Drugs Home > Fentanyl Sublingual Tablets Dosage

Before prescribing fentanyl sublingual tablets, your healthcare provider will consider how you respond to the drug and other medical conditions you have, among other things. There is a significant variation in the dosage that can be tolerated and that is effective at relieving pain. However, the initial dose of fentanyl sublingual tablets should be 100 mcg and then gradually increased, if necessary.

An Introduction to Your Fentanyl Sublingual Tablets Dose

The dose of fentanyl sublingual tablets (Abstral®) your healthcare provider recommends will vary, depending on a number of factors, including:
  • The type and severity of your pain
  • How you respond to the medication
  • Other medications you are taking
  • Other medical conditions you may have.
As is always the case, do not adjust your dose unless your healthcare provider specifically tells you to do so.

Initial Dosing Guidelines for Fentanyl Sublingual Tablets

The initial fentanyl sublingual tablets dosage for treating breakthrough pain is 100 mcg. If this amount adequately relieves your pain, you should continue using the 100-mcg dose for each breakthrough pain episode. If 100 mcg does not adequately relieve your pain within 30 minutes, you may take one additional 100-mcg tablet. You must then wait at least two hours before taking another dose.

How Is the Dose Adjusted?

If the initial 100-mcg tablet does not adequately relieve your breakthrough pain, your fentanyl sublingual tablet dosage can be slowly increased, until an amount is found that provides adequate pain relief with minimal side effects. This is called dose titration. Normally, fentanyl sublingual tablets are increased by 100 mcg at each breakthrough pain episode, up to 400 mcg.
If a 400-mcg dose does not adequately relieve your pain, the next increase is usually to 600 mcg. If the 600-mcg amount is ineffective, the dosage is then usually increased to 800 mcg.
During dose titration, you may be asked to use more than one fentanyl sublingual tablet at a time to get to the correct dose. You should not, however, use more than four tablets at a time.
If you are still in pain 30 minutes after using a fentanyl sublingual tablet, you may take another dose of the same strength. Do not take more than two doses to treat a breakthrough pain episode.
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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