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Fentanyl (nasal)

Generic name: fentanyl (nasal) [ FEN-tan-il ]
Dosage form: nasal spray (300 mcg/inh)
Drug class: Opioids (narcotic analgesics)

Medically reviewed by Drugs.com on Oct 27, 2023. Written by Cerner Multum.

What is fentanyl nasal?

Fentanyl nasal (for the nose) is an opioid medication used to treat "breakthrough" cancer pain. Fentanyl nasal is not for treating pain that isn't cancer-related, such as pain from surgery, dental work, or migraine headaches.

Fentanyl nasal is given with other non-fentanyl opioid pain medicine that is used around the clock.

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

Fentanyl nasal side effects

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

Opioid medicine can slow or stop your breathing, and death may occur. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.

Fentanyl may cause serious side effects. Call your doctor at once if you have:

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Serious side effects may be more likely in older adults and those who are malnourished or debilitated.

Long-term use of opioid medication may affect fertility (ability to have children) in men or women. It is not known whether opioid effects on fertility are permanent.

Common side effects of fentanyl may include:

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.

Warnings

Do not use fentanyl nasal to replace any other form of fentanyl. If you switch from another form of fentanyl, you will not use the same dose.

MISUSE OF OPIOID MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it.

Taking opioid medicine during pregnancy may cause life-threatening withdrawal symptoms in the newborn.

Fatal side effects can occur if you use opioid medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing.

Before taking this medicine

You should not use fentanyl if you are allergic to it, or if you have:

You should not use fentanyl nasal unless you already use a similar opioid medicine and your body is tolerant to it.

Do not give this medication to anyone under 18 years old.

Tell your doctor if you have ever had:

If you use opioid medicine while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on opioids may need medical treatment for several weeks.

Do not breastfeed. Fentanyl can cause drowsiness, breathing problems, or withdrawal symptoms in a nursing infant.

How should I use fentanyl nasal?

Follow the directions on your prescription label and read all medication guides. Never use fentanyl in larger amounts, or for longer than prescribed. Tell your doctor if you feel an increased urge to take more of fentanyl.

Never share opioid medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH. Keep the medication in a place where others cannot get to it. Selling or giving away opioid medicine is against the law.

Never use fentanyl nasal together with a second form of fentanyl or to replace any other form of fentanyl (injection, skin patch, dissolving film, or "lollipop" device).

If you switch to fentanyl nasal from another form of fentanyl, you will not use the same dose. You must start with the lowest dose.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

Call your doctor if you still have pain more than 30 minutes after using the nasal spray, or if you have breakthrough pain more than 4 times in one day.

You must wait at least 2 hours after your last dose of fentanyl nasal before you can treat a new pain episode.

Do not stop using fentanyl suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

Store at room temperature, away from heat and moisture. Keep this medicine out of the reach of children. The amount of fentanyl in each bottle of Lazanda can be fatal to a child.

Do not keep leftover opioid medication. Just one dose can cause death in someone using this medicine accidentally or improperly. Read and carefully follow the instructions provided with this medicine about how to safely dispose of any unused portion.

What happens if I miss a dose?

Since fentanyl is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next dose. Do not use two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A fentanyl overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include extreme drowsiness, weak pulse, fainting, and slow breathing (breathing may stop).

What should I avoid while taking fentanyl nasal?

Do not drink alcohol. Dangerous side effects or death could occur.

Avoid driving or hazardous activity until you know how fentanyl will affect you. Dizziness or drowsiness can cause falls, accidents, or severe injuries.

Grapefruit may interact with fentanyl and lead to unwanted side effects. Avoid the use of grapefruit products.

What other drugs will affect fentanyl nasal?

You may have breathing problems or withdrawal symptoms if you start or stop taking certain other medicines. Tell your doctor if you also use an antibiotic, antifungal medication, seizure medication, or medicine to treat HIV or hepatitis C.

Opioid medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:

This list is not complete. Other drugs may affect fentanyl, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.

Popular FAQ

Any drug that is classified as an "opioid" can cause constipation. Examples of commonly prescribed opioids that may cause this side effect include morphine, tramadol, fentanyl, methadone, hydrocodone, codeine and oxycodone. Continue reading

When illegally used fentanyl is abused or taken in an overdose, this opioid can quickly be fatal because it is so potent and people are not used to its effects. Fentanyl is often laced into street drugs and consumed unknowingly by users, leading to death. Also, when it's used in combination with other central nervous system depressants like opioids, alcohol or benzodiazepines, the risk of overdose and death multiplies. Continue reading

A fentanyl overdose may result in signs and symptoms such as:

  • stupor (dazed or nearly unconscious)
  • coma (cannot be awakened, unable to speak)
  • pupil constriction
  • slowed or absent breathing (respiratory depression or failure)
  • cyanosis (bluish or purplish tint to the skin, lips or fingernails due to low oxygen levels)
  • vomiting
  • heartbeat slows or stops
  • death
Continue reading

Fentanyl test strips can be found at your local health department, at a community needle-exchange program, from reliable online sources, or even vending machines in some states. Once the strip is dipped into a sample of the drug (usually dissolved in a small amount of water), the results indicate if fentanyl is present. Follow the instructions for use on your specific test strips. Continue reading

Traces of fentanyl can stay in your system for a lot longer than it takes for the effects of fentanyl to wear off. Drug testing can detect fentanyl or its metabolites (breakdown products) in urine for 24 to 72 hours, in blood for 5 to 48 hours, and in hair for up to 3 months, but it cannot be consistently detected in saliva. Continue reading

Both illicit fentanyl and carfentanil are extremely dangerous opioids that may lead to a quick overdose and death when abused, but carfentanil is more potent than fentanyl. Multiple doses of the anti-overdose drug naloxone (Narcan) may not be effective to reverse an overdose. Continue reading

Fentanyl is an extremely potent, synthetic (man-made) opioid. It is about 50 times more potent than heroin and 100 times more potent than morphine. In contrast, heroin is 2 to 3 times more powerful than morphine. Fentanyl is a legally prescribed drug for pain in the US and is classified as Schedule II controlled substance when used for legitimate purposes. Heroin is illegal in the U.S. and is classified as a Schedule I controlled substance. Continue reading

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Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.