Fentanyl

Examples

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Brand Name	Chemical Name
Actiq	fentanyl citrate oral transmucosal

Brand Name	Chemical Name
Duragesic	fentanyl transdermal system

Duragesic is available as a skin patch. The medicine is absorbed through the skin. The patch provides a steady release of medicine for 2 to 3 days. Patches are available that deliver 25 micrograms (mcg), 50 mcg, 75 mcg, and 100 mcg per hour.

The U.S. Food and Drug Administration (FDA) recently issued a public health advisory for the fentanyl skin patch. Use the fentanyl patch exactly as prescribed by your doctor. This is very important so that you do not get too much of the drug. If you get too much fentanyl in your system, you could have serious problems that can lead to death.

Fentanyl is also available as a small, grape-flavored cone on a stick that looks like a lollipop. The drug is quickly absorbed through the mucous membranes in your mouth, inside the cheek. Doses of 200, 400, 600, 800, 1200, and 1600 mcg are available for the treatment of breakthrough pain.

How It Works

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Fentanyl acts upon specific receptors in your brain and spinal cord to decrease the feeling of pain and to reduce your emotional response to pain. The action of fentanyl is similar to other drugs in the morphine category (opioids).

Why It Is Used

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Fentanyl is used to manage moderate to severe pain, usually in people who have chronic pain. Fentanyl is often used when your other pain medicines no longer work, when you prefer a patch instead of a pill, or when you have difficulty swallowing.

How Well It Works

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Fentanyl has been shown to be safe and effective for treatment of moderate to severe cancer pain.¹

Side Effects

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Fentanyl has many side effects, including:

• Drowsiness.
• Lightheadedness.
• Weakness and fatigue.
• Feelings of elation (euphoria).
• Dry mouth.
• Difficulty urinating.
• Difficulty breathing.
• Constipation, which may be severe.
  • Talk with your doctor about using laxatives to prevent constipation.
  • You can prevent constipation at home. Make sure you drink enough fluids. Most adults should drink between 8 and 10 glasses of water, or noncaffeinated beverages each day. Include fruits, vegetables, and fiber in your diet each day.
• Skin reactions, such as irritation, itching, or hives.

Fentanyl should be used with caution by older adults and by people who have lung disease, such as chronic obstructive pulmonary disease (COPD) or asthma.

Fentanyl can cause your body to expect this medicine daily (drug dependency) if it is used for longer than a week or so. Dependency is not the same as addiction, which is a behavioral disorder marked by craving a drug.

Reasons not to use fentanyl

Fentanyl can cause serious or life-threatening respiratory problems (hypoventilation). For that reason it should not be used in:

• The management of acute or postoperative pain, including outpatient surgeries.
• The management of pain that responds to other pain medicine.
• Doses greater than 25 mcg per hour at the beginning of opioid therapy.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

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In some people, fentanyl impairs balance, coordination, or the ability to think. Do not drive or operate any type of equipment if you are taking fentanyl. If you develop severe side effects, call your doctor, and remove the patch from your skin or take the lollipop out of your mouth.

Do not drink alcohol or use other drugs while you are taking fentanyl.

Fentanyl can interact with many other drugs. Make sure that your doctor is aware of all the medicines you are taking.

Fentanyl should be used during pregnancy only if the benefits to the mother outweigh the risks to the fetus. Talk with your doctor before using fentanyl if you are or may be pregnant. This drug can pass through your body in breast milk and should not be used while you are breast-feeding.

When you remove your fentanyl patch, fold the adhesive ends in on each other, and flush it down the toilet. You may also dispose of any unused patches or lollipops by flushing them down the toilet.

Avoid the use of heat, such as a heating pad, electric blanket, hot tub, or sauna, while you are using a fentanyl patch. Heat can increase the amount of fentanyl released from the patch, increasing the risk of serious side effects.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

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Citations

1. Foley KM (2005). Management of cancer pain. In VT DeVita Jr et al., eds., Cancer: Principles and Practice of Oncology, 7th ed., pp. 2615–2649. Philadelphia: Lippincott Williams and Wilkins.

Credits

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Author	Cynthia Tank
Editor	Renée Spengler, RN, BSN
Associate Editor	Michele Cronen
Associate Editor	Lisa Shaw
Primary Medical Reviewer	Adam Husney, MD - Family Medicine
Specialist Medical Reviewer	Michael Seth Rabin, MD - Medical Oncology
Last Updated	November 4, 2005