Fentanyl

Examples

Generic Name	Brand Name
fentanyl	Duragesic [transdermal]
fentanyl citrate injection

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 in several strengths that deliver between 12.5 and 100 micrograms (mcg) of medicine every hour.

Use fentanyl 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 can also be taken in a tablet or injected into a vein (intravenous).

How It Works

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

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. The patch may be tried when you prefer a patch instead of a pill, or when you have difficulty swallowing.

How Well It Works

Fentanyl has been shown to be safe and effective for treatment of cancer pain that is either acute (bad pain that lasts a short time) or chronic (pain that comes and goes for a long time).¹

Side Effects

Fentanyl has many side effects, including:

• Drowsiness.
• Light-headedness.
• 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 non-caffeinated beverages each day. Include fruits, vegetables, and fibre 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 behavioural 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 post-operative 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

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.

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. If you are or may be pregnant, talk with your doctor before using fentanyl. 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. You can dispose of any used or unused patches in one of two ways:

1. Return the patches to your pharmacy. Check with your pharmacy to see if it has a program for disposing of patches.
2. Put them in a waste container in a way that prevents someone else from using them. To do this:
   • Place the patches in a child-resistant container.
   • Fill the container with water and flour, sawdust, or kitty litter.
   • Close the container. Before you put it in the trash, place the container in a paper or dark plastic bag so that someone can't see into it.

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, which causes more risk of serious side effects.

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

Author:	Shannon Erstad, MBA/MPH Ralph Poore	Last Updated: February 12, 2008
Medical Review:	Anne C. Poinier, MD - Internal Medicine Michael Seth Rabin, MD - Medical Oncology Douglas A. Stewart, MD - Medical Oncology
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