Fentanyl

(FEN ta nil)

What key warnings do I need to know about before giving this drug to my child?

• This warning is for the skin patch only. It is only used to treat lasting, long-term pain that cannot be helped by other drugs. It is only for use in patients who are taking pain drugs (such as morphine, oxycodone, or hydromorphone) and are used to them. It is not for mild pain or pain that comes and goes. It may slow down breathing too much if not used the right way. It is not for use in children younger than 2 years of age. Do not use a cut patch or one that does not look right. Watch patients getting this drug for misuse, abuse, and addiction. Some drug interactions may not be safe. Check with your child's doctor.
• Sometimes drugs are not safe when your child takes them with other drugs. They can cause bad side effects. This is one of those drugs. Be sure to talk to your child’s doctor about all the drugs your child takes.
• Please read the medication guide.

Is it safe for my child to take this drug?

• Not if your child has an allergy to fentanyl or any other part of this drug.
• Be sure to let the doctor know if your child has any allergies or side effects to drugs, foods, or dyes. Make sure to tell about the allergy and what signs your child had. This includes telling about rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
• Not if your child has any of these health problems: Asthma, bowel block, or very bad lung disease.

Why does my child need this drug?

• It is used to ease pain.

How does this drug work?

• Fentanyl lowers the feeling of pain and how one reacts to pain.

How is this drug given?

• All products:
• Have your child drink lots of noncaffeine liquids every day unless told to drink less liquid by your child's doctor.
• Keep a pain diary.
• Shot:
• It is given as a shot into a vein.
• Skin patch:
• Do not use patches that are cut or do not look right.
• If you or anyone else touches the gel, wash the skin with lots of water. Do not use soap.
• Wash your hands before and after use.
• Your child may bathe, shower, or swim after putting on.
• Put patch on clean, dry, healthy skin on your child's upper back. The chest, upper leg, or upper arm may also be used in older children.
• Move the site with each patch.
• If the patch falls off, put a new one on.
• If the patch loosens, put tape ONLY on the edges of the patch to hold it in place.

How long does this drug take to work?

• Your child may start feeling better soon after starting this drug.

What do I do if my child misses a dose? (does not apply to patients in the hospital)

• Give a missed dose as soon as you think about it.
• If it is close to the time for your child's next dose, skip the missed dose and go back to your child's normal time.
• Many times this drug is given on an as needed basis.

What safety measures do I need to take when my child is using this drug?

• Keep a list of all your child's drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your child's doctor.
• All products:
• Do not run out of this drug.
• This drug may be habit-forming with long-term use.
• If your child has been taking this drug for many weeks, talk with your child's doctor before stopping. You may want to slowly stop this drug.
• Check all drugs your child is taking with your child's doctor. This drug may not mix well with some other drugs.
• Avoid giving your child other drugs and natural products that may slow your child's actions.
• Avoid grapefruit and grapefruit juice.
• If your child has kidney disease, talk with the doctor.
• If your child has liver disease, talk with the doctor.
• If your child has lung disease, talk with the doctor.
• If your child has thyroid disease, talk with the doctor.
• This drug may cause your child to be less alert. Have your child avoid tasks or actions that call for alertness. These include playing (for example, riding a bicycle, rollerblading, sports) or using items that call for your child to have focus or coordination (for example, scissors, lawnmower, electric scooters, or toy cars). Your child's actions will be closely watched until you see how this drug affects him/her. School work may be hard for your child to focus on and get done.
• Your child may get sunburned more easily. Avoid lots of sun, sunlamps, and tanning beds. Use sunscreen and dress your child in clothing and eyewear that protects him/her from the sun.
• Skin patch:
• Have your child avoid use of heat sources (such as sunlamps, tanning beds, heating pads, electric blankets, heat lamps, saunas, hot tubs, heated waterbeds). Avoid long, hot baths or sunbathing. Your child's temperature may rise and cause too much drug to be let go all at once.
• Fever may cause too much drug to pass into your child's body. Call our child's doctor.
• The patch may have metal. Take off your child's patch before an MRI.

What are some side effects of this drug?

• Trouble breathing. Slow breathing, shallow breathing, or trouble breathing are all signs of this. Call your doctor right away.
• Feeling lightheaded, sleepy, having blurred eyesight, or a change in thinking clearly. Have your child avoid tasks or actions that call for him/her to be alert or have clear eyesight until you see how this drug works.
• Feeling dizzy. Have your child get up slowly over a few minutes when sitting or lying down. Have your child be extra careful climbing stairs.
• Upset stomach or throwing up. Many small meals and good mouth care may help. Older children may suck hard, sugar-free candy.
• Not able to sleep.
• Dry mouth. Good mouth care may help. Older children may suck hard, sugar-free candy. Have your child see a dentist often.
• Hard stools (constipation). Drinking more liquids, working out, or adding fiber to your diet may help. Talk with your doctor about a stool softener or laxative.
• Seizures may rarely happen.

When do I need to call my child's doctor?

• If any of this news causes you to be worried, any of the unwanted side effects happen, or if your child is not better after taking this drug.
• If you think there was an overdose, call your local poison control center or ER right away.
• If your child shows signs of a very bad reaction, call your child's doctor or the ER right away. These include wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; swelling of face, lips, tongue, or throat; or if your child is not acting normal.
• If your child has a fever higher than 102°F (38.5°C). Your doctor may tell you to use a lower dose while your child has a fever.
• If anyone else touches your child's patch.
• If your child shows signs of very bad dizziness or passes out.
• If your child has trouble breathing, slow breathing, or shallow breathing.
• If your child has a change in thinking clearly and with logic.
• If your child is feeling very nervous and excitable.
• If your child is feeling very tired or weak.
• If your child has poor pain control.
• If your child has a very bad upset stomach or is throwing up.
• If your child has very hard stools (constipation).
• If your child gets a rash.
• If your child’s health problem does not get better or if you believe your child’s health problem is worse.

How do I store and/or throw out this drug?

• Store at room temperature. Do not freeze.
• The shot will be given to your child in a hospital or doctor's office. You will not store it at home.
• After you take off a skin patch, be sure to fold the sticky sides of the patch to each other.
• Throw away unused patches when they are no longer needed. Take them from the pouch, take off liner, and fold in half.
• Throw away any unused drug by flushing down a toilet or sink.
• In Canada, take any unused drugs to the pharmacy. Also, visit http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/med/disposal-defaire-eng.php#th to learn about the right way to get rid of unused drugs.http://www.hc-sc.gc.ca/hl-vs/iyh-vsv/med/disposal-defaire-eng.php#th to learn about the right way to get rid of unused drugs.

General drug facts

• If your child has a very bad allergy, he/she needs to wear an allergy ID at all times.
• You may get this drug by drug order only. If there are refills, call your pharmacy. If your child does not have refills left, you may need to call your child's doctor.
• Get rid of this drug when your child no longer needs it or if the drug is outdated.
• Do not share your child's drug with others and do not give anyone else's drug to your child.
• Keep all drugs out of the reach of children and pets.
• Keep a list of all your child's drugs (prescription, natural products, vitamins, OTC) with you. Give this list to your child's doctor.
• Call your doctor for help with any side effects. If in the U.S., you may also call the FDA at 1-800-FDA-1088 or if in Canada, you may also call Health Canada's Vigilance Program at 1-866-234-2345.
• Talk with the doctor before giving your child any new drug, including OTC, natural products, or vitamins.
• If you do not use a drug the right way, it may not be safe. Follow what your child’s doctor tells you.

Copyright © 1978- Lexi-Comp Inc., The Children's Hospital, Denver, CO., and Pediatric Pharmacy Advocacy Group, Inc. All Rights Reserved. This information is protected under US and international copyright law. Unauthorized use or reproduction is prohibited.