Fentanyl, Injection

What are other names for this medicine?

Type of medicine: narcotic analgesic (painkiller)

Generic and brand names: fentanyl, injection; Sublimaze

What is this medicine used for?

This medicine is a narcotic analgesic. It may be given by injection (shot) or by infusion to relieve pain. It may also be used for anesthesia during surgery or labor.

This medicine may also be given through a special infusion pump.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• breathing problems or a lung disorder such as asthma or COPD
• stomach or intestinal blockage, severe diarrhea, or constipation
• a head injury or brain tumor
• acute pancreatitis or biliary tract disease
• Addison's disease
• glaucoma
• heart disease or irregular heartbeat
• liver or kidney disease
• low blood pressure
• enlarged prostrate gland or trouble urinating
• problems with alcohol or drug abuse
• seizures
• sleep apnea
• thyroid problems

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

This medicine is given by a healthcare provider.

What should I watch out for?

You may need to take this medicine for a long time. If you need to take this medicine for more than a few days, do not stop taking it suddenly. You may have to reduce your dosage gradually to avoid withdrawal symptoms. Follow your healthcare provider's instructions.

This medicine is a controlled substance. It is illegal for you to give it to anyone else.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

This medicine increases the effects of alcohol and other drugs that slow down your nervous system. Do not drink alcohol or take other medicines unless your healthcare provider approves.

This medicine may make you dizzy or drowsy. Do not drive or operate machinery unless you are fully alert.

You may feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may lessen this effect. Also, drinking alcohol may increase this effect.

Contact your healthcare provider if your condition does not improve in a few days or if it gets worse.

This medicine may make you constipated. You may need to take a laxative or stool softener while taking this medicine. Talk with healthcare provider or pharmacist about this.

Adults over the age of 65 may be at greater risk for side effects from this medicine. Talk with your healthcare provider about this.

Important notice: Taking an overdose of this medicine can cause very serious problems. If you think you have taken an overdose, get medical care right away.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you are unable to reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives, itching, rash, tightness in your chest, trouble breathing, swelling of your lips, tongue or throat).

Serious (report these to your healthcare provider right away): Seizures, hallucinations (seeing or hearing things that are not there), severe muscle weakness, decreased urination, trembling, fast or irregular heartbeat, sudden fainting, slow breathing or shortness of breath, confusion, pinpoint pupils of the eyes, blurred vision.

Other: Dizziness; drowsiness; lightheadedness; nausea; vomiting; constipation; itching; headache; dry mouth; sweating; loss of appetite; change in sexual desire or ability; pain, redness, or swelling at the injection site.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• antianxiety medicines such as alprazolam (Xanax), chlordiazepoxide (Librium), clonazepam (Klonopin), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), triazolam (Halcion), temazepam (Restoril), flurazepam (Dalmane), and oxazepam (Serax)
• antibiotics such as clarithromycin (Biaxin), erythromycin (Ery-Tabs, E.E.S.), ciprofloxacin (Cipro), rifampin (Rifadin, Rimactane), and doxycycline (Vibramycin)
• antiseizure medicines such as carbamazepine (Tegretol), primidone (Mysoline), gabapentin (Neurontin), felbamate (Felbatol), lamotrigine (Lamictal), levetiracetam (Keppra), topiramate (Topamax), valproic acid (Depacon, Depakene, Depakote), oxcarbazepine (Trileptal), tiagabine (Gabitril), and phenytoin (Dilantin)
• antifungals such as clotrimazole (Mycelex), fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole (Nizoral)
• antihistamines such as diphenhydramine (Benadryl), hydroxyzine (Atarax, Vistaril), and chlorpheniramine (Chlor-Trimeton)
• anti-HIV medicines such as amprenavir (Agenerase), indinavir (Crixivan), nelfinavir (Viracept), ritonavir (Norvir), stavudine (Zerit), zidovudine (Retrovir), efavirenz (Sustiva), nevirapine (Viramune), and saquinavir (Invirase, Fortovase)
• antinausea medicines such as prochlorperazine (Compazine), and promethazine (Phenergan)
• antipsychotic medicines such as chlorpromazine (Thorazine), fluphenazine (Permitil, Prolixin), perphenazine, trifluoperazine (Stelazine), thioridazine, haloperidol (Haldol), clozapine (Clozaril), risperidone (Risperdal), and olanzapine (Zyprexa)
• barbiturates such as phenobarbital, butabarbital (Butisol), and pentobarbital (Nembutal)
• beta blockers such as atenolol (Tenormin), acebutolol (Sectral), betaxolol (Kerlone), carteolol, bisoprolol (Zebeta), pindolol, metoprolol (Lopressor, Toprol XL), timolol, sotalol (Betapace), nadolol (Corgard), propranolol (Inderal), labetalol (Normodyne, Trandate), and carvedilol (Coreg)
• calcium channel blockers such as diltiazem (Cardizem, Dilacor, Tiamate, Tiazac), nicardipine (Cardene), nifedipine (Procardia, Adalat), isradipine (DynaCirc), felodipine (Plendil), amlodipine (Norvasc), and verapamil (Calan, Isoptin, Verelan)
• cimetidine (Tagamet, Tagamet HB 200)
• heart medicines such as amiodarone (Cordarone, Pacerone)
• herbs with sedative effects such as kava, St. John's wort, gotu kola, valerian
• isoniazid (Nydrazid)
• MAO inhibitor antidepressants such as phenelzine (Nardil), selegiline (Eldepryl, Emsam), tranylcypromine (Parnate), and isocarboxazid (Marplan) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• muscle relaxants such as cyclobenzaprine (Flexeril), carisoprodol (Soma), tizanidine (Zanaflex), methocarbamol (Robaxin), and baclofen (Lioresal)
• naltrexone (ReVia)
• other narcotic analgesics such as codeine, hydrocodone (Vicodin, Lortab), oxycodone (Percocet, Tylox, OxyContin), morphine (MS Contin), propoxyphene (Darvocet N-100), pentazocine (Talwin), meperidine (Demerol), fentanyl (Duragesic patches), methadone (Dolophine), buprenorphine (Buprenex, Subutex), butorphanol (Stadol), nalbuphine, oxymorphone (Opana), and hydromorphone (Dilaudid)
• sibutramine (Meridia)
• sleeping pills such as zolpidem (Ambien), zaleplon (Sonata), and chloral hydrate
• SSRI antidepressants such as sertraline (Zoloft), fluoxetine (Prozac), citalopram (Celexa), escitalopram (Lexapro), nefazodone, paroxetine (Paxil), venlafaxine (Effexor), and fluvoxamine (Luvox)
• tricyclic antidepressants such as amitriptyline (Elavil), nortriptyline (Aventyl, Pamelor), imipramine (Tofranil), desipramine (Norpramin), and doxepin (Sinequan)

Do not drink alcohol while you are taking this medicine.

Do not eat grapefruit or drink grapefruit juice while taking this medicine. Grapefruit affects the way this medicine works and may increase the risk of side effects.

Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.