What is Actiq (Fentanyl)?

Fentanyl citrate is a narcotic pain medicine.

Fentanyl citrate treats “breakthrough” cancer pain that is not controlled by other medicines. This medication is not for short-term pain relief.

Fentanyl citrate may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Actiq (Fentanyl)?

Do not use fentanyl citrate if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects could occur.
You should not use this medication unless you are already being treated with a similar opioid pain medicine and your body is tolerant to it. Talk with your doctor if you are not sure you are opioid-tolerant.
Keep both the used and the unused Actiq units out of the reach of children. The amount of fentanyl citrate in the Actiq unit can be fatal to a child who accidentally sucks on or swallows the unit.
Seek emergency medical attention if you think you have used too much of this medicine or if anyone else has accidentally swallowed it. An overdose of this medicine can be fatal. Overdose symptoms may include weak pulse, fainting, shallow breathing, or breathing that stops.
Fentanyl citrate may be habit-forming and should be used only by the person it was prescribed for. Fentanyl citrate should never be given to another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it.
Keep track of how many Actiq units have been used from each new supply of this medicine. Fentanyl citrate is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.
Do not use more than four Actiq units per day.

What should I discuss with my healthcare provider before taking Actiq (Fentanyl)?

You should not use this medication unless you are already being treated with a similar opioid pain medicine and your body is tolerant to it. Opioid medicines include fentanyl (Actiq, Duragesic), hydrocodone (Lortab, Vicodin), hydromorphone (Dilaudid, Palladone), morphine (Kadian, MS Contin, Oramorph, and others), oxycodone (Oxycontin), oxymorphone (Numorphan, Opana), and others. Talk with your doctor if you are not sure you are opioid-tolerant.

You should not use fentanyl citrate if you have had an allergic reaction or severe side effects when using any narcotic pain medicine.

If you have any of these other conditions, you may need a dose adjustment or special tests to safely use this medication:

a breathing disorder such as asthma or chronic obstructive pulmonary disease (COPD)
a seizure disorder
a history of head injury or brain tumor
liver or kidney disease
low blood pressure, heart disease
a history of depression or other mental illness; or
a history of drug or alcohol addiction

FDA pregnancy category C. It is not known whether fentanyl citrate is harmful to an unborn baby. It could cause addiction or withdrawal symptoms in a newborn if the mother uses fentanyl citrate during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

Fentanyl citrate can pass into breast milk and may cause sleepiness or breathing problems in a nursing baby. Fentanyl citrate may also cause addiction and withdrawal symptoms in a nursing infant. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Older adults may be more sensitive to the effects of this medicine.

If you are diabetic, you should know that each fentanyl citrate lozenge contains 2 grams (one-half teaspoon) of sugar.

Actiq Side Effects

What are the possible side effects of Actiq (Fentanyl)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using fentanyl citrate and call your doctor at once if you have any of these serious side effects:

shallow breathing, slow heart rate
extreme sleepiness; or
feeling light-headed, fainting

Less serious side effects may include:

dry mouth
headache, dizziness, weakness, anxiety; or
nausea, vomiting, or constipation

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Actiq Interactions

What other drugs affect Actiq (Fentanyl)?

Cold or allergy medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety can add to sleepiness caused by fentanyl citrate. Tell your doctor if you regularly use any of these medicines, or any other narcotic pain medicine.

There are many other medicines that can cause serious medical problems if you take them together with fentanyl citrate, especially:

aprepitant (Emend)
diltiazem (Cardizem, Cartia, Dilacor, Tiazac)
verapamil (Calan, Covera, Isoptin, Verelan)
an antibiotic such as clarithromycin (Biaxin) or erythromycin (E-Mycin, Ery-Tab, E.E.S.)
an antifungal medication such as fluconazole (Diflucan), ketoconazole (Nizoral), or itraconazole (Sporanox); or
HIV medicines such as indinavir (Crixivan), fosamprenavir (Lexiva), nelfinavir (Viracept), or ritonavir (Norvir)

This list is not complete and other drugs may interact with fentanyl citrate. Tell your doctor about all medications you use. This includes prescription, over the counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

What should I avoid while taking Actiq (Fentanyl)?

Grapefruit and grapefruit juice may interact with fentanyl and lead to potentially dangerous effects. Discuss the use of grapefruit products with your doctor. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.

Actiq Dosage

How should I take Actiq (Fentanyl)?

Actiq (fentanyl citrate oral transmucosal) comes with a kit and instructions for storing and disposing of the Actiq units. Keep both the used and the unused Actiq units out of the reach of children. The amount of fentanyl citrate in the Actiq unit can be fatal to a child who accidentally sucks on or swallows the unit.

You will also receive instructions for using the medicine. Follow these instructions carefully. Do not use the medication in larger amounts or for longer than prescribed by your doctor. Your doctor may occasionally change your dose to make sure you get the best results.

The Actiq transmucosal unit is a fentanyl citrate lozenge attached to a plastic handle. Each unit is wrapped in a child-proof blister pack. Cut the blister pack open with scissors when you are ready to use the unit.

Place the medicine in your mouth between your cheek and gum, and hold the handle with your fingers. Twirl the handle to move the medicine around in your mouth while sucking on it.

Allow the medicine to dissolve in your mouth for 15 minutes. Swallow when needed. Do not bite or chew the lozenge. Do not eat or drink anything while the unit is in your mouth. If you need to use a second unit, wait at least 15 minutes after you have finished the first unit.

Do not use more than four Actiq units per day.

If you feel dizzy or sick to your stomach before the medicine has completely dissolved, stop using the unit and call your doctor.

If you switch from using Actiq to using other forms of fentanyl, you will not use the same dose. Many forms of fentanyl are given at lower doses than Actiq. If you use the same dose of each medication, you may have life-threatening overdose symptoms.

Do not stop using any other pain medicines your doctor has prescribed for you. Call your doctor if fentanyl citrate does not relieve your pain.

Fentanyl may be habit-forming and should be used only by the person it was prescribed for. Never share fentanyl with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.

Keep track of how many Actiq units have been used from each new supply of this medicine. Fentanyl is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

Do not stop using fentanyl citrate suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using fentanyl citrate.

Store at room temperature away from moisture and heat. Leave each unit in its child-proof blister pack until you are ready to use it.

Pay special attention to your dental hygiene. Fentanyl citrate can cause dry mouth leading to tooth decay.

What happens if I overdose on Actiq (Fentanyl)?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

The amount of fentanyl citrate in the Actiq unit can be fatal to a child who accidentally sucks on or swallows the unit.

Overdose symptoms may include weak pulse, fainting, shallow breathing, or breathing that stops.

What happens if I miss a dose of Actiq (Fentanyl)?

Since fentanyl citrate is used as needed, you may not be on a dosing schedule. If you are using the medication regularly, use the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose.

Do not use more than four (4) Actiq units per day.

Edited from everydayhealth.com.

Actiq (Fentanyl)