Pediatric 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


All products:

  • This drug may cause very bad and sometimes deadly breathing problems. Call the doctor right away if your child has slow, shallow, or trouble breathing.
  • 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.
  • 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 the doctor if your child or someone in your family has ever had drug abuse, alcohol abuse, or mental or mood problems.
  • Many other drugs interact with this drug. These drugs can raise the chance of side effects as well as very bad and sometimes deadly breathing problems. Talk with the doctor and pharmacist to make sure that it is safe for your child to use this drug with all of his/her other drugs.
  • Do not switch brands of this drug unless you talk with your child’s doctor. It may lead to deadly overdose.
  • You may need to get some of these drugs through a special program. Talk with the doctor.

If your child is pregnant:

  • 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 your child first starts this drug or anytime the dose is raised. Talk with your child’s doctor.
  • Have your child avoid use of heat sources (such as sunlamps, tanning beds, heating pads, electric blankets, heat lamps, saunas, hot tubs, heated waterbeds). Avoid long, hot baths or sunbathing. Your child’s temperature may rise and cause too much drug to pass into your child’s body.

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 child’s pain well enough or your child cannot take them.


  • 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).

Skin system:

  • If your child has been given this form of this drug, talk with the doctor for information about the benefits and risks. Talk with the doctor if you have questions or concerns about giving this drug to your child.

What do I need to tell the doctor BEFORE my child takes this drug?

All products:

  • If your child has an allergy to this drug or any part of this drug.
  • If your child is allergic to any drugs like this one or any other drugs, foods, or other substances. Tell the doctor about the allergy and what signs your child had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
  • If your child has 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 your child has taken certain drugs used for low mood (depression) like isocarboxazid, phenelzine, or tranylcypromine or drugs used for certain other health problems in the last 14 days. Taking this drug within 14 days of those drugs can cause very bad high blood pressure. Talk with your child’s doctor.
  • If your child is taking any of these drugs: Buprenorphine, butorphanol, nalbuphine, or pentazocine.

Skin patch:

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

What are some things I need to know or do while my child takes this drug?

All products:

  • Tell dentists, surgeons, and other doctors that your child is using this drug.
  • Have your child avoid tasks or actions that call for alertness until you see how this drug affects your child. These are things like riding a bike, playing sports, or using items such as scissors, lawnmowers, electric scooters, toy cars, or motorized vehicles.
  • Do not stop giving this drug to your child all of a sudden without calling the doctor. Your child may have a greater risk of signs of withdrawal. If your child needs to stop this drug, you will want to slowly stop it as ordered by the doctor.
  • Do not give your child more of this drug than what the doctor told you to give. Giving more of this drug than you are told may raise the chance of very bad side effects.
  • Do not give this drug with other strong pain drugs or pain patches without talking to your child’s doctor first.
  • Talk with the doctor before giving your child other drugs and natural products that may slow your child’s actions.
  • Alcohol may interact with this drug. Be sure your child does not drink alcohol.
  • Your child will be closely watched by the doctor.
  • If your child drinks grapefruit juice or eats grapefruit often, talk with your child’s doctor.

If your child is pregnant or breast-feeding a baby:

  • Talk with the doctor if your child is pregnant, becomes pregnant, or is breast-feeding a baby. You will need to talk about the benefits and risks of using this drug.

Skin patch:

  • The patch may have metal. Take off your child’s patch before an MRI.

What are some side effects that I need to call my child’s 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 child’s doctor or get medical help right away if your child has 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.
  • Trouble breathing, slow breathing, or shallow breathing.
  • Shortness of breath.
  • Change in thinking clearly and with logic.
  • Feeling very tired or weak.
  • Very upset stomach or throwing up.
  • Very hard stools (constipation).
  • Chest pain.
  • Fast or slow heartbeat.
  • Feeling very sleepy.
  • Seizures.

Skin patch:

  • 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 child’s doctor or get medical help if any of these side effects or any other side effects bother your child or do not go away:

All products:

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

Skin patch:

  • 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 child’s doctor. Call your child’s doctor for medical advice about side effects.
You may report side effects to your national health agency.

How is this drug best given?

Give this drug as ordered by your child’s doctor. Read all information given to you. Follow all instructions closely.


  • It is given as a shot.

Skin patch:

  • 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.
  • 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 your child’s upper back. The chest, upper leg, or upper arm may also be used in older children.
  • 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 your child is having pain for it to work.
  • Your child 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.
  • If you or anyone else touches the gel, wash the skin with lots of water. Do not use soap.
  • 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.


  • Place lozenge in your child’s mouth between the cheek and lower gum.
  • Have your child suck oral lozenge. Do not let your child chew, break, or crush it. Do not let your child swallow it whole.

Cheek film:

  • Use right after opening.
  • Have your child wet the inside of the cheek with the 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 let your child chew or swallow.
  • Your child may drink liquids 5 minutes after using.
  • Your child 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 split or break tablet.
  • Do not let your child chew or crush.
  • Do not let your child eat or drink until tablet has melted all the way.
  • If the drug has not melted all the way after 30 minutes, your child can swallow the rest of it with water.
  • Change the side of mouth with each dose.

Nose spray:

  • For the nose only.
  • Prime pump by spraying it 4 times into the supplied pouch. A green bar will show when it is ready to use.
  • 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 your child’s tongue and let melt all the way before swallowing. Do not let your child chew, suck, or swallow the tablet.
  • Do not let your child eat or drink until tablet has melted all the way.
  • Your child may wet the mouth with water, if needed, before taking.

What do I do if my child misses 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.


  • Call your child’s doctor to find out what to do.

All other products:

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

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


  • The shot will be given to your child 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 child’s symptoms or health problems do not get better or if they become worse, call your child’s doctor.
  • Do not share your child’s drug with others and do not give anyone else’s drug to your child.
  • Keep a list of all your child’s drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your child’s doctor.
  • Talk with your child’s doctor before giving your child 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 child’s 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



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©2016 Memorial Sloan Kettering Cancer Center - Generated on February 4, 2016