Fentanyl is a Medicine belongs to Analgesic opoids group whose information about Brand can be referenced from   Book : Martindale    Page : 64   Edition : 38,

  ►   Brandname : Fendrop,Duragesic,Fentora,Abstral,Denpax,Effentora,Durotep

  ►  Strength : Injection with 50  microgram/ml, oral lozenge with 100  mcg, oral lozenge with 200  mcg, oral lozenge with 400  mcg, oral lozenge with 600  mcg, oral lozenge with 800  mcg, Lozenge on a stick with 200  micrograms, Lozenge on a stick with 400  micrograms, Lozenge on a stick with 600  micrograms, Lozenge on a stick with 800  micrograms, Lozenge on a stick with 1200  micrograms, Lozenge on a stick with 1600  micrograms, Transdermal System with 12.5  micrograms/hour, Transdermal System with 25  micrograms/hour, Transdermal System with 50  micrograms/hour, Transdermal System with 75  micrograms/hour, Transdermal System with 100  micrograms/hour, Buccal tablet with   , sublingual tablet with   , Nasal Spray with   ,

Reference of this Medicine for its Strength can be taken from   Book : Basic & Clinical pharmacology    Page : 562   Edition : 12, Martindale    Page : 60   Edition : 38,
A Route of administration in pharmacology and toxicology is the path by which a drug, fluid, poison, or other substance is taken into the body. Routes of administration are generally classified by the location at which the substance is applied. Common examples include oral and intravenous administration.

  ►  Route of administration : IV, IM, Transdermal, intranasal, transmucosal,
Reference :-   Book : Martindale    Page : 60   Edition : 37,

Dosing of Medicine differ in Adult & Pediatrics ↓


Adult Dose

S.No Ailment   Route   Dose Min   Dose Max   Unit   Dosage Form   Frequency   Additional Info
1 As adjunct to general anaesthesia IV 50 200 micrograms Injection Dosage recommendations show a wide range depending on the technique. Given to patients with spontaneous respiration; as initial dose with supplements of 50 micrograms. Patients whose ventilation is assisted may be given 300 micrograms to 3.5 mg (up to 50 micrograms/kg) as an initial dose, with supplements of 100 to 200 micrograms depending on the patient’s response. High doses have been reported to moderate or attenuate the response to surgical stress.
2 For premedication IM 50 100 micrograms Injection Given above is the equivalent dose of fentanyl at 30 to 60 minutes before the induction of anaesthesia. Similar doses to those used for premedication may also be given by intramuscular injection postoperatively, and by intramuscular or slow intravenous injection as an adjunct to regional anaesthesia.
3 Management of breakthrough cancer pain transmucosal 200 micrograms Lozenge on a stick It is used as an analgesic in the management of breakthrough cancer pain in those already receiving and tolerant to opioid treatment. This initial unit dose may be taken over 15 minutes for an episode of breakthrough pain and repeated once if necessary after a further 15 minutes. Doses are subsequently titrated according to response, up to a unit dose of 1.6 mg if necessary. Once the patient has been stabilised on an effective dose, no more than 4 unit doses should be taken daily.
4 Management of breakthrough cancer pain transmucosal 100 micrograms Tablet Also given as a buccal and Sublingual tablet. This initial dose may be taken for an episode of breakthrough pain and repeated once if necessary after 30 minutes; thereafter, depending on the brand used, patients must wait at least 2-4 hours before treating another episode. Doses are subsequently titrated according to response. The dose of the maintenance opioid used for persistent pain should be re-evaluated if the patient has more than 4 episodes of breakthrough pain a day.
5 Management of breakthrough cancer pain intranasal 50 micrograms Nasal Spray Depending on the brand used, the initial dose of 50-100 micrograms is sprayed into one nostril for an episode of breakthrough pain and repeated once if necessary after 10 minutes; thereafter, depending on the brand used, patients must wait at least 2-4 hours before treating another episode. Doses are subsequently titrated according to response; up to a max of 4 episodes may be treated daily. The dose of the maintenance opioid used for persistent pain should be re-evaluated if the patient has more than 4 episodes of breakthrough pain daily.

Ref :-  Book : Martindale    Page : 60   Edition : 38,




Pediatric Dose

S.No Ailment   Age Min   Age Max   Weight ( Kg ) Route   Dose Min   Dose Max   Unit   Dosage Form   Frequency  Additional Info  
1 Adjunct to general anaesthesia 2 Year 12 Year IV 1 3 micrograms/kg Injection
2 To provide analgesia and respiratory depression IV infusion 1 5 microgram/kg Injection
3 intractable chronic pain Transdermal Patch
4 Management of breakthrough cancer pain transmucosal Lozenge on a stick

Ref :- Book : Martindale    Page : 61   Edition : 38,
Precaution :- If a Patient is using 'Fentanyl' drug in  Generalized, Tonic-Clonic Seizures  disease, then Please Not to be given .

►  Side Effect : nausea, vomiting, constipation, Dizziness, Sedation, headache, urinary retention, pruritus, respiratory depression, hypotension, Confusion, abuse potential,
Ref :-   Book : Principle of Pharmacology (The Pathophysiologic Basis of Drug Therapy)    Page : 280   Edition : 3,

►  Drug Interaction : Drug interaction of Fentanyl is with Antipsychotics, Tricyclic antidepressants, Hypnotics, Anxiolytics, Anaesthetics, Alcohol, Monoamine Oxidase Inhibitor, , ,  Ciprofloxacin , Cisapride , Mexiletine , Selegiline , Ritonavir, Zonisamide , Cyclizine , Cimetidine , Metoclopramide , Domperidone ,
Ref :-   Book : Martindale    Page : 58   Edition : 37, Martindale    Page : 58.1   Edition : 37,


  ►    Mechanism of Drug Drug Interaction :  Use of fentanyl with non-vagolytic neuromuscular blockers may produce bradycardia and possibly asystole. Fentanyl is metabolised via the cytochrome P450 isoenzyme CYP3A4; use with potent inhibitors of this isoenzyme, such as ritonavir and other HIV-protease inhibitors, may increase fentanyl plasma concentrations. As serious and sometimes fatal reactions have followed use of pethidine in patients receiving MAOIs (including moclobemide), pethidine and related drugs are contra-indicated in patients taking MAOIs or within 14 days of stopping such treatment; other opioid analgesics should be avoided or given with extreme caution. Life-threatening reactions have also been reported when selegiline, a selective inhibitor of monoamine oxidase type B, has been given with pethidine. The depressant effects of opioid analgesics are enhanced by other CNS depressants such as alcohol, anaesthetics, anxiolytics, hypnotics, tricyclic antidepressants, and antipsychotics. Cyclizine may counteract the haemodynamic benefits of opioids. Cimetidine inhibits the metabolism of some opioids, especially pethidine. The actions of opioids may in turn affect the activities of other drugs. For instance, their gastrointestinal effects may delay absorption as with mexiletine or may be counteractive as with cisapride, metoclopramide, or domperidone. Opioid premedicants such as papaveretum have been reported to reduce serum concentrations of ciprofloxacin.,
Ref :-   Book : Martindale    Page : 58   Edition : 37,


►  Contraindication : severe asthma, paralytic ileus, respiratory depression/ hypoventilation, upper airway obstruction,
Ref :-   Book : Principle of Pharmacology (The Pathophysiologic Basis of Drug Therapy)    Page : 280   Edition : 3,
  ►  Mechanism of Action :   Synthetic agonist of the μ-opioid receptor that result in inhibition of neurotransmission.,
Ref :-   Book : Principle of Pharmacology (The Pathophysiologic Basis of Drug Therapy)    Page : 280   Edition : 3,

Pathway of Dietry Product


​   ► Act.Comp / Nutrient / Food / Herb as follows :- opium ie papaversomniferum with Another pathway, opium ie papaversomniferum with Another pathway,

  ►  Pathway with its reference as follows :-
  • Morphine, Narcotine, Codeine, Papaverine have sedative property --- (: Kokate, C. (2013). Pharmacognosy (4th ed.). Pune: Nirali Prakashan. )
  • Morphine have sedative property --- (Kokate, C.K. and A.p. Purohit. Pharmacognosy. Nirali prakashan: Chennai, 2013. Print. )

  •   ►  URL -- https://www.sapnaonline.com/books/pharmacognosy-ck-kokate-8196396155-9788196396152, http://freepharmadownloads.blogspot.com/2013/02/pharmacognosy-ckkokate-free-download.html,


    Dietry Substance Interactions


    ​   ► This Medicine interact with :- NA



    ContraIndication Dietry Substance


    ​   ► This Medicine contraindicate with :- with Cause excessive drawsinesss when taken with drug., CANNABIS with Cannabis enhance the effect of morphine,

      ►  Reference :-
  • Eldelberg, D. The New Age of nutritional and herbal remedies. New Zealand.
  • Eldelberg, D. The New Age of nutritional and herbal remedies. New Zealand

  •   ►  URL -- https://books.google.co.in/books?id=WZhj8EO9N3sC&pg=PA49&lpg=PA49&dq=The+New+Age+of+nutritional+and+herbal+remedies.++book&source=bl&ots=UVld-vNZL0&sig=5KwkKUUvW45p0TkfVUCtMZxnbow&hl=en&sa=X&ved=0ahUKEwiajLCNocrOAhVMto8KHfD2D-4Q6AEIMDAE#v=onepage&q=The%20,

    ►   Route of Elimination :   Hepatic (Metabolism), Renal,
    Ref :-   Book : Goodman    Page : 505   Edition : 12,


    ►    Plasma Half-life :   Min value :-   3 hours,    Max value :-   4 hours,
    Ref :-   Book : Goodman    Page : 505   Edition : 12,


    ►    Peak Plasma Concentration :   Min value :-   ~5 min,    Max value :-   NA
    Ref :-   Book : Goodman    Page : 505   Edition : 12,