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Lazanda
Lazanda (fentanyl) is a transmucosal formulation of the potent opioid analgesic fentanyl, used primarily for the management of breakthrough pain in adults with cancer who are already receiving and are tolerant to opioid therapy. It is designed to provide rapid pain relief through absorption in the mucous membranes of the mouth.
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Frequently Asked Questions
How quickly does Lazanda work for breakthrough pain?
Lazanda typically provides pain relief within 15 to 30 minutes after administration.
Can I use Lazanda if I'm not currently on opioid therapy?
No, Lazanda is intended for patients who are already opioid-tolerant due to the risk of respiratory depression and overdose.
What should I do if I miss a dose?
If you miss a dose and need pain relief, take it as soon as you remember, but do not exceed the recommended maximum dose within a 2-hour period.
Are there any special storage instructions for Lazanda?
Store Lazanda at room temperature, away from moisture and heat, and keep it out of reach of children.
Is it safe to drive after using Lazanda?
Due to the potential for sedation and drowsiness, it is advisable to avoid driving or operating heavy machinery until you know how Lazanda affects you.
Comprehensive Drug Guide
How Does Lazanda Work?
Lazanda works by binding to the opioid receptors in the brain and spinal cord, which are responsible for transmitting pain signals. This action effectively reduces the perception of pain and alters the emotional response to pain. Fentanyl's rapid onset of action is particularly useful for managing breakthrough pain.
Common Dosages
- Nasal spray: Typically available in a metered dose of 100 mcg, 200 mcg, 400 mcg, and 800 mcg per spray.
Typical Dosing
- The initial dose is individualized based on the patient's current opioid therapy. Dosing typically begins at the lowest strength (100 mcg) and can be adjusted based on the patient's pain relief and side effects.
- Patients may use Lazanda for breakthrough pain as needed, with a maximum of two doses within a 2-hour period.
Typical Dosing
FDA Approved Indications
- Breakthrough pain in adults with cancer who are already on a stable dose of opioid therapy.
Who Shouldn't Take Lazanda?
- Known hypersensitivity to fentanyl or any other components of the formulation.
- Severe respiratory depression or acute or severe asthma.
- Patients who are not opioid-tolerant.
Advice From The Pharmacist
- Use Lazanda exactly as prescribed, ensuring to follow the dosing instructions carefully.
- Avoid using Lazanda in combination with other central nervous system depressants, including alcohol, benzodiazepines, and other opioids.
- Patients should be monitored for signs of respiratory depression, especially when starting treatment or increasing the dose.
Side Effects of Lazanda
Common Side Effects
- Drowsiness or sedation
- Nausea and vomiting
- Constipation
- Confusion
- Dizziness
Uncommon/Severe Side Effects
- Respiratory depression (slow or difficult breathing)
- Severe allergic reactions (rash, itching, swelling)
- Overdose, which may lead to coma or death.
Risks and Warnings of Lazanda
- Respiratory Depression: Lazanda can cause significant respiratory depression, which can be life-threatening. Close monitoring is required, particularly in opioid-naïve patients.
- Potential for Abuse: As a potent opioid, Lazanda has a high potential for addiction, abuse, and misuse. Patients should be carefully evaluated for risk factors.
- Caution in Special Populations: Use with caution in the elderly, those with compromised respiratory function, or those with hepatic or renal impairment.
Interactions with Lazanda
Common Drug Interactions
- CNS Depressants: Concomitant use with other medications that cause sedation or respiratory depression may increase the risk of serious side effects.
- Inhibitors of CYP3A4: Certain medications that inhibit this enzyme can increase fentanyl levels, requiring careful monitoring and potential dosage adjustments.
Alternatives to Lazanda
- Other Transmucosal Opioids: Such as Abstral (sublingual fentanyl) or Actiq (fentanyl lozenge).
- Oral Opioids: Such as oxycodone or morphine for managing persistent pain.
- Non-Opioid Analgesics: Such as acetaminophen or NSAIDs for managing mild to moderate pain.
