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Side Effects > Fentanyl

Fentanyl Side Effects

Brand Names: Fentora, Actiq, Duragesic, Sublimaze, Ionsys

Please note - some side effects for Fentanyl may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA at http://www.fda.gov/medwatch/ or 1-800-FDA-1088 (1-800-332-1088).


For the consumer

For the professional

Side Effects of Fentanyl - for the consumer


Fentanyl

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Fentanyl:

Anxiety; confusion; constipation; difficulty walking; dizziness; drowsiness; dry mouth; headache; indigestion; itching; nausea; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur when using Fentanyl:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); hallucinations; muscle rigidity; seizures; slow or irregular heartbeat; slowed breathing; trouble breathing; weakness.


Fentanyl Lozenge

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Fentanyl Lozenge:

Accidental injury; anxiety; confusion; constipation; difficulty walking; dizziness; drowsiness; dry mouth; headache; indigestion; itching; nausea; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur when using Fentanyl Lozenge:

Severe allergic reactions (rash; hives; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); excessive dizziness; excessive drowsiness; fainting; fatigue; hallucinations; muscle rigidity; seizures; shock (changes in skin color); slow heartbeat; slowed breathing; trouble breathing; weakness.


Fentanyl Patch

All medicines may cause side effects, but many people have no, or minor side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Fentanyl Patch:

Constipation; diarrhea; dizziness; dry mouth; exaggerated sense of well-being; headache; indigestion; loss of appetite; nausea; nervousness or anxiety; redness or discomfort on skin where patch is applied; sleepiness; sleeplessness; stomach pain or discomfort; sweating; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur when using Fentanyl Patch:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; confusion; depression; difficulty urinating; excessive dizziness; excessive drowsiness; fainting; fatigue; fever; hallucinations; interrupted or difficult breathing; memory loss; muscle rigidity; seizures; shock (changes in skin color); slow heartbeat; slowed or irregular breathing; tremor; weakness.


Fentanyl Tablet

All medicines may cause side effects, but many people have no, or minor side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Fentanyl Tablet:

Constipation; diarrhea; dizziness; drowsiness; headache; mouth pain or irritation; nausea; numbness or tingling at the site where the tablet is used; stomach pain; vomiting; weakness or tiredness.

Seek medical attention right away if any of these SEVERE side effects occur when using Fentanyl Tablet:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; confusion; fainting; fast, slow, or irregular heartbeat; fever, chills, or persistent sore throat; hallucinations; mood or mental changes (eg, depression); mouth sores, ulcers, bleeding, or inflammation; numbness or tingling in the hands, legs, or feet; severe drowsiness; severe dry eyes, mouth, or skin; severe or persistent dizziness; shortness of breath; slowed breathing; swelling of the hands, feet, or ankles; unusual bruising or bleeding; unusual or severe weakness or tiredness; yellowing of the eyes or skin.

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For the professional


Fentanyl

In post-marketing experience, deaths from hypoventilation due to inappropriate use of Fentanyl transdermal system have been reported.

Premarketing Clinical Trial Experience

Although Fentanyl transdermal system use in postoperative or acute pain and in patients who are not opioid-tolerant is CONTRAINDICATED, the safety of Fentanyl transdermal system was originally evaluated in 357 postoperative adult patients for 1 to 3 days and 153 cancer patients for a total of 510 patients. The duration of Fentanyl transdermal system use varied in cancer patients; 56% of patients used Fentanyl transdermal system for over 30 days, 28% continued treatment for more than 4 months, and 10% used Fentanyl transdermal system for more than 1 year.

Hypoventilation was the most serious adverse reaction observed in 13 (4%) postoperative patients and in 3 (2%) of the cancer patients. Hypotension and hypertension were observed in 11 (3%) and 4 (1%) of the opioid-naive patients.

Various adverse events were reported; a causal relationship to Fentanyl transdermal system was not always determined. The frequencies presented here reflect the actual frequency of each adverse effect in patients who received Fentanyl transdermal system. There has been no attempt to correct for a placebo effect, concomitant use of other opioids, or to subtract the frequencies reported by placebo-treated patients in controlled trials.

Adverse reactions reported in 153 cancer patients at a frequency of 1% or greater are presented in Table 1; similar reactions were seen in the 357 postoperative patients.

In the pediatric population, the safety of Fentanyl transdermal system has been evaluated in 291 patients with chronic pain 2 to 18 years of age. The duration of Fentanyl transdermal system use varied; 20% of pediatric patients were treated for ≤ 15 days; 46% for 16 to 30 days; 16% for 31 to 60 days; and 17% for at least 61 days. Twenty-five patients were treated with Fentanyl transdermal system for at least 4 months and 9 patients for more than 9 months.

There was no apparent pediatric-specific risk associated with Fentanyl transdermal system use in children as young as 2 years old when used as directed. The most common adverse events were fever (35%), vomiting (33%), and nausea (24%).

Adverse events reported in pediatric patients at a rate of ≥ 1% are presented in Table 1.

TABLE 1: ADVERSE EVENTS (at rate of ≥ 1%) Adults (N = 380) and Pediatric (N = 291) Clinical Trial Experience
Body System Adults Pediatrics
*
Reactions occurring in 3% to 10% of Fentanyl transdermal system patients
Reactions occurring in 10% or more of Fentanyl transdermal system patients
Body as a Whole Abdominal pain*, headache*, fatigue*, back pain, fever, influenza-like symptoms*, accidental injury, rigors Pain*, headache*, fever, syncope, abdominal pain, allergic reaction, flushing
Cardiovascular Arrhythmia, chest pain Hypertension, tachycardia
Digestive Nausea, vomiting, constipation, dry mouth, anorexia*, diarrhea*, dyspepsia*, flatulence Nausea, vomiting, constipation*, dry mouth, diarrhea
Nervous Somnolence, insomnia, confusion, asthenia, dizziness*, nervousness*, hallucinations*, anxiety*, depression*, euphoria*, tremor, abnormal coordination, speech disorder, abnormal thinking, abnormal gait, abnormal dreams, agitation, paresthesia, amnesia, syncope, paranoid reaction Somnolence*, nervousness*, insomnia*, asthenia*, hallucinations, anxiety, depression, convulsions, dizziness, tremor, speech disorder, agitation, stupor, confusion, paranoid reaction
Respiratory Dyspnea*, hypoventilation*, apnea*, hemoptysis, pharyngitis*, hiccups, bronchitis, rhinitis, sinusitis, upper respiratory tract infection* Dyspnea, respiratory depression, rhinitis, coughing
Skin and Appendages Sweating, pruritus*, rash, application site reaction – erythema, papules, itching, edema Pruritus*, application site reaction*, sweating increased, rash, rash erythematous, skin reaction localized
Urogenital Urinary retention*, micturition
disorder
Urinary retention

The following adverse effects have been reported in less than 1% of the 510 adult postoperative and cancer patients studied:

Cardiovascular: bradycardia

Digestive: abdominal distention

Nervous: aphasia, hypertonia, vertigo, stupor, hypotonia, depersonalization, hostility

Respiratory: stertorous breathing, asthma, respiratory disorder

Skin and Appendages, General: exfoliative dermatitis, pustules

Special Senses: amblyopia

Urogenital: bladder pain, oliguria, urinary frequency

Post-Marketing Experience

Adults

The following adverse reactions have been reported in association with the use of Fentanyl transdermal system and not reported in the premarketing adverse reactions section above:

Body as a Whole: edema

Cardiovascular: tachycardia

Metabolic and Nutritional: weight loss

Special Senses: blurred vision

Urogenital: decreased libido, anorgasmia, ejaculatory difficulty

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More resources:

Drugs.com Actiq

Drugs.com Ionsys

Drugs.com Fentora

Drugs.com Duragesic

PDR Fentanyl

MedFacts Fentora

MedFacts Actiq Lozenge

MedFacts Fentanyl

MedFacts Duragesic Patch

Micromedex Sublimaze - Includes detailed dosage instructions.

Micromedex Duragesic Transdermal-Systemic - Includes detailed dosage instructions.

Micromedex Fentanyl - Includes detailed dosage instructions.

FDA Sublimaze

FDA Ionsys

FDA Fentanyl

FDA Duragesic

FDA Fentora

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