Fentanyl (By mouth)

Introduction:

Fentanyl (FEN-ta-nil)

Treats cancer pain in people whose pain is not always relieved by other pain medicines. This medicine is a narcotic pain reliever.

Brand Name(s):

Actiq

When This Medicine Should Not Be Used:

How to Use This Medicine:

Lozenge, Lollipop

• Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
• You should receive an Actiq® Welcome Kit that includes patient instructions and storage containers. Read and follow these instructions carefully before using this medicine. Ask your doctor or pharmacist if you have any questions, and tell them if you did not receive an Actiq® Welcome Kit.
• Use scissors to open the foil pouch when you are ready to use the medicine.
• Place the medicine in your mouth between your cheek and lower gum and suck on the medicine. Do not chew the medicine. Use the handle to move the medicine from one side to the other.
• Suck on the medicine for a full 15 minutes. If you use the medicine more quickly or more slowly, you may not get as much relief.
• Drink plenty of fluids to help avoid constipation.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine:

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Do not refrigerate or freeze.
• Keep the medicine in the sealed foil pouch until ready to use. Do not use the medicine if the foil pouch has been damaged or opened.
• To dispose of any used or partially used medicine, follow the patient instructions in the Actiq® Welcome Kit. Call your doctor or pharmacist if you have questions about this. Before throwing the handle away, rinse the used handle with hot tap water until all medicine left on the handle is dissolved. Throw the handle away in a trash container that is out of reach of children and pets.
• If you cannot rinse and throw away the handle or partially used medicine right away, put it in the temporary storage bottle you should have received with your Actiq® Welcome Kit. Then rinse the handle and throw it away as soon as possible.
• To dispose of any unused medicine, read and follow all the patient instructions in your Actiq® Welcome Kit. Flush any unused medicine down the toilet, but do not throw the pouch or packaging in the toilet. Use scissors to cut open the foil pouch. Cut off the end of the handle containing the medicine so that it falls into the toilet bowl. Flush the toilet twice. Throw away the foil pouch, remaining handle, and packaging in a trash container that is out of reach of children and pets.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Tell your doctor if you are using any medicines that make you sleepy. These include sleeping pills, cold and allergy medicine, narcotic pain relievers, and sedatives.
• Make sure your doctor knows if you are using phenothiazine medicine such as prochlorperazine, Compazine®, Mellaril®, Phenergan®, Thorazine®, Trilafon®. Tell your doctor if you are also using erythromycin (Ery-Tab®), itraconazole (Sporanox®), ketoconazole (Nizoral®), or ritonavir (Norvir®).
• Make sure your doctor knows if you have used an MAO inhibitor (MAOI) such as Eldepryl®, Marplan®, Nardil®, or Parnate® within the past 14 days.
• Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have lung disease or breathing problems such as chronic obstructive pulmonary disease (COPD), heart rhythm problems, diabetes, liver disease, or kidney disease. Also tell your doctor if you have a recent head injury, or other problems that could increase the pressure in your head.
• This medicine may make you drowsy or dizzy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
• This medicine does not replace the pain medicine you take on a regular schedule. Do not stop taking other pain medicine prescribed by your doctor.
• This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.
• This medicine can cause serious illness or even death if taken by a child or by anyone who is not already taking prescription medicine on a regular schedule for cancer pain.
• Each unit of this medicine contains about 2 grams of sugar, and using the medicine may increase your risk of tooth decay. Talk with your dentist if you have concerns about tooth decay from using this medicine.
• If you are switching from the buccal form of fentanyl to the oral transmucosal form, make sure you read the patient instruction carefully. These forms are very different.
• Do not stop using this medicine suddenly without asking your doctor. You may need to slowly decrease your dose before stopping it completely.
• If your symptoms do not improve or if they get worse, call your doctor.
• This medicine may cause constipation. This is more common if you use it for a long time. Ask your doctor if you should also use a laxative to prevent and treat constipation.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
• Blistering, peeling, red skin rash.
• Blue lips, fingernails, or skin.
• Blurred vision.
• Breast pain, discharge, or lump.
• Change in how much or how often you urinate.
• Chest pain or tightness.
• Dry mouth, increased thirst, muscle cramps, nausea or vomiting.
• Eye pain, redness, or discharge.
• Fast, slow, or irregular heartbeat.
• Fever, chills, cough, sore throat, and body aches.
• Lightheadedness, dizziness, or fainting.
• Nosebleeds or coughing up blood.
• Numbness or weakness in your arm or leg, or on one side of your body.
• Pain in your lower leg (calf).
• Pain on urination.
• Red or black stools.
• Red or dark brown urine.
• Ringing in the ears, or ear pain or discharge.
• Seizures or tremors.
• Severe drowsiness or sleepiness.
• Sores or white patches on your lips, mouth, or throat.
• Sudden or severe headache, problems with vision, speech, or walking.
• Swelling in your hands, ankles, or feet.
• Trouble breathing.
• Unusual bleeding or bruising.
• Unusual tiredness or weakness.
• Unusual vaginal bleeding.
• Yellowing of your skin or the whites of your eyes.

If you notice these less serious side effects, talk with your doctor:

• Anxiety, confusion, depression, mood or mental changes.
• Mild headache.
• Mild skin rash or itching.
• Nausea, vomiting, or constipation.
• Trouble sleeping.

If you notice other side effects that you think are caused by this medicine, tell your doctor: