What it's for (Indications)
- For anesthesia and the management of severe, chronic, intractable malignant and non-malignant pain in opioid-tolerant patients.
- Not indicated for acute, intermittent, mild, or post-operative pain.
Dosage Information
| Type | Guideline |
|---|---|
| Standard | Fentanyl should only be prescribed by healthcare providers knowledgeable about extended-release/long-acting opioids and their associated risks. Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals. Initiate the dosing regimen individually, considering the patient's underlying pain, prior analgesic treatment and response, and risk factors for addiction, abuse, and misuse. Titrate to higher doses only for patients where lower doses are insufficiently effective and the expected benefits clearly outweigh the substantial risks. Monitor closely for respiratory depression, especially during initiation and following dosage increases. |
Safety & Warnings
Common Side Effects
- Common: Nausea, vomiting, hypotension (decreased blood pressure).
- Severe: Addiction, abuse, misuse, life-threatening respiratory depression, accidental exposure, neonatal opioid withdrawal syndrome, opioid-induced hyperalgesia and allodynia, serotonin syndrome, adrenal insufficiency, severe hypotension, gastrointestinal adverse reactions (including paralytic ileus), seizures, and withdrawal symptoms.
Serious Warnings
- Black Box Warning: WARNING: SERIOUS AND LIFE-THREATENING RISKS FROM USE OF FENTANYL TRANSDERMAL SYSTEM. Opioid Addiction, Abuse, and Misuse: Use exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death. Assess each patient’s risk prior to prescribing and regularly reassess for the development of these behaviors and conditions. Life-threatening Respiratory Depression: Serious, life-threatening, or fatal respiratory depression may occur.
- Addiction, Abuse, Misuse, and risk of overdose/death.
- Life-threatening respiratory depression (especially during initiation and dosage increases).
- Accidental exposure.
- Concomitant use with benzodiazepines or other central nervous system depressants can lead to profound sedation, respiratory depression, coma, and death.
- Neonatal opioid withdrawal syndrome if used during pregnancy.
- Opioid-induced hyperalgesia and allodynia.
- Serotonin syndrome when co-administered with serotonergic drugs.
- Adrenal insufficiency.
- Severe hypotension.
- Gastrointestinal adverse reactions (e.
- g.
- , paralytic ileus).
- Seizures.
- Withdrawal symptoms upon discontinuation.
- Avoid driving or operating machinery due to potential impairment.
- Avoid alcohol consumption.
- Use with extreme caution in patients with COPD (lung disorder that makes it hard to breathe) or raised intracranial pressure.
- Pregnancy: Consult a doctor.
- Lactation: Women who are breastfeeding should avoid this medicine.
How it Works (Mechanism of Action)
Fentanyl is an opioid agonist that interacts predominately with the opioid mu-receptor. These mu-binding sites are distributed in the human brain, spinal cord, and other tissues.
Commercial Brands (Alternatives)
No other brands found for this formula.