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What should I discuss with my healthcare provider before using fentanyl nasal (Lazanda)?

Do not use fentanyl nasal if you have used an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate) in the last 14 days.

Tell your doctor if there are children living in the home where you will store this medicine. Keep out of the reach of children. The amount of fentanyl in Lazanda can be fatal to a child.

To make sure you can safely use fentanyl nasal, tell your doctor if you have any of these other conditions:

• a breathing disorder such as wheezing, asthma, or chronic obstructive pulmonary disease (COPD);
• seizures, epilepsy, or a history of head injury or brain tumor;
• low blood pressure, slow heartbeats or other heart rhythm disorder;
• mental illness such as depression, schizophrenia, or hallucinations;
• liver or kidney disease;
• any type of debilitating condition; or
• a history of drug or alcohol addiction.

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.

FDA pregnancy category C. It is not known whether fentanyl will harm an unborn baby. Fentanyl may cause breathing problems, seizure, or addiction and withdrawal symptoms in a newborn if the mother takes the medication during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant while using fentanyl nasal.

Fentanyl may also cause drowsiness, breathing problems, or addiction and withdrawal symptoms in a nursing infant. Do not breast-feed while you are taking fentanyl nasal.

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

How should I use fentanyl nasal (Lazanda)?

Use exactly as prescribed. Never use fentanyl nasal in larger amounts, or for longer than recommended by your doctor. Keep using your around-the-clock narcotic pain medicine but never use Lazanda together with a second form of fentanyl.

This medication comes with patient instructions for safe use, and directions for priming and disposal of the nasal spray. Ask your doctor or pharmacist if you have any questions.

If you switch to Lazanda from another form of fentanyl, you will not use the same dose. You must start with the lowest dose (100 micrograms).

The usual starting dose of fentanyl nasal is 1 single spray into 1 nostril. Your doctor may change your dose to make sure you get the best results. Follow dosing instructions very carefully. Do not use more than one dose for each episode of breakthrough cancer pain.

Call your doctor if you still have pain within 30 minutes after using the nasal spray. Do not use the nasal spray more than 4 times in 24 hours. You must wait at least 2 hours after your last dose of fentanyl nasal before you can treat a new pain episode.

Do not treat more than 4 pain episodes per day with fentanyl nasal. Call your doctor if you have breakthrough pain more than 4 times in one day.

Do not stop using Lazanda or your other narcotic pain medicine without your doctor's advice. Ask your doctor how to avoid withdrawal symptoms when you stop using pain medication.

Keep out of the reach of children. The amount of fentanyl in each bottle of Lazanda can be fatal to a child.

Store at room temperature, away from heat and moisture. Keep the bottle tightly closed and stored in the child-resistant container when not in use.

Do not use a bottle of Lazanda that has not been used for 5 days or longer. Once you have primed a spray bottle, throw it away after 14 days, even if there is still medicine left in it.

Keep track of the amount of medicine used from each carton. Fentanyl is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

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