Fentanyl Citrate Injection (patient information)

About your treatment
Your doctor has ordered fentanyl, an analgesic (painkiller), to relieve your pain. The drug will be added to an intravenous fluid that will drip through a needle or catheter placed in your vein. You will probably receive fentanyl continuously for around-the-clock pain relief. Your doctor may also order other pain medications to make you feel more comfortable. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

Your health care provider (doctor, nurse, or pharmacist) may measure the effectiveness and side effects of your treatment using laboratory tests and physical examinations. It is important to keep all appointments with your doctor and the laboratory. The length of treatment depends on how you respond to the medication.

Precautions
Before administering fentanyl:


 * tell your doctor and pharmacist if you are allergic to fentanyl, morphine, codeine (or medications that contain codeine such as Tylenol with Codeine), hydrocodone (e.g., Vicodin), hydromorphone (e.g., Dilaudid), oxycodone (e.g., Percocet), oxymorphone (Numorphan), or any other drugs.
 * tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially antidepressants; cough, cold, and allergy medications; MAO inhibitors [phenelzine (Nardil) or tranylcypromine (Parnate)]; other pain relievers; sedatives; sleeping pills; tranquilizers; and vitamins.
 * tell your doctor if you have or have ever had liver or kidney disease, a history of alcohol abuse, lung or thyroid disease, heart disease, prostatic hypertrophy, or urinary problems.
 * tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking fentanyl, call your doctor.
 * you should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.
 * remember that alcohol can add to the drowsiness caused by this drug.

Administering your medication
Before you administer fentanyl, look at the solution closely. It should be clear and free of floating material. Gently squeeze the bag or observe the solution container to make sure there are no leaks. Do not use the solution if it is discolored, if it contains particles, or if the bag or container leaks. Use a new solution, but show the damaged one to your health care provider.

It is important that you use your medication exactly as directed. Fentanyl can be habit forming. Do not administer it more often or for a longer period than your doctor tells you. Do not change your dosing schedule without talking to your health care provider. Your health care provider may tell you to stop your infusion if you have a mechanical problem (such as a blockage in the tubing, needle, or catheter); if you have to stop an infusion, call your health care provider immediately so your therapy can continue.

Minor Side Effects
Fentanyl may cause side effects. Tell your health care provider if any of these symptoms are severe or do not go away:


 * skin rash
 * itching
 * blisters
 * swelling
 * dizziness
 * lightheadedness
 * drowsiness
 * upset stomach
 * vomiting
 * constipation
 * stomach pain
 * difficulty urinating

Severe Side Effects
If you experience any of the following symptoms, call your health care provider immediately:


 * difficulty breathing
 * fainting
 * seizures

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

Storing your medication
Your health care provider probably will give you a several-day supply of fentanyl at a time. You will be told to store it in the refrigerator. Take your next dose from the refrigerator 1 hour before using it; place it in a clean, dry area to allow it to warm to room temperature. Do not allow fentanyl to freeze.

If you are receiving fentanyl intramuscularly (in your muscle), your health care provider will tell you how to store it properly.

Store your medication only as directed. Make sure you understand what you need to store your medication properly.

Keep your supplies in a clean, dry place when you are not using them, and keep all medications and supplies out of reach of children. Your health care provider will tell you how to throw away used needles, syringes, tubing, and containers to avoid accidental injury.

In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Signs of infection
If you are receiving fentanyl in your vein or under your skin, you need to know the symptoms of a catheter-related infection (an infection where the needle enters your vein or skin). If you experience any of these effects near your intravenous catheter, tell your health care provider as soon as possible:


 * tenderness
 * warmth
 * irritation
 * drainage
 * redness
 * swelling
 * pain

Brand names

 * Actiq®
 * Duragesic®
 * Sublimaze®