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Fentanyl
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About fentanyl
| Type of medicine | Analgesic |
| Used for | Pain |
| Also called | Durogesic DTrans® Sublimaze® Actiq® Tilofyl® Matrifen® Osmach® |
| Available as | Patch, lozenge and injection |
Fentanyl is used to relieve severe pain; it works on the nerves and brain to reduce the pain you feel.
Before taking or using fentanyl
Before taking or using fentanyl make sure your doctor or pharmacist knows:
- If you are pregnant, trying for a baby or breast-feeding.
- If you suffer from liver, kidney, respiratory (breathing), prostate or thyroid problems.
- If you suffer from epilepsy or hypotension (low blood pressure).
- If you have recently suffered a serious head injury.
- If you suffer from phaeochromocytoma (a rare growth on the adrenal glands).
- If you have been constipated for more than a week, with or without tummy pain and bloatedness.
- If you have ever had a problem with addiction to drugs or alcohol.
- If you have ever had an allergic reaction after taking this or any other medicine.
- If you are taking any other medicines including medicines you buy, herbal or homeopathic medicines.
- If you have taken a monoamine oxidase inhibitor (MAOI) for depression within the last two weeks.
How to use fentanyl
- Before beginning treatment, read the manufacturer's printed information leaflet. Use fentanyl exactly as your doctor has told you.
- Fentanyl is for you. Never give it to others even if their condition appears to be the same as yours.
- Fentanyl lozenges - should not be swallowed or chewed. Move the applicator around the mouth to ensure contact with the tongue and the inside of cheeks. As the lozenge dissolves, the fentanyl is absorbed through the lining of the mouth into the body. Initially, use one lozenge over a 15 minute period. If pain does not ease within 15 minutes, repeat with another lozenge. Do not use more than 4 lozenges in any 24 hour period. If there is still some lozenge left on the applicator this should be disposed of out of the reach of children. You can run it under a hot tap until the lozenge has all gone and then the applicator can be thrown away.
- Fentanyl patches - should be placed on a dry, non-hairy area of your upper arm or upper body as directed. Apply by pressing it firmly onto the skin with the palm of the hand for approximately 30 seconds to make sure that it sticks well to the skin. Avoid touching the adhesive side of the patch and wash your hands after applying the patch. It may take up to 24 hours for the first fentanyl patch you use to reach it's full effect.
- Fentanyl patches should not be placed on irritated skin, shaved skin or skin that has received radiotherapy. Do not cut or divide the patch in any way before using it.
- Speak to your doctor if you develop a high temperature as this can increase the absorption of fentanyl through the skin.
- Try to avoid the patch coming into contact with a heat source such as a heating pad, hot water bottle, electric blanket, or a heated water bed as this may increase the amount of fentanyl released from the patch. Having long hot baths or sunbathing for long periods of time while wearing a patch are also best avoided.
- Fentanyl patches should be removed after 72 hours (3 days) and before applying a new patch on a different area of skin. You should try to avoid placing a patch in the same area for at least seven days. Fold the removed patch in half, put it back into the packaging and dispose of it as you have been directed or return it to your local pharmacy.
Getting the most from your treatment
- Alcohol will increase any feelings of drowsiness. Avoid alcoholic drinks
- Fentanyl can cause constipation. Constipation can often be eased by eating plenty of fibre, such as wholegrain cereals, fruit, green leafy vegetables and drinking 6-8 glasses of water each day.
- Symptoms of too high a dose of fentanyl include trouble breathing, tiredness, extreme sleepiness, inability to think or talk normally, feeling faint and confusion. If you experience these symptoms, contact your doctor straight away.
- Because fentanyl is a controlled drug, if you are planning a trip abroad, check with the government department HM Revenue and Customs to see if you need any documentation for your medicine. HM Revenue and Customs (HMRC) has a list of medicines that contain controlled drugs and can tell you the amount that you are allowed to take abroad. If you need to pack more of your medicine than you are allowed you will need to apply in writing for a licence from the Home Office before you travel.
Can fentanyl cause problems
Along with their useful effects all medicines can cause unwanted side effects, which usually improve as your body adjusts to the new medicine. Speak with your doctor or pharmacist if any of the following side effects continue or become troublesome.
| Side-effects | What can I do if I experience this |
| Rash, itching underneath the fentanyl patch | A rash underneath the patch can often be avoided by rotating the place where it is applied. Speak with your doctor if this continues. |
| Feeling or being sick | It usually passes after a few days; as you adjust to the medicine. Your doctor may be able to prescribe a medicine to ease nausea. |
| Constipation | Try to eat a well balanced diet containing plenty of fibre and drink 6-8 glasses of water each day. If constipation continues to be a problem speak to your pharmacist or doctor. |
| Drowsiness, dizziness | Make sure your reactions are normal before driving, operating machinery or doing any other jobs which could be dangerous if you are not fully alert or dizzy. Avoid alcohol; it will increase any feelings of drowsiness. |
| Dry mouth | Try chewing sugar-free gum, sucking pieces of ice or sugar-free sweets. If this becomes troublesome speak to your pharmacist or doctor. |
| Sweating | Use a cold wet flannel applied to the forehead. |
| Headache | Ask your pharmacist to recommend a suitable pain-killer. If headache continues speak with your doctor. |
| Breathlessness, difficulty urinating (passing water), a fast, slow or fluttering heartbeat, seeing or hearing things that aren't real, mood changes, sexual problems, skin rashes or itching. | Speak with your dcotor. |
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.
How to store fentanyl
- Keep all medicines out of the reach of children. This includes used patches and part-finished lozenges.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
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References
- British National Formulary; 54th Edition (September 2007) British Medical Association and Royal Pharmaceutical Society of Great Britain, London.
- Manufacturer's PIL, Matrifen®, Nycomed, electronic Medicines Compendium. Approved September 2007, accessed 7 February 2008.
- Manufacturer's PIL, Actiq®, Cephalon UK Ltd, electronic Medicines Compendium. Revised July 2006, accessed 7 February 2008
The authors and editors of this article are employed to create accurate and up to date content reflecting reliable research evidence, guidance and best clinical practice. They are free from any commercial conflicts of interest. Find out more about updating.
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