REMS: FDA approved a REMS for fentanyl to ensure that the benefits outweigh the risks. The REMS may apply to one or more preparations of fentanyl. See the FDA REMS page ([Web]) |
Fentanyl is a synthetic phenylpiperidine-derivative opiate agonist.230, 240, 256, 706
Fentanyl is a strong analgesic used to relieve pain.230, 240, 256, 704, 706
Fentanyl is available in several dosage forms including buccal tablets (Fentora®)230 and lozenges (Actiq®),256 transdermally as fentanyl transdermal system,230 and as a solution for injection.704, 706
The CDC clinical guideline for prescribing opioids for pain gives recommendations for clinicians providing pain care to adults for the management of acute, sub-acute, and chronic pain.707 Acute pain (duration <1 month) has a sudden onset and is usually occurring after injury, trauma, or medical procedures or surgery.760 Subacute pain (duration of 1-3 months) may be the continuation of acute pain or pain with a longer duration of unresolved pain.707 Chronic pain has a longer duration (>3 months) and may result from an underlying medical condition or disease, injury, medical treatment, inflammation, or unknown cause.707
Fentanyl should not be used for an extended period of time unless the pain remains severe enough to require an opioid analgesic and for which alternative treatment options continue to be inadequate.707
Acute pain and subacute pain, if unresolved, may evolve into chronic pain.707 The CDC guideline addresses the following four areas: 1) determining whether to initiate opioids for pain, 2) selecting opioids and determining opioid dosages, 3) deciding duration of initial opioid prescription and conducting follow-up, and 4) assessing risk and addressing potential harms of opioid use.707 The full text of the recommendations can be accessed at http://www.cdc.gov/opioids/healthcare-professionals/prescribing/guideline/at-a-glance.html.707
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Fentanyl citrate is used for analgesic action of short duration during the anesthetic periods, premedication, induction and maintenance, and in the immediate postoperative period (recovery room) as the need arises.704, 706 It is also used as an opioid analgesic supplement in general or regional anesthesia.704, 706 Fentanyl citrate is used along with a neuroleptic as an anesthetic premedication, for the induction of anesthesia and as an adjunct in the maintenance of general and regional anesthesia.704, 706 In selected high-risk patients, such as those undergoing open heart surgery or certain complicated neurological or orthopedic procedures it is used as an anesthetic agent with oxygen.704, 706
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Females and Males of Reproductive Potential
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Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.
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Routes | Dosage Forms | Strengths | Brand Names | Manufacturer |
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Oral | [Dosage Form] | [Strength/Concentration] | [Trade Name] ([Preparation Details]) | [Company Name] |
AHFS® Drug Information. © Copyright, 1959-2024, Selected Revisions January 1, 2020. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, MD 20814.
Only references cited for selected revisions after 1984 are available electronically.
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