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Fentanyl (also spelled fentanil) is an opioid used as a pain medication and together with other medications for anesthesia. Fentanyl is also made illegally and used as a recreational drug, often mixed with heroin or cocaine. It has a rapid onset and effects generally last less than an hour or two. Medically, fentanyl is used by injection, as a patch on the skin, as a nasal spray, or in the mouth. Dosage and Administration
- To be prescribed only by healthcare providers knowledgeable in use of potent opioids for management of chronic pain.
- Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals.
- Individualize dosing based on the severity of pain, patient response, prior analgesic experience, and risk factors for addiction, abuse, and misuse.
- Initial dose selection: consult conversion instructions.
- Each transdermal system is intended to be worn for 72 hours.
- Adhere to instructions concerning administration and disposal of DURAGESIC.
- Mild to Moderate Hepatic and Renal Impairment: Initiate treatment with one half the usual starting dose, titrate slowly, and monitor for signs of respiratory and central nervous system depression.
- Do not abruptly discontinue DURAGESIC in a physically-dependent patient.
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Used to relieve pain that is mild or that will go away in a few days.
Risk of Increased Fentanyl Absorption with Elevated Body Temperature: Monitor patients with fever closely for sedation and respiratory depression and reduce the dose if necessary. Warn patients to avoid strenuous exertion that may lead to increased body temperature.
Life-Threatening Respiratory Depression in Patients with Chronic Pulmonary Disease or in Elderly, Cachectic, or Debilitated Patients: Monitor closely, particularly during initiation and titration.
Serotonin Syndrome with Concomitant Use of Serotonergic Drugs: Potentially life-threatening condition could result from concomitant serotonergic drug administration. Discontinue DURAGESIC immediately if serotonin syndrome is suspected.
Adrenal Insufficiency: If diagnosed, treat with physiologic replacement of corticosteroids, and wean patient off of the opioid.
Severe Hypotension: Monitor during dose initiation and titration. Avoid the use of DURAGESIC in patients with circulatory shock.
Risks of Use in Patients with Increased Intracranial Pressure, Brain Tumors, Head Injury or Impaired Consciousness: Monitor for sedation and respiratory depression. Avoid use of DURAGESIC in patients with impaired consciousness or coma.
Opioid non-tolerant patients.
Acute or intermittent pain, postoperative pain, mild pain.
Significant respiratory depression.
Acute or severe bronchial asthma in an unmonitored setting or in absence of resuscitative equipment.
Known or suspected gastrointestinal obstruction, including paralytic ileus.
- Known hypersensitivity to fentanyl or any of the components of the transdermal system. Wiki