Fentanyl - nasal


Patient Medicine Information
Why do I need this medicine?
Fentanyl is a strong painkiller. It is used to relieve sudden flare-up of cancer pain.
How do I use this medicine?
Use Fentanyl nasal spray exactly as directed by your doctor or according to the instructions on the label. Do not use more or less than instructed by your doctor.

This medicine is available as a nasal spray.

To use the nasal spray, follow these steps:
  1. If you are using the nasal spray for the first time or if you have not used it for a long period, prim the bottle by removing the cap and pressing the pump a few times (usually about 3-4 times), and spray into the air or in the provided pouch until it releases a fine mist. Perform this process in well ventilated area, away from yourself or others, and away from surfaces or objects that could come in contact with others, especially children. Omit this step and proceed to step 2 if using single-dose spray container.
  2. Blow your nose gently to clear your nostril before using the nasal spray.
  3. Hold the bottle upright with your thumb supporting the bottom, and your index and middle finger on either side of the spray tip.
  4. Close one nostril by placing your index finger against the side of your nose, then insert the spray tip into the other nostril.
  5. Press the pump down quickly and completely once, while breathing through your nose. Take the spray tip out and wipe it with clean tissue. Throw away the tissue afterwards.
  6. If you need a second dose after 10 minutes, repeat steps to spray into the other nostril.
Make sure you know how to use your nasal spray. If you have problems or do not understand the instructions, ask your doctor or pharmacist.

Do not share your nasal spray with others.

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.
What should I do if I have forgotten to use this medicine?
Use 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 use your medicine, let your doctor and pharmacist know.
When should I not use this medicine?
Alert your doctor if you have the following conditions:
  • have ever 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)
  • previously received facial radiotherapy
  • recurrent episodes of nose bleeding
as Fentanyl nasal spray may not be suitable for you.

Do not use this medicine if you are breastfeeding. Do not start breastfeeding until at least 5 days after stopping the treatment.

Do not use Fentanyl if you are taking medicines containing sodium oxybate, and 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.
What should I take note of while using this medicine?
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
  • liver 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.

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.
What side effects could I experience?
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, dizziness with sensation of spinning, throat irritation, nausea, vomiting, constipation, flushing, feeling very warm, and excessive sweating.

Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
  • severe, slow or shallow breathing, unusual or extreme 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)
  • convulsive pain, 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
Can I use this with other medicines?
Do not use Fentanyl if you are taking medicines containing sodium oxybate, and 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
  • medicines for cold or allergy used in the nose e.g. oxymetazoline, xylometazoline
  • 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
  • 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.
What special dietary instructions should I follow?
Avoid alcohol and grapefruit or grapefruit juice.
How should I store this medicine?
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 nasal spray to the clinic, hospital, or pharmacy for disposal. Do not throw it away in the household waste.
This information is independently developed by MIMS based on fentanyl - nasal and is provided for your reference only. It is not a replacement for and should only be used in conjunction with full consultation with a licensed healthcare professional, the information provided by your pharmacist and/or the manufacturer of the medication. It may not contain all the available information you require and cannot substitute professional medical care, nor does it take into account all individual circumstances. Although great effort has been made to ensure content accuracy, we shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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