Fentanyl, also spelled fentanil, is a potent opioid used as a pain medication. Together with other drugs, fentanyl is used for anesthesia. It is also used illicitly as a recreational drug, sometimes mixed with heroin, cocaine, benzodiazepines or methamphetamine.
Generic name: fentanyl
Brand names: Actiq (lozenge), Lazanda (nasal spray), Fentora (sublingual tablet), Subsys (sublingual spray)
Dosage form: injection, nasal spray, transdermal patch, sublingual tablet, sublingual spray, transmucosal lozenge (lollipop)
Drug class: Narcotic analgesics
What Is Fentanyl?
Fentanyl is a synthetic opioid medicine used to treat moderate to severe pain, it is up to 100 times stronger than other opioids like morphine, heroin or oxycodone. Fentanyl is from the class of medicines called narcotic analgesics.
What Is Fentanyl Used For?
- Fentanyl patches are used for long lasting pain relief for constant, around the clock cancer pain.
- Fentanyl nasal sprays, lollipops, injections, sublingual tablets and sprays are immediate acting and used for breakthrough pain. Breakthrough pain is when you have a flare up of pain, even though you are taking regular pain medicine for chronic or persistent pain.
Because fentanyl is a powerful prescription opioid it can be misused, abused and cause overdose deaths.
Fentanyl is classified as schedule 2 under the controlled substances act (CSA).
Fentanyl can slow or stop your breathing, and may be habit-forming. MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.
Using this medicine during pregnancy may cause life-threatening withdrawal symptoms in the newborn.
Fatal side effects can occur if you use this medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing.
Before Taking This Medicine
You should not use fentanyl unless you are already being treated with a similar opioid pain medicine and your body is tolerant to it. Talk with your doctor if you are not sure you are opioid-tolerant.
You should only use or take fentanyl if you have your own personal prescription for this medicine. You should not use fentanyl if you are allergic to it, or if you have:
- severe asthma or other breathing problems; or
- a stomach or bowel obstruction (including paralytic ileus).
To make sure fentanyl is safe for you, tell your doctor if you have ever had:
- breathing problems, sleep apnea;
- a head injury, brain tumor, or mental illness;
- alcoholism or drug addiction;
- urination problems;
- a seizure disorder;
- liver or kidney disease; or
- problems with your gallbladder, pancreas, or thyroid.
If you are using fentanyl patches, tell your doctor if you have been sick with a fever. Having a high temperature can increase the amount of drug you absorb through your skin.
If you use opioid medicine while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on opioids may need medical treatment for several weeks.
Do not breastfeed while you are using fentanyl.
Do not change to another form of fentanyl eg injection, skin patch, dissolving film, or “lollipop” device. If you switch from another form of fentanyl, you will not use the same dose.
Long acting fentanyl:
- fentanyl patches
Immediate acting fentanyl:
- fentanyl lozenge on a plastic handle – lollipop (Actiq)
- fentanyl nasal spray (Lazanda)
- fentanyl sublingual tablet (Fentora)
- fentanyl sublingual spray (Subsys)
- fentanyl injection
General Fentanyl Dosing Information
- Do not use fentanyl unless you are already being treated with a similar opioid pain medicine and your body is tolerant to it. Talk with your doctor if you are not sure you are opioid-tolerant.
- Take fentanyl exactly as prescribed by your healthcare provider. Follow the directions on your prescription label and read all medication guides. Never use fentanyl in larger amounts, or for longer than prescribed. Tell your doctor if you feel an increased urge to use more fentanyl.
- Never share opioid medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it. Selling or giving away opioid medicine is against the law.
- Do not replace one form of fentanyl with any other form of fentanyl, such as injection, skin patch, nasal spray, under the tongue spray, sublingual tablet or “lollipop” device).
- Store fentanyl in its original packaging at room temperature.
- Keep fentanyl out of the reach of children or pets. A small amount of fentanyl can be fatal to a child or pet who accidentally ingests or absorbs it. Seek emergency medical attention if this happens.
- Do not keep leftover opioid medication. Just one dose can cause death in someone using this medicine accidentally or improperly. Ask your pharmacist where to locate a drug take-back disposal program. If there is no take-back program, dispose of any unused skin patches in the same folded manner. Do not flush the fentanyl patch foil pouch or patch liners; place them in a trash container out of the reach of children and pets. For sublingual tablets, sublingual sprays, nasal sprays, lozenges carefully follow disposal instructions when this medicine is no longer needed.
Fentanyl Side Effects
Get emergency medical help if you have signs of an allergic reaction to fentanyl: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Like other narcotic medicines, fentanyl can slow your breathing. Death may occur if breathing becomes too weak. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.
Fentanyl may cause serious side effects. Call your doctor at once if you have:
- slow heart rate, sighing, shallow breathing, breathing that stops during sleep;
- severe drowsiness, feeling like you might pass out;
- confusion, extreme fear, unusual thoughts or behavior; or
- low cortisol levels – nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.
Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
Serious side effects may be more likely in older adults and those who are malnourished or debilitated.
Long-term use of opioid medication may affect fertility (ability to have children) in men or women. It is not known whether opioid effects on fertility are permanent.
Common fentanyl side effects may include:
- headache, dizziness, drowsiness, pale skin, feeling weak or tired
- constipation, nausea, vomiting, stomach pain or
- sleep problems (insomnia)
- swelling in your hands or feet
- increased sweating, or cold feeling
- for patches itching, redness, or rash where a patch was worn.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.