Contraindicated in:

• Hypersensitivity to fentanyl or adhesives;

• Known intolerance;

• Acute pain (onset not rapid enough);

• Postoperative pain;

• Mild or intermittent pain;

• Alcohol intolerance (small amounts of alcohol released into skin);

• OB: Not recommended during labor and delivery;

• Lactation: May cause adverse affects in infant.

• Diabetes;

• Patients with severe pulmonary or hepatic disease;

• CNS tumors;

• ↑ intracranial pressure;

• Head trauma;

• Adrenal insufficiency;

• Undiagnosed abdominal pain;

• Hypothyroidism;

• Alcoholism;

• Cardiac disease (particularly bradyarrhythmias);

• Fever or situations that increase body temperature (↑ release of fentanyl from delivery system);

• Titration period (additional analgesics may be required);

• Cachectic or debilitated patients (dose ↓ suggested because of altered drug disposition);

• Pedi: Safety not established for children <2 yr; pediatric patients initiating therapy at 25 mcg/hr should be opioid tolerant and receiving at least 60 mg oral morphine equivalents per day;

• Geri: Dose ↓ suggested due to altered drug disposition.