Fentanyl

Fentanyl, is a potent opioid analgesic and is mainly a -opioid agonist. It is used as an adjunct to general anesthetics.

Generic Name 藥名	HA Code 藥物代碼	Classification藥物分類
Fentanyl patch 12 mcg/hr	FENT08	DD
Fentanyl patch 25 mcg/hr	FENT07	DD

Mechanism of Action

Equivalent doses of opioid analgesics

Analgesic/Route	Dose
Codeine: PO	100 mg
Diamorphine: IM, IV, SC	3 mg
Dihydrocodeine: PO	100 mg
Morphine: PO	10 mg
Morphine: IM, IV, SC	5 mg
Oxycodone: PO	6.6 mg
Tramadol: PO	100 mg

Route of Adminstration Fentanyl is usually given parenterally, intranasally, or by the transmucosal route as the citrate, or in transdermal patches as the base.

Dosage

For the treatment of intractable chronic pain in adults:

Chronic severe pain:

Transdermal patches: 12mcg/72hours, adjusted at 48-72hours in steps of 12-25mcg/hour if needed.

Max: 300mcg/hours

• Doses should be individually titrated according to previous opioid usage
• Use of a patch providing 25 micrograms of fentanyl per hour is equivalent to about 60 to 90mg daily of oral morphine sulphate
• More than one patch may be applied if doses greater than 100 micrograms/hour are required
• Elderly or debilitated patients should be observed carefully for signs of toxicity

Transmucosal: a lozenge-on-a-stick dosage form, for management of breakthrough cancer pain.

• An initial unit dose of 200 micrograms may be taken over 15 minutes for breakthrough pain and repeated if necessary, after a further 15 minutes.

Buccal and sublingual tablets containing fentanyl citrate for transmucosal delivery.

• An initial dose of 100 micrograms may be taken for breakthrough pain and repeated once if necessary after 30 minutes.

Intranasal preparations containing fentanyl citrate, equivalent to 50 to 400 micrograms of fentanyl per spray.

• An initial dose or 50 to 100 micrograms is sprayed into one nostril for breakthrough pain and repeated once if necessary, after 10 minutes. Patients must wait at least 2 or 4 hours before treating another episode.