Fentanyl, Transmucosal

What are other names for this medicine?

Generic and brand names: fentanyl, transmucosal; Actiq

What is this medicine used for?

This medicine, in the form of a lozenge that looks like a lollipop, is used to treat breakthrough cancer pain.

What should my health care provider know before I take this medicine?

Before using this medicine, tell your health care provider if you have:

• allergies
• head injury
• heart disease
• intestinal disease
• kidney disease
• liver disease
• lung disease
• seizures.

Females of childbearing age: Tell your health care provider if you are pregnant or breast-feeding. Do not breast-feed while taking this medicine without your health care provider's approval.

How do I take it?

Use this medicine exactly as your health care provider prescribes. Using too much of this medicine can be dangerous. Your health care provider will adjust your dosage until the lowest and most effective dosage is determined. Do not stop taking this medicine without your health care provider's approval. You may have to gradually reduce your dosage.

Read the instructions that come in the package with the medicine.

• Keep the medicine in the sealed child-proof pouch until you are ready to use it.
• Open the foil package with scissors right before you use it.
• Place the medicine in your mouth between your cheek and lower gum. Move the medicine from one side to the other using the handle.
• The medicine should be gently sucked and allowed to dissolve (melt) slowly between your check and gum. Do not chew the unit.
• Allow the medicine to dissolve over a 15-minute period.
• Do not swallow the white plastic matrix attached to the handle.

What should I watch out for?

This medicine can be fatal to a child. Keep this medicine out of the reach of children and discard properly. See the disposal instructions that come in the medicine package.

If you need emergency care, surgery, or dental work, tell the health care provider or dentist you are taking this medicine.

This medicine may make you dizzy or drowsy. Do not drive or operate machinery unless you are fully alert.

You may feel dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may help.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your health care provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your health care provider right away. If you are unable to reach your health care provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives, itching, rash, tightness in your chest, trouble breathing).

Serious (report these to your health care provider right away): Cold, clammy skin; seizures; feeling faint; pinpoint pupils of the eyes; blurred vision; severe dizziness, drowsiness, nervousness, restlessness, or weakness.

Other: Dizziness, nausea, vomiting, itching, flushing, constipation, trouble urinating.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your health care provider if you are taking:

• antihistamines or medicine for hay fever, allergies, or colds
• erythromycin (E-Mycin)
• itraconazole (Diflucan)
• ketoconazole (Nizoral)
• MAO inhibitors such as furazolidone (Furoxone), phenelzine (Nardil), procarbazine (Matulane), selegiline (Eldepryl), and tranylcypromine (Parnate) (Do not take an MAO inhibitor and this medicine within 14 days of each other.)
• medicine for seizures such as phenytoin (Dilantin), carbamazepine (Tegretol), primidone (Mysoline), phosphenytoin (Cerebyx), and valproic acid (Depakote, Depakene)
• muscle relaxants such as cyclobenzaprine (Flexeril), baclofen (Lioresal), and dantrium sodium (Dantrium)
• ritonavir (Norvir)
• sedatives such as phenobarbital, amobarbital (Amytal), butalbital (Butisol), and flurazepam (Dalmane)
• tranquilizers such as diazepam (Valium), chlordiazepoxide, (Librium), alprazolam (Xanax), and chlorazepate (Tranxene)
• sleeping pills such as pentobarbital (Nembutal), secobarbital (Seconal), triazolam (Halcion), temazepam (Restoril), zaleplon (Sonata), zolpidem (Ambien), and estazolam (ProSom)

Do not drink alcohol while you are taking this medicine.

The effects of this medicine may be increased if you take it with grapefruit juice. Discuss this with your health care provider.

Keep a list of all your medicines (prescription, nonprescription, supplements, natural remedies, and vitamins) with you. Be sure that you tell all health care providers who treat you about all the products you are taking.

How should I store this medicine?

Keep the medicine in the sealed child-proof pouch until you are ready to use it. Store it at room temperature. Protect from heat, high humidity, and bright light.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your health care provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicine in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.