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Does a patient have to be on morphine before using a Durogesic DTrans patch?

April 26, 2017durogesic Morphine patch patient

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Does a patient have to be on morphine before using a Durogesic DTrans patch?

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For cancer patients, in line with the SIGN 44 Guidelines (References) it is recommended to titrate with oral morphine until the pain becomes stable before converting to the patch. However in patients who have chronic cancer pain there is evidence that after failure of maximum dose of Step 2 analgesic, 25mcg transdermal fentanyl can be commenced without the need for initial normal release morphine.