What Is Fentanyl Citrate?

Fentanyl citrate is a very potent narcotic medication that a doctor may recommend for a patient who needs general anesthesia or has opioid tolerance and acute pain. This medication takes effect immediately and is 100 times more powerful than morphine. Patients and care providers need to exercise care when they use fentanyl citrate, as there is a risk of serious adverse reactions to the drug, including respiratory arrest and death.

This medication is available in several formats for different applications. In a hospital setting, fentanyl citrate is given in injection form. It can be used as a pre-anesthetic drug, during anesthesia, or in postoperative pain management for the patient. An anesthesiologist will determine an appropriate dosage and monitor the patient while the medication is in use for any signs of distress. One concern is the risk of apnea, where the patient will stop breathing independently because there is too much fentanyl in his system.

Doctors can also prescribe fentanyl citrate lozenges, tablets, and dissolving films for management of breakthrough pain. This is most common with cancer patients who may have extreme pain and a high tolerance for the opioids usually used to manage pain. A patient who does not respond to morphine, for example, would be a candidate for this drug. The patient takes the drug as needed for pain and receives careful instruction in how to manage the medication responsibly.

One well known formulation of fentanyl citrate for management of cancer pain is Actiq®, which comes in the form of a lollipop the patient or a caregiver can swab across the cheeks and gums. Fentanyl citrate is more effective when taken transmucosally than when injected, as it will absorb very rapidly into the bloodstream and start to deliver immediate relief. One problem with transmucosal forms of the drug is that patients may have trouble taking them if they have dry mouth or extreme nausea that makes it hard to hold drugs in the mouth while they dissolve.

Patients on this medication can experience side effects like fatigue, nausea, dizziness, and vomiting. The drug tends to cause less nausea and stomach distress than other narcotics, although patients may also have to battle gastrointestinal discomfort caused by other medications like chemotherapy drugs. Patients who have adverse reactions to opioids should discuss them with a doctor before accepting a prescription for fentanyl citrate, as there is a risk of a bad reaction to the drug.