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Prescription Drug Database

You can search for a drug in two ways. Enter the drug name in the box below, or select a letter to find all of the drug names beginning with that letter.

Uncertain about brand names and common names?

The brand name is the name under which a specific manufacturer markets a product (e.g., Tylenol®). The common name is the standard name of the medicine (e.g., acetaminophen). Check the label on your medicine for this information.

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Brand Name: Abstral

Common Name: fentanyl tablet

How does this medication work? What will it do for me?

Fentanyl tablets belong to the group of medications called opioids. It is used to manage breakthrough pain for people with cancer who are 18 years of age and older and who are already receiving opioid medication (e.g., morphine, hydromorphone, fentanyl patches, oxycodone) for constant cancer pain. Breakthrough pain is pain that occurs despite taking regular doses of opioid pain medication for constant cancer pain.

This medication should not be used to treat other types of pain because it can cause life-threatening breathing problems for people who are not taking opioid medication chronically to manage cancer pain. This medication acts on the brain to increase pain tolerance and usually works within 10 to 30 minutes of taking it.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful (and even result in death) for people to take this medication if their doctor has not prescribed it.

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What form(s) does this medication come in?

100 µg
Each white, round, sublingual tablet contains fentanyl 100 µg. Nonmedicinal ingredients: mannitol, silicified microcrystalline cellulose, croscarmellose sodium, and magnesium stearate.

200 µg
Each white, oval-shaped, sublingual tablet contains fentanyl 200 µg. Nonmedicinal ingredients: mannitol, silicified microcrystalline cellulose, croscarmellose sodium, and magnesium stearate.

300 µg
Each white, triangle-shaped, sublingual tablet contains fentanyl 300 µg. Nonmedicinal ingredients: mannitol, silicified microcrystalline cellulose, croscarmellose sodium, and magnesium stearate.

400 µg
Each white, diamond-shaped, sublingual tablet contains fentanyl 400 µg. Nonmedicinal ingredients: mannitol, silicified microcrystalline cellulose, croscarmellose sodium, and magnesium stearate.

600 µg
Each white, "D"-shaped, sublingual tablet contains fentanyl 600 µg. Nonmedicinal ingredients: mannitol, silicified microcrystalline cellulose, croscarmellose sodium, and magnesium stearate.

800 µg
Each white, capsule-shaped, sublingual tablet contains fentanyl 800 µg. Nonmedicinal ingredients: mannitol, silicified microcrystalline cellulose, croscarmellose sodium, and magnesium stearate.

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How should I use this medication?

This medication should only be prescribed by doctors that are knowledgeable about using opioids (e.g., morphine, hydromorphone, oxycodone) for cancer pain. Before starting this medication, your pain control should be stabilized with opioid medications.

The initial dose of this medication must always be one 100 µg (microgram) tablet placed under the tongue. Your doctor will adjust the dose of this medication until you get adequate pain relief with tolerable side effects. Your doctor will monitor you closely while finding the dose that works for you.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Do not take more of this medication than your doctor prescribed. Doing so could lead to serious and possibly life-threatening effects. If you do not have adequate pain relief after 30 minutes of taking a dose, do not take another dose of this medication. Your doctor will prescribe another pain medication for you to take if this happens.

Each dose of this medication should be separated by at least 2 hours and should not be used more than 4 times in one day. If you experience breakthrough pain more than 4 times in one day, contact your doctor as you may need to have the dose of long-acting opioid medication adjusted by your doctor.  If your long-acting opioid dose changes, you doctor will reassess your dose of this medication.

Each fentanyl tablet is individually sealed in a child-resistant blister package. Do not open the package until you are ready to use this medication. If your mouth is dry, take a sip of water before taking this medication, but make sure your hands are dry before touching the tablet. To open the package, pull apart one of the blister units by tearing it along the perforations. Peel back the foil starting at the unsealed area and gently remove the tablet. Do not try to push the tablet out through the foil as this will damage the tablet.

Place the tablet under the tongue on the floor of your mouth right away. If your prescribed dose is more than one tablet, spread them out on the floor of your mouth, but do not use more than 4 tablets at one time. Do not eat or drink anything until the tablet has dissolved and you can no longer feel it in your mouth. Do not chew, suck or swallow this medication as it will not be as effective.

It is important to take this medication exactly as prescribed by your doctor.

Store this medication in its original packaging at room temperature and protect it from moisture. Keep this medication in a safe place away from children or pets, and to prevent theft. Accidental use by a child or pet may result in death, so if this occurs, get immediate medical attention for the child or pet. Do not take this medication in front of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

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Who should NOT take this medication?

Do not take this medication if you:

• are allergic to fentanyl or any ingredients of this medication
• are allergic to other related opioid medications (e.g., meperidine)
• have not been taking other opioid medications (e.g., morphine, hydromorphone, oxycodone) regularly for constant cancer pain and your body is not used to regular opioid medication
• have only acute pain (e.g., headache, migraine, dental pain) or pain related to surgery
• have severe breathing problems or severe obstructive lung problems (e.g., chronic bronchitis, emphysema)

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What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• constipation
• diarrhea
• drowsiness
• headache
• loss of appetite
• nausea
• tiredness
• trouble sleeping
• vomiting
• weakness

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• abdominal pain
• agitation
• anxiety
• dizziness or lightheadedness, especially when standing from a lying or sitting position
• mood changes
• severe constipation
• signs of decreased red blood cells (anemia; e.g., pale skin, fatigue, shortness of breath, rapid heartbeat)
• skin rash
• slow or fast heart beat
• swelling of legs, feet or hands

Stop taking the medication and seek immediate medical attention if any of the following occur:

• symptoms of a severe allergic reaction (e.g., hives; difficulty breathing; swelling of the face, mouth, throat, or tongue)
• symptoms of overdose (e.g., trouble breathing; extreme drowsiness with slowed breathing; slow, shallow breathing; feeling faint, dizzy, confused; difficulty thinking, talking, or walking; seizures; hearing, seeing, or feeling things that are not there [also known as hallucinations])

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

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Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Alcohol and other medications that cause drowsiness: Do not combine this medication with alcohol or other medications (e.g., antidepressants, sleeping pills, anxiety medications) that cause drowsiness since additive drowsiness can occur and be dangerous.

Dependence: As with other opioid medications, physical dependence can occur when this medication is taken for long periods of time. This is not the same as addiction. Misuse of this medication is not usually a problem when it is used appropriately to treat pain. Consult your doctor if you have any questions.

Do not stop using fentanyl tablets suddenly since withdrawal symptoms may occur. These symptoms include nausea, vomiting, diarrhea, shivering, and anxiety. Your doctor will advise you on how to safely stop taking fentanyl tablets.

It is important to tell your doctor if you or a family member have ever been dependent on or misused alcohol, prescription medications, or street drugs.

Difficulty breathing: Fentanyl tablets can cause serious and life-threatening breathing problems. If you experience slowed, shallow, or difficulty breathing, seek immediate medical attention. If you are taking other medications that can slow breathing (e.g., anxiety medications, sleeping pills) are a senior, or have chronic bronchitis or emphysema that is not severe, you are more at risk of experiencing these symptoms. Make sure you follow the instructions on how to properly use this medication. If you have any questions, contact your doctor or pharmacist. If you have severe chronic lung conditions (e.g., bronchitis, emphysema), you should not take this medication.

Drowsiness/reduced alertness: This medication may cause drowsiness or dizziness. Do not drive, operate machinery, or perform other potentially hazardous tasks until you have determined how this medication affects you.

Grapefruit: Do not drink grapefruit juice or eat grapefruit while you are taking this medication. This can interfere with how the medication leaves your body and cause unwanted and potentially serious side effects.

Head injury: People with head injuries or increased pressure in the brain, or reduced consciousness may have a higher risk of experiencing side effects (breathing problems) or worsening of their condition while taking this medication. Your doctor will weigh the risks and benefits of you using this medication and will monitor you closely for side effects.

Kidney function: If you have reduced kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: If you have reduced liver function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Other medical conditions: If you have lung problems, an abnormally slow heartbeat (bradycardia), gallstones, or pancreatitis (inflammation of the pancreas), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Proper use: It is important for you and people caring for you to understand how to use this medication correctly. If you experience, or your caregiver notices, the following symptoms of taking too much fentanyl tablets, get immediately medical attention:

• difficulty thinking, talking, or walking
• extreme drowsiness with slowed breathing
• feeling faint, dizzy, confused
• hallucinations (hearing, seeing, or feeling things that are not there)
• seizures
• slow, shallow breathing
• trouble breathing

Tolerance: Fentanyl tablets may lead to tolerance when used for a long period of time. Tolerance means that your body gets used to the medication so that more medication may be needed to produce the same pain relief. Your doctor will recommend the dose of fentanyl tablets that is most appropriate for you. Do not change your dose or the way you are using the medication on your own. If you find that a dose of fentanyl is not providing the same amount of pain relief as before, contact your doctor.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant or plan to become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking fentanyl, it may cause life-threatening breathing difficulties for your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children and adolescents less than 18 years of age. Accidental ingestion of this medication by children may lead to severe and even fatal consequences. Keep this medication out of the reach of children.

Seniors: Seniors may be more sensitive to the side effects of this medication.

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What other drugs could interact with this medication?

There may be an interaction between fentanyl tablets and any of the following:

alcohol amiodarone antihistamines that cause drowsiness (e.g., diphenhydramine, chlorpheniramine) aprepitant "azole" antifungals (e.g., fluconazole, itraconazole, ketoconazole, posaconazole) barbiturates (e.g., phenobarbital) benzodiazepines (e.g., clonazepam, diazepam, lorazepam) buprenorphine butorphanol carbamazepine certain protease inhibitors (e.g., ritonavir, indinavir, nelfinavir, saquinavir) chloral hydrate corticosteroids (e.g., prednisone, dexamethasone) cyclosporine diltiazem droperidol efavirenz haloperidol imatinib macrolide antibiotics (e.g., clarithromycin, erythromycin, telithromycin)

MAO inhibitors (e.g., phenelzine, tranylcypromine) modafinil muscle relaxants (e.g., cyclobenzaprine, baclofen) nalbuphine naloxone nefazodone nevirapine norfloxacin other opioid medications (e.g., meperidine, morphine, codeine, oxycodone, hydromorphone) oxcarbazepine pentazocine phenothiazines (e.g., perphenazine, chlorpromazine) phenytoin pioglitazone quinidine rifabutin rifampin sibutramine St. John's wort tetracycline tramadol verapamil zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

The Prescription Drug Database contains information developed by Canadian pharmacists.

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