Relief of Pain and Inflammation : Narcotic Analgesics
IFENT3 “Fentanyl injection” 0.05 mg/ml; 10 ml/amp
IFENT5 “Fentanyl–Fresenius injection” 0.05 mg/ml; 10 ml/amp
OPAIN1 “Painkyl buccal soluble films table” 200 mcg/tab
TDURO4 “Durogesic D patch” 12 mcg/hour
TFENT2 “Fentanyl Transdermal Patch”25 mcg/hour
TFENT5 “Fentanyl Transdermal Patch” 50 mcg/hour
適應症：
IFENT3, IFENT5：麻醉和麻醉前給藥、急性劇烈疼痛之緊急治療。
OPAIN1：癌症病患突發性疼痛(breakthrough pain)之處置，且適用對象僅限於18歲(含)以上且正在使用類鴉片藥物治療其潛在持續性癌疼痛並具耐受性者。
TDURO4, TFENT2, TFENT5：需要使用類鴉片製劑控制的慢性疼痛和頑固性疼痛。
Usual dose:
Usual dose:
Loading dose: 200 mcg; if switched from other fentanyl forms shoud be not over than 200 mcg. Max.: 1200mcg, each dose shoud be at less 2 hours interval.
General anesthesia; adjunct: IV, (low dose) 2 mcg/kg; (moderate dose) 2-20 mcg/kg; (high dose) 20-50 mcg/kg.
Regional anesthesia; adjunct: 50-100 mcg IM or slow IV over 1-2 min when additional analgesia is required.
Pain: TTS, initial 25 mcg/patch repeated q72h; dose titrated individually. Dose adjustment can take place q3d based on oral morphine 90 mg/day = Durogesic 25 mcg/patch.
Postoperative pain: 50-100 mcg IM; may repeat after 1-2 h if needed.
Dose adjustment:
When using 200 mcg is not remission of pain, titrated upwards 200 mcg per time until max. dose.
Do not using 4 patches at the same time.
Each dose shoud be at less 2 hours interval.
Geriatric: do not initiate transdermal fentanyl at doses > 25 mcg/h unless the p’t is already receiving > 135 mg/day oral morphine or equivalent dose of another opioid.
Contraindication: paralytic ileus, acute or postoperative pain, acute or severe bronchial asthma, situations of significant respiratory depression (especially in unmonitored settings that lack resuscitative equipment)
Precaution: Initiate transdermal fentanyl using the recommended dose and titrate upwards no more often than q3d after the first dose or q6d thereafter until effective analgesia is achieved.
Adverse effect:
Common: pruritus, sweating symptom, constipation, nausea, vomiting, xerostomia, asthenia, confusion, dizziness, sedated, urinary retention.
Serious: cardiac dysrhythmia, chest pain, hypertension, hypotension, apnea, hypoventilation, respiratory depression.