Fentanyl

Adult Medication

Brand Names: US

Abstral; Actiq; Duragesic; Fentora; Ionsys; Lazanda; Onsolis [DSC]; Subsys

Brand Names: Canada

Abstral; Apo-Fentanyl Matrix; Co-Fentanyl; Duragesic MAT; Fentanyl Citrate Injection, USP; Fentora; Mylan-Fentanyl Matrix Patch; PMS-Fentanyl MTX; RAN-Fentanyl Matrix Patch; Sandoz Fentanyl Patch; Teva-Fentanyl

Warning

Skin system:

  • You must be the only person to use this drug. Be sure no one else touches the system or the drug inside it. This drug is only for use if you are in a hospital. If you are leaving the hospital, make sure that this drug is removed before you leave. Talk with your doctor.

All other products:

  • This drug is only for people who have been taking drugs like this one and are used to the effects. Use of this drug by people who have not or by children may cause deadly breathing problems. If this happens, get medical help right away.

All products:

  • This drug may cause very bad and sometimes deadly breathing problems. Call your doctor right away if you have slow, shallow, or trouble breathing.
  • Even one dose of this drug may be deadly if it is taken by someone else or by accident, especially in children. If this drug is taken by someone else or by accident, get medical help right away.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • This drug may be abused. It is habit-forming.
  • Misuse or abuse of this drug can lead to overdose and death.
  • Tell your doctor if you or a family member has abused drugs or alcohol or had mental or mood problems.
  • Many drugs interact with this drug and can raise the chance of side effects like deadly breathing problems. Talk with your doctor and pharmacist to make sure it is safe to use this drug with all of your drugs.
  • Do not switch brands of this drug unless you talk with your doctor. It may lead to deadly overdose.
  • You may need to get some of these drugs through a special program. Talk with the doctor.
  • Using this drug for a long time during pregnancy may lead to withdrawal in the newborn baby. This can be life-threatening. Talk with the doctor.

Skin patch:

  • The chance of very bad and sometimes deadly breathing problems may be greater when you first start this drug or anytime your dose is raised. Talk with your doctor.
  • Avoid hot baths, sunbathing, and use of heat sources (including tanning beds, heating pads, and hot tubs). Avoid activities like heavy exercise. Tell your doctor if you get a fever. A rise in body temperature may cause too much drug to pass into your body. This can cause overdose and deadly breathing problems.

What is this drug used for?

Skin patch:

  • It is used to ease very bad pain.
  • It is only to be used when around-the-clock (continuous) care is needed for a long time. It is also only to be used when other pain drugs do not treat your pain well enough or you cannot take them.

Skin system:

  • It is used to ease pain after surgery.

Shot:

  • It is used to ease pain.
  • It is used during surgery.

All other products:

  • It is used to ease pain.
  • This drug is not for mild pain or pain that only lasts a short time (like headaches, toothaches, or pain after surgery).

What do I need to tell my doctor BEFORE I take this drug?

All products:

  • If you have an allergy to this drug or any part of this drug.
  • If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
  • If you have any of these health problems: Very bad asthma, trouble breathing, recent head injury, growths or tumors in the brain, raised pressure in the brain, or very bad bowel or stomach problems like bowel block.
  • If you have taken certain drugs used for low mood (depression) like isocarboxazid, phenelzine, or tranylcypromine or drugs used for Parkinson’s disease like selegiline or rasagiline in the last 14 days. Taking this drug within 14 days of those drugs can cause very bad high blood pressure. Talk with your doctor.
  • If you are taking any of these drugs: Buprenorphine, butorphanol, nalbuphine, or pentazocine.

Skin patch:

  • If you have any of these health problems: Kidney disease or liver disease.
Under the tongue (sublingual) spray:
  • If have sores in your mouth, talk with your doctor.
This is not a list of all drugs or health problems that interact with this drug.
Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take this drug?

All products:

  • Tell dentists, surgeons, and other doctors that you use this drug.
  • Avoid driving and doing other tasks or actions that call for you to be alert until you see how this drug affects you.
  • Do not stop taking this drug all of a sudden without calling your doctor. You may have a greater risk of signs of withdrawal. If you need to stop this drug, you will want to slowly stop it as ordered by your doctor.
  • Do not take more than what your doctor told you to take. Taking more than you are told may raise your chance of very bad side effects.
  • Do not take this drug with other strong pain drugs or if you are using a pain patch without talking to your doctor first.
  • Talk with your doctor before you use other drugs and natural products that slow your actions.
  • Avoid drinking alcohol while taking this drug.
  • You will be watched closely by your doctor.
  • If you drink grapefruit juice or eat grapefruit often, talk with your doctor.
  • If you are 65 or older, use this drug with care. You could have more side effects.
  • Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using this drug while you are pregnant.
  • Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

All skin products:

  • The patch may have metal. Take off the patch before an MRI.

Skin system:

  • Take this drug off of the skin as you have been told before having certain tests like CT scans, MRIs, and X-rays.
  • If you have a defibrillator or pacemaker, talk with your doctor.

What are some side effects that I need to call my doctor about right away?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

All products:

  • Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
  • Very bad dizziness or passing out.
  • Feeling confused.
  • Very upset stomach or throwing up.
  • Very hard stools (constipation).
  • Feeling very tired or weak.
  • Trouble breathing, slow breathing, or shallow breathing.
  • Shortness of breath.
  • Chest pain.
  • Fast or slow heartbeat.
  • Feeling very sleepy.
  • Seizures.

All skin products:

  • Very bad irritation where this drug is used.

Cheek tablet:

  • Very bad mouth pain or irritation.
  • Mouth sores.
  • Swelling in the feet or hands.
  • Swelling in the arms or legs.

What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

All products:

  • Dizziness.
  • Dry mouth.
  • Upset stomach or throwing up.
  • Hard stools (constipation).
  • Loose stools (diarrhea).
  • Headache.
  • Feeling sleepy.
  • Feeling tired or weak.
  • Feeling cold.
  • Not hungry.
  • Not able to sleep.
  • Sweating a lot.
  • Belly pain.

All skin products:

  • Irritation where this drug is used.

Cheek tablet:

  • Mouth or tongue irritation.
  • Mouth tingling.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to your national health agency.

How is this drug best taken?

Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

Shot:

  • It is given as a shot.

Skin patch:

  • Wash your hands before and after use.
  • Clip hair at site before putting patch on. Do not shave.
  • Take off old patch first.
  • Put patch on clean, dry, healthy skin on the chest, back, upper leg, or upper arm.
  • Put the patch in a new area each time you change the patch.
  • Do not put the patch on the belt line, bra line, or skin folds.
  • You do not need to put the patch on or near where you are having pain for it to work.
  • You may bathe, shower, or swim for short periods after putting on the patch. Cover the patch with plastic wrap and tape to help keep it in place.
  • If the patch falls off, put a new one on.
  • If the patch loosens, put tape ONLY on the edges of the patch to hold it in place.
  • Do not use patches that are cut or do not look right.
  • The patch has a lot of drug in it even after it is used. Carefully follow how to handle, store, and throw out this drug. Talk with the doctor.

Skin system:

  • Your doctor will put on the skin.
  • Follow how to use as you have been told by the doctor or read the package insert.
  • If you are not sure how to use this drug, talk with your doctor.
  • Do not take this drug off or move it from where it has been placed.

All skin products:

  • Misuse or abuse of this drug by placing it in the mouth or chewing, swallowing, injecting, or snorting it can lead to overdose and death.
  • If you or anyone else touches the gel, wash the skin with lots of water. Do not use soap.

Lozenge:

  • Place lozenge in your mouth between the cheek and lower gum.
  • Suck oral lozenge. Do not chew, break, or crush it. Do not swallow it whole.

Cheek film:

  • Use right after opening.
  • Wet the inside of your cheek with your tongue or water.
  • Place the film inside the mouth on a wet cheek. Hold for 5 seconds so it sticks to the cheek. Let it melt.
  • Do not chew or swallow.
  • You may drink liquids 5 minutes after using.
  • You may eat after film melts.

Cheek tablet:

  • Use right after opening.
  • Place tablet in the mouth above a rear molar tooth between the upper cheek and gum and let melt. You may also place it under the tongue and let it melt.
  • Do not chew, break, or crush.
  • Do not eat or drink until this drug has melted all the way.
  • If the drug has not melted all the way after 30 minutes, you can swallow the rest of it with water.
  • Change the side of mouth with each dose.

Nose spray:

  • For the nose only.
  • Prime pump before first use by spraying it 4 times into the supplied pouch. If this drug has not been used for 5 days, re-prime by spraying 1 time.
  • Close 1 nostril.
  • Put spray 1/2 inch into nostril. Press down on finger grip. A click will sound letting you know the dose was given.
Under the tongue (sublingual) spray:
  • Spray into the mouth under the tongue.

Under the tongue (sublingual) tablet:

  • Use right after opening.
  • Place under tongue and let melt all the way. Do not chew, suck or swallow tablet.
  • Do not eat or drink until this drug has melted all the way.
  • You may wet your mouth with water, if needed, before you take.

What do I do if I miss a dose?

Skin patch:

  • Put on a missed patch as soon as you think about it after taking off the old one.
  • Do not apply double dose or extra doses.

Shot and skin system:

  • Call the doctor to find out what to do.

All other products:

  • If you use this drug on a regular basis, use a missed dose as soon as you think about it.
  • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
  • Do not use 2 doses at the same time or extra doses.
  • Many times this drug is taken on an as needed basis. Do not take more often than told by the doctor.

How do I store and/or throw out this drug?

Shot and skin system:

  • This drug will be given to you in a hospital or doctor’s office. You will not store it at home.

All other products:

  • Store at room temperature. Do not freeze.

Skin patch:

  • After you take off a skin patch, be sure to fold the sticky sides of the patch to each other.

All products:

  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Follow the information that comes with this drug for throwing out doses that are not needed. Check with your pharmacist if you have questions about how to throw out this drug.

General drug facts

  • If your symptoms or health problems do not get better or if they become worse, call your doctor.
  • Do not share your drugs with others and do not take anyone else’s drugs.
  • Keep a list of all your drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your doctor.
  • Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins.
  • Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.
  • If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.

Last Reviewed Date

2016-01-26

Copyright

© 2016 Wolters Kluwer Clinical Drug Information, Inc. and its affiliates and/or licensors. All rights reserved.
If you have any questions or concerns, talk with a member of your healthcare team. You can reach them Monday through Friday from 9:00 am to 5:00 pm at ____________________. After 5:00 pm, during the weekend, and on holidays, please call____________________. If there’s no number listed, or you’re not sure, call 212-639-2000.
Fentanyl
©2016 Memorial Sloan Kettering Cancer Center - Generated on May 20, 2016