Fentanyl sublingual spray
What is this medicine?
FENTANYL (FEN ta nil) is a pain reliever. It is used to treat breakthrough cancer pain that your long acting pain medicine does not control. Do not use this medicine for a pain that will go away in a few days like pain from surgery, doctor or dentist visits. The medicine is used only by people who have been taking an opioid or narcotic pain medicine for at least a week.
How should I use this medicine?
This medicine is only for use in the mouth. Follow the directions on the prescription label. Open package with scissors right before use. Each unit contains enough medicine for one spray. Spray the medicine into the mouth underneath the tongue. Ask your doctor or health care provider if you have any questions. Do not take your medicine more often than directed.
A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.
Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.
What side effects may I notice from receiving this medicine?
Side effects that you should report to your doctor or health care professional as soon as possible:
allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
signs and symptoms of low blood pressure like dizziness; feeling faint or lightheaded, falls; unusually weak or tired
trouble passing urine or change in the amount of urine
Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
What may interact with this medicine?
Do not take this medication with any of the following medicines:
This medicine may also interact with the following medications:
antihistamines for allergy, cough and cold
antiviral medicines for HIV or AIDS
certain antibiotics like erythromycin and clarithromycin
certain medicines for anxiety or sleep
certain medicines for bladder problems like oxybutynin, tolterodine
certain medicines for blood pressure, heart disease, irregular heart beat
certain medicines for depression like amitriptyline, fluoxetine, sertraline
certain medicines for diabetes like pioglitazone, troglitazone
certain medicines for fungal infections like ketoconazole and itraconazole
certain medicines for seizures like phenobarbital, phenytoin, primidone
certain medicines for stomach problems like dicyclomine, hyoscyamine
certain medicines for travel sickness like scopolamine
certain medicines for Parkinson's disease like benztropine, trihexyphenidyl
general anesthetics like halothane, isoflurane, methoxyflurane, propofol
local anesthetics like lidocaine, pramoxine, tetracaine
MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
medicines that relax muscles for surgery
other narcotic medicines for pain or cough
phenothiazines like chlorpromazine, mesoridazine, prochlorperazine, thioridazine
St. John's wort
steroid medicines like prednisone or cortisone
What if I miss a dose?
This medicine is only used when needed for pain. Do not take double or extra doses.
Where should I keep my medicine?
Keep out of the reach of children. This drug can be abused. Keep your medicine in a safe place to protect it from theft. Do not share this medicine with anyone. Selling or giving away this medicine is dangerous and is against the law.
Discard unused medicine and used packaging carefully. Pets and children can be harmed if they find used or lost packages. Follow the directions in the MedGuide.
Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F). Keep this medication in the original container.
What should I tell my health care provider before I take this medicine?
They need to know if you have any of these conditions:
history of a drug or alcohol abuse problem
low blood pressure
lung or breathing disease, like asthma
an unusual or allergic reaction to fentanyl, other medicines, foods, dyes, or preservatives
pregnant or trying to get pregnant
What should I watch for while using this medicine?
Tell your health care provider if your pain does not go away, if it gets worse, or if you have new or a different type of pain. You may develop tolerance to this drug. Tolerance means that you will need a higher dose of the drug for pain relief. Tolerance is normal and is expected if you take this drug for a long time.
Do not suddenly stop taking your drug because you may develop a severe reaction. Your body becomes used to the drug. This does NOT mean you are addicted. Addiction is a behavior related to getting and using a drug for a nonmedical reason. If you have pain, you have a medical reason to take pain drug. Your health care provider will tell you how much drug to take. If your health care provider wants you to stop the drug, the dose will be slowly lowered over time to avoid any side effects.
If you take other drugs that also cause drowsiness like other narcotic pain drugs, benzodiazepines, or other drugs for sleep, you may have more side effects. Give your health care provider a list of all drugs you use. He or she will tell you how much drug to take. Do not take more drug than directed. Get emergency help right away if you have trouble breathing or are unusually tired or sleepy.
Talk to your health care provider about naloxone and how to get it. Naloxone is an emergency drug used for an opioid overdose. An overdose can happen if you take too much opioid. It can also happen if an opioid is taken with some other drugs or substances, like alcohol. Know the symptoms of an overdose, like trouble breathing, unusually tired or sleepy, or not being able to respond or wake up. Make sure to tell caregivers and close contacts where it is stored. Make sure they know how to use it. After naloxone is given, you must get emergency help right away. Naloxone is a temporary treatment. Repeat doses may be needed.
You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this drug affects you. Do not stand up or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells. Alcohol may interfere with the effect of this drug. Avoid alcoholic drinks.
This drug will cause constipation. If you do not have a bowel movement for 3 days, call your health care provider.
Your mouth may get dry. Chewing sugarless gum or sucking hard candy and drinking plenty of water may help. Contact your health care provider if the problem does not go away or is severe.
July 31, 2020