Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Abdominal conditions: Fentanyl may make the diagnosis of abdominal conditions more difficult or it may worsen these conditions. If you have abdominal conditions such as inflammatory or obstructive bowel disease, acute cholecystitis, or pancreatitis, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Accidental exposure: Accidental exposure to this medication may lead to serious complications or death. Accidental exposure can occur when a patch is transferred to someone else through hugging or moving them in bed. Children are especially at risk. If this happens, immediately remove the patch from the person, wash the area with water, and seek immediate medical attention. If you are applying the patch for someone, wash your hands with water only immediately after applying or removing the patch.
After use, the patch still contains enough medication to serious harm someone who is not using fentanyl. When you remove the patch, fold it in half, so the sticky side sticks to itself. Return the used patches to your pharmacy for safe disposal. Do not discard the used patch in the household garbage.
Dependence and withdrawal: As with other opioid medications (narcotics), fentanyl may become habit-forming if taken for long periods of time. If you have a history of past or current substance use problems you may be at greater risk of developing abuse or addiction while taking this medication. Drug abuse is not a problem for people who require this medication for pain relief. Physical dependence (a need to take regular doses to prevent physical symptoms) has been associated with some narcotic analgesics.
Withdrawal symptoms may be experienced if the dose is significantly reduced or suddenly discontinued. Reducing the dose gradually under medical supervision can help prevent or decrease these withdrawal symptoms when this medication is no longer required for pain control.
Difficulty breathing: Fentanyl can cause serious and life-threatening breathing problems. If you experience slowed breathing or difficulty breathing, seek immediate medical attention. If you have lung problems and are taking other medications that can slow breathing, you are more at risk of experiencing these symptoms.
Make sure you follow the instructions on how to properly use this medication. If you have any questions, contact your doctor or pharmacist. If you have a chronic lung condition, such as bronchitis, emphysema, or asthma, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Drowsiness/reduced alertness: This medication may impair the mental or physical abilities required for certain tasks, such as driving a car or operating machinery. Do not drive or operate dangerous machinery while using this medication until you have determined how this medication affects you.
Fever or heat exposure: If you develop a fever you may get higher doses than expected from the patch because the release of medication depends on heat. Tell your doctor if you develop a fever, and have a plan in place in the event that your body temperature rises.
Avoid exposing the application site to direct external heat sources, such as heating pads, electric blankets, heated water beds, heat lamps, hot water bottles, saunas, hot whirlpool spa baths, or intensive sunbathing. This exposure to heat can cause the patch to release too much medication.
Head injury: If you have head injuries or increased pressure in the head you may have a higher risk of experiencing side effects (breathing problems) or worsening of your condition while taking this medication. Discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Kidney function: The kidneys are partially responsible for removing fentanyl from the body. If you have reduced kidney function you may experience increased side effects of fentanyl as a result of it not being removed as quickly as expected.
If you have kidney disease or reduced kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Liver function: Fentanyl is broken down by the liver so it can be removed from the body through the kidneys. Liver disease or reduced liver function may cause a build-up of fentanyl in the body and cause side effects. If you have liver disease or decreased liver function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
If you experience symptoms of liver problems (e.g., abdominal pain, persistent vomiting, feeling unwell, fever, itching, yellowing of the skin and eyes, dark urine), contact your doctor immediately.
Slowed heart rate: This medication can cause a serious and life-threatening reduced heart rate. If this occurs, seek immediate medical attention. If you have an irregular heartbeat and are taking other medications that can slow heart rate, you are more at risk of experiencing these symptoms.
If you have a slowed heart rate or heart rhythm problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.
Stopping medication: Do not stop using fentanyl abruptly, since withdrawal symptoms may occur if fentanyl is stopped suddenly. These symptoms include seizures, irritability, sleep problems, agitation, tremors, diarrhea, abdominal cramps, vomiting, headache, muscle cramps, extreme anxiety, tension, restlessness, sweating, and confusion. Your doctor will advise you on how to safely stop taking fentanyl if you no longer require it for pain control.
Tolerance: Fentanyl transdermal patches may lead to tolerance when used for a long period of time. Tolerance means that your body gets used to the medication so that more medication may be needed to produce the same pain relief. Your doctor will recommend the dose of fentanyl patch that is most appropriate for you. Do not change your dose or the way you are using the medication on your own. Speak to your doctor if you have any questions.
Pregnancy: Fentanyl crosses the placental barrier and may cause harm to an unborn baby. Withdrawal symptoms have been noted in newborns of mothers who used fentanyl during pregnancy. This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: Fentanyl passes into breast milk. If you are a breast-feeding mother and are using fentanyl, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication have not been established for children less than 18 years of age.
Seniors: Seniors may be more sensitive to the effects of this medication and may require lower doses.