What Is Intranasal Fentanyl?

Amanda Barnhart

Intranasal fentanyl is a narcotic pain medication that is administered through a spray bottle positioned in the nostrils. The intranasal form of the medication is typically used to treat breakthrough pain in cancer patients who do not get relief from other, more common pain medications. Fentanyl is also available as a pill, lozenge, skin patch, and injection, though the intranasal route allows the drug to enter the bloodstream more quickly than some other forms. This allows patients to better manage their pain effectively, even when the pain is sudden and severe.

Intranasal fentanyl is administered through a spray bottle that's positioned in the nostrils.
Intranasal fentanyl is administered through a spray bottle that's positioned in the nostrils.

Fentanyl often works better than other opioid pain medications for people with cancer, particularly patients who already take morphine or oxycodone for chronic pain. Intranasal fentanyl acts on the mucus membranes in the nasal passages. The spray forms a gel inside these membranes and is then absorbed by the bloodstream.

Patients who are prescribed intranasal fentanyl are carefully monitored. This is an extremely powerful pain medication with a high risk of dependency and abuse. Doctors who consider using intranasal fentanyl on a patient must make sure that the patient is resistant to other opioid medications. The drug is powerful enough to induce a severe adverse reaction or even be fatal if used on a patient who is not tolerant to opioids or if given in improper dosage.

While the risks of intranasal fentanyl are high, it is often a desirable alternative to other forms of the drug because of how quickly it acts and how short its duration is. Each individual dose of intranasal fentanyl lasts approximately 30 to 60 minutes, making it a good choice for patients with severe intermittent pain that does not last long. Due to the different delivery method of the drug, typically it is only used in patients who require the quick, short-lasting relief. Substituting the intranasal form of the medication for another form, such as the transdermal patch or the oral medication, could result in a dangerous overdose because of how quickly the body reacts to the drug.

It is important for patients on intranasal fentanyl to communicate with their doctors about their dosages and any side effects they experience. While it’s dangerous to take more than the recommended amount of any pain medication, intranasal drugs are particularly so because it can be difficult to judge how much of the drug a patient is taking. Patients should never combine fentanyl nasal spray with any other pain medication unless advised to do so by their doctors, and they should keep their physicians informed about any other medications or supplements they take to prevent dangerous drug interactions. 

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