fentanyl (nasal)

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Pronunciation: FEN tan il

Brand: Lazanda

What is the most important information I should know about fentanyl nasal?

Do not use fentanyl nasal unless you are already being treated with a similar opioid pain medicine and your body is tolerant to it. Do not use Lazanda to replace any other form of fentanyl. If you switch from another form of fentanyl, you will not use the same dose.

Fentanyl can slow or stop your breathing, and may be habit-forming. Use only your prescribed dose. Never share fentanyl with another person.

Fentanyl nasal is not for treating pain that isn't cancer-related, such as pain from surgery, dental work, or migraine headaches. MISUSE OF NARCOTIC PAIN MEDICATION CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription

Many other drugs can interact with fentanyl. Tell your doctor about all your medications and any you start or stop using during treatment with fentanyl nasal.

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

What is fentanyl nasal?

Fentanyl is an opioid pain medication. An opioid is sometimes called a narcotic.

Fentanyl nasal (for the nose) is used to treat "breakthrough" cancer pain. Lazanda is taken together with other non-fentanyl narcotic pain medicine that is used around the clock. This medication is not for treating pain that isn't cancer-related, such as pain from surgery, dental work, or migraine headaches.

Unless given in a hospital, Lazanda is available use only under a special program. You must be registered in the program and understand the risks and benefits of taking this medication.

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

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

Do not use fentanyl nasal unless you are already being treated with a similar opioid pain medicine and your body is tolerant to it. Talk with your doctor if you are not sure you are opioid-tolerant.

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.

Some medicines can interact with fentanyl and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.

To make sure fentanyl nasal is safe for you, tell your doctor if you have:

  • any type of breathing problem or lung disease;
  • a history of head injury, brain tumor, or seizures;
  • a history of drug abuse, alcohol addiction, or mental illness;
  • urination problems;
  • liver or kidney disease;
  • a blockage in your stomach or intestines;
  • problems with your gallbladder, pancreas, or thyroid; or
  • if you use a sedative like Valium (diazepam, alprazolam, lorazepam, Ativan, Klonopin, Restoril, Tranxene, Versed, Xanax, and others).

Fentanyl is more likely to cause breathing problems in older adults and people who are severely ill, malnourished, or otherwise debilitated.

It is not known whether this medicine will harm an unborn baby. If you use fentanyl 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 habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant.

Fentanyl may also cause drowsiness, breathing problems, or 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?

Do not use Lazanda to replace any other form of fentanyl, such as Abstral, Actiq, Fentora, Onsolis, Duragesic, or generic brands of fentanyl (injection, skin patch, dissolving film, or "lollipop" device).

Fentanyl may be habit-forming, even at regular doses. Never share this medicine with another person. MISUSE OF NARCOTIC PAIN MEDICATION CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Selling or giving away fentanyl nasal is against the law.

Follow all directions on your prescription label. Fentanyl can slow or stop your breathing. Never use fentanyl nasal in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Keep using your around-the-clock narcotic pain medicine but never use Lazanda together with a second form of fentanyl.

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 fentanyl nasal suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using this medicine.

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

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.

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.

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.

What happens if I miss a dose?

Since fentanyl nasal is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

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.

Fentanyl may impair your thinking or reactions. Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

Avoid using a decongestant nasal spray while you are using fentanyl nasal.

Grapefruit and grapefruit juice may interact with fentanyl and lead to unwanted side effects. Discuss the use of grapefruit products with your doctor.

What are the possible side effects of fentanyl nasal?

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

Like other narcotic medicines, fentanyl can slow your breathing. Death may occur if breathing becomes too weak.

Stop using fentanyl nasal and call your doctor at once if you have:

  • slow heart rate, weak or shallow breathing, sighing;
  • confusion, extreme fear, unusual thoughts or behavior;
  • feeling like you might pass out;
  • infertility, missed menstrual periods;
  • impotence, sexual problems, loss of interest in sex; or
  • low cortisol levels --nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.

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.

Common side effects may include:

  • nausea, vomiting, constipation; or
  • fever.

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.

What other drugs will affect fentanyl nasal?

Some drugs can raise or lower your blood levels of fentanyl, which may cause side effects or make fentanyl less effective. Tell your doctor if you also use certain antibiotics, antifungal medications, heart or blood pressure medications, or medicines to treat HIV or AIDS.

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

  • other narcotic medications --opioid pain medicine or prescription cough medicine;
  • drugs that make you sleepy or slow your breathing --a sleeping pill, muscle relaxer, sedative, tranquilizer, or antipsychotic medicine; or
  • drugs that affect serotonin levels in your body --medicine for depression, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting.

This list is not complete. Other drugs may interact with fentanyl, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

Your pharmacist can provide more information about fentanyl nasal.

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.

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