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Precautions and Warnings With Fentanyl

Specific Fentanyl Warnings and Precautions

Some warnings and precautions to be aware of prior to using this pain medicine include the following:
  • Fentanyl patches should only be applied to the skin. They should not be taken by mouth, chewed, swallowed, or used in any other way than prescribed. Using this medication improperly is extremely dangerous and could even lead to death.
  • Some people may get mouth pain, irritation, or sores when using fentanyl products that dissolve or are sprayed in the mouth, especially at the application site (the area of the mouth where the fentanyl product is placed). Talk to your healthcare provider if you experience any of these problems.
  • Fentanyl medications should only be used in people who are already taking scheduled, around-the-clock opioids and are tolerant to their effects, which means the body has gotten used to the opioid. People who are not opioid tolerant may experience life-threatening breathing problems, or even death, from taking this medication.
  • Heat may cause too much of the medication to be released from fentanyl patches, increasing the risk of overdose. Avoid anything that could heat the skin, including heating pads, electric blankets, hot tubs, saunas, tanning beds, hot baths, and sunbathing if you are using the fentanyl patch. Contact your healthcare provider immediately if you develop a fever or if your body temperature increases from physical exercise.
  • Fentanyl medications are not interchangeable. Substituting one fentanyl product for the same dose of another fentanyl product could result in an overdose, as the doses used in these medications are not the same.
  • This drug may cause serious problems, including death, if used in children and people for whom it was not prescribed. Do not share fentanyl with someone else, even if they have the same symptoms as you. Also, be sure to store and dispose of the medication properly (see Fentanyl Storage and Disposal for more information).
  • Fentanyl is a narcotic medication with a significant potential for abuse (see Fentanyl Abuse). Do not take the drug more frequently or at a higher dose than prescribed. If you believe you may be developing a problem with abuse, please seek help from a healthcare provider.
  • This medicine can cause life-threatening breathing problems (called "respiratory depression"). People who have respiratory depression may take slow and shallow breaths or deep breaths separated by long pauses. Certain people may have an increased risk for respiratory depression with fentanyl, including:
    • Older adults
    • People who already have breathing difficulties
    • People who are not tolerant to opioids
    • People who are taking certain other medications.
  • This medication can cause problems in people with head injuries or high intracranial pressure. It should only be used with extreme caution in such people.
  • Fentanyl may cause a slow heart rate (bradycardia) and should be used with caution in people who already have a very slow heart rate.
  • Do not drive or operate heavy machinery until you know how this medicine affects you. It might make you extremely drowsy. Your reflexes and reaction times may be significantly altered, even if you feel fine.
  • Like other narcotics, fentanyl can cause physical dependence, which could lead to withdrawal symptoms if the medication is stopped abruptly. Do not suddenly stop taking this medication. If you no longer need it, your healthcare provider may be able to gradually decrease your dosage to help reduce the chance of experiencing uncomfortable withdrawal symptoms (see Fentanyl Withdrawal for more information).
  • Each fentanyl product comes with a guide that describes the correct way to use it. Make sure to read this guide each time you get your prescription filled, as new information may be available.
  • Do not drink alcohol while using this medication. Consuming alcohol with fentanyl could increase your risk for serious side effects, including extreme drowsiness, confusion, memory loss, or difficulty breathing.
  • All narcotic pain medications can cause constipation. Ask your healthcare provider about laxatives and stool softener medications that can help prevent or treat constipation with fentanyl.
  • This drug passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to beginning treatment (see Fentanyl and Breastfeeding).
  • Fentanyl is a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are currently unknown (see Fentanyl and Pregnancy).
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