Transdermal analgesic patch

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Salonpas brand analgesic patches Salonpas Pain Relieving Patch.jpg
Salonpas brand analgesic patches

A transdermal analgesic or pain relief patch is a medicated adhesive patch used to relieve minor to severe pain. There are many types of analgesic patches based on the main ingredients in the patches. These include patches containing counterirritants, which are used to treat mild to moderate pain, and patches containing opioids such as buprenorphine and fentanyl, used to relieve moderate to severe pain. Fentanyl is often used for opioid-tolerant patients. Nitroglycerin, also known as glyceryl trinitrate (GTN), a medication used for heart failure, high blood pressure, anal fissures, painful periods, and to treat and prevent chest pain, can also be found in patches. Beyond these are patches that contain drugs such as diclofenac and lidocaine and various other drugs. The main purpose of transdermal analgesic patches are to administer drugs in a more viable way to patients, as opposed to oral consumption or intravenous administration such as an injection. [1]

Contents

Counterirritant patches

Counterirritant patches contain ingredients such as capsaicin, methyl salicylate, camphor, or menthol, which are thought to mask pain signals by causing other sensations (itching, warmth, or cooling) in the areas they are applied to. [2] In the United States, patches sold under the brand name Salonpas are approved by the Food and Drug Administration under a New Drug Application (NDA) for the treatment of mild to moderate pain caused by soft tissue injury (e.g., strains, sprains), arthritis, or backache. While Salonpas patches may provide some relief, the effects are not strong and the evidence supporting their efficacy is weak. [3]

Other products, including Bengay and Mentholatum, which are not covered by NDA, indicate relief of minor pain. [2] Counterirritant patches are sold over-the-counter and do not require a prescription. Other over-the-counter products marketed for the relief of minor injury or arthritis pain include Absorbine Jr. Pain Relief, Excedrin Cooling Pads, and Icy Hot Patches. [4]

In Japan, Salonpas, produced by Hisamitsu Pharmaceutical, remains a popular brand. Other manufacturers, including Yutoku Pharmaceutical, SS Pharmaceutical, and Suzuki Nippondo also produce similar over-the-counter patches containing methyl salicylate or glycol salicylate. [5]

In Australia, patches sold under the brand names Eco Pain and Dencorub are approved by the Therapeutic Goods Administration and listed on the Australian Register for Therapeutic Goods (ARTG) as a Class 1 Medical Device. They are approved for sale over-the-counter for the treatment of mild pain caused by soft tissue injury (e.g., strains, sprains), arthritis, or backache.

Fentanyl patches

Fentanyl transdermal patches are sold under the brand name Duragesic or as generic equivalents. Fentanyl is an opioid with rapid onset of pain relief; it is often used to treat breakthrough pain. Fentanyl patches release fentanyl through the skin and may provide pain relief for up to 72 hours. [6]

Several deaths or life-threatening overdoses have been linked to misuse of fentanyl patches. [7] Fentanyl patches are indicated only for patients with moderate to severe chronic pain who have been taking regular narcotic pain medication for more than a week and who are considered opioid-tolerant. Overdose can occur when patients use more patches than prescribed, change the patches too frequently, or expose the patches to extreme heat. [7]

Diclofenac patches

Diclofenac is the active ingredient in patches like Flector. Diclofenac is a non-steroidal anti-inflammatory drug that is commonly used to reduce symptoms in soft-tissue injuries, sports injuries, or osteoarthritic knee injuries. The patches have shown to reduce symptoms that are found with oral diclofenac and are proven to reduce pain and stiffness. There may be minor side effects like redness or rash at the site of the patch. [1]

Nitroglycerin

Lidocaine patches

Lidocaine is the active ingredient in patches such as Lidoderm. The lidocaine patch is proven to reduce acute or short-term pain after surgeries or procedures at rest. There has been no proven decreased opioid use from lidocaine patches. There has been no research regarding specific procedures and the effects of transdermal lidocaine, but the efficacy of lidocaine is considered minor. [8]

History

Transdermal drug delivery was influenced by topical drug delivery. Sherman Kramer and Dale Wurster, his teacher, were both based in pharmacology and are credited with the beginning stages of transdermal patch delivery in 1961. By attaching a diffusion cell to the volunteers and monitoring their levels of the drug administered, it was discovered that the levels of the drug could be affected by the absorption of the skin and the diffusion area of the patch. 10 years later, Alejandro Zaffaroni filed a patent for transdermal drug delivery through a rate-controlling membrane. Arnold Beckett, a British pharmacist, held experiments with a patch system that were studied and proven to maintain steady blood levels through administration of the drug. [9] These discoveries laid the foundation for transdermal patch systems and individual research with specific drugs for transdermal patch systems followed.

See also

Manufacturers
Products

Related Research Articles

<span class="mw-page-title-main">Analgesic</span> Any member of the group of drugs used to achieve analgesia, relief from pain

An analgesic drug, also called simply an analgesic, pain reliever, or painkiller, is any member of the group of drugs used to achieve relief from pain. Analgesics are conceptually distinct from anesthetics, which temporarily reduce, and in some instances eliminate, sensation, although analgesia and anesthesia are neurophysiologically overlapping and thus various drugs have both analgesic and anesthetic effects.

<span class="mw-page-title-main">Ketoprofen</span> NSAID analgesic medication

Ketoprofen is one of the propionic acid class of nonsteroidal anti-inflammatory drugs (NSAID) with analgesic and antipyretic effects. It acts by inhibiting the body's production of prostaglandin.

<span class="mw-page-title-main">Fentanyl</span> Opioid medication

Fentanyl is a potent synthetic piperidine opioid primarily used as an analgesic. It is 20 to 40 times more potent than heroin and 100 times more potent than morphine; its primary clinical utility is in pain management for cancer patients and those recovering from painful surgeries. Fentanyl is also used as a sedative. Depending on the method of delivery, fentanyl can be very fast acting and ingesting a relatively small quantity can cause overdose. Fentanyl works by activating μ-opioid receptors. Fentanyl is sold under the brand names Actiq, Duragesic and Sublimaze, among others.

<span class="mw-page-title-main">Pain management</span> Interdisciplinary approach for easing pain

Pain management is an aspect of medicine and health care involving relief of pain in various dimensions, from acute and simple to chronic and challenging. Most physicians and other health professionals provide some pain control in the normal course of their practice, and for the more complex instances of pain, they also call on additional help from a specific medical specialty devoted to pain, which is called pain medicine.

<span class="mw-page-title-main">Transdermal patch</span> Adhesive patch used to deliver medication through the skin

A transdermal patch is a medicated adhesive patch that is placed on the skin to deliver a specific dose of medication through the skin and into the bloodstream. An advantage of a transdermal drug delivery route over other types of medication delivery is that the patch provides a controlled release of the medication into the patient, usually through either a porous membrane covering a reservoir of medication or through body heat melting thin layers of medication embedded in the adhesive. The main disadvantage to transdermal delivery systems stems from the fact that the skin is a very effective barrier; as a result, only medications whose molecules are small enough to penetrate the skin can be delivered by this method. The first commercially available prescription patch was approved by the U.S. Food and Drug Administration in December 1979. These patches administered scopolamine for motion sickness.

<span class="mw-page-title-main">Topical medication</span> Medication applied to body surfaces

A topical medication is a medication that is applied to a particular place on or in the body. Most often topical medication means application to body surfaces such as the skin or mucous membranes to treat ailments via a large range of classes including creams, foams, gels, lotions, and ointments. Many topical medications are epicutaneous, meaning that they are applied directly to the skin. Topical medications may also be inhalational, such as asthma medications, or applied to the surface of tissues other than the skin, such as eye drops applied to the conjunctiva, or ear drops placed in the ear, or medications applied to the surface of a tooth. The word topical derives from Greek τοπικόςtopikos, "of a place".

<span class="mw-page-title-main">Oxymorphone</span> Opioid analgesic drug

Oxymorphone is a highly potent opioid analgesic indicated for treatment of severe pain. Pain relief after injection begins after about 5–10 minutes, after oral administration it begins after about 30 minutes, and lasts about 3–4 hours for immediate-release tablets and 12 hours for extended-release tablets. The elimination half-life of oxymorphone is much faster intravenously, and as such, the drug is most commonly used orally. Like oxycodone, which metabolizes to oxymorphone, oxymorphone has a high potential to be abused.

<span class="mw-page-title-main">Liniment</span> Ointment-like medicated topical preparation for application to skin

Liniment, also called embrocation and heat rub, is a medicated topical preparation for application to the skin. Some liniments have viscosity similar to that of water; others are lotion or balm; still others are in transdermal patches, soft solid sticks, and sprays. Liniment usually is rubbed in to the skin, which the active ingredients penetrate.

<span class="mw-page-title-main">Sufentanil</span> Synthetic opioid analgesic drug

Sufentanil, sold under the brand names Dsuvia and Sufenta, is a synthetic opioid analgesic drug approximately 5 to 10 times as potent as its parent drug, fentanyl, and 500 times as potent as morphine. Structurally, sufentanil differs from fentanyl through the addition of a methoxymethyl group on the piperidine ring, and the replacement of the phenyl ring by thiophene. Sufentanil first was synthesized at Janssen Pharmaceutica in 1974.

Bengay, spelled Ben-Gay before 1995, is a topical analgesic heat rub for temporary relief from muscle and joint pain associated with arthritis, bruises, simple backaches, overuse, sprains and strains.

<span class="mw-page-title-main">Magnesium salicylate</span> Common analgesic and nonsteroidal anti-inflammatory drug

Magnesium salicylate is a common analgesic and nonsteroidal anti-inflammatory drug (NSAID) used to treat mild to moderate musculoskeletal pain such as in tendons and muscles. It is also used to treat joint pain like arthritis, general back pain, and headaches.

<span class="mw-page-title-main">RUB A535</span> Topical pain relief medicine

RUB A535 is a rubefacient introduced in 1919 and manufactured by Church & Dwight in Montreal, Quebec, Canada.

<span class="mw-page-title-main">Phonophoresis</span>

Phonophoresis, also known as sonophoresis, is the method of using ultrasound waves to increase skin permeability in order to improve the effectiveness of transdermal drug delivery. This method intersects drug delivery and ultrasound therapy. By assisting transdermal drug delivery, phonophoresis can be a painless treatment and an alternative to a needle.

<span class="mw-page-title-main">Tapentadol</span> Opioid analgesic of benzenoid class

Tapentadol, brand names Nucynta among others, is a centrally acting opioid analgesic of the benzenoid class with a dual mode of action as an agonist of the μ-opioid receptor and as a norepinephrine reuptake inhibitor (NRI). Analgesia occurs within 32 minutes of oral administration, and lasts for 4–6 hours.

"Pain ladder", or analgesic ladder, was created by the World Health Organization (WHO) as a guideline for the use of drugs in the management of pain. Originally published in 1986 for the management of cancer pain, it is now widely used by medical professionals for the management of all types of pain.

An equianalgesic chart is a conversion chart that lists equivalent doses of analgesics. Equianalgesic charts are used for calculation of an equivalent dose between different analgesics. Tables of this general type are also available for NSAIDs, benzodiazepines, depressants, stimulants, anticholinergics and others.

<span class="mw-page-title-main">Hisamitsu Pharmaceutical</span> Japanese pharmaceutical corporation

The Hisamitsu Pharmaceutical Co., Inc., headquartered in Saga and Tokyo, is a Japanese multinational pharmaceutical corporation that develops and markets prescription and over-the-counter drug (OTC) products, especially external pain relieving products such as the transdermal patch. Hisamitsu has specialised in transdermal drug delivery system technology (TDDS) since the introduction of its original line of patches in 1903.

<span class="mw-page-title-main">Medherant</span> British pharmaceutical company

Medherant Ltd is a British pharmaceutical company, based in Coventry. The company develops over-the-counter (OTC) and prescription transdermal patches for drug delivery.

<span class="mw-page-title-main">Antiarthritics</span> Drug class

An antiarthritic is any drug used to relieve or prevent arthritic symptoms, such as joint pain or joint stiffness. Depending on the antiarthritic drug class, it is used for managing pain, reducing inflammation or acting as an immunosuppressant. These drugs are typically given orally, topically or through administration by injection. The choice of antiarthritic medication is often determined by the nature of arthritis, the severity of symptoms as well as other factors, such as the tolerability of side effects.

<span class="mw-page-title-main">Norfentanyl</span> Synthetic opioid analgesic metabolite and precursor

Norfentanyl is an inactive synthetic opioid analgesic drug precursor. It is an analog and metabolite of fentanyl with the removal of the phenethyl moiety from fentanyl chemical structure.

References

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  2. 1 2 Pray, W. Steven (1 September 2008). "The pharmacist's role in the appropriate selection of a nonprescription product for pain relief". U.S. Pharmacist. Retrieved 2010-03-24.
  3. Hall, Harriet. "Salonpas". Science-Based Medicine. Archived from the original on 5 February 2021. Retrieved 14 April 2021.
  4. Levy, Sandra (10 December 2001). "External painkillers lead sales in analgesics market". Drug Topics. Retrieved 2010-03-24.
  5. Ghosh, Tapash K.; William R. Pfister; Su Il Yum (1997). Transdermal and Topical Drug Delivery Systems. Informa Health Care. ISBN   1-57491-041-8.
  6. American Society of Health-System Pharmacists, Inc. (15 January 2021). "Fentanyl Transdermal Patch". MedlinePlus. Retrieved 3 August 2021.
  7. 1 2 US Department of Health and Human Services (21 December 2007). "Information for Healthcare Professionals: Fentanyl Transdermal System (marketed as Duragesic and generics)". US Food and Drug Administration Postmarket Drug Safety Information for Patients and Providers. Retrieved 2010-03-24.
  8. Smoker, Jordan; Cohen, Alexa; Rasouli, Mohammad R.; Schwenk, Eric S. (2019-11-14). "Transdermal Lidocaine for Perioperative Pain: a Systematic Review of the Literature". Current Pain and Headache Reports. 23 (12): 89. doi:10.1007/s11916-019-0830-9. ISSN   1531-3433. PMID   31728770. S2CID   207988031.
  9. Pastore, Michael N; Kalia, Yogeshvar N; Horstmann, Michael; Roberts, Michael S (May 2015). "Transdermal patches: history, development and pharmacology: History of transdermal patches". British Journal of Pharmacology. 172 (9): 2179–2209. doi:10.1111/bph.13059. PMC   4403087 . PMID   25560046.