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Fentanyl

Supportive Care

Brand names:

Actiq®; Duragesic®; Sublimaze®

Often used for:

Pain

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What is fentanyl?

Fentanyl is an opioid medicine used to control pain. Fentanyl comes in different forms and strengths. It may be used for severe or ongoing pain in patients who still have pain while taking other pain medicines. Fentanyl may also be used to control pain during and after surgery.

Some forms of fentanyl work immediately. Fast-acting forms include sublingual tablets and spray, oral lozenges, buccal tablets, dissolvable film, and intranasal spray. These medicines are often used for pain that occurs while on another opioid pain medicine (breakthrough pain).

Fentanyl may also be given through a patch placed on the skin. The skin patch releases medicine more slowly over time and may be used for pain that is more chronic or persistent.

Fentanyl prescription is regulated for safety purposes. Fentanyl may be habit-forming with long-term use. The care team will watch for signs of misuse or addiction. Families may be asked to keep a record of the doses taken so the doctor can prescribe the best possible pain control.

Patients receiving fentanyl may be monitored for changes in breathing, heart rate, and oxygen levels.

Fentanyl is a strong pain medicine. Too much of the medicine can be deadly. Follow dosing and handling instructions carefully, and keep away from children and pets.

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May be taken as a dissolvable tablet, film, or lozenge by mouth

 
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May be given as a patch or device placed on the skin

 
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May be given as a spray into the mouth or nose

 
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May be given as a liquid by injection

 
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Possible side effects

  • Drowsiness
  • Constipation
  • Dizziness
  • Feeling sleepy
  • Breathing problems
  • Nausea and vomiting
  • Loss of appetite
  • Diarrhea
  • Headache
  • Fatigue or weakness
  • Dry mouth
  • Mood changes (feeling sadder or happier than normal)
  • Problems sleeping
  • Problems urinating
  • Abdominal pain
  • Feeling cold
  • Sweating
  • Mouth sores or tingling (cheek tablet)
  • Swelling in the hands, feet, or legs
  • Low blood pressure

Not all patients who take fentanyl will experience these side effects. Common side effects are in bold, but there may be others. Please report all suspected side effects to your doctor or pharmacist.

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Possible long-term problems

  • Some patients may experience tolerance or dependence with long-term use.
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Tips for families

Be sure to discuss these and other recommendations with your doctor or pharmacist.

  • Do not switch brands or forms of fentanyl without talking to a doctor.
  • If taking this medicine regularly, patients should increase fluid and fiber intake to help prevent constipation. Tell the care team if the patient has not had a bowel movement in 3 to 5 days. Patients may need to take a laxative to relieve constipation.
  • If patients have taken fentanyl for a long time, they should not stop taking fentanyl without medical supervision. The dose may be decreased slowly to reduce bad effects due to withdrawal.
  • Fentanyl may be dangerous if used with certain other medicines including other pain medicines, sedatives, muscle relaxants, antihistamines, and cold medicines.
  • Patients should avoid drinking alcohol while on this medicine.
  • Patients should tell their doctor if they are pregnant, attempting to get pregnant, or breastfeeding.

Fentanyl at home:

  • Do not take fentanyl more often or in greater amounts than recommended.
  • This medicine may make you dizzy or drowsy and increase the risk of falls. Do not drive or do anything that could be dangerous until you see how this medicine affects you. Be careful using the stairs or when getting up after lying or sitting down.
  • Watch for slow, rapid, or labored breathing or unusual drowsiness.
  • Each form of fentanyl has specific directions for use. Discuss any questions with your doctor or pharmacist. The information below is for general understanding only. Always follow the instructions given with your prescription.
    • Skin Patch (Duragesic®): Apply to clean, dry skin. Do not use a patch if it is cut or damaged. Change the patch every 72 hours; do not apply new patch in the same place. Used patches should be flushed down the toilet for disposal. High temperatures may cause too much medicine to be released. Avoid heat sources such as heating pads, hot tubs, sunbathing, and hot baths. The patch may have metal and should be removed before an MRI.
    • Buccal Film (Onsolis®): Wet inside of cheek with the tongue or water. Place film inside cheek, and hold for 5 seconds until it sticks. Leave in place, and allow to dissolve (about 15-30 minutes). Do not chew, cut, or tear the film.
    • Buccal Tablet (Fentora®): Place tablet inside the upper cheek, and allow to dissolve (about 15-25 minutes). Do not chew, crush, split, break, or swallow the tablet.
    • Nasal Spray (Lazanda®): Insert the nozzle into one nostril. Close off the other nostril using a finger. Press on the bottle to deliver one spray. A “click” and dose counter will indicate that the dose was given. Do not blow nose for at least 30 minutes.
    • Oral Lozenge (Actiq®): Hold the handle, and place the lozenge inside the lower cheek on one side of the mouth. Every so often, move the lozenge to the other side of the mouth. Twirl the handle to help melting. Allow to dissolve over 15 minutes. Suck on the lozenge, but do not bite, chew, or swallow whole.
    • Sublingual Spray (Subsys®): Hold the spray unit upright with fingers and thumb. Point the nozzle to aim the spray under the tongue. Squeeze fingers and thumb together to deliver the dose. Do not spit out the medicine or rinse your mouth.
    • Sublingual Tablet (Abstral®): Place the tablet under the tongue, and allow to dissolve. If needed, wet the area with water before taking the medicine. Do not chew, crush, suck, or swallow the tablet. Do not eat or drink until the tablet is completely dissolved.
  • Give a missed dose as soon as possible. If it is near the time for the next dose, skip the dose. Do not give 2 doses at the same time.
  • Store fentanyl at room temperature.
  • Do not use the medicine past the expiration date.
  • Follow instructions for safe storage and disposal.

Fentanyl resources

Learn More About Fentanyl

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Always check the medication label. Many medicines look the same. Do not take any new medicine, including over-the counter medicines or supplements, without checking with your doctor or pharmacist. Talk to your doctor or pharmacist about what to do in the case of a missed dose, allergic reaction, or medical emergency. 

This information is not intended to be a complete guide and is not a substitute for talking with your provider. Medicine names, appearance, formulas, or availability may vary by clinic location. Always follow the instructions given by your care team.