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fentaNYL Citrate
FentaNYL Citrate is a potent opioid analgesic used for managing severe pain, particularly in patients who are opioid-tolerant and require around-the-clock pain control or in acute settings such as surgical anesthesia. FentaNYL works by binding to the mu-opioid receptors in the brain and spinal cord, altering the perception of pain. It is significantly more potent than morphine and is typically reserved for patients with severe pain that cannot be managed by other opioids.
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Frequently Asked Questions
How long does it take for fentaNYL to start working?
Intravenous fentaNYL starts working within minutes. Transdermal patches may take 12 to 24 hours to reach their full effect.
Can I use fentaNYL for breakthrough pain?
FentaNYL is available in formulations for breakthrough pain, such as oral lozenges or sublingual tablets. These formulations are used for opioid-tolerant cancer patients experiencing sudden pain episodes.
What should I do if I miss a dose of fentaNYL (patch)?
If you forget to change your patch at the scheduled time, apply a new patch as soon as you remember. Do not apply two patches at the same time.
Can fentaNYL cause addiction?
Yes, fentaNYL is a highly addictive opioid with a high potential for abuse and dependence. Patients using fentanyl should be closely monitored for signs of misuse.
How should I store fentaNYL patches?
Store fentaNYL patches at room temperature, away from heat, light, and moisture. Keep them out of reach of children and pets. Dispose of used patches safely to prevent accidental exposure.
Comprehensive Drug Guide
How Does fentaNYL Citrate Work?
FentaNYL Citrate works by binding to opioid receptors in the brain, spinal cord, and other parts of the body, mimicking the action of endogenous endorphins. By binding to the mu-opioid receptor, fentaNYL reduces the transmission of pain signals and alters the emotional response to pain, providing powerful analgesic effects. It also affects other bodily systems, such as respiratory and gastrointestinal function.
Common Dosages
- Transdermal patches: Typically dosed between 12 mcg/hour to 100 mcg/hour, applied every 72 hours for continuous pain relief.
- Injection: Dose varies based on the patient's condition and response, typically starting at 50 to 100 mcg for pain relief.
- Lozenges and tablets: Available in doses from 200 mcg to 1600 mcg, used for breakthrough pain in opioid-tolerant cancer patients.
Typical Dosing
FDA Approved Indications
- Management of severe pain in opioid-tolerant patients.
- Breakthrough pain in cancer patients.
- Anesthesia and pain management during surgery.
- Postoperative pain (in the form of injection).
- Chronic pain management (via transdermal patches).
Who Shouldn't Take fentaNYL Citrate?
- Known hypersensitivity to fentanyl or other opioids.
- Significant respiratory depression.
- Acute or severe bronchial asthma.
- Gastrointestinal obstruction, including paralytic ileus.
- Non-opioid tolerant patients, especially with long-acting formulations like transdermal patches.
Advice From The Pharmacist
- Do not use fentanyl in opioid-naïve patients, as it can cause fatal respiratory depression. FentaNYL Citrate is only for patients with a history of long-term opioid use.
- Apply transdermal patches to a non-irritated, hairless area of the skin on the chest, back, or upper arm, and change the patch every 72 hours.
- Avoid exposing patches to heat, such as heating pads, saunas, or hot tubs, as this can increase the rate of fentanyl absorption and lead to overdose.
- Patients using fentanyl should be regularly monitored for signs of respiratory depression, particularly when starting therapy or increasing the dose.
- Dispose of used patches safely to prevent accidental exposure to children or pets, as even residual fentanyl can be harmful.
Side Effects of fentaNYL Citrate
Common Side Effects
- Drowsiness or dizziness
- Constipation
- Nausea and vomiting
- Dry mouth
- Sweating
Uncommon/Severe Side Effects
- Respiratory depression, which can be life-threatening, especially with improper use or dosing.
- Bradycardia (slow heart rate).
- Severe hypotension.
- Addiction, abuse, and dependence.
- Serotonin syndrome, especially when combined with certain antidepressants or other serotonergic drugs.
Risks and Warnings of fentaNYL Citrate
- Respiratory Depression: FentaNYL Citrate carries a high risk of fatal respiratory depression, particularly in opioid-naïve individuals or if used in higher-than-prescribed doses. Patients should be closely monitored, especially when initiating treatment.
- Abuse and Dependence: FentaNYL is highly addictive and carries a significant risk for misuse, abuse, and diversion. It should only be prescribed to patients with a legitimate need for pain relief.
- Drug Interactions: FentaNYL should not be combined with benzodiazepines, alcohol, or other CNS depressants, as this can increase the risk of respiratory depression.
- Serotonin Syndrome: FentaNYL may increase the risk of serotonin syndrome when used with SSRIs, SNRIs, or MAO inhibitors. Symptoms include agitation, confusion, rapid heart rate, and muscle rigidity.
Interactions with fentaNYL Citrate
Common Drug Interactions
- Benzodiazepines and other CNS depressants: Combining these with fentanyl increases the risk of severe respiratory depression, sedation, and death.
- MAO inhibitors: Should not be used with fentanyl due to the risk of serotonin syndrome.
- Antidepressants (SSRIs, SNRIs, tricyclics): Can increase the risk of serotonin syndrome.
- Grapefruit juice: Can increase the levels of fentanyl in the blood, raising the risk of side effects or overdose.
Alternatives to fentaNYL Citrate
- Morphine: Another potent opioid used for severe pain management.
- Hydromorphone (Dilaudid): A strong opioid analgesic used for acute or chronic severe pain.
- Methadone: Often used for severe chronic pain or opioid dependence.
- Oxycodone: Another opioid used for managing moderate to severe pain.
