Using transdermal patches in neonates

Branching off my other thread about acute limb ischemia in neonates, I would like to focus on using transdermal patches in neonates. In that case we used a nitroglycerin patch to localize vasodilation and facilitate blood flow to the ischemic limb.

Sometimes topical administration of drugs may be required (e.g., palliative analgesia with fentanyl patches, local vasodilation with nitroglycerin patches), or treatment with a drug only available as a transdermal patch (scopolamine/hyoscine). Since there are no transdermal patches approved for use in children, as well as neonates, neonatal clinicians should understand how to safely manipulate transdermal patches and adapt them to the neonate based on limited evidence and pharmacological reasoning.

Attached hereby is a poster presented a couple of years ago in EAPS 2024:Shaniv and Litvin - Transdermal Patches for Neonates.pdf

It reviews the composition and pharmacology of transdermal patches, and demonstrates our preferred method of patch manipulation using partial covering rather than cutting patches, which is a common but hazardous practice:

Welcome to share your experience - do you use transdermal patches in your NICUs? How often? In what way?