Image Source: https://www.dea.gov/factsheets/fentanyl
Pharmaceutical form: Tablets
Bag of fentanyl pills
(Light Blue/ Circle/ Imprint: 'M,' '30')
Overview:
Fentanyl is a synthetic opioid drug which is similar to morphine, but it is 50 to 100 times more potent than morphine. It is mainly used as an analgesic (pain relief) and anaesthetic. Fentanyl can slow or stop your breathing and may be habit-forming if more than the prescribed amount is taken.
Medical Use:
The medical use of fentanyl is that it helps with managing chronic pain, severe cancer pain, nerve damage, back injury, major trauma and surgery. It is available in many forms, which are patches to stick on your skin, lozenges, tablets that disintegrate in your mouth, intravenous injections, sublingual tablets and a spray applied inside your nose.
Side-effects:
All opioids have severe side effects. During usage of fentanyl, it can be highly effective in controlling pain, but it carries a range of potential side effects, including:
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 behaviour
Low cortisol levels - nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.
Older adults and individuals who are malnourished or weakened may be at a higher risk of experiencing severe side effects.
Common morphine side effects may include:
Rash or skin reaction from a fentanyl patch
Constipation
Headache or dizziness
Fatigue or drowsiness (especially soon after a dose)
Loss of appetite, nausea and vomiting
Euphoria
Drug interactions:
Interaction with Medicine: 589 drugs (252 are major, 335 are moderate, and 2 are minor)
Most frequent- Ambien (zolpidem), Ativan (lorazepam), Benadryl (diphenhydramine), Colace (docusate), Cymbalta (duloxetine), Dilaudid (hydromorphone), Flexeril (cyclobenzaprine), Lasix (furosemide), Lexapro (escitalopram), Lipitor (atorvastatin), Lyrica (pregabalin), MiraLAX (polyethene glycol 3350), Morphine Sulfate ER (morphine), Neurontin (gabapentin), Nexium (esomeprazole), Norco (acetaminophen/hydrocodone), OxyContin (oxycodone), Paracetamol (acetaminophen)and many more.
Interaction with Alcohol/Food: 1 alcohol/food interaction
ALL TYPES of Alcohol
Avoid consuming grapefruit and grapefruit juice
Special instructions for the preparation of meals, If your doctor has not told you otherwise, continue to eat normally.
Interaction with Disease: 17 types of disease
Impaired GI motility, Infectious diarrhoea, Liver disease, Prematurity, Acute alcohol intoxication, Drug dependence, Gastrointestinal obstruction, Hypotension, Intracranial pressure, Respiratory depression, Fever, Adrenal insufficiency, Biliary spasm, Renal dysfunction, Seizure disorders, Urinary retention and Arrhythmias.
Dosing:
Usual Adult Dose for Anesthesia:
Premedication for Anesthesia:
50 to 100 mcg IM, 30 to 60 minutes prior to surgery.
Lozenge: 5 mcg/kg (400 mcg is the maximum dose).
Lower doses should be used for vulnerable patients.
Usual Pediatric Dose for Anesthesia
Usual concentration: Determined by weight; some clinicians use the following:
Children less than 12 kg: 10 mcg/mL
Children 12 to 30 kg: 25 mcg/mL
Children greater than 30 kg: 50 mcg/mL
Demand dose: Usual initial: 0.5 to 1 mcg/kg/dose; usual range: 0.5 to 1 mcg/kg/dose
Lockout: Usual initial: 5 doses/hour
Lockout interval: Range: 6 to 8 minutes
Usual basal rate: 0 to 0.5 mcg/kg/hour
**Talk with your doctor if you are not sure you are opioid-tolerant.
Store fentanyl in its original packaging at room temperature.
Citation:
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. “Fentanyl | Opioids - CDC” Centers for Disease Control and Prevention on August 8, 2023, https://www.cdc.gov/opioids/basics/fentanyl.html#:~:text=What%20is%20fentanyl%3F,pain%2C%20typically%20advanced%20cancer%20pain.&text=It%20is%2050%20to%20100,abuse%20in%20the%20United%20States.
“Fentanyl - Alcohol and Drug Foundation” Alcohol and Drug Foundation on August 24, 2023, https://adf.org.au/drug-facts/fentanyl/
“Fentanyl - about, use, side effects and alternatives” Healthdirect on May 2023, https://www.healthdirect.gov.au/fentanyl
Melisa Puckey. “Fentanyl: Uses, Dosage, Side Effects & Warnings” Drugs.com on Aug 13, 2023, https://go.drugbank.com/drugs/DB00295
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