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At a glance

Fentanyl is an opioid analgesic used for the management of breakthrough pain in cancer patients and severe chronic pain.

Indications
  • Breakthrough Pain: Used for management of breakthrough pain in cancer patients who are already receiving and tolerant to opioid therapy.
  • Severe Chronic Pain: Used for management of persistent, moderate to severe chronic pain.
  • Surgical Anesthesia: Used as part of anesthesia during surgery.
Pharmacology

Fentanyl is an opioid analgesic. Fentanyl interacts predominately with the opioid mu-receptor but also binds to kappa and delta-type opioid receptors. These mu-binding sites are discretely distributed in the human brain, spinal cord, and other tissues. In clinical settings, Fentanyl exerts its principal pharmacologic effects on the central nervous system.

Dosage

Adult Dose:

  • Oral (Breakthrough Pain): Initial: 100 mcg; re-dosing may occur 30 minutes later; titration up to 200 mcg (one tablet in each side of mouth); titrate above 400 mcg by 200 mcg increments.
  • Injection (Surgery): Premedicant: 1-2 mL IM 45 minutes before induction; Anesthesia: 2-10 mL IV; max 50 mcg/kg.
  • Transdermal Patch (Chronic Pain): 12-100 mcg/hr; replace every 72 hr; opioid-naive: <=25 mcg/hr; dose based on prior opioid use.

Elderly and Debilitated: Reduce dosage.

Side effects

Common Side Effects:

  • Constipation
  • Dizziness
  • Headache
  • Nausea
  • Sleepiness
  • Vomiting

Serious Side Effects: Respiratory depression, apnoea, muscular rigidity, myoclonic movements, bradycardia.

Use in pregnancy

Use in Pregnancy: Category C; fentanyl may be unsafe; animal studies have shown harmful effects on the developing baby.

Pregnancy Category: C — always consult a doctor before taking during pregnancy.

Precautions & warnings

Precautions:

  • Opioid analgesics impair mental and/or physical ability required for potentially dangerous tasks (driving or operating machinery).
  • Titrate with caution in patients with chronic obstructive pulmonary disease or pre-existing conditions predisposing to respiratory depression.
  • Caution in head injuries and increased intracranial pressure.
  • Use with caution in patients with bradyarrhythmias.
  • Caution in hepatic or renal disease.
Overdose effects

Overdose: Overdose may produce narcosis, marked skeletal muscle rigidity, cardio-respiratory depression and cyanosis; administer oxygen and assisted respiration; use naloxone.

Storage conditions

Storage: Store between 20-25 degree C. Protect from light.

Fentanyl — see the full informationPharmacology, precautions, pregnancy, overdose and the rest on the generic page
⚠️ This information is for educational purposes only — not a substitute for medical advice. Consult a registered physician before taking any medicine.