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Fentanyl Lozenge Dosage
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Once an effective dosage is established, only one fentanyl lozenge should be used for each episode of breakthrough pain, and no more often than every four hours. You may find that, on occasion, pain is not relieved 15 minutes after completing a fentanyl lozenge dose. In those instances, you may use one additional lozenge. You must then wait at least four hours before using another lozenge for breakthrough pain.
Do not use more than four lozenges each day. Your healthcare provider may choose to increase the dose of your regularly scheduled, long-acting opioid if you experience more than four episodes of breakthrough pain a day.
Keep in mind that fentanyl lozenge doses are highly individualized. You should keep track of how often you experience breakthrough pain, and how well the lozenges work for pain relief. If several breakthrough episodes require two lozenges for successful pain relief, your healthcare provider may need to reevaluate your dosage. Further adjustments may be needed in order to continue to provide adequate pain relief with minimal side effects.
Some considerations to keep in mind during treatment with fentanyl lozenges include the following:
- This medication comes in the form of a lozenge, for oral use. The normal dosage is one fentanyl lozenge every four hours as needed for pain.
- The lozenge should be placed in the mouth, between the cheek and the lower gum. You should then suck on the lozenge and consume it over a 15-minute period. Twirl the handle often, occasionally moving the medication from one side of the mouth to the other.
- Do not bite or chew the lozenge. Doing so may cause too little of the medication to be released, resulting in less pain relief.
- You should not drink or eat anything during the 15-minute period you are using a fentanyl lozenge.
- If you are still experiencing pain 15 minutes after finishing the lozenge (30 minutes after you first start using the medication), you can use one additional lozenge. Do not use more than two lozenges for each breakthrough pain episode, or use this medication more often than four times a day.
- If you experience side effects, such as dizziness, drowsiness, or nausea, before the lozenge is completely dissolved, remove it from your mouth and dispose of it (see Actiq Storage and Disposal for information about safe disposal).
- Continue to take your regularly scheduled, around-the-clock, opioid pain medication while using fentanyl lozenges. These lozenges alone will not control your pain.
- Fentanyl lozenges can be very dangerous, and could even cause death if ingested by a child. Store this medication in a safe place, out of the reach of children (see Actiq Storage and Disposal for more information).
- This medication comes in a sealed blister package. It should be opened with scissors immediately prior to use.
- For the medication to work properly, it must be used as prescribed. Do not increase your dose or suddenly stop using this medication without your healthcare provider's approval.
- If you are unsure about anything related to your dosage, please talk with your healthcare provider or pharmacist.
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Fentanyl Lozenge Drug Information
Written by/reviewed by: Susan Lakey, PharmD, MPH
Last reviewed by: Kristi Monson, PharmD