Adult & childn 12-17 yr IV injDuring surgery w/o assisted breathing Initially 50-200 mcg, followed by a further 50 mcg dose if needed. During surgery w/ assisted breathing Initially 300-3,500 mcg, followed by a further 100-200 mcg dose if needed. IV infusion Initially 1 mcg/kg every min for the 1st 10 min, followed by a further 0.1 mcg/kg dose every 10 min for the duration of the operation. Drip will normally be stopped 40 min before the end of operation. Childn 2-11 yr During surgery w/ or w/o assisted breathing Initially 1-3 mcg/kg, followed by a further 1-1.25 mcg/kg dose if needed.
Hypersensitivity to fentanyl or other opioid medicines. Patients w/ asthma, shallow breathing or other breathing difficulties. Patients taking or who have recently (w/in the last 2 wk) taken MAOIs.
Risk of slower breathing than usual or shortness of breath. Monitor BP & heart rate. Caution in patients w/ under active thyroid gland; lung disease; myasthenia gravis; liver or kidney disease; opioid therapy or history of opioid or drug use; alcoholism; severe undiagnosed headaches; recent head injury; low blood vol; pain in the right upper side of abdomen; controlled Na diet. Can affect ability to drive & use machines. Do not drive or use any tools or machines for at least 24 hr after fentanyl inj. Repeated use can result in tolerance & addiction. Risk of w/drawal symptoms if discontinuing treatment. Pregnancy. Do not use during childbirth; can affect baby's breathing. Do not breastfeed or use breast milk that has been expressed for 24 hr after having fentanyl inj. Caution in elderly or weak patients due to ill health.
Muscle stiffness; nausea or vomiting. Feeling agitated; jerky or uncoordinated movements; drowsiness; dizziness; blurred vision, blind spots or haloes around lights; slow or irregular heartbeat; unusually low or high BP; pain along the veins; choking caused by spasm of the throat muscles; wheezing or difficulty breathing; stopping breathing for a short period of time; itchy rash or redness of the skin; confusion.
Drug Interactions
Increased risk of drowsiness, resp depression, coma w/ sedatives eg, benzodiazepines or related drugs. Do not use w/ MAOIs eg, phenelzine or moclobemide, or w/in the last 2 wk of stopping them. Potential interaction w/ SSRIs or SNRIs (eg, citalopram, duloxetine, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, venlafaxine); tranquilizer; CNS depressants; ritonavir & other PIs eg, indinavir & saquinavir; droperidol; muscle relaxants; antifungals eg, fluconazole or voriconazole; midazolam. Do not drink alcohol during treatment.
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