Fentanyl is a very strong analgesic similar to opium, which in Germany falls under the Narcotics Act. Due to its high analgesic and strong sedative effect, the opioid is used intravenously as an anesthetic, especially during surgery. Because of its rapid onset of action fentanyl is also used in emergency medicine. As a transdermal therapeutic system (TTS), the Fentanyl patch is used as a pain patch in patients who regularly need painkillers.
Fentanyl patch: Dosage and Side Effects
The Fentanyl patch is less susceptible to oral ingestion because it is absorbed through the blood rather than the stomach. Fentanyl patches work directly on the affected area, for example in osteoarthritis. During treatment with a Fentanyl patch heat is to be avoided, in addition, the pain plaster must be changed every 72 hours. Nevertheless, painkillers containing fentanyl are among the strongest painkillers according to the WHO and should not be used recklessly.
Fentanyl nasal spray for breakthrough pain
A newer dosage form is a nasal spray launched in 2009. Especially cancer patients benefit from the Fentanyl nasal spray. In contrast to fentanyl lozenges or lollipops, the analgesic effect of the nasal spray is achieved more quickly, because the active ingredient can be absorbed very well via the nasal mucosa - a disadvantage sometimes caused by dry air and associated dry mucous membranes. Even with a cold, the dosage of Fentanyl nasal spray proves to be problematic.
The remedy reaches its high effect quickly, it does not last long, which corresponds to the property of the rapidly onset, but usually short-lived breakthrough pain. The easy handling of Fentanyl nasal spray in oncology achieved a positive response. Like the Fentanyl patch, the Fentanyl nose spray and lollipops can be used on an outpatient basis. In addition to pain relief, many patients additionally welcome the potent sedative effect of fentanyl - a reason why it is now and then also used in dentistry.
Fentanyl: dosage and effect
Fentanyl has about one hundred times more potency than morphine, and its side effects are similar to those of morphine. Any dosage form must be under medical supervision. Particular attention should be given to the dosage of fentanyl, as an increased dose may lead to respiratory depression, in the worst case fatality. Due to the effect of fentanyl on the respiratory center, therapy should be regularly monitored at the beginning for the purpose of correct adjustment.
Fentanyl: side effects
The most common side effects include fatigue, constipation, sweating, anxiety or euphoria, nausea and vomiting. Also slowed heart activity or muscle cramps can occur as side effects of fentanyl. The most severe side effects are associated with overdose or abuse.
Incorrect use of the Fentanyl patch can result in serious side effects, including death, as the Food and Drug Administration has warned the United States since 2005. In the year 2009 alone it should have come to 397 deaths in the US.
Fentanyl: withdrawal and addiction
Fentanyl is also referred to as "super heroin" in the US. The calming effect can lead to awareness-changed perception to sleep-like states. There is a risk of rapid and heavy dependency. Consumers risk their lives with every injection because the dosage of the drug is barely controllable. Also, the already immensely strong effect of fentanyl after further development to the designer drug is difficult to predict.
Apart from serious side effects it also leads to severe symptoms during withdrawal. Caution: It is not only the abuse that leads to addiction and may require withdrawal after termination or sudden discontinuation of therapy; Patients - including those with cancer - who used Fentanyl Patch or Fentanyl Nasal Spray also reported severe side effects and many complaints related to withdrawal.
Especially with the so-called cold withdrawal, the seamless transition from a high dose to a complete renunciation, occur typical symptoms such as anxiety, shivering, diarrhea, nausea and vomiting. Similar to heroin, the replacement drug methadone is sometimes used in fentanyl withdrawal. Due to the extremely strong effects, side effects and risks, the use of fentanyl for medical purposes should be carefully considered.