CSP seeks clarification on risk of fentanyl patches in pools

The CSP is clarifying whether exercising in hydrotherapy pools, which may raise body temperature, could be a risk for patients wearing fentanyl transdermal patches.


Photo: Marc Hill

It follows the publication of updated guidance from MedicinePlus, a medical information website run by the US National Library of Medicine.

The revised guidance, published on 15 January, says extreme heat could cause the patches [which are prescribed to treat severe pain] to release too much medication into a patient’s body, leading to serious or life-threatening symptoms.

It advises patients not to expose the patches, or the area of skin surrounding them, to direct heat such as electric blankets, heat lamps, saunas and hot tubs. They should also avoid sunbathing, taking long, hot baths and any physical activity that could raise their temperature.

Hydrotherapy and exercise risk

Natalie Beswetherick, CSP director of practice and development, said independent prescribers will be aware of these risks.

However, the current information on patches fails to mention if exercising in hydrotherapy pools may also pose a risk.

Ms Beswetherick told Frontline: ‘The main concern is that physios who are not prescribers may be treating patients who have been prescribed fentanyl transdermal patches but are unaware of the potential for accidental overdose caused by heating a transdermal patch. It is important that we raise members’ awareness of this potential risk.’

As a result, the CSP has requested that a specific reference to hydrotherapy be added to the product characteristics and patient information leaflets for fentanyl patches.

More info required

Jacqueline Pattman, honorary chair of the Aquatic Therapy Association of Chartered Physiotherapists, told Frontline that more information was required from the drugs manufacturers, as there is currently no evidence that the temperature range of hydrotherapy pools, which should be between 32-35.5° C, could adversely affect the patches.

Product warnings from the manufacturers currently state that ‘serum fentanyl concentrations may increase by about one-third if the skin temperature increases to 40° C’.

‘We strongly support the CSP’s request for clarification and a specific reference to hydrotherapy be added to the product characteristics and patient information leaflets for fentanyl patches, to provide clear guidance to patients and physiotherapists,’ Ms Pattman said.

Author: Robert Millett

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