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In the hosting industry, the Domain Name System DNS is one of the most critical pieces, right behind websites themselves.  Without DNS, that website you ve worked so hard on would be completely invisible.  Although it s possible to access some sites using only the IP address of their web server, this is not the case for virtual websites, which require that their hostname be included in the HTTP request header.  Without a working DNS record, virtual websites are completely inaccessible.   But I ve found that DNS is something that is not well understood by many website operators.  The basics of creating A records which translate a hostname to an IP address are simple enough, but when it comes to understanding how changes are propagated in DNS, this is often something of a mystery.

There is a widely held belief that any change made the DNS zone file of a domain is instantly seen throughout the Internet.  Yet nothing could be further from the truth.  When advising that changes be made to a zone file to fix a problem, I routinely add the following caveat:

Please allow up to 24 hours for any change to completely propagate throughout the world-wide DNS system.

Changes to a zone file are almost never instantaneous regardless of how despreate you are that they be instantaneous.  Any change requires time before it will be seen everywhere on the Internet.  But what many don t understand is that how fast or slow these updates are propagated is actually under their direct control through the SOA record.

Let me be completely clear on this one point.  Although you have control over the speed that updates are propagated throughtout the Internet, they will never, ever, be instantenous.  There will always be a delay.  Your only control is over how short or long this delay will be.

The SOA record is perhaps the least understood record in the entire zone file.  But it controls the speed that any update is propagated thourghout the Internet.  The purpose of the SOA record is:

Identify the DNS server that is authoritative for all information within the domain.

List the email address of the person in charge of the domain.

Control how often secondary servers check for changes to the zone file.

Control how long secondary servers keep the zone file active when the primary server cannot be contacted.

Control how long a negative response is cached by a DNS resolver but for some DNS servers, this is also how long a DNS resolver should cache any response.

Now if you control all of the authorative DNS servers for a domain that is, the DNS servers that actually host the zone files and can answers queries for the domain as opposed to having to ask another DNS server, then with the exception of how long negative responses should be cached, these settings may not seem as important since you can force the secondary servers to update whenever needed.  By if you are using third-party name servers which you do not control as your secondary name servers such as Peer 1 s SuperDNS servers, then these settings are vitally important to how fast any changes are propagated.  So let s go over each of these settings.

I will be using the official names for each of these fields as listed in RFC 1035: Domain Names Implementation and Specification.

Fully-qualified domain name of the primary or master name server for the zone file.  Within the structure of DNS, there can only be one server that holds the master, editable zone file.  Yes, there are exceptions, but I won t cover them here.   All secondary name servers create their zone files by transferring the contents from the primary name server.  Changes to the domain s resource records are made to the primary name server s zone file and are then propagated to the secondary name servers when they check for updates.

The domain name of the primary name server must end with a period.

Email address of the person responsible for the domain s zone file.  Often it will be an alias or group address rather than a particular idividual.  It uses a special format where the character is replaced with a . period character and the email address ends with a period.  So the email address hostmaster example.com would become hostmaster.example.com. note that the endding period is part of the email address.

Never use an email address which uses a period before the character such as host.master example.com since DNS will automatically interpret the first period as the character where host.master.example.com. would become host master.example.com.

Serial number of the zone file that is incremented each time a change is made.  The secondary name servers compare the serial number returned by the primary name server with the serial number in their copy of the zone file to determine if they should update their zone file.  If the serial number from the primary name server is greater than their serial number, they will do a zone update transfer.  Otherwise, no action is taken.

If you make a change to the zone file on the primary name server and forget to increment the serial number, the change will not be propagated to the secondary name servers even if you attempt to force a zone update transfer.  The primary and secondary name servers will remain out of sync until the serial number is incremented on the primary name server.  Unless you are manually editing the zone files something that is not uncommon when using BIND, most DNS servers or frontend DNS applications will increment the serial number for you.  But if you find that updates are not being propagated to the secondary name servers, the serial number is the first thing you should check.

In the early days of DNS, the serial number was just that a number that was incremented by 1 each time the zone file was changed.  So that one could have a better idea of when the zone file was actually changed, it s recommended but not required that you use the format YYYYMMDDnn, where YYYY is the year, MM is the month, DD is the day, and nn is the revision number in case the zone file is changed more than once in a single day.

Never use a decimal in the serial number, such as 20130511.01, even if it is allowed by your DNS server.  The serial number is an unsigned 32-bit number, so using a decimal in the serial number will cause it be converted to something unexpected.

Time in seconds that a secondary name server should wait between zone file update checks.  The value should not be so short that the primary name server is overwhelmed by update checks and not so long that propagation of changes to the secondary name servers are unduely delayed.  If you control the secondary name servers and the zone file doesn t change that often, then you might want to set this to as long as day 86400 seconds, especially if you can force an update on the secondary name servers if needed.  But if your secondary name servers are not under your control, then you ll probably want to set this to somewhere between 30 minutes 1800 seconds and 2 hours 7200 seconds to ensure any changes you make are propagated in a timely fashion.

Even if you configure your primary name server to send NOTIFY messages which I will cover in a future article to the secondary name servers whenever a change is made, you should never completely depend on this to ensure timely propagation of the changes, especially when using third-party secondary name servers. The decision to honor a NOTIFY message is entirely up to the secondary name server and some DNS servers do not support NOTIFY.

Time in seconds that a secondary name server should wait before trying to contact the primary name server again after a failed attempt to check for a zone file update.  There are all kinds of reasons why a zone file update check could fail, and not all of them mean that there is something wrong with the primary name server.  Perhaps it was too busy handling other requests just then.  The Retry Interval simply tells the secondary name server to wait for a period of time before trying again.  A good retry value would be between 10 minutes 600 seconds and 1 hour 3600 seconds, depending on the length of the Refresh Interval.

The retry interval should always be shorter than the refresh interval.  But don t make this value too short.  When in doubt, use a 15 minute 900 second retry interval.

Time in seconds that a secondary name server will treat its zone file as valid when the primary name server cannot be contacted.  If your primary name server goes offline for some reason, you want the secondary name names to keep answering DNS queries for your domain until you can get the primary back online.  Make this value too short and your domain will disapear from the Internet before you can bring the primary back online.  A good value would be something between 2 weeks 1209600 seconds and 4 weeks 2419200 seconds.

If you stop using a domain and delete it from the configuration of the primary name server, remember to remove it from the secondary name servers as well.  This is especially important if you use third-party secondary name servers since they will continue to answer queries for the deleted domain answers which could now be completely incorrect until the expiry interval is reached.

MINIMUM:  Negative Caching Time To Live

This field requires special attention since how it s interpreted depends on the DNS server you are using.  There have been three possible meanings for the MINIMUM field:

Defines the minimum time in seconds that a resource record should be cached by any name server.  Though this was the original meaning of this field and it still retains the name from this meaning, it was never actually used this way by most name servers.  This meaning is now officially deprecated.

Defines the default Time To Live TTL for all resource records that do not have an explicit TTL.  This only applies to the zone file on the primary name server since a zone transfer to the secondary server adds the explicit TTL to the resource record if it is missing.  Versions of BIND prior to 8.2 use the MINIMUM field as the default TTL for all resource records, as do all versions of Windows DNS Server.

Defines the time in seconds that any name server or resolver should cache a negative response.  This is now the official meaning of this field as set by RFC 2308.

Unlike all the other SOA fields, MINIMUM effects every name server or resolver that queries your domain.  If your DNS server is compliant with RFC 2308, then this field only applies to how long a negative response that is, for a query where no resource record is found is cached.  But if your DNS server uses this as the default TTL for resource records without an explicit TTL, then it controls how long any response could be cached by a name server.

If you make this too long, then name servers and resolvers will keep using their cached result even after all the secondary name servers have updated their zone files.  And there is no method available for you to force these name servers and resolvers to flush their cache.  Again, if your DNS server is compliant with RFC 2308, it only applies to negative responses.  But if not, then all resource records without an explicit TTL will use this value as the default TTL.  If you were to set this to 1 week 604800 seconds, then it could take up to a week for any change to finally be seen everywhere on the Internet.

This was added in RFC 2308 to define the default TTL to should be used for any resource record that does not have an explicit TTL.  But as pointed out earlier, not all DNS servers support it.  BIND 8.2 and higher use TTL to define the default TTL in their zone files, but Windows DNS Server does not, relying on the SOA MINIMUM field instead,  So check you DNS server manual to find out how it sets the default TTL.

There is no hard and fast rule for setting the refresh, retry, and TTL values.  For domains where changes are rarely done, longer values are usually preferred.  But if are planning to make changes, then reducing these values before hand, especially the default TTL, can go a long way to ensuring your changes get propagated in a timely fashion.  But you must change these values at least as far in advance as the default TTL.  If, for example, the current default TTL is set to one week, you ll need to change the default TTL at least a week before the zone file is changed to ensure that every DNS server and resolver is using the new TTL.  Otherwise you could find that scattered sections of the Internet don t see the change until the older, cached record finally expires.

In news:49834d70 0 18007 607ed4bc xxxxxx, news.optonline.net Nick, posted the following: I have 3 DNS servers in 3 different domains, all AD integrated.

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In this section of our Privacy Policy, we discuss how we may use the Personal Information and Non-Personal Information that we collect about you.

Communications. By registering for the Services, you are consenting to receive certain communications. Specifically, we may use your registration information to send you communications about our products and services and the products and services of our third party sponsors through pop-ups, banners and e-mails. You may also subscribe to receive certain e-mail newsletters sent to registered users from time to time which you may manage through the newsletter subscriptions area within your account settings.

Marketing and Advertising. In connect with advertising and marketing activities, WebMD may:

Target advertising and marketing communications based on information that we collect about your use of the Services and information about you that we obtain from third party sources. For example, a user that WebMD believes is a cardiologist may be served cardiology-related advertisements on both WebMD-owned and third party websites that a user that WebMD believes is a neurologist will not see. Similarly, a user that WebMD believes is a healthcare professional that treats diabetes may be served advertisements for new diabetes therapies that other users would not see. WebMD serves these ads through the use of cookies and web beacons, as described above. WebMD may also geographically target advertising and marketing communications based on your Internet Protocol IP address.

Personalize the Services, including the content and advertising that registered users see within the Medscape Network, on third party sites and through other communications such as e-mail, based on their interests. For example, you may see different articles and advertisements in different places on www.medscape.com and in e-mails that we send to you based on i information you have shared with WebMD such as your specialty; ii information that WebMD has obtained by observing your previous activity within the Medscape Network; or iii information that WebMD has received from third party sources, as described in this Privacy Policy.

Work with third parties to allow advertisers to serve you ads within the Medscape Network using information that such advertisers have collected from third party sources. For example, if you looked at an advertisement for an automobile on a third party website you may receive an advertisement for that automobile on a Site through the use of cookies.

Member Profiles. As described above, we use web beacons and cookies to track your use of the Services, including content consumption, and may associate this information with other information that we have about you, including Personal Information, thereby creating a profile of you that we may update from time to time Member Profile.

Research, Development and Evaluation Activities. We use information that we collect about users of our Services, including Personal Information, to evaluate and improve the effectiveness of the Services including advertising and Sponsored Programs, to develop new Services and for market analysis. We may combine this information with information that we obtain from third parties.

Account Management. We may use your account information to administer your account, respond to your inquiries you send to us and to send you administrative communications about the Services.

Disclosure of Your Information to Third Parties

Companies and People Who Work for Us: We each contract with other companies and individuals to help us provide the Services and to otherwise assist us in the operation of our businesses. For example, we may host one of our Sites on another company s computers, hire technical consultants to maintain our clinical tools, work with companies to analyze data, provide marketing assistance including assisting us in targeting our advertisements as described herein or to provide customer service or fulfillment services. In addition, if you are a healthcare professional, we may request that a third party validate your licensure status and other information against available databases of healthcare professionals. Notwithstanding anything to the contrary herein, we may provide these companies and individuals with Personal Information about users of our Services so that they can fulfill their responsibilities to us, however, we do require that they agree to limit their use of this Personal Information to the fulfillment of these responsibilities.

Aggregated Information. We may provide aggregated information about users of our Services to third parties as we deem appropriate in our sole discretion. For example, WebMD may tell a customer what percentage of registered users of the Medscape Network reside in a particular geographical area or specialize in a particular clinical area, or what percentage of participants in a market research survey selected a particular response to a survey question. We may also use Personal Information to evaluate the performance of an advertising campaign and may provide aggregate outcomes information to the advertiser.

Advertising and Sponsored Programs: We may provide your Personal Information to third party sponsors of advertisements and Sponsored Programs. Specifically, when you are exposed to an advertisement through the Services, whether on a Site, in a newsletter or through some other means, or when you engage in a Sponsored Program, e.g., access a sponsored information resource or open a Sponsored Program e-mail from WebMD Professional, WebMD may provide your Personal Information, such as your name and specialty, but not your contact information such as email address and postal address, to the sponsor of the advertisement or Sponsored Program and/or its agents on the sponsor s behalf. We may also provide such third parties with details about your engagement with the advertisement or Sponsored Program e.g., whether you viewed or otherwise interacted with certain content, your answers to any polling questions contained in the Sponsored Program that you have chosen to provide and information about you that we have received from third parties. Additionally, when you register as a member of the Medscape Network, we may provide your Personal Information, excluding contact information, to potential sponsors of advertisements and Sponsored Programs that may be offered or provided to you through the Services. We are not responsible for how these third parties use your information and manage your privacy.

Member Profiles. WebMD may provide Member Profiles excluding contact information, such as email address and postal address, and information about your participation in specific named CME and CE activities to third parties, including our pharmaceutical manufacturer customers, which they may use for their business purposes including marketing. We require these third parties to agree that they will use Member Profiles in accordance with applicable laws and regulations. By registering as a member of the Medscape Network and using the Services, you consent to WebMD s disclosure of your Member Profiles to third parties as described herein.

Market Research Surveys: If you receive remuneration for participating in a Sponsored Survey, we may be required to provide the sponsor or the market research company acting on its behalf with your Personal Information for the sponsor s recordkeeping and/or regulatory reporting purposes. If you chose to access a Sponsored Survey that is conducted by a third party market research company, we may identify you to this company through the survey link. Sometimes market research companies send us lists of individuals they wish to reach with particular Sponsored Surveys, and we may inform these companies which of these individuals are members of the Medscape Network so that they can manage their survey recruitment needs accordingly. Also, certain market research survey opportunities made available to you through the Services require the market research company to contact you directly to conduct the Sponsored Survey. We will inform you in the associated survey invitation that we intend to provide your contact information to the market research company that is conducting the Sponsored Survey so that you can decide at such time if you wish to proceed with the opportunity. We do not disclose your Sponsored Survey responses to the associated sponsor in a manner identifiable to you.

Continuing Medical Education: We may share your Personal Information with the accreditors of our continuing education programs. Medscape is accredited by the Accreditation Council for Continuing Medical Education ACCME, the American Nurses Credentialing Center and the Accreditation Council for Pharmacy Education to provide continuing education to physicians, nurses and pharmacists, respectively collectively, CME/CE. As an accredited entity, Medscape is required to periodically submit Personal Information about CME/CE participants and the CME/ CE activities that Medscape certifies, as requested by the applicable accrediting entity. Medscape and WebMD Global LLC WebMD Global, an affiliated company that also provides continuing medical education activities through the Medscape Network, may provide your Personal Information to other accredited providers who certify CME/CE offered through the Services as required by these other providers to process the credits that that you earn by completing the applicable CME/CE activity, to fulfill their reporting obligations to the ACCME and other accrediting bodies and as required for their internal recordkeeping purposes. Supporters of Medscape and WebMD Global s continuing medical education activities will receive only aggregated data about CME/CE activities that they support including participation and outcomes measurement.

Logging in to Another Website Using Your Medscape Credentials: Certain third party websites permit you to log in using your Medscape username and password. If you choose to log in to one of these websites using your Medscape log in credentials, we may give this website information included in your registration profile including Personal Information such as your name, specialty, occupation and email address, but not your Medscape username and password, which the operator of the website has agreed to use in accordance with its website s privacy policy. You should review the third party website s privacy policy before logging in. If the privacy policy of the third party site permits, we may receive information about your use of this third party site, which we may use in accordance with this Privacy Policy.

Consent: We may disclose your Personal Information to a third party in a manner not addressed by this Privacy Policy subject to your consent.

Business Transfers: If one of us transfers a business unit such as a subsidiary or an asset such as a website to another company, that company will be required to treat any Personal Information collected under this Privacy Policy consistent with the applicable terms of this Privacy Policy.

Legal Requirements: We may release account and other Personal Information when we believe release 1 is required to comply with valid legal requirements such as a law, regulation, search warrant, subpoena or court order; or 2 is reasonable in response to a physical threat to you or others, to protect property or defend or assert legal rights of us or others.

We have implemented technology and security policies and other measures to protect the personal data that we have under our control from unauthorized access, improper use, alteration, unlawful or accidental destruction, and accidental loss. We also require that all of our employees and others who have access to or are associated with the processing of your data respect your confidentiality.

We use security methods to determine the identity of registered users, so that appropriate rights and restrictions can be enforced for that user. Reliable verification of user identity is called authentication. We use both passwords and usernames to authenticate users. Users are responsible for maintaining the security of their Medscape login credentials.

Access to Information and Choices

Account Information. You may update your registration information at any time through the Account Management feature available on each of the Sites and Apps. You may also contact Customer Support at MedscapeCustomerSupport webmd.net and request that your registration information be updated or deleted. Upon your request, we will delete your registration information from our active databases and where feasible, from our backup media. Note that if we delete your account, we may maintain certain demographic information about you for product improvement purposes.

Cookies. Most browser software can be set to reject Cookies. Most browsers offer instructions on how to reset the browser to reject Cookies in the Help section of the toolbar. However, if you reject our cookies, you will not be able to access the Sites. Certain Ad Servers allow you to prevent them from collecting data through the use of cookies. In order to do so, you must opt-out of such data collection with each individual site. Currently, you can opt out of cookies for several Ad Servers by visiting the Network Advertising Initiative gateway opt-out site. This website will also allow you to review the Ad Server s privacy policies. The Sites do not respond to web browser do not track signals.

Note to Users Outside of the United States

WebMD, Medscape and WebMD Global are located in the United States. We will collect, store, and process your information that we obtain from the use of the Services in the United States and these activities shall be governed by applicable United States laws and regulations and this Privacy Policy. The information may be available to the United States government or its agencies under legal process made in the United States. In addition, we may transfer your information outside the United States to service providers and customers with operations in other countries. By using the Services, you consent to such collection, storage and processing in the United States and elsewhere, though the United States and other jurisdictions may not afford the same level of data protection as considered adequate in your own country. We will take reasonable steps to protect your information.

The Medscape Network and the Services are designed and intended for use by adults, and are not intended for nor designed to be used by children under the age of 18. We do not collect Personal Information from any person we know is under the age of 18.

We reserve the right to modify this Privacy Policy at any time and any changes will be effective upon posting of the modified Policy unless we advise otherwise. If we make any material changes to this Policy we will notify you by email sent to the email address included in your account profile and/or by means of a notice on the Medscape Network at the time that the change becoming effective. We encourage you to periodically review this Privacy Policy for the latest information on our privacy practices. If you do not accept the terms of this Privacy Policy, we ask that you do not register with us and that you do not use the Services. By continuing to use the Services after changes are made to this Privacy Policy, you are consenting to such changes.

For privacy questions or concerns about one of our Web sites or Services, please contact MedscapePrivacy webmd.net.

The Medscape Terms of Use can be found at

Effective date: November 24, 2015.

Medscape Access

duragesic patch time onset duragesic patch time onset

DURAGESIC fentanyl transdermal system CII contains a high concentration of a potent Schedule II opioid agonist, fentanyl. Schedule II opioid substances which include fentanyl, hydromorphone, methadone, morphine, oxycodone, and oxymorphone have the highest potential for abuse and associated risk of fatal overdose due to respiratory depression. Fentanyl can be abused and is subject to criminal diversion. The high content of fentanyl in the patches DURAGESIC may be a particular target for abuse and diversion.

DURAGESIC is indicated for management of persistent, moderate to severe chronic pain that:

Requires continuous, around-the-clock opioid administration for an extended period of time, and

Cannot be managed by other means such as nonsteroidal analgesics, opioid combination products, or immediate-release opioids

should ONLY be used in patients who are already receiving opioid

therapy, who have demonstrated opioid tolerance, and who require a

total daily dose at least equivalent to DURAGESIC 25

mcg/hr. Patients who are considered opioid-tolerant are those who have

been taking, for a week or longer, at least 60 mg of morphine daily, or

at least 30 mg of oral oxycodone daily, or at least 8 mg of oral

hydromorphone daily or an equianalgesic dose of another opioid.

Because serious or life-threatening hypoventilation could occur, DURAGESIC is contraindicated:

In patients who are not opioid-tolerant

In the management of acute pain or in patients who require opioid analgesia for a short period of time

In the management of post-operative pain, including use after out-patient or day surgeries e.g., tonsillectomies

In the management of mild pain

In the management of intermittent pain e.g., use on an as needed basis prn

See CONTRAINDICATIONS section of the full Prescribing Information for further information.

Since the peak fentanyl concentrations generally occur between 20 and

72 hours of treatment, prescribers should be aware that serious or

life-threatening hypoventilation may occur, even in opioid-tolerant

patients, during the initial application period.

DURAGESIC with all cytochrome P450 3A4 inhibitors

such as ritonavir, ketoconazole, itraconazole, troleandomycin, clarithromycin, nelfinavir, nefazodone, amiodarone, amprenavir, aprepitant, diltiazem, erythromycin, fluconazole, fosamprenavir, grapefruit juice, and verapamil may result in an increase in fentanyl

plasma concentrations, which could increase or prolong adverse drug

effects and may cause potentially fatal respiratory depression.

Patients receiving DURAGESIC and any CYP3A4 inhibitors

should be carefully monitored for an extended period of time and dosage

adjustments should be made if warranted. See CLINICAL

PHARMACOLOGY-Drug Interactions, WARNINGS, PRECAUTIONS, and DOSAGE AND

ADMINISTRATION sections of the full Prescribing Information for further

The safety of DURAGESIC has not been established in children under 2 years of age. DURAGESIC should be administered to children only if they are opioid-tolerant and 2 years of age or older. See PRECAUTIONS - Pediatric Use section of the full Prescribing Information.

is ONLY for use in patients who are already tolerant to opioid therapy

of comparable potency. Use in non-opioid tolerant patients may lead to

fatal respiratory depression. Overestimating the DURAGESIC

dose when converting patients from another opioid medication can result

in fatal overdose with the first dose see DOSAGE and ADMINISTRATION –

Initial DURAGESIC Dose Selection - section of full

Prescribing Information for further information. Due to the mean

elimination half-life of approximately 20-27 hours, patients who are

thought to have had a serious adverse event, including overdose, will

require monitoring and treatment for at least 24 hours.

DURAGESIC can be abused in a manner

similar to other opioid agonists, legal or illicit. This risk should be

considered when administering, prescribing, or dispensing DURAGESIC in situations where the healthcare professional is concerned about increased risk of misuse, abuse, or diversion.

Persons at increased risk for opioid abuse include those with a

personal or family history of substance abuse including drug or

alcohol abuse or addiction or mental illness e.g., major depression.

Patients should be assessed for their clinical risks for opioid abuse

or addiction prior to being prescribed opioids. All patients receiving

opioids should be routinely monitored for signs of misuse, abuse, and

addiction. Patients at increased risk of opioid abuse may still be

appropriately treated with modified-release opioid formulations;

however, these patients will require intensive monitoring for signs of

DURAGESIC patches are intended for transdermal use on intact skin only. Do not use a DURAGESIC patch if the seal is broken or the patch is cut, damaged, or changed in any way.

application site and surrounding area to direct external heat sources,

such as heating pads or electric blankets, heat or tanning lamps,

saunas, hot tubs and heated water beds, while wearing the system. Avoid

taking hot baths or sunbathing. There is a potential for

temperature-dependant increases in fentanyl released from the system

resulting in possible overdose and death. Patients wearing DURAGESIC

systems who develop fever or increased core body temperature due to

strenuous exertion should be monitored for opioid side effects and the

DURAGESIC dose should be adjusted if necessary.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

DURAGESIC - fentanyl patch Ortho-McNeil-Janssen Pharmaceuticals, Inc.-----DURAGESIC Fentanyl Transdermal System CII. Full Prescribing Information.

The onset, duration, and Prepare to apply a DURAGESIC patch: Choose the time of day that is best for you to apply DURAGESIC DURAGESIC- fentanyl patch.

Welcome. What is DURAGESIC®?

duragesic patch time onset

Duragesic and Durogesic / ˌ d ɜːr ə ˈ dʒ iː z ɪ k / are trade names of fentanyl transdermal patches, used for relief of moderate to severe pain. The patches.

DURAGESIC is: A strong Do not apply more than 1 patch at the same time unless your healthcare provider tells you to. You should wear the DURAGESIC patch.

The fentanyl skin patch is only used for opioid If you need to apply more than 1 patch at a time, place the patches far enough apart so that the edges do not.

duragesic patch time onset

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