Monograph Details
|
|
Pain & Pyrexia
> Narcotic analgesics
|
|
ACTIQ |
| Manufacturer |
|
Cephalon, Inc. |
| Legal Classification |
|
CII |
| Pharmacological Class |
|
Opioid. |
| Generic Name |
|
Fentanyl (as citrate) 200, 400, 600, 800, 1200, 1600micrograms; units for oral transmucosal administration; raspberry-flavored. |
| Indications |
|
Breakthrough cancer pain in patients who are receiving and are tolerant to opioids (opioid tolerance is defined as taking at least 60mg of morphine/day, transdermal fentanyl 50micrograms/hour, or equianalgesic dose of another opioid for at least one week). |
| Children |
|
<16yrs: not recommended. May be fatal to children. |
| Adults |
|
≥16yrs: Place unit between cheek and lower gum, occasionally switching sides. Suck (do not chew) over 15 minutes; if excessive opioid effects occur, remove unit and reduce next dose. Initially one 200microgram unit. Titrate, evaluating dose over several episodes of pain, until a single unit provides adequate analgesia. If re-dosing for one pain episode is needed, start second unit 15 minutes after first unit is finished. Prescribe 6 units during titration. After a successful dose is determined: max 4 units/day. Discontinue gradually. |
| Contraindications |
|
Acute or post-op pain. Non-opioid tolerant patients. |
| Precautions |
|
Be fully familiar with opioid analgesia. COPD. Predisposition to hypoventilation. Head injury. Increased intracranial pressure. Bradycardia. Biliary colic. Impaired consciousness. Cardiac, renal, or hepatic disease. Elderly. Pregnancy (Cat.C). Labor & delivery, nursing mothers: not recommended. |
| Interactions |
|
Additive CNS depression with alcohol, other CNS depressants, inhibitors of CYP3A4 (e.g., azole antifungals, macrolides). Avoid within 14 days of MAOIs. May be antagonized by drugs that induce CYP3A4. Caution with respiratory depressants. |
| Adverse Reactions |
|
Nausea, somnolence, dizziness, asthenia, respiratory and/or circulatory depression, hypotension, shock. |
| How Supplied |
|
Units—24 |
|
|
|
|
