Important WarningBuccal fentanyl should be used only to treat breakthrough cancer pain (sudden episodes of pain that ... Full Alert
Buccal fentanyl is used to treat breakthrough pain (sudden episodes of pain that occur despite round the clock treatment with pain medication) in cancer patients who are taking regularly scheduled doses of another narcotic (opiate) pain medication, and who are tolerant (used to the effects of the medication) to narcotic pain medications. Fentanyl is in a class of medications called narcotic (opiate) analgesics. It works by changing the way the brain and nervous system respond to pain.
Buccal fentanyl comes as a lozenge on a handle (Actiq) and a tablet (Fentora) to dissolve in the mouth. Fentanyl buccal lozenges and tablets are used as needed to treat breakthrough pain, but not more often than four times a day. Follow the directions on your prescription label carefully and ask your doctor or pharmacist to explain any part you do not understand.
Your doctor will probably start you on a low dose of fentanyl buccal lozenges or tablets and gradually increase your dose until you find the dose that will relieve your breakthrough pain. When you start using buccal fentanyl and are still trying to reach the correct dose, if you still have pain after using one buccal lozenge or tablet, your doctor may tell you to use a second lozenge or tablet. You may use the second lozenge 15 minutes after you finish the first lozenge, or use the second tablet 30 minutes after you started using the first tablet. Do not use a second lozenge or tablet to treat the same episode of pain unless your doctor tells you that you should. Talk to your doctor about how well the medication is working and whether you are experiencing any side effects so that your doctor can decide whether your dose should be adjusted.
Do not use fentanyl buccal lozenges or tablets more than four times a day. Call your doctor if you experience more than four episodes of breakthrough pain per day. Your doctor may need to adjust the dose of your other pain medication to better control your pain.
Fentanyl buccal lozenges and tablets should be used along with your other pain medication(s). Do not stop taking your other pain medication(s) when you begin your treatment with fentanyl buccal lozenges or tablets.
Buccal fentanyl may be habit-forming. Do not use a larger dose of buccal fentanyl, use the medication more often, or use it for a longer period of time than prescribed by your doctor. Do not stop using fentanyl buccal lozenges or tablets without talking to your doctor. Your doctor will probably decrease your dose gradually. If you suddenly stop using fentanyl buccal lozenges or tablets, you may experience unpleasant withdrawal symptoms.
To use fentanyl buccal lozenges, follow these steps:
- Check the blister package and the handle of the lozenge to make sure the lozenge contains the dose of medication you have been prescribed.
- Use scissors to cut open the blister package, and remove the lozenge. Do not open the blister package until you are ready to use the medication.
- Place the lozenge in your mouth, between your cheek and gum. Actively suck on the lozenge, but do not chew or bite it. Move the lozenge around in your mouth, from one side to the other, using the handle. Twirl the handle often.
- Do not eat or drink anything while the lozenge is in your mouth.
- Finish the lozenge in about 15 minutes.
- If you begin to feel dizzy, very sleepy, or nauseous before you have finished the lozenge, remove it from your mouth. Dispose of it immediately as described below or put it in the temporary storage bottle for later disposal.
- If you finished the entire lozenge, throw the handle away in a garbage can that is out of the reach of children. If you did not finish the entire lozenge, hold the handle under hot running water to dissolve all the medication, and then throw the handle away in a garbage can that is out of the reach of children and pets.
To use fentanyl buccal tablets, follow these steps:
- Separate one blister unit from the blister card by tearing along the perforations. Peel back the foil to open the blister unit. Do not try to push the tablet through the foil. Do not open the blister unit until you are ready to use the tablet.
- Place the tablet in your mouth between one of your upper back teeth and your gum.
- Leave the tablet in place until it dissolves completely. You may notice a gentle bubbling feeling between your cheek and gum as the tablet dissolves. It may take 14 to 25 minutes for the tablet to dissolve. Do not split, chew, bite, or suck the tablet.
- If any of the tablet is left in your mouth after 30 minutes, swallow it with a drink of water.
- If you begin to feel dizzy, very sleepy, or nauseous before the tablet dissolves, rinse your mouth with water and spit the remaining pieces of tablet into the sink or toilet. Flush the toilet or rinse the sink to wash away the tablet pieces.
This medication should not be prescribed for other uses; ask your doctor or pharmacist for more information.
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