Fentanyl (Systemic)

Brand Names : Actiq

Before Using This Medicine

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For transmucosal fentanyl, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to fentanyl, including the stick-on patch. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy - Although studies on birth defects with fentanyl have not been done in pregnant women, it has not been reported to cause birth defects.

Breast-feeding - Fentanyl passes into breast milk. Nursing babies whose mothers are using this medicine regularly may receive enough of it to cause unwanted effects such as drowsiness or breathing problems. A mother who wishes to breast-feed and who needs treatment for continuing pain should discuss the risks and benefits of different pain treatments with her health care professional.

Children - Studies with transmucosal fentanyl have been done only in adult patients, and there is no specific information comparing use of transmucosal fentanyl in children with use in other age groups. It contains a medicine in an amount which can be fatal to a child . Patients and their caregivers should keep transmucosal fentanyl out of the reach of children and discard open units properly.

Older adults - Elderly people may be especially sensitive to the effects of narcotic analgesics. This may increase the chance of side effects during treatment. Your health care professional will take this into consideration when deciding on the amount of transmucosal fentanyl you should receive.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are using transmucosal fentanyl, it is especially important that your health care professional know if you are taking any other dosage form of fentanyl (e.g., injection, patch) or nonprescription (over-the-counter [OTC] medicine) or any of the following:

• Alcohol or
• Central nervous system (CNS) depressants (medicines that cause drowsiness), including other narcotics or
• Erythromycin (e.g., E-Mycin) or
• Itraconazole (e.g., Diflucan) or
• Ketoconazole (e.g., Nizoral) or
• Ritonavir (e.g., Norvir) - These medicines may add to the effects of transmucosal fentanyl. This may increase the chance of serious side effects.

• Monoamine oxidase (MAO) inhibitor activity (isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate]) - Taking transmucosal fentanyl while you are taking or within 2 weeks of taking MAO inhibitors may cause an increased chance of serious side effects

Other medical problems - The presence of other medical problems may affect the use of transmucosal fentanyl. Make sure you tell your doctor if you have any other medical problems, especially:

• Alcohol abuse or history of or
• Drug dependence, especially narcotic abuse or dependence, history of or
• Kidney disease or
• Liver disease - The chance of side effects may be increased
• Emphysema or other chronic lung disease or
• Head injuries - Some of the side effects of transmucosal fentanyl can cause serious problems in people who have these medical problems

• Slow heartbeat - Transmucosal fentanyl can make this condition worse