Fentanyl is a medicine to relieve intense pain , such as from cancer or surgery. This drug can also be used as an anesthetic or additional drug to increase the effect of anesthetic during surgery .

Fentanyl is an opioid class of pain medication that works by blocking pain signals in nerve cells that go to the brain. This drug is available in the form of injections and transdermal patches that are shaped like plaster or patch. Fentanyl should not be used carelessly and must be in accordance with a doctor's prescription.

Fentanyl trademarks: Durogesic, Etanyl, Fentanyl, Fentanyl Citrate

What is Fentanyl

class Prescription drug
Category Analgesics and anesthetics
Benefit Relieves severe pain, is an additional drug used during anesthesia or anesthetic procedures
Used by Adults and children
Fentanyl for pregnant and lactating women Category C: Animal studies have shown an adverse effect on the fetus, but there have been no controlled studies in pregnant women.

Drugs should only be used if the expected benefit outweighs the risk to the fetus.

Fentanyl can be absorbed into breast milk. If you are breastfeeding, do not use this medication without telling your doctor.

Drug form Transdermal injections and patches

Warning Before Using Fentanyl

Fentanyl should only be used as prescribed by a doctor. Note the following points before using fentanyl:

  • Tell your doctor about any history of allergies you have. Fentanyl should not be given to patients who are allergic to this drug.
  • Tell your doctor if you have or currently have asthma, seizures , epilepsy, arrhythmias , adrenal gland disorders, liver disease, kidney disease, lung disease , intestinal obstruction, paralytic ileus , low blood pressure, mental disorders , or enlarged prostate .
  • Tell your doctor if you have or have ever had sleep apnea , a head injury, alcohol addiction , urinary disorders, pancreatitis , thyroid disease, drug abuse , or gallbladder disorders.
  • Tell your doctor if you are taking any medications, supplements or herbal products.
  • Tell your doctor if you are pregnant, breastfeeding or planning a pregnancy.
  • Tell your doctor that you are having treatment with fentanyl before having surgery, including dental surgery.
  • Do not consume alcoholic beverages and grapefruit juice while on treatment with fentanyl, because they can increase the risk of dangerous side effects.
  • Do not drive a vehicle or do activities that require alertness while using fentanyl, because this drug can cause dizziness or drowsiness .
  • Immediately see a doctor if there is an allergic drug reaction, serious side effects, or an overdose after using fentanyl.

Dosage and Rules for Using Fentanyl  

The following are common dosages for fentanyl based on the drug form, condition, and age of the patient:

Drug form: Injection and infusion

Conditions: As premedication before surgical procedures

  • Adult: 50–100 mcg, given by injection into a muscle (intramuscular/IM) or into a vein (intravenously/IV) 30–60 minutes before surgery.

Conditions: As an adjunct to general anesthesia during major surgery (major surgery)

  • Adult: Initial dose is 1–2 mcg/kg per hour. Maintenance dose 2–20 mcg/kg/dose by IV injection.
  • Children >2 years: 2-3 mcg/kg by IV or IM injection every 1-2 hours as needed.

Conditions: As an adjuvant to general anesthesia during minor surgery (minor surgery)

  • Adult: 0.5–2 mcg/kg/dose by IV injection.

Medication form: Transdermal patch

Condition: Chronic pain condition in patients who are not resistant to opioids

  • Children >2 years and adults: 25–100 mcg/hour, given every 72 hours.

How to Use Fentanyl Properly

Always follow the doctor 's recommendations while taking treatment with fentanyl. Fentanyl injection will be given by a doctor or medical officer under the supervision of a doctor. The injection can be given into a muscle (IM), into a vein (IV), or put in an IV infusion.

Fentanyl transdermal patch form should not be used on skin that is injured or irritated. Use the patch on flat, dry areas of skin, such as the chest, back, or upper arms for better adherence. If necessary, clip the hair in the skin area where the drug will be attached.

Paste and press the transdermal patch for 30 seconds, so that the drug sticks properly. Release the drug after 72 hours or as directed by your doctor. Be sure to remove the old patch first, then stick the new patch in a different area. Do not use more than one patch at a time.

Perforated fentanyl transdermal patch can increase the speed of drug absorption into the skin. Therefore, do not use patches that are damaged.

After using the medicine, do not wash your hands with soap or other cleansers. Just wash your hands under running water.

Do not increase or decrease your dose without consulting your doctor first. This drug can cause dependence or overdose if used in excess.

If you forget to use the transdermal fentanyl patch, apply the patch as soon as you remember. Do not use an extra patch to make up for a forgotten dose.

Store the fentanyl transdermal patch in the package in a cool, dry place. Keep the medicine out of direct sunlight and the reach of children.

Fentanyl Interactions with Other Drugs

Some of the drug interactions below can occur if fentanyl is used together with certain drugs:

  • Increased blood levels of fentanyl and risk of side effects when used with erythromycin, clarithromycin , ritonavir, or amiodarone
  • Increased risk of developing serotonin syndrome when used with antidepressant drugs
  • Increased risk of fatal side effects, such as seizures, coma, and even death if used with other opioid class drugs, such as morphine or tramadol
  • Decreased blood levels of fentanyl when used with phenobarbital , carbamazepine, phenytoin, ammonium chloride , or rifampicin
  • Increased risk of developing hypotension when used with phenothiazines
  • Decreased effect of fentanyl when used with naloxone

In addition, interaction effects can also occur when using fentanyl when consuming certain foods or drinks, for example:

  • Increased risk of fatal side effects when used with alcohol
  • Increased blood levels of fentanyl when used with grapefruit juice
  • Decreased blood levels of fentanyl when used with St. John's Wort

Fentanyl Side Effects and Dangers

Some of the side effects that can occur due to the use of fentanyl are:

  • Stomach ache
  • Constipation
  • Nausea or vomiting
  • Drowsiness
  • Body feels weak
  • Headache, dizziness, or vertigo
  • The skin that was injected or attached to the drug feels itchy or irritated

Check with your doctor if the side effects above don't improve or get worse. Immediately see a doctor if you experience an allergic drug reaction or serious side effects, such as:

  • Severe dizziness
  • Hard to breathe
  • Anxiety and insomnia
  • Irritability or hallucinations
  • No appetite
  • Pounding heart or fast heart rate
  • Diarrhea or stomach cramps
  • Muscle pain or stiffness
  • Loss of consciousness, convulsions, fainting
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