Once an effective dose is found, your healthcare provider will prescribe it -- this is considered your maintenance dose. Normally, for short-acting products, once a maintenance dosage is established, one dose should be enough to adequately treat the majority of your breakthrough pain episodes.
You may find that, over time, your maintenance dose no longer effectively relieves your pain. If you are using short-acting fentanyl products, contact your healthcare provider if your dose does not adequately manage your pain for several breakthrough episodes in a row. You may need an increase.
If you find that you experience more than four episodes of breakthrough pain each day, contact your healthcare provider. Your long-acting opioid medication dosage may need to be increased.
Some considerations to keep in mind during treatment with fentanyl include the following:
- This medication comes in many different forms, and the directions for each individual fentanyl product vary. Refer to the information for your specific product.
- When using fentanyl products that dissolve in the mouth, you should generally avoid eating or drinking anything until the medication is completely dissolved. However, you may drink liquids five minutes after placing fentanyl film in your mouth.
- Do not cut, tear, bite, chew, break, or swallow any fentanyl product.
- Do not cover fentanyl patches with bandages or tape. If the patch will not stick, you may use first aid tape around the patch edges only, or use a special clear adhesive dressing. Tell your healthcare provider or pharmacist if you have a problem with the patch sticking.
- In general, fentanyl medications used on an as-needed basis should not be used more than four times a day. Tell your healthcare provider if you feel you need to use it more often.
- Fentanyl medications come in individual, sealed packages. Do not open the packages until you are ready to use the medicine.
- When using "as-needed" fentanyl medications, make sure to continue taking your regularly scheduled, around-the-clock, opioid pain medication as well. Using an "as-needed" fentanyl product alone will not control your pain.
- All fentanyl products must be stored in a safe place, out of the reach of children and protected from theft, and disposed of properly. This is because fentanyl is a desired drug of abuse. It is a strong medication that can be dangerous if ingested by a child or someone for whom it was not prescribed (see Fentanyl Storage and Disposal for more information).
- For the medication to work properly, it must be used as prescribed. Do not increase your dose or suddenly stop using this drug without your healthcare provider's approval.