{"id":3987,"date":"2025-03-31T18:11:54","date_gmt":"2025-03-31T18:11:54","guid":{"rendered":"https:\/\/kidneydiseaseclinic.net\/kdc\/fentanyl-txt\/"},"modified":"2025-03-31T18:11:54","modified_gmt":"2025-03-31T18:11:54","slug":"fentanyl-txt","status":"publish","type":"post","link":"https:\/\/kidneydiseaseclinic.net\/kdc\/fentanyl-txt\/","title":{"rendered":"Fentanyl.txt"},"content":{"rendered":"

Fentanyl<\/h1>\n

CLINICAL USE <\/H3>
\nOpioid analgesic:Short surgical procedures Ventilated patients Chronic intractable pain

DOSE IN NORMAL RENAL FUNCTION <\/H3>IV injection: with spontaneous respiration: 50\u2013 \u2014200 mcg, then 50 mcg as requiredwith assisted ventilation: 0.3\u20133.5 mg, \u2014then 100\u2013200 mcg as required

IV infusion <\/H4>: with spontaneous respiration: \u201450\u201380 nanograms\/kg\/minute adjusted according to responsewith assisted ventilation: 10 mcg\/kg \u2014over 10 minutes, then 0.1\u20133 mcg\/kg\/minuteTopical (chronic pain): 12\u2013300 mcg\/hour, patches changed every 72 hoursLozenges: 200\u2013800 mcg over 15 minutes repeated after 15 minutes if required; maximum 2 doses per pain episode and 4 doses daily

PHARMACOKINETICS <\/H3>
  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :336.5<\/li>\n
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :80\u201385<\/li>\n
  • %Excreted unchanged in urine &nbsp &nbsp : <7<\/li>\n

  • Volume of distribution (L\/kg) &nbsp &nbsp &nbsp :4<\/li>\n

  • half-life \u2013 normal\/ESRD (hrs)&nbsp &nbsp &nbsp :2\u20137\/Possibly increased

    DOSE IN RENAL IMPAIRMENT <\/H3>

    GFR (mL\/MIN)<\/H4>
  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function Titrate according to response
  • 10 to 20 &nbsp &nbsp : 75% of normal dose. Titrate according to response
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : 50% of normal dose. Titrate according to response

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES <\/H3>
  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR <10 mL\/min <\/p>\n
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in GFR <10 mL\/min
  • HDF\/high flux &nbsp :Not dialysed. Dose as in GFR <10 mL\/min
  • CAV\/VVHD &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR=10\u201320 mL\/min

    IMPORTANT DRUG INTERACTIONS <\/H3>Potentially hazardous interactions with other drugs\n
  • Antidepressants: possible CNS excitation or depression (hypertension or hypotension) in patients also receiving MAOIs (including moclobemide) \u2013 avoid concomitant use; possibly increased sedative effects with tricyclics\n
  • Antivirals: concentration increased by ritonavirSodium oxybate: enhanced effect of sodium oxybate \u2013 avoid concomitant use

    ADMINISTRATION <\/H3>

    Reconstition<\/H4>_

    Route <\/H4>IV, IM, topically, oral

    Rate of Administration <\/H4>\u2013

    Comments<\/H4>Compatible with sodium chloride 0.9% and glucose 5%

    OTHER INFORMATION <\/H4>For short surgical procedures the degree of renal impairment is irrelevantFor other indications, renal impairment may have a moderate effect on the elimination of the drug; however, as fentanyl is titrated to response the usual dose and method of administration remains valid.
    \n","protected":false},"excerpt":{"rendered":"

    Fentanyl CLINICAL USE Opioid analgesic:Short surgical procedures Ventilated patients Chronic<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[7],"class_list":["post-3987","post","type-post","status-publish","format-standard","hentry","category-blog","tag-post-by-auto-php"],"_links":{"self":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/3987","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/comments?post=3987"}],"version-history":[{"count":0,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/posts\/3987\/revisions"}],"wp:attachment":[{"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/media?parent=3987"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/categories?post=3987"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kidneydiseaseclinic.net\/kdc\/wp-json\/wp\/v2\/tags?post=3987"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}