WARNING

Fentanyl nasal spray, like any medication containing fentanyl, carries several risks, including:

• Overdose: Fentanyl is a potent opioid pain reliever. Misuse, accidental ingestion, or improper dosing can lead to overdose, which can be fatal.
• Respiratory depression: Fentanyl can slow down breathing, leading to respiratory depression. This risk is higher in individuals with respiratory conditions or those taking other central nervous system depressants.
• Addiction: Fentanyl is highly addictive, and misuse can lead to physical and psychological dependence.
• Withdrawal: Abrupt discontinuation of fentanyl can lead to withdrawal symptoms such as nausea, vomiting, diarrhea, sweating, anxiety, and insomnia.
• Tolerance: Prolonged use of fentanyl can lead to tolerance, requiring higher doses to achieve the same effect, which increases the risk of overdose.
• Sedation and drowsiness: Fentanyl can cause extreme drowsiness and sedation, impairing one’s ability to drive or operate machinery safely.
• Drug interactions: Fentanyl can interact with other medications, especially other central nervous system depressants like benzodiazepines, increasing the risk of respiratory depression and overdose.

It’s crucial to use fentanyl nasal spray exactly as prescribed by a healthcare professional and to be aware of its potential risks and side effects. Any concerns or adverse reactions should be promptly reported to a healthcare provider.

Why is this medication prescribed?

Fentanyl nasal spray is prescribed primarily for the management of breakthrough pain in cancer patients who are already receiving opioid medication and who require additional pain relief that cannot be adequately managed with their current opioid regimen.

Breakthrough pain is a sudden, intense spike in pain that occurs despite around-the-clock opioid therapy for persistent pain. Fentanyl nasal spray provides rapid relief from breakthrough pain by delivering a potent opioid medication directly through the nasal mucosa into the bloodstream.

How should this medicine be used?

Here’s how fentanyl nasal spray should be used:

• Prescription: Fentanyl nasal spray should only be used as prescribed by a healthcare professional, typically after assessing the patient’s opioid tolerance and determining the appropriate dose.
• Dosage: The dosage of fentanyl nasal spray is individualized based on the patient’s opioid tolerance and the severity of breakthrough pain. It’s essential to use the lowest effective dose to minimize the risk of side effects and overdose.
• Administration: Before using the nasal spray, the patient should blow their nose to clear the nasal passages. The device should be primed before the first use by pressing the pump firmly several times until a fine mist appears. Then, the patient should insert the tip of the nasal spray device into one nostril while holding the other nostril closed, and administer the prescribed dose by pressing down on the pump.
• Avoidance of sniffing: Patients should avoid sniffing during and immediately after administration to ensure the medication reaches the nasal mucosa and is absorbed properly.
• Interval between doses: Fentanyl nasal spray should not be used more frequently than every two hours. If pain relief is not achieved after 30 minutes of administration, patients may use their prescribed rescue medication, as directed by their healthcare provider.
• Storage: Fentanyl nasal spray should be stored at room temperature away from moisture and heat, and kept out of reach of children.
• Disposal: Unused or expired fentanyl nasal spray should be disposed of properly according to local regulations or guidelines to prevent accidental ingestion or misuse.

It’s crucial for patients to understand and follow the instructions provided by their healthcare provider regarding the safe and appropriate use of fentanyl nasal spray. Any questions or concerns about its use should be discussed with a healthcare professional.

Other uses for this medicine

Fentanyl nasal spray is specifically approved for the management of breakthrough pain in cancer patients who are already receiving and tolerant to around-the-clock opioid therapy. It is not indicated for other types of pain or for use in opioid-naive patients. Off-label use of fentanyl nasal spray for non-cancer pain or in patients who are opioid-naive can be extremely dangerous and should be avoided.

What special precautions should I follow?

Special precautions for using fentanyl nasal spray include:

• Opioid Tolerance: Fentanyl nasal spray should only be used in patients who are already receiving and tolerant to around-the-clock opioid therapy. Using fentanyl nasal spray in opioid-naive patients can lead to overdose and death.
• Dosing: The dose of fentanyl nasal spray should be carefully titrated to achieve adequate pain relief while minimizing the risk of side effects and overdose. The lowest effective dose should be used.
• Respiratory Depression: Fentanyl can cause respiratory depression, which can be life-threatening. Patients should be closely monitored for signs of respiratory depression, especially when initiating therapy or increasing the dose.
• Sedation and Dizziness: Fentanyl can cause sedation and dizziness, which can impair the patient’s ability to drive or operate machinery safely. Patients should be cautioned against engaging in activities that require mental alertness until they know how fentanyl affects them.
• Drug Interactions: Fentanyl can interact with other medications, especially other central nervous system depressants such as benzodiazepines, sedatives, and alcohol. Concurrent use of these medications can increase the risk of respiratory depression and overdose.
• Abuse and Misuse: Fentanyl nasal spray has a high potential for abuse and misuse, which can lead to addiction, overdose, and death. It should be used only by the patient for whom it is prescribed and stored securely to prevent diversion.
• Pregnancy and Lactation: Fentanyl may cause fetal harm if used during pregnancy and can pass into breast milk, potentially causing harm to a nursing infant. The benefits and risks of using fentanyl nasal spray should be carefully considered in pregnant or breastfeeding women.
• Disposal: Unused or expired fentanyl nasal spray should be disposed of properly according to local regulations or guidelines to prevent accidental ingestion or misuse.

Patients should discuss any concerns or questions about fentanyl nasal spray with their healthcare provider before starting treatment.

What special dietary instructions should I follow?

Special dietary instructions are not typically associated with Fentanyl Nasal Spray. However, patients should follow their healthcare provider’s instructions regarding their overall diet and any specific dietary recommendations related to their underlying condition or treatment.

What should I do if I forget a dose?

If a dose of Fentanyl Nasal Spray is missed, patients should take it as soon as they remember unless it is almost time for the next scheduled dose. In that case, the missed dose should be skipped, and the patient should resume their regular dosing schedule. Patients should not double the dose to catch up. If unsure about what to do, patients should consult their healthcare provider or pharmacist for guidance.

What side effects can this medication cause?

Fentanyl Nasal Spray, like other medications, can cause side effects. Some common side effects associated with Fentanyl Nasal Spray include:

• Respiratory Depression: This is the most serious side effect and can be life-threatening, especially if the medication is not used properly or in patients who are not opioid-tolerant.
• Sedation and Drowsiness: Fentanyl can cause drowsiness, confusion, and sedation, which can impair the ability to perform tasks that require mental alertness, such as driving.
• Nausea and Vomiting: Gastrointestinal disturbances like nausea and vomiting are common side effects of opioid medications, including Fentanyl Nasal Spray.
• Constipation: Opioids can slow down bowel movements, leading to constipation. It’s essential to maintain adequate fluid intake and dietary fiber to help prevent this side effect.
• Headache: Some patients may experience headaches as a side effect of Fentanyl Nasal Spray.
• Dizziness: Fentanyl can cause dizziness, which may increase the risk of falls, particularly in older adults.
• Dry Mouth: Dry mouth can occur as a side effect of Fentanyl Nasal Spray.
• Fatigue: Some patients may experience fatigue or weakness while using Fentanyl Nasal Spray.
• Itching or Rash: Skin reactions such as itching or rash may occur in some individuals.
• Injection Site Reactions: Patients using Fentanyl Nasal Spray may experience irritation or redness at the application site.

It’s essential for patients to report any side effects they experience to their healthcare provider, especially if they are severe or persistent. Additionally, patients should seek immediate medical attention if they experience symptoms of respiratory depression, such as slow or shallow breathing, or signs of an allergic reaction, such as rash, itching, or difficulty breathing.

What should I know about storage and disposal of this medication?

Here’s what you should know about the storage and disposal of Fentanyl Nasal Spray:

Storage:

• Fentanyl Nasal Spray should be stored at room temperature (between 20-25°C or 68-77°F).
• Keep the medication away from heat and moisture.
• Store it in a secure place, out of reach of children and pets.
• Do not freeze Fentanyl Nasal Spray.
• Keep the nasal spray in its original packaging until ready to use.

Disposal:

• Unused or expired Fentanyl Nasal Spray should be disposed of properly.
• Follow local regulations or guidelines for medication disposal.
• Do not flush Fentanyl Nasal Spray down the toilet or pour it down the drain unless instructed to do so by your healthcare provider or pharmacist.
• Dispose of the medication in a sealed container or bag to prevent accidental ingestion by humans or animals.
• If unsure about proper disposal methods, consult your healthcare provider or pharmacist.

In case of emergency/overdose

In Case of Emergency/Overdose of Fentanyl Nasal Spray:

• Call emergency services immediately or go to the nearest emergency room.
• If possible, provide information about the amount of Fentanyl Nasal Spray ingested, the time of ingestion, and any symptoms experienced.
• Stay with the individual until medical help arrives.
• If the person is experiencing respiratory depression or unconsciousness, perform rescue breathing or CPR if you are trained to do so.
• Do not attempt to induce vomiting unless instructed to do so by emergency personnel.

What other information should I know?

• Avoid alcohol while using Fentanyl Nasal Spray, as it can increase the risk of side effects such as respiratory depression and drowsiness.
• Inform your healthcare provider about all medications you are currently taking, including prescription drugs, over-the-counter medications, and herbal supplements, as they may interact with Fentanyl Nasal Spray.
• Do not share Fentanyl Nasal Spray with others, even if they have similar symptoms, as it may be harmful to them.
• Follow your healthcare provider’s instructions carefully regarding dosing and administration of Fentanyl Nasal Spray.
• Keep all appointments with your healthcare provider for monitoring and dose adjustments as needed.
• If you have any questions or concerns about Fentanyl Nasal Spray, talk to your healthcare provider or pharmacist.