Complications of oral exposure to fentanyl transdermal delivery system patches

J Med Toxicol. 2010 Dec;6(4):443-7. doi: 10.1007/s13181-010-0092-8.


Purpose: Fentanyl is a synthetic opioid available therapeutically as an intravenous, transbucal, or transdermal preparation. It is also used as a drug of abuse through a variety of different methods, including the oral abuse of transdermal fentanyl patches. This is a series of patients with oral fentanyl patch exposure reported to our center and represents the first series of oral fentanyl patch exposures collected outside of the postmortem setting.

Methods: In this series, we examined the New York Poison Control Center database for all cases of oral abuse of fentanyl reported between January 2000 and April 2008.

Results: Twenty cases were reported, nine were asymptomatic or had symptoms of opioid withdrawal; 11 had symptoms of opioid intoxication. Eight patients were administered naloxone and all showed improvement in clinical status. Only one case resulted in a confirmed fatality-this patient had an orally adherent patch discovered at intubation.

Conclusions: Oral exposure may result in life-threatening toxicity. Patients should be closely assessed and monitored for the opioid toxidrome, and if symptomatic, should be managed with opioid antagonists and ventilatory support.

MeSH terms

  • Administration, Oral
  • Adult
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / adverse effects*
  • Analgesics, Opioid / blood
  • Databases, Factual
  • Female
  • Fentanyl / administration & dosage
  • Fentanyl / adverse effects*
  • Fentanyl / blood
  • Humans
  • Male
  • Middle Aged
  • Naloxone / therapeutic use
  • Narcotic Antagonists / therapeutic use
  • Poisoning / blood
  • Poisoning / etiology*
  • Poisoning / therapy
  • Respiration, Artificial
  • Substance-Related Disorders
  • Suicide, Attempted
  • Transdermal Patch / adverse effects*
  • Treatment Outcome


  • Analgesics, Opioid
  • Narcotic Antagonists
  • Naloxone
  • Fentanyl