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Fentanyl

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About Fentanyl

Fentanyl tablets are used to help relieve severe ongoing pain (such as due to cancer). It belongs to a class of drugs known as opioid (narcotic) analgesics. Fentanyl patch doses work in the brain to change how your body feels and responds to pain. Fentanyl withdrawal symptoms and Fentanyl patch side effects can be based on your medical condition.

Do not use the patch form of fentanyl to relieve pain that is mild or that will go away in a few days. This medication is not for occasional (“as needed”) use.

How to use

Read the Medication Guide and, if available, the Instructions for Use provided by your pharmacist before you start using Fentanyl tablets and each time you get a refill. Learn how to properly use, store, and discard the patches. If you have any questions, ask your doctor or pharmacist.

Use this medication on a regular schedule as directed by your doctor, not as needed for sudden (breakthrough) pain.

  • Apply Fentanyl patch doses to the skin as directed by your doctor.
  • Do not apply on burns, cuts, irritated skin, or skin that has been exposed to radiation (x-ray treatment).
  • Select a dry, non-hairy area on a flat part of your body, such as the chest, sides, back, or upper arms.
  • In young children or in people unable to think clearly (such as due to dementia), apply the patch on the upper back to lessen the chance it might be removed or placed in the mouth.
  • If there is hair on the skin, use scissors to clip the hair as close as possible to the skin.
  • Do not shave hair since this might cause skin irritation.
  • If needed, use water to clean the area.
  • Do not use soap, oils, lotions, or alcohol on the application site.
  • Dry the skin well before applying the patch.

The patch is usually changed every 72 hours. To avoid irritation, apply to a different area each time. Be sure to remove the old patch before applying a new patch. The used patch still contains enough fentanyl to cause serious harm, even kill a child or pet, so fold it in half with the sticky sides together and discard properly.

Precautions 

Do not let children see you apply a patch, and do not apply the patch where children can see it. Children have found patches that have fallen off or removed patches on sleeping adults and put them in their mouths or on their bodies with fatal results.

Do not use the patch if it appears to be broken, cut, or damaged. Remove from the sealed pouch, peel off the protective liner, and apply right away to the skin. Press firmly in place with the palm of the hand for 30 seconds, making sure the contact is complete (especially around the edges). If your prescribed dose is for more than one patch, make sure the edges of the patches do not touch or overlap. Wash your hands after applying the patch.

If you accidentally touch the sticky layer to your skin or handle a cut or damaged patch, wash the area well with clear water. If the patch comes off and accidentally sticks to the skin of another person, immediately remove the patch, wash the area with water, and get medical help for them right away. Do not use soap, alcohol, or other products to wash the area.

Dosage and treatment

Fentanyl patch doses are based on your medical condition and response to treatment. Do not apply more patches than directed, change them more frequently, or use them for a longer time than prescribed.

Suddenly stopping Fentanyl tablets may cause Fentanyl withdrawal symptoms, especially if you have used it for a long time or in high doses. To prevent withdrawal, your doctor may lower your dose slowly. Tell your doctor or pharmacist right away if you have any Fentanyl withdrawal symptoms such as restlessness, mental/mood changes (including anxiety, trouble sleeping, thoughts of suicide), watering eyes, runny nose, nausea, diarrhea, sweating, muscle aches, or sudden changes in behavior.

When this medication is used for a long time, it may not work as well. Talk with your doctor if this medication stops working well.

Though it helps many people, Fentanyl tablets may sometimes cause addiction. This risk may be higher if you have a substance use disorder (such as overuse of or addiction to drugs/alcohol). Use this medication exactly as prescribed to lower the risk of addiction. Ask your doctor or pharmacist for more details.

Tell your doctor if your pain does not get better or if it gets worse.

Side effects

  • Nausea
  • vomiting
  • constipation
  • lightheadedness
  • dizziness
  • drowsiness
  • headache
  • Mild irritation
  • itching
  • redness at the application site

Some of these Fentanyl withdrawal symptoms and Fentanyl patch side effects may decrease after you have been using this medication for a while. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

To prevent constipation, eat dietary fiber, drink enough water, and exercise. You may also need to take a laxative. Ask your pharmacist which type of laxative is right for you.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that your doctor has prescribed this medication because he or she has judged that your benefit is greater than the risk of side effects. Many people using this medication do not have serious Fentanyl withdrawal symptoms and Fentanyl patch side effects.

Some serious and rare side effects

Tell your doctor right away if you have any serious and Fentanyl patch side effects, including interrupted breathing during sleep (sleep apnea), mental/mood changes (such as agitation, confusion, hallucinations), severe stomach/abdominal pain, difficulty urinating, slow/fast/pounding heartbeat, signs of your adrenal glands not working well (such as loss of appetite, unusual tiredness, weight loss).

Get medical help right away if you have any very serious Fentanyl patch side effects, including fainting, seizure, slow/shallow breathing, severe drowsiness/difficulty waking up.

Fentanyl tablets may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.

A very serious allergic reaction to this drug is rare. However, get medical help right away.

Warnings & Precautions

  1. Before using Fentanyl patch doses, tell your doctor or pharmacist if you are allergic to it.
  2. Before using this medication, tell your doctor or pharmacist your medical history.
  3. Do not drive, use machinery, or do anything that needs alertness until you can do it safely.
  4. Avoid alcoholic beverages.
  5. Avoid activities that might cause your body temperature to rise.
  6. Before having surgery, tell your doctor or dentist about all the products you use.

If you are going to have an MRI test, tell testing personnel that you are using this patch. Some patches may contain metals that can cause serious burns during an MRI. Ask your doctor whether you will need to remove your patch before the test and apply a new patch afterward, and how to do so properly.

Older adults may be more sensitive to the Fentanyl withdrawal symptoms and Fentanyl patch side effects, especially confusion, dizziness, drowsiness, and slow/shallow breathing.

During pregnancy, Fentanyl patch doses should be used only when clearly needed. It may harm an unborn baby. Discuss the risks and benefits with your doctor. This drug passes into breast milk and may have undesirable effects on a nursing infant. Tell the doctor right away if your baby develops unusual sleepiness, difficulty feeding, or trouble breathing. Consult your doctor before breastfeeding.

Storage

Store at room temperature away from light and moisture. Do not freeze. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush Fentanyl tablets down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. For more details, read the Instructions for Use, or consult your pharmacist or local waste disposal company.

Drug interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

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