Fentanyl

  • Generic Name or Active Ingridient: Fentanyl

Doctors prescribe fentanyl to treat breakthrough pain in cancer patients. Duragesic is a transdermal patch that slowly releases the painkiller, fentanyl. Fentanyl is 81 times more powerful than morphine and is intended for use by patients with moderate to severe pain that is expected to last for a long time. Fentanyl should be used only by people who are tolerant to other opiates after taking this type of medication for at least one week, and for whom other round-the-clock medications do not provide sufficient relief. Learn More About Fentanyl Uses

Other, off label uses for this medicine

While there are off-label uses for this medication, the FDA reports some physicians prescribe fentanyl inappropriately. These off-label and contraindicated uses include pain relief from surgery, headaches and for occasional or mild pain. Inappropriate use of fentanyl raises the risk for abuse, overdose and death.

More Off-Label Uses for Fentanyl

Administration/Dosage

Fentanyl is available in a tablet or film designed to dissolve in your mouth rather than being swallowed. Duragesic is a brand name transdermal patch containing fentanyl. One skin patch may provide effective pain relief for up to three days. Apply the patch to hairless areas of skin like your chest, back, upper arm, or sides of your waist. Clip hair as necessary before applying the patch – do not shave skin, as broken skin may absorb more opioid, risking overdose. Wash your hands after applying a Duragesic patch.

Dosage depends on the size of the patch; larger Duragesic patches deliver more fentanyl than do smaller patches. Sizes range from 12.5 and 100 micrograms per hour. Depending on the source and severity of your pain, your doctor may increase your dosage every three days at first, and then not more often than every six days. Fentanyl prescriptions cannot be refilled – you must visit your doctor and request she write a new prescription.

The dose of opioid in a single fentanyl tablet or Duragesic patch is fatal to small children and pets that happen to chew or suck on the patch.

Since fentanyl is administered as needed to treat pain rather than on a schedule, you are not likely to miss a dose. If you forget to change or apply a new fentanyl Duragesic patch, apply one as soon as you remember. Wear the newly applied patch for the prescribed amount of time, usually three days. Do not wear two patches at once unless directed to do so by your doctor.

Read More About Fentanyl Administration and Dosage

Action

Fatty tissue just under your skin absorbs fentanyl from the Duragesic patch and then gradually releases the medicine into your bloodstream. The medicine in fentanyl tablets or film is absorbed through mucous membranes in your mouth. Fentanyl works by changing the way your brain and nervous system respond to pain. More About How Fentanyl Works

Precautions

Tell your doctor if you are allergic to fentanyl or any other medications. Notify your doctor if you are already taking pain medication, especially if you are taking other opioid medications like morphine, OxyContin and Dilaudid. Notify your physician about any pertinent medical conditions, especially breathing disorders like COPD, a history of head trauma or brain tumor, a heart rhythm disorder, liver or kidney disease.

Fentanyl may make you drowsy. Do not operate cars or heavy machinery until you know how your body reacts to Duragesic. While taking fentanyl, do not drink alcohol or take other medications that may make you sleepy, such as cold medicine, muscle relaxers and medication for depression or anxiety. Alcohol and some medications add to drowsiness or breathing problems associated with fentanyl.

Fentanyl patches may cause constipation. Speak with your physician about dietary changes and medication to prevent or treat constipation while taking fentanyl.

Talk with your doctor about eating grapefruit or drinking grapefruit juice while using fentanyl.

Wearing a Duragesic patch may burn your skin if worn during a Magnetic Resonance Imaging test, or MRI. Remove the patch before your test.

Read More About Fentanyl Precautions

Warnings

Contact your local emergency room if you suffer serious side effects such as:

  • Fast Heartbeat.
  • Chest Pain.
  • Rash.
  • Seizure.
  • Coughing Up Blood.

Discard any cut, torn or damaged Duragesic patches. Using a patch that is damaged can cause overdose of potentially lethal medication. Apply patch to unbroken, clean, dry skin. Do not chew, smoke, cut or suck on patches. While wearing Duragesic patches, avoid heat sources like saunas, spas, electric blankets, heat lamps and heated water beds. Exposure to heat may cause rapid absorption of a potentially lethal dose of medicine. You may bathe, swim or shower while wearing a Duragesic patch. If the patch should fall off, dispose of the used patch properly and apply a new patch to clean, dry skin. Do not take fentanyl if you suffer from the digestive disorder known as paralytic ileus, which is a medical condition in which food does not easily pass through your intestinal tract. Your doctor may choose an alternate to fentanyl for your pain control.

Notify your physician and pharmacist if you have ever had head injuries, brain tumors, strokes or other medical conditions that cause increase cranial pressure. Tell your medical team if you have ever had seizures, slow heart or respiratory rate, difficulty urinating, Addison's disease, low blood pressure or disease of the thyroid, liver, kidney, pancreas or gall bladder.

Tell your doctor if you are pregnant, plan to become pregnant or are breastfeeding while taking fentanyl. If you become pregnant while taking fentanyl, contact your physician right away.

Notify your dentist or surgeon if you need dental or other types of surgery while taking fentanyl.

Fentanyl can make you drowsy. Do not operate heavy machinery until you know how you react to fentanyl.

You may feel light-headed when rising from a lying position. Get up slowly, especially when you are new to fentanyl, resting your feet on the floor for a few moments before standing up.

Do not drink alcohol while taking fentanyl. Doing so may increase the chance that you will experience unpleasant or serious side effects.

Discontinuing fentanyl suddenly can cause unpleasant withdrawal symptoms.

More Warnings About Using Fentanyl

Drug Interactions

Fentanyl may interact with other drugs in an unfavorable or potentially deadly way. Tell your doctor if you take any of the following drugs:

  • Amiodarone.
  • Antidepressants.
  • Antihistamines.
  • Carbamazepine.
  • Cimetidine.
  • Diltiazem.
  • Erythromycin.
  • Fluvoxamine.
  • Medications for Anxiety.
  • Medications for Cough, Cold or Allergies.
  • Medications for Nausea.
  • Muscle Relaxants.
  • Nevirapine.
  • Other Medications for Pain.
  • Phenobarbital.
  • Phenytoin, or Dilantin.
  • Rifabutin.
  • Rifampin.
  • Sedatives.
  • Sleeping Pills.
  • Tranquilizers.
  • Verapamil.

Notify your doctor or pharmacist if you are currently taking monoamine oxidase inhibitors, otherwise known as MAO inhibitors, or if you have stopped taking this class of drugs within the past 2 weeks. MAO inhibitors include isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar) and tranylcypromine (Parnate). Tell your doctor if you are taking any herbal remedies, vitamin supplements or holistic medicines. Be certain to notify your physician or pharmacist if you take St. John's wort.

More Drug Interactions

Side effects

Fentanyl may cause moderate to severe side effects. Tell your doctor about any side effects that are acute or do not go away on their own. Fentanyl side effects include:

  • Diarrhea.
  • Nausea.
  • Constipation.
  • Dry Mouth.
  • Confusion.
  • Sweating.
  • Abdominal Pain.
  • Headache.
  • Fatigue.
  • Weight Loss.
  • Dizziness.
  • Hallucinations.
  • Anxiety.
  • Depression.
  • Flu-like Symptoms.

Learn More About Duragesic Side Effects

Overdose

Overdose of fentanyl is a serious and potentially life-threatening medical situation. Overdose can cause respiratory distress or even respiratory arrest. Overdose symptoms include:

  • Difficulty Breathing.
  • Extreme Sleepiness or Tiredness.
  • Difficulty Thinking, Talking or Walking Normally.
  • Small, Pinpoint Pupils.
  • Faintness.
  • Dizziness.
  • Confusion.
  • Coma or Loss of Consciousness.

If you suspect that you or someone you know has taken an overdose of fentanyl, contact your local poison control center at 1-800-222-1222 or call your emergency room immediately. If the victim has collapsed or is not breathing, call 911 for emergency medical assistance.

Learn More About Fentanyl Overdose

Abuse

The U.S. government classifies fentanyl as a Schedule II controlled substance, which means it poses a high risk for abuse and dependency. Fentanyl falls into the same category as morphine, methadone and OxyContin. These drugs carry a high potential for abuse and fatal overdose, both among those who use fentanyl as prescribed by a doctor and those who use fentanyl for recreational purposes. Never share fentanyl with another person, especially if he has a history of substance abuse.

Fentanyl users may become addicted quickly. On the black market, it is used orally most often but it can be smoked, snorted or injected. People who use fentanyl by prescription to ease significant pain are likely to become addicted after using Duragesic for long periods of time.

Read More About Fentanyl Abuse

Withdrawal

Withdrawal symptoms appear when you stop taking fentanyl. Withdrawal is extremely unpleasant and can be very difficult to overcome without professional medical help. Symptoms of withdrawal include:

  • Restlessness.
  • Teary Eyes.
  • Runny Nose.
  • Yawning.
  • Sweating.
  • Chills.
  • Hair Standing on End.
  • Muscle Aches.
  • Large Pupils.
  • Irritability.
  • Anxiety.
  • Backache.
  • Joint Pain.
  • Weakness.
  • Stomach Cramps.
  • Difficulty Falling Asleep or Staying Asleep.
  • Nausea.
  • Loss of Appetite.
  • Vomiting.
  • Diarrhea.
  • Rapid Heartbeat.
  • Rapid Breathing.

Detox

Treatment options for fentanyl addiction are expanding every day. You can choose from in-patient care or out-patient, depending on your needs. Treatment plans include detoxification, rehabilitation and after-care therapy. Learn More About Fentanyl Detoxification Programs

Storage

Store Duragesic patches in the protective pouch they came in, away from excess heat and moisture. Do not store Duragesic patches in your bathroom or car. Keep fentanyl in a secure location where children, pets and adults cannot accidentally or purposefully take this opioid.

Dispose of used or outdated Duragesic patches by folding the sticky sides of the patch together so that it seals itself closed. Flush discarded patches down the toilet; flush the toilet several times to be sure the patch is properly disposed of. Throw away pouches and protective liners in the trash. Never put used Duragesic patches or unneeded fentanyl in the garbage.