Fentanyl is a strong painkiller. It is used to relieve sudden flare-up of cancer pain.
Take Fentanyl exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
This medicine is available as a buccal tablet, lozenge, or film.
If you are taking the buccal tablet, do not swallow, chew or crush the tablet. Place the buccal tablet near a molar tooth between the gum and the cheek. If the tablet has not completely dissolved after 30 minutes, it may be swallowed with a glass of water. Alternate sides of mouth with the next dose.
If you are taking the buccal lozenge, do not swallow, chew or crush the lozenge. Lodge the lozenge between the gums and the cheek and suck the lozenge. Move the lozenge around the mouth using the applicator until the lozenge completely dissolves (about 15 minutes).
If you are taking the buccal film, wet the inside of your cheek using your tongue or rinse your mouth with water if necessary. Place the buccal film inside your mouth with the printed side against the inside of your moistened cheek. Press it against your cheek and hold for 5 seconds. Leave the buccal film in place until it dissolves for about 15-30 minutes. Alternate sides of mouth with the next dose.
Avoid moving or touching the film while it dissolves. Do not eat until after the buccal film melts completely in your cheeks.
Do not cut, tear, chew, crush, or swallow the buccal film.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on the severity of your condition and response to the medication.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have the following conditions:
- have never taken a strong painkillers e.g. morphine, oxycodone, hydromorphone before
- lung disease
- pain that comes and goes, pain due to recent surgery, mild pain
- bowel disorders e.g. paralytic ileus (bowel obstruction caused by slow movement or paralysis of the intestines)
as Fentanyl may not be suitable for you.
Do not take this medicine if you are breastfeeding. Do not start breastfeeding until at least 5 days after stopping the treatment.
Do not take Fentanyl if you are currently taking or have taken a medicine that is used to treat depression known as monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days.
Inform your doctor if you have the following conditions:
- low blood pressure
- heart disease e.g. slow heartbeat, heart failure, recent heart attack
- breathing difficulties during sleep
- head injury, brain disease or brain tumours
- mood disorders e.g. depression, anxiety disorders
- epilepsy (fits or seizures)
- myasthenia gravis (a muscle weakness disorder)
- adrenal glands disorders
- prostate enlargement or problems in urinating
- stomach and bowel diseases including constipation
- excessive drinking or problems related to alcohol withdrawal
- thyroid disease
- kidney disease
- iver disease
Let your doctor know if you are pregnant.
Be sure to check with your doctor or pharmacist before giving Fentanyl to the elderly, and those who are cachectic or debilitated (a person who is physically or mentally weak usually due to illness or old age). These people may be more sensitive to the side effects.
If you are going to have an operation, including minor surgery and dental work, inform your doctor or dentist that you are taking Fentanyl.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Your blood pressure and pulse rate may drop to unsafe levels without you noticing it. You may need to monitor your blood pressure and pulse rate regularly.
- Routine test (e.g. liver function) may be done while you are being treated with this medicine. Your doctor will advise you about how often you need to have this test.
- Regular monitoring of lung and mental status, and for signs of drug misuse, abuse or dependence may also be needed.
Fentanyl may cause dizziness, drowsiness, or some problems with your eyesight such as blurred vision. If affected, do not drive or take part in any activity in which you need to be alert.
This medicine may cause your blood pressure to fall suddenly when you get up from a sitting or lying down position and you may feel giddy. To minimise this problem, stand up slowly.
Other side effects include any of the following: headache, nausea, vomiting, constipation, dry mouth, diarrhoea, throat or stomach pain, taste disturbances, indigestion, muscle or back pain, difficulty sleeping, excessive sweating, and pain, redness, irritation, or swelling at the site of application.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- severe, slow or shallow breathing, extreme or unusual dizziness or drowsiness
- light-headedness, feeling faint, slow heartbeat, chest pain
- very high fever, rigid muscles, involuntary movements, mental status changes e.g. being too depressed or anxious, hallucinations (seeing, hearing or feeling things that are not existent)
- fits or seizures
- pain or increased sensitivity to pain while taking this medicine
- combination of nausea, vomiting, loss of appetite, tiredness, weakness and dizziness
- rashes, breathlessness, swelling of the face, eyes or mouth
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Do not take Fentanyl if you are currently taking or have taken a medicine that is used to treat depression known as monoamine oxidase inhibitor (MAOI) such as isocarboxazid, phenelzine and tranylcypromine in the last 14 days.
Inform your doctor and pharmacist if you are taking any of these medicines:
- medicines to treat depression e.g. citalopram, duloxetine, fluoxetine, fluvoxamine
- medicines for mood disorders e.g. aripiprazole, haloperidol, olanzapine, risperidone
- medicines for anxiety e.g. alprazolam, diazepam, clonazepam
- medicines for sleep disorder e.g. temazepam, zaleplon, zolpidem
- certain medicines for cold or allergy e.g. clemastine, diphenhydramine, hydroxyzine
- medicines for HIV infection e.g. ritonavir, nelfinavir, amprenavir, fosamprenavir
- medicines to treat fungal infection e.g. ketoconazole, itraconazole, fluconazole
- certain antibiotics e.g. erythromycin, clarithromycin, troleandomycin
- medicines for epilepsy (fits or seizures) e.g. phenytoin, carbamazepine, phenobarbital
- medicines for irregular heartbeat e.g. diltiazem, verapamil
- other strong painkillers e.g. nalbuphine, pentazocine, buprenorphine
- medicine to treat TB (infection known as tuberculosis) e.g. rifampicin
- St. John’s wort (herbal medicine)
This list does not include all medicines that may interact with Fentanyl.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Avoid alcohol and grapefruit or grapefruit juice.
Store in a cool, dry, and secure place away from the reach of children.
Medicines must not be used past the expiry date.
Always return any used, unused or expired Fentanyl to the clinic, hospital, or pharmacy for disposal. Do not throw it away in the household waste.
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