Fentanyl
Fentanyl is a highly potent synthetic opioid pain reliever, estimated to be 50 to 100 times more potent than morphine. It works by binding to the body's opioid receptors, which are found in areas of the brain and nervous system that control pain and emotions. Due to its extreme potency and high risk of abuse, dependence, and fatal overdose, its use is strictly regulated.
Dosage by Body Weight
Dosing must be highly individualized and carefully titrated by a healthcare provider. Transdermal patches and transmucosal formulations (lozenges, buccal tablets, sprays) are strictly contraindicated in opioid-naive patients due to the high risk of fatal respiratory depression. Safe outpatient use requires demonstrated opioid tolerance.
- Body Weight
- Below 5 kg
- Dose
- Strictly restricted / Specialist use only
- Frequency
- As determined by a pediatric anesthesiologist or neonatologist
- Tracking Notes
- Extremely high risk of life-threatening respiratory depression. Restricted strictly to neonatal intensive care or controlled surgical settings.
- Body Weight
- 5-7 kg
- Dose
- Strictly restricted / Specialist use only
- Frequency
- As determined by a medical specialist
- Tracking Notes
- Not for routine use. Weight-based dosing (typically 1 to 2 mcg/kg IV) must only be calculated and administered by trained clinical staff in acute settings.
- Body Weight
- 8-10 kg
- Dose
- Strictly restricted / Specialist use only
- Frequency
- As determined by a medical specialist
- Tracking Notes
- Contraindicated for outpatient or opioid-naive use. Requires continuous physiological monitoring if administered intravenously in a clinical setting.
- Body Weight
- 11-15 kg
- Dose
- Strictly restricted / Specialist use only
- Frequency
- As determined by a medical specialist
- Tracking Notes
- Transdermal patches and buccal formulations are generally not indicated. Highly restricted to specialized pediatric palliative care or anesthesia.
- Body Weight
- 16-20 kg
- Dose
- Strictly restricted / Specialist use only
- Frequency
- As determined by a medical specialist
- Tracking Notes
- Lozenges (e.g., Actiq) are only indicated for breakthrough cancer pain in opioid-tolerant pediatric patients aged 2 years and older who meet specific weight and tolerance criteria.
| Body Weight | Dose | Frequency | Tracking Notes |
|---|---|---|---|
| Below 5 kg | Strictly restricted / Specialist use only | As determined by a pediatric anesthesiologist or neonatologist | Extremely high risk of life-threatening respiratory depression. Restricted strictly to neonatal intensive care or controlled surgical settings. |
| 5-7 kg | Strictly restricted / Specialist use only | As determined by a medical specialist | Not for routine use. Weight-based dosing (typically 1 to 2 mcg/kg IV) must only be calculated and administered by trained clinical staff in acute settings. |
| 8-10 kg | Strictly restricted / Specialist use only | As determined by a medical specialist | Contraindicated for outpatient or opioid-naive use. Requires continuous physiological monitoring if administered intravenously in a clinical setting. |
| 11-15 kg | Strictly restricted / Specialist use only | As determined by a medical specialist | Transdermal patches and buccal formulations are generally not indicated. Highly restricted to specialized pediatric palliative care or anesthesia. |
| 16-20 kg | Strictly restricted / Specialist use only | As determined by a medical specialist | Lozenges (e.g., Actiq) are only indicated for breakthrough cancer pain in opioid-tolerant pediatric patients aged 2 years and older who meet specific weight and tolerance criteria. |
Formulation
Purpose
Management of severe chronic pain requiring continuous, around-the-clock opioid administration (such as cancer pain), management of breakthrough pain in patients already tolerant to opioid therapy, and as an anesthetic agent or sedative in clinical settings.
Generic Name
Fentanyl CitrateBranded Drug Names
Fentanyl is listed as a generic drug name. Common branded medicines that may contain the same active ingredient include:
Scheduled Drug
Yes. This medicine should be supplied or used only according to applicable prescription and regulatory requirements.