Brand Names : Duragesic
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 health care professional will make. For fentanyl,
the following should be considered:
Allergies - Tell your health care professional if you have ever
had any unusual or allergic reaction to fentanyl, alfentanil (e.g., Alfenta),
or sufentanil (e.g., Sufenta). Also tell your health care professional if
you are allergic to any other substances, including the adhesives that keep
stick-on bandages in place.
Pregnancy - Although studies on birth defects with fentanyl have
not been done in pregnant women, it has not been reported to cause birth defects.
However, using any narcotic regularly during pregnancy may cause physical
dependence in the fetus. This may lead to withdrawal side effects after birth.
Also, use of this medicine near the end of pregnancy may cause drowsiness
and breathing problems in newborn babies.
Breast-feeding - Fentanyl passes into the breast milk. Nursing babies
whose mothers are using this medicine regularly may receive enough of it to
cause unwanted effects such as drowsiness, breathing problems, and physical
dependence. Similar effects may also occur with some other narcotics if they
are taken regularly in large amounts. 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 the fentanyl skin patch have been done
only in adult patients, and there is no specific information comparing the
use of this medicine in children with use in other age groups.
Adolescents - Studies with the fentanyl skin patch have been
done only in patients 18 years of age and older. There is no specific information
comparing the use of this medicine in teenagers with use in other age groups.
Older adults - Elderly people are especially sensitive to the effects
of narcotic analgesics. This may increase the chance of side effects, especially
breathing problems, during treatment. Your health care professional will take
this into consideration when deciding on the amount of transdermal 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 health care professional
may want to change the dose, or other precautions may be necessary. When you
are using fentanyl, it is especially important that your health care professional
know if you are taking any of the following:
Buprenorphine (e.g., Buprenex) or
Dezocine (e.g., Dalgan) or
Nalbuphine (e.g., Nubain) or
Pentazocine (e.g., Talwin) - Like all narcotic analgesics, these
medicines may add to the effects of fentanyl, which may increase the chance
of side effects or overdose. However, buprenorphine, dezocine, nalbuphine,
and pentazocine sometimes decrease the effects of fentanyl, so that fentanyl
might be less effective in relieving pain. Also, these medicines can cause
withdrawal side effects if they are given to someone who is physically dependent
CYP3A4 (an isoenzyme that breaks down fentanyl in the body) inducers
Carbamazepine (e.g., Tegretol) or
Phenytoin (e.g., Dilantin) or
Rifampin (e.g., Rifadin) - Giving these medicines with fentanyl
will decrease the pain-relieving effects of fentanyl.
CYP3A4 inhibitors such as:
Azole antifungal agents (e.g., ketoconazole (Nizoral)) or
Macrolide antibiotics (e.g., erythromycin or
Protease inhibitors (ritonavir (Norvir)) - Giving these medicines
with fentanyl may cause too much fentanyl in your blood.
Central nervous system (CNS) depressants (medicines that cause drowsiness),
including other narcotics, or
Tricyclic antidepressants - These medicines may add to the effects
of fentanyl. This may increase the chance of serious side effects
Naltrexone (e.g., Trexan) - Fentanyl will not be effective in
people taking naltrexone
Other medical problems - The presence of other medical
problems may affect the use of fentanyl. Make sure you tell your health care
professional if you have any other medical problems, especially:
Alcohol abuse, or history of, or
Drug dependence, especially narcotic abuse or dependence, or history
Emotional problems or
Kidney disease or
Liver disease or
Underactive thyroid - The chance of side effects may be increased
Brain tumor or
Diarrhea caused by antibiotic treatment or poisoning or
Emphysema, asthma, or other chronic lung disease or
Enlarged prostate or problems with urination or
Gallbladder disease or gallstones or
Intestinal problems such as colitis or Crohn's disease - Some
of the side effects of fentanyl can cause serious problems in people who have
these medical problems
Slow heartbeat - Fentanyl can make this condition worse