Fentanyl

This information from Lexicomp^® explains what you need to know about this medication, including what it’s used for, how to take it, its side effects, and when to call your healthcare provider.

Brand Names: US

Actiq [DSC]; Duragesic-100 [DSC]; Duragesic-12 [DSC]; Duragesic-25 [DSC]; Duragesic-50 [DSC]; Duragesic-75 [DSC]; Fentora [DSC]; Lazanda [DSC]; Subsys [DSC]

Brand Names: Canada

FentaNYL Citrate SDZ; Fentora; PMS-FentaNYL MTX [DSC]; SANDOZ FentaNYL; TEVA-FentaNYL

What is this drug used for?

• It is used to manage pain.

All products other than injection:

• This drug is not for mild pain or pain that only lasts a short time (like headaches, toothaches, or pain after surgery).
• This drug is only for use by people who have been taking pain drugs (opioids) and are used to their effects. Talk with the doctor.

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

All products:

• If your child is allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell the doctor about the allergy and what signs your child had.
• If your child has any of these health problems: Lung or breathing problems like asthma, trouble breathing, or sleep apnea; high levels of carbon dioxide in the blood, or stomach or bowel block or narrowing.
• If your child has any of these health problems: Kidney disease or liver disease.
• If your child has taken certain drugs for depression or certain other health problems in the last 14 days. This includes isocarboxazid, phenelzine, or tranylcypromine. Very high blood pressure may happen.
• If your child is taking any of these drugs: Buprenorphine, butorphanol, linezolid, methylene blue, nalbuphine, or pentazocine.

All oral products:

• 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 to give this drug with all of your child’s other 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 all of your child’s health care providers that your child is taking this drug. This includes your child’s doctors, nurses, pharmacists, and dentists.
• 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.
• To lower the chance of feeling dizzy or passing out, have your child rise slowly if your child has been sitting or lying down. Have your child be careful going up and down stairs.
• If your child has been taking this drug for a long time or at high doses, it may not work as well and your child may need higher doses to get the same effect. This is known as tolerance. Call the doctor if this drug stops working well. Do not give more than ordered.
• Long-term or regular use of opioid drugs like this drug may lead to dependence. Lowering the dose or stopping this drug all of a sudden may cause a greater risk of withdrawal or other severe problems. Talk to your child’s doctor before you lower the dose or stop giving this drug. You will need to follow the doctor’s instructions. Tell your child’s doctor if your child has more pain, mood changes, thoughts of suicide, or any other bad effects.
• Do not give more than the doctor told you to give. Do not give more often or for longer than you were told. Doing any of these things 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.
• If your child’s pain gets worse, if your child feels more sensitive to pain, or if your child has new pain after taking this drug, call your child’s doctor right away. Do not give more than ordered.
• If your child drinks grapefruit juice or eats grapefruit often, talk with your child’s doctor.
• Be sure your child does not drink alcohol or use products that have alcohol in them. Unsafe and sometimes deadly effects may happen.
• This drug may raise the chance of seizures in some people, including people who have had seizures in the past. Talk to the doctor to see if your child has a greater chance of seizures while taking this drug.

If your child is breast-feeding a baby:

• Tell your child’s doctor if your child is breast-feeding a baby. This drug passes into breast milk and may harm your child’s baby. Get medical help right away if your child’s baby seems very sleepy, is limp, or has trouble breathing.

Lozenge:

• Take care of your child’s teeth. See a dentist often.
• If your child has high blood sugar (diabetes), talk with the doctor. Some of these products have sugar.

Skin patch (Duragesic):

• 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, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Signs of low blood sugar like dizziness, headache, feeling sleepy, feeling weak, shaking, a fast heartbeat, confusion, hunger, or sweating.
• Trouble breathing, slow breathing, or shallow breathing.
• Noisy breathing.
• Breathing problems during sleep (sleep apnea).
• Severe dizziness or passing out.
• Feeling confused.
• Severe constipation or stomach pain. These may be signs of a severe bowel problem.
• Chest pain.
• Fast or slow heartbeat.
• Seizures.
• Depression.
• Trouble controlling body movements.
• Swelling in the arms or legs.
• Change in eyesight.
• A severe and sometimes deadly problem called serotonin syndrome may happen if your child takes this drug with certain other drugs. Call your child’s doctor right away if your child has agitation; change in balance; confusion; hallucinations; fever; fast or abnormal heartbeat; flushing; muscle twitching or stiffness; seizures; shivering or shaking; sweating a lot; severe diarrhea, upset stomach, or throwing up; or severe headache.
• Taking an opioid pain drug like this drug may lead to a rare but severe adrenal gland problem. Call the doctor right away if your child feels very tired or weak, passes out, or has severe dizziness, very upset stomach, throwing up, or decreased appetite.
• Long-term use of an opioid drug may lead to lower sex hormone levels. Call your child’s doctor if your child has a lowered interest in sex, fertility problems, no menstrual period, or ejaculation problems.

Cheek tablet:

• Mouth sores.
• Swelling in the feet or hands.

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:

• Feeling dizzy, sleepy, tired, or weak.
• Dry mouth.
• Constipation, diarrhea, stomach pain, upset stomach, throwing up, or decreased appetite.
• Headache.
• Trouble sleeping.
• Feeling cold.
• Sweating a lot.
• Irritation where this drug was used.

Cheek tablet:

• 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.

Injection:

• It is given as a shot.

Skin patch (Duragesic):

• Wash your hands before and after use.
• Touch the sticky side of the patch as little as possible.
• 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.
• 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.
• If there is hair where you are putting the patch, clip the hair as close to the skin as you can. Do not shave the hair.
• Do not put on skin where you have just used creams, oils, lotions, or other skin products.
• 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 you have a problem with the patch not sticking, you may put first aid tape on the edges of the patch to hold it in place. If the patch still will not stick, you may put a see-through film dressing (like Bioclusive or Askina Derm) over the patch. Be sure you know what kind of see-through dressing you can use. Do not cover the patch with any other bandage or tape.
• Do not cut or divide patches. Do not use patches that are damaged.
• Do not let the area where the patch was placed touch anyone else’s skin.
• If you or anyone else touches the gel, wash the skin with lots of water. Do not use soap.
• If the patch gets on someone else’s skin, take it off right away. Wash the area with water and get medical help for that person right away. Getting this drug on another person’s skin can cause severe side effects and even death.
• 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.

Lozenge:

• Place lozenge in your child’s mouth between the cheek and lower gum. Move it from side to side in your child’s mouth using the handle.
• Have your child suck oral lozenge. Do not let your child chew, break, or crush it. Do not let your child swallow it whole.
• After a dose, throw away the handle in the trash out of the reach of children and pets. If any drug is left on the handle, run it under hot water before throwing away to make sure the drug is dissolved.

Cheek tablet:

• Use right after opening.
• Place tablet in the mouth above a rear molar tooth between the upper cheek and gum and let dissolve. You may also place it under the tongue and let it dissolve.
• 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 dissolved all the way.
• If the drug has not dissolved 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 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.
• This product has a dose counter to keep track of how many sprays are left. When the dose counter has an 8 in it, spray the rest of the drug into the pouch. Do not try to use more than 8 sprays from a bottle. Put the pouch and the empty bottle into the storage container and throw away.
• After you have held the pouch, wash your hands right away.

Under the tongue (sublingual) spray:

• Spray into the mouth under the tongue.

What do I do if my child misses a dose?

Skin patch (Duragesic):

• 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.

Injection:

• 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?

Injection:

• If you need to store this drug at home, talk with your child’s doctor, nurse, or pharmacist about how to store it.

All other products:

• Store at room temperature in a dry place. Do not store in a bathroom.

Nose spray:

• After each use, put the bottle back in the storage container that comes with this drug.
• Protect from light.
• After opening, throw away any part not used after 60 days.

Skin patch (Duragesic):

• After you take off a skin patch, be sure to fold the sticky sides of the patch to each other. Throw away used patches where children and pets cannot get to them.

All products:

• Store this drug in a safe place where children cannot see or reach it, and where other people cannot get to it. A locked box or area may help keep this drug safe. Keep all drugs away from pets.
• Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

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.
• 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.
• A drug called naloxone can be used to help treat an overdose of this drug. Talk with your child’s doctor or pharmacist about how to get or use naloxone. If you think there has been an overdose, call your poison control center or get medical care right away even if naloxone has been used. Be ready to tell or show what was taken, how much, and when it happened.

Consumer Information Use and Disclaimer

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used as a tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances. Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient. UpToDate, Inc. and its affiliates disclaim any warranty or liability relating to this information or the use thereof. The use of this information is governed by the Terms of Use, available at https://www.wolterskluwer.com/en/know/clinical-effectiveness-terms.

Last Reviewed Date

2024-01-17

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