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What should I discuss with my healthcare provider before taking fentanyl (Abstral)?

Do not take fentanyl 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 each Abstral tablet can be fatal to a child.

To make sure you can safely take fentanyl sublingual, 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 personal or family 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 sublingual.

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 sublingual.

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

How should I take fentanyl sublingual (Abstral) (Abstral)?

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

If you switch to Abstral from another form of fentanyl, you will not use the same dose. You must start with the lowest dose (100 micrograms). Your doctor may change your dose to make sure you get the best results.

To use Abstral sublingual tablets:

• Keep the tablet in its blister pack until you are ready to take the medicine. Separate a single blister from the rest of the pack by tearing along the dotted lines, then peel the foil backing off. Do not push a tablet through the foil or you may damage the tablet.
• If your mouth is dry, swallow a sip of water before taking the Abstral tablet.
• Drop the tablet into the palm of your hand. Using dry fingers, place the tablet under your tongue, as far back as you can. The tablet will begin to dissolve right away.
• Do not break, chew, suck, or swallow the tablet whole. Allow it to dissolve in your mouth without chewing. Do not drink or eat anything during this time.
• You may use a second tablet 30 minutes after the first. Use only the same strength and amount you used for the first dose.
• Call your doctor if you still have pain after taking the second tablet. Do not take more than 2 tablets for each episode of breakthrough cancer pain.
• You must wait at least 2 hours after your last dose of Abstral before you can treat a new pain episode.

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

Do not stop taking Abstral 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 Abstral tablet can be fatal to a child.

Store the blister pack in its original carton at room temperature, away from heat and moisture. Throw away any unused tablets by removing them from the blister pack and flushing them down a toilet.

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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