUL OR FATAL SIDE EFFECTS. Do not use Ionsys unless you are already being treated with a similar opioid (narcotic) pain medicine and your body is tolerant to it. Talk with your doctor if you are not sure you are opioid-tolerant. Fentanyl may be habit-forming and should be used only by the person it was prescribed for. Ionsys should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. Keep both used and unused Ionsys devices out of the reach of children or pets. The amount of fentanyl in these units can be fatal to a child or pet who accidentally sucks on or swallows the unit. Seek emergency medical attention if this happens.

Avoid drinking alcohol, or using other medicines that make you sleepy (such as cold medicine, other pain medication, muscle relaxers, and medicine for depression or anxiety). They can add to extreme drowsiness or breathing problems caused by fentanyl.

Before using Ionsys

Do not use Ionsys unless you are already being treated with a similar opioid (narcotic) pain medicine and your body is tolerant to it. Opioid medicines include morphine (Kadian, MS Contin, Oramorph, and others), oxycodone (Oxycontin), and hydromorphone (Dilaudid). Talk with your doctor if you are not sure you are opioid-tolerant. Before using fentanyl, tell your doctor if you are allergic to fentanyl or any other medications, or if you have:

a breathing disorder such as chronic obstructive pulmonary disease (COPD);
a history of head injury or brain tumor;
a heart rhythm disorder;
liver disease; or
kidney disease.

If you have any of these conditions, you may need a dose adjustment or special tests to safely use Ionsys.

FDA pregnancy category C. Ionsys may be harmful to an unborn baby, and could cause addiction or withdrawal symptoms in a newborn. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Fentanyl may also cause addiction and withdrawal symptoms in a nursing infant. Do not use Ionsys without telling your doctor if you are breast-feeding a baby. Older adults may be more likely to have side effects from this medicine. Ionsys may be habit-forming and should be used only by the person it was prescribed for. Ionsys should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.

How should I use Ionsys?

Use Ionsys exactly as it was prescribed for you. Do not use the medication in larger or smaller amounts, or use it for longer than recommended by your doctor. MISUSE OF THIS MEDICATION CAN CAUSE HARMFUL OR FATAL SIDE EFFECTS. Ionsys transdermal devices are used only while you are in a hospital. You will not be allowed to use the devices at home. Do not leave the hospital with a device on your skin.

If the skin must be washed before Ionsys is applied, use clear water only. Allow the skin to dry completely before applying the medicine.

Do not use soaps, oils, lotions, alcohol, or other chemicals on the skin where you will apply Ionsys. These substances could increase the amount of fentanyl that your skin absorbs, possibly causing harmful effects.

The Ionsys transdermal device will be applied where you can reach it, such as your chest or the outer side of your upper arm. The device is worn for 24 hours or until the device has delivered 80 doses of fentanyl.

To release the medicine from the transdermal device, press the dosing button twice. The device will sound a beep when the dose starts, and a red light will come on for 10 minutes while the dose is delivered. The light will also flash between doses to let your caregivers know how many doses are left in the device. Tell your care provider if the device comes loose or falls off.

The transdermal device will allow you to give yourself up to 6 doses per hour. Do not allow others to press the dosing button for you.

Do not use the Ionsys device if the device has been damaged. Doing so could expose you to too much fentanyl, which can cause a life-threatening overdose.

Keep both used and unused Ionsys devices out of the reach of children or pets. The amount of fentanyl in these units can be fatal to a child or pet who accidentally sucks on or swallows the unit. Seek emergency medical attention if this happens.

Fentanyl is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.

What happens if I miss a dose?

Since Ionsys is used as needed, you may not be on a dosing schedule.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine or if anyone has accidentally swallowed it. A fentanyl overdose can be fatal. Overdose symptoms may include slow breathing, extreme weakness or dizziness, pinpoint pupils, cold and clammy skin, or fainting.

What should I avoid while using Ionsys?

This medication is for use only on the skin. Avoid touching the gel inside a transdermal device. Do not allow the medicine to come into contact with your eyes, nose, mouth, or lips. If it does, rinse with water. Do not use soap or other chemicals. Fentanyl can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Avoid drinking alcohol, which can increase dizziness or drowsiness. Tell your doctor if you regularly use other medicines that make you sleepy (such as cold medicine, other pain medicine, muscle relaxers, and medicine for depression or anxiety). They can add to extreme drowsiness or breathing problems caused by fentanyl.

Ionsys side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using Ionsys and call your doctor at once if you have any of these serious side effects:

weak, shallow breathing;
severe weakness, feeling light-headed or fainting;
cold, clammy skin; or
pale skin, easy bruising or bleeding.

Less serious side effects may include:

nausea, vomiting, stomach pain, constipation, gas;
dizziness, drowsiness, anxiety, sleep problems (insomnia);
muscle stiffness, back pain;
itching, blistering, redness, or swelling where the device was worn; or
increased sweating, urinating less than usual.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect Ionsys?

Before using Ionsys, tell your doctor if you are using any of the following drugs:

carbamazepine (Tegretol, Carbatrol);
phenytoin (Dilantin);
diltiazem (Cartia, Dilacor, Tizac);
St. John's wort;
rifampin (Rifater, Rifamate, Rimactane);
antibiotics such as clarithromycin (Biaxin), erythromycin (E-Mycin Ery-Tab, E.E.S.), itraconazole (Sporanox), ketoconazole (Nizoral), or troleandomycin (Tao); or
HIV medicines such as amprenavir (Agenerase), tipranavir (Aptivus), indinavir (Crixivan), saquinavir (Invirase), lopinavir/ritonavir (Kaletra), fosamprenavir (Lexiva), ritonavir (Norvir), atazanavir (Reyataz), or nelfinavir (Viracept).

This list is not complete and there may be other drugs that can interact with Ionsys. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about Ionsys.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Ionsys only for the indication prescribed.
Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.