What is Fentanyl: How to use, Side Effects, Dosage

What is Fentanyl: How to use, Side Effects, Dosage

What is Fentanyl

General Name: Fentanyl (injection) (FEN ta nil). Brand: Sublimaze

Other brand names of fentanyl are: Abstral (subcutaneously), Actiq (Lupus Pill), Duragesic (Fatty Patch), Fentora (Icy), Ionsys (Genital System), Lazanda (Nasal Spray) and Subys Spray Hearing)

Fentanyl is used as part of anesthesia to help prevent pain after surgery or other medical procedure. It is an opioid medication. An opioid is sometimes called a narcotic.

The molecular weight of fentanyl base is 336.5, and the empirical formula is C22H28N2O. The n-octanol: water partition coefficient is 860:1. The pKa is 8.4. DURAGESIC (fentanyl transdermal system) is a transdermal system containing fentanyl. The chemical name is N-Phenyl-N-(1-(2-phenylethyl)-4-piperidinyl) propanamide.

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How to use Fentanyl?

The health care provider will give you this injection as part of an anesthetic that is given to your surgery or medical treatment. Fentanyl is injected into a muscle, or injected into the vein via IV.

Dosage of Fentanyl

Initial dose

DURAGESIC should only be prescribed by healthcare professionals who are known to be using strong drugs to manage chronic pain.

Due to the risk of respiratory depression, DURAGESIC is only resistant to opioid patients. When you start DURAGESIC treatment, stop all other free medications. As DURAGESIC is only for use in opioid-resistant patients, do not start any patient with DURAGESIC as the first drug.

Patients who believe in drug resistance are those who take at least 60 mg of morphine per day or at least 30 mg daily oral cordon oxide or at least 8 mg daily oral hydromorphine or another equialgesic drug for one week or more.

Start the dose regimen for each patient individually, depending on the patient's previous treatment experience and the risk factors for addiction, abuse and abuse. Patients should be monitored for respiratory depression, especially during the first 24-72 hours of initiation of DURAGESIC therapy, when the serum concentration of the primary patch increases.

The recommended dose when converting from other drugs to DURAGESIC is intended to minimize the potential for overdoosing patients with the first dose.

When you start DURAGESIC treatment stop all other antidepressants.

While useful tables of opioid equations are readily available, there are significant differences between groups in the relative strength of drugs and drugs. In this way, it's best to guess the patient's 24-hour fentanyl requirement and evaluate the rescue medications (for example, opiate release drugs) instead of meeting the 24-hour fentanyl requirements that may pose adverse reactions. In a DURAGESIC clinical trial, patients converted their previous drug to DURAGESIC using Table 1 as guidance for the initial DURAGESIC dose.

Fentanyl injections can be injected into muscle (muscle) or intravenous. The usual dose for surgery pre-surgery in adults is 0.05 mg to 0.1 mg per dose given by intramuscular injection or intravenous injection. For anesthetics, the dose per intravenous dose is 0.5 to 20 micrograms per kilogram. Also, intravenous infusion may also be used containing 1-2 micrograms per kilogram of hour. There are several recommended treatments for treating pain. Fentanyl is also used for patient-managed anesthetics (PCA).

Symptoms of Fentanyl

DURAGESIC drug properties should also be considered when taking too much medication. Even in the face of recovery, continuous medical monitoring is needed because of the possibility of extensive effects. The deaths due to overdose have been reported with abuse and abuse of DURAGESIC. Acute administration to opioids can lead to respiratory depression, drowsiness to the stage of twitching or coma, skeletal muscular weakness, cold and sticky skin, limited students, and sometimes bradycardia, blood pressure, and death.

Side effects of Fentanyl

Your caregivers will watch for any side effects you have, which may clear up within minutes after stopping the fentanyl infusion or decreasing the dose (copied by respecting the source website priority):

Weak or shallow breathing;

Fast or slow heart rate;

Tight muscles or

Severe weakness, dizziness or back pain.

Common side effects of fentanyl may include:


Slow heartbeat;

Muscle stiffness;

Dizziness, vision problems;

Nausea, vomiting;

Itching, sweating; or

High blood pressure (confusion, anxiety, stinging in the neck or ears).

The following serious side reactions are some of the side effects of this drug:

Addiction, Abuse, and Abuse

Life-threatening respiratory depression

Accident Exposure

Opioid Neonatal Harvesting Syndrome

Interaction with depressants in the central nervous

Hypotension effects see

Fentanyl can cause respiratory depression (decrease in the amount or depth of breathing), muscle strength and decrease heart rate.

Additional side effects include:




Sleepiness and


Other important side effects include:

Dry mouth

Stomach ache,

Loss of appetite




Being nervous



Depression, and



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Drugs that may interact with Fentanyl

Drugs could interact with many other drugs and cause serious side effects or death. Make sure your doctor knows if you also use it:

Drugs that cause drowsiness or slow breathing - Sleeping pills, sedation, relaxation, sedation, or anti-inflammatory drugs; or

Other Drugs - Antidepressants or cough medications prescribed.

Drugs that provide serotonin levels in your body - medication for depression, Parkinson's disease, migraine headaches, serious infections, or the prevention of nausea and vomiting.

This is not a complete list. Other medications may interact with fentanyl, including prescription and over-the-counter medications, vitamins and herbal products. Not all possible interactions are listed in this medication guide.Consult your doctor about any medicine you take.

Depression of the central nervous system

Concomitant use of DURAGESIC with other CNS antidepressants, including sedation, sleep disorders, sedation, general anesthesia, phenotyazins, other drugs and alcohol, can be a risk of respiratory depression, deep sedation, coma and death. Monitor patients with CNS and DURAGESIC depression for signs of respiratory depression, sedation, and low blood pressure.

When combination therapy is considered with each of the above drugs, the dose of one or both drugs should be reduced.

Drugs that are affected by Cytochrome P450 3A4 isoenzymes

CYP3A4 inhibitors

Since CYP3A4 isoenzyme plays an important role in the metabolism of fentanyl, drugs that inhibit CYP3A4 activity may reduce fentanyl secretion, which can lead to increased concentrations of fentanyl in the plasma and lead to increased opioid effects. These effects can be further increased by simultaneous use of 3A4 inhibitors. If the intervention is necessary at the same time as DURAGESIC, monitor patients for respiratory and tranquilizing depression at frequent intervals and consider dose adjustments to obtain the effects of sustained drugs.

Inducers of CYP3A4

CYP450 3A4 inducers may stimulate fentanyl metabolism and therefore may increase the secretion of the drug, which may result in decreased plasma concentrations of fentanyl, ineffectiveness or possibly the development of discontinuation syndrome in patients who are physically dependent on fentanyl if co-administered with DURAGESIC It is essential to monitor drug withdrawal symptoms and take dose adjustments in order to obtain sustainable drug effects.

After stopping CYP3A4 induction therapy, as the induction reduction effects, the plasma concentration of fentanyl increases, which can increase the effects of treatment and complications or prolong it, and may cause severe respiratory depression.

MAO inhibitors

Avoid using DURAGESIC in patients requiring monoamine oxidase-inhibitor (MAO) suppression simultaneously or within 14 days of stopping this treatment, as MAO inhibitors with severe and unpredictable severity, using Opioid analgesics have been reported.

Mixed agonist / antagonist and minor opioid analgesic drugs

A mixture of agonists / antagonists (for example, pentazocine, nalophene and butorphanol) and partial antagonists (buprenorphine) may reduce the analgesic effect of DURAGESIC or may cause withdrawal symptoms. Avoid taking anti-agonist / antagonist drugs and minor antagonists in patients receiving DURAGESIC.


Anticholinergics or other anticholinergic drugs used simultaneously with anti-drug therapies may increase urinary retention or severe constipation, which may result in paralysis. When DURAGESIC is co-administered with anticholinergic drugs, patients are monitored for symptoms of urinary retention or decreased gastrointestinal motility.

Substance abuse and dependence

Controlled substance

DURAGESIC contains fentanyl, a controlled substance in Plan II, which has high potential for misuse of other drugs such as morphine, hydromorphone, methadone, oxidodon and oximorphon. DURAGESIC can be abused and exploited, addicted and criminalized.

The substance content of long-term formulations increases the adverse effects of misuse and abuse.


All patients undergoing drug treatment need to be closely monitored for signs of abuse and addiction, since the use of anti-inflammatory drugs also carries the risk of drug addiction even in appropriate medical conditions.

Drug abuse is the non-pharmacological use of over-the-counter medications and administration even for one time against its psychological and physiological effects. Substance abuse includes: Using prescription or over-the-counter medications to get "high" or use steroids to increase performance and build muscle.

Cluster drug addiction is a behavioral, cognitive, and physiological phenomenon that occurs after repeated consumption of substances and includes the following: the desire for consumption of the drug, the problems in controlling its intake, the continued use of it with The existence of harmful consequences, higher priority for medication, the use of other activities and commitments, more tolerance and sometimes physical harvesting.

The "drug search" behavior in addicts and drugs is very common. Drug search tactics include emergency calls or visits to near end hours of the office, refusal of proper examination, testing or referral, repeat loss of copies, manipulation of copies, unwillingness to provide previous medical records or contact information.

The strict observance of prescribing information, such as quantity, frequency and appeal, is highly recommended, as required by law. Abuse and addiction are separate and distinct from physical dependence and tolerance. Physicians should be aware that addiction may be associated with simultaneous tolerance and physical dependence symptoms in all addicts. DURAGESIC, like other drugs, can be diverted to non-medical uses into illegal distribution channels.

Suitable patient assessments, appropriate prescribing, periodic re-evaluation of treatment, and appropriate disposal and storage are appropriate measures that help to limit drug abuse.

Danger of abuse of DURAGESIC

DURAGESIC is used only for restorative use. The abuse of DURAGESIC creates a risk of excessive transmission and death. This risk increases with the simultaneous misuse of DURAGESIC with alcohol and depression of the other central nervous system (with warnings, prevention and drug conflicts). The deliberate compromise of the transdermal delivery system may lead to uncontrolled delivery of fentanyl and is a big danger to the abuser, which may lead to excessive death and death. Abuse may occur with the transdermal system in the absence of a legitimate goal, or by swallowing, snorting or infusion of fentanyl extracted from the transdermal system.


Both tolerance and physical dependence can be created during chronic treatment. Tolerance requires an increase in the dose of drugs to maintain the defined effect, such as analgesia (in the absence of disease progression or other external factors). Tolerance may develop into the desired and unnecessary effects of drugs, and may grow due to different effects at different rates.

Physical dependence can cause withdrawal symptoms after sudden discontinuation or significant dose reduction. Elimination of this drug may be precipitated by the administration of drugs with an epidemic antagonist activity, such as naloxone, nalmfen, angiotonase, a mixed agonist / antagonist (pentazocine, butorphanol, nalbuphine), or partial agonists (buprenorphine). Physical dependency may not be significantly more clinical use for several weeks to several weeks.

DURAGESIC should not be stopped suddenly. If DURAGESIC suddenly stops at a physically dependent patient, it may have a release syndrome. Some or all of the following may indicate the syndrome: restlessness, stutter, rhinorrhea, yawning, nausea, chills, mistreatment, and midrias. Other symptoms and symptoms may include: irritability, anxiety, back pain, arthral pain, weakness, abdominal cramps, insomnia, nausea, anorexia, vomiting, diarrhea, or increased blood pressure, respiratory rate, or heart rate.

For whom Fentanyl might not be safe

Some medications could interact with fentanyl and cause a serious condition called serotonin syndrome.

Make sure your doctor knows if you take medication for depression, mental illness, Parkinson's disease, serious infections, migraine headache, or nausea and vomiting. Ask your doctor before any change in the way your medicine is used.

Use Fentanyl while pregnancy

Before starting or continuing treatment with DURAGESIC, consult with your doctor whether you can become pregnant or are planning to become pregnant and want to use this drug.

4-Fentanyl can cross the placenta and enter the fetus. Effects on developing fetuses are unclear. However, fentanyl can breathe newborns exposed to fentanyl in their mothers. Regular use of fentanyl by pregnant women can lead to withdrawal reactions in newborns. Therefore, if fentanyl is injected near delivery, caution should be considered.

Warnings of Fentanyl

Remember, keep this and all other drugs out of the reach of children, never share your drugs with others, and use fentanyl injection only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.


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