Fentanyl Injection
Fentanyl
50mcg/1ml
Sun Pharmaceutical Industries Ltd.
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| Retail Price | 68.80 NPR |
Available as:
Indications
Fentanyl Injection is used for:
Pain, Cancer pain, Anesthesia, Analgesia, Breakthrough pain
Adult Dose
Oral
Breakthrough cancer pain
Adult: As tab: Initially, 100 mcg for an episode of breakthrough pain; may repeat once after 30 min if needed; wait for at least 2 or 4 hr before treating another episode.
Sublingual
Breakthrough cancer pain
Adult: Tab: Initially, 100 mcg for an episode of breakthrough pain; may repeat once after 30 min if needed; wait for at least 2 or 4 hr before treating another episode.
Parental
Surgery Premedication
50-100 mcg/dose IM or slow IV 30-60 min prior to surgery
Adjunct to regional anesthesia: 25-100 mcg/dose slow IV over 1-2 min
General Anesthesia
Minor surgical procedures: 0.5-2 mcg/kg/dose IV
Major surgery: 2-20 mcg/kg/dose initially; 1-2 mcg/kg/hr maintenance infusion IV; discontinue infusion 30-60 min prior to end of surgery; limit total fentanyl doses to 10-15 mcg/kg for fast tracking and early extubation
Adjunct to general anesthesia (rarely used): 20-50 mcg/kg/dose IV
Transdermal
Chronic Severe Pain
Indicated for chronic pain in opioid-tolerant patients, severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate
25-100 mcg/hr, reapplied q72hr until adequate analgesia is achieved.
During transfer to fentanyl patches, previous opioid treatment should be phased out gradually.
If patient requires doses >100 mcg/hr, >1 patch may be used; consider alternative or additional therapy if doses >300 mcg/hr are required.
Replace patch every 72 hr and apply the new patch to a different site; avoid using the same area of skin for a few days.
Refer to opioid conversion table in prescribing information
Elderly: Dose reduction may be needed.
Child Dose
Renal Dose
Administration
Contra Indications
Hypersensitivity.
Precautions
Myasthaenia gravis. Head injury; increased intracranial pressure; intracranial lesions; renal or hepatic impairment; neonates; opioid-nontolerant patients. Increased risk of respiratory depression in elderly, debilitated patients, patient with hypoxia or hypercapnia. Hypothyroidism, prostatic hyperplasia, inflammatory bowel disorders, bradycardia or bradyarrhythmias. Rapid IV infusion may cause skeletal muscle and chest wall rigidity, impaired ventilation or respiratory distress/arrest. Prolonged use may cause tolerance, psychological and physical dependence. Abrupt withdrawal after prolonged admin may lead to withdrawal symptoms. Lactation. Pregnancy (avoid high doses or prolonged usage).
Lactation: Drug distributed in breast milk; breastfeeding not recommended
Pregnancy-Lactation
Interactions
Concomitant use w/ CYP3A4 inhibitors (e.g. erythromycin, clarithromycin, troleandomycin, azole antifungals, ritonavir, amiodarone, nefazodone, aprepitant, diltiazem and verapamil) increases serum levels of fentanyl and may potentiate fatal resp depression. Increased risk of life-threatening serotonin syndrome w/ SSRIs, SNRIs and MAOIs. May reduce serum levels w/ rifamycin derivatives. Enhanced depressant effect w/ general anaesth, tranquilisers, barbiturates and narcotics. May increase excretion w/ ammonium Cl. May increase hypotensive effect w/ phenothiazines. May reduce efficacy of pegvisomant.
Adverse Effects
Side effects of Fentanyl :
Reduce pulmonary compliance and/or apnoea, bronchoconstriction, laryngospasm; nausea, vomiting; bradycardia, oedema, CNS depression, confusion, dizziness, drowsiness, headache, sedation, hypotension, peripheral vasodilation, increased intracranial pressure, itching, rash, erythema, papules, pruritus, exfoliative dermatitis, pustules, macular rash; gum bleeding and irritation, taste perversion, dental caries, tooth loss, gum line erosion; throat irritation, nasal ulcers, epistaxis, rhinorrhoea; coughing; urinary retention.
High IV dose may cause chest wall rigidity.
Transdermal: Rash, erythema and itching.
Potentially Fatal: Respiratory depression, trunk rigidity, laryngospasm, bronchoconstriction.
Mechanism of Action
Fentanyl is a potent opioid analgesic that increases pain threshold, alters pain reception and inhibits ascending pain pathways by binding to stereospecific receptors w/in the CNS.
Note
Fentanyl 50mcg/1ml Injection manufactured by Sun Pharmaceutical Industries Ltd.. Its generic name is Fentanyl. Fentanyl is availble in Nepal.
Farmaco Nepal drug index information on Fentanyl Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.