Consumer medicine information

Fentanyl Injection BP [8706]

Fentanyl

BRAND INFORMATION

Brand name

Fentanyl Solution for injection

Active ingredient

Fentanyl

Schedule

S8

 

Consumer medicine information (CMI) leaflet

Please read this leaflet carefully before you start using Fentanyl Injection BP [8706].

What is in this leaflet

This leaflet answers some of the common questions people ask about Fentanyl. It does not contain all the information that is known about Fentanyl.

It does not take the place of talking to your doctor or pharmacist.

All medicines have risks and benefits. Your doctor has weighed the risks of you being given Fentanyl against the benefits they expect it will have for you.

If you have any concerns about being given this medicine, ask your doctor or pharmacist.

Keep this leaflet.

You may need to read it again.

What FENTANYL is for

Fentanyl is a powerful drug used to relieve pain and produce sleepiness.

It can be used as a premedication before an operation, or with a general anaesthetic during an operation. It can also be used after painful operations to reduce the pain that you feel.

Fentanyl belongs to a group of medicines called opioid (narcotic) analgesics.

Fentanyl works by changing the messages that are sent to the brain about pain.

Your doctor will have explained why you are being treated with Fentanyl and told you what dose you will be given. Follow all directions given to you by your doctor carefully. They may differ from the information contained in this leaflet.

Your doctor may prescribe this medicine for another use. Ask your doctor if you want more information.

Fentanyl can be addictive, but when it is used only to relieve or prevent pain it is unlikely to become habit forming.

Before you are given FENTANYL

When you must not use it

You should not be given Fentanyl if you are pregnant or breastfeeding unless your doctor says it is safe. Ask your doctor about the risks and benefits involved.

We do not know if it is safe for you to be given Fentanyl while you are pregnant.

It may affect your baby if it is given early in pregnancy or in the last weeks before your baby is due.

We do not know if your baby can take in Fentanyl from breast milk if you are breastfeeding.

Fentanyl injection will only be used if the solution is clear, the package is undamaged and the use by (expiry) date marked on the pack has not been passed.

Before you are given it

You must tell your doctor if:

  1. you have been given Fentanyl before and had any problems with it
  2. you have any allergies to
  • any ingredients listed at the end of this leaflet
  • other strong analgesics (pain killers) eg. morphine or pethidine.
  • any other substances

If you have an allergic reaction, you may get a skin rash, hay fever or an asthma attack.

  1. you have any of these medical conditions
  • problems with your breathing such as severe asthma, severe bronchitis or emphysema.
  • a history of fits or head injuries.
  • myasthenia gravis (muscle weakness)
  • heart problems
  • liver or kidney problems

It may not be safe for you to be given Fentanyl if you have any of these conditions.

Taking other medicines

Tell your doctor if you are taking any other medicines, including medicines that you buy without a prescription at the chemist, supermarket or health food shop.

These medicines may affect the way Fentanyl works.

Your doctor or pharmacist can tell you what to do if you are taking any other medicines.

If you have not told your doctor about any of these things, tell them before you are given any Fentanyl.

How FENTANYL is given

Fentanyl will be given to you by injection by your doctor or specially trained nurse.

The injection may be given into a vein or into a muscle.

Overdose

The doctor or nurse giving you Fentanyl will be experienced in its use, so it is extremely unlikely that you will be given too much.

However, the first sign of overdosage is often muscle spasm, followed by a marked slowing of your breathing, accompanied by a bluish tinge on the skin. You will probably lose consciousness.

Fentanyl doses should be carefully worked out, so problems with overdosage are unlikely. There are other drugs, eg. naloxone or nalorphine, which can be used if needed to reverse the effects of too much Fentanyl.

Side effects

Tell your doctor or nurse as soon as possible if you do not feel well after you have been given Fentanyl.

Fentanyl helps most people suffering severe pain, but it may have unwanted side-effects in a few people. All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects.

Ask your doctor, nurse or pharmacist to answer any questions you may have.

After you have been given Fentanyl you will probably feel light-headed, dizzy, sleepy and you may feel quite strange, especially if you are not lying down.

Tell your doctor or nurse if you notice any of the following side effects and they worry you.

Fentanyl may cause

  • slowing down of breathing
  • muscle spasm

Fentanyl sometimes causes

  • changes in blood pressure (higher or lower)
  • dizziness
  • nausea (feeling sick)
  • vomiting
  • blurred vision
  • itching
  • euphoria (exaggerated sense of well-being)

Some people may get other side effects after being given Fentanyl.

Tell your doctor if you notice anything else that is making you feel unwell.

Storage

If you are storing Fentanyl at home they should be kept in the original pack in a cool dry place where the temperature stays below 30 °C.

Do not store it or any other medicine in the bathroom or near a sink.

Heat and dampness can destroy some medicines.

Keep it where young children cannot reach it.

A locked cupboard at least one-and-a-half metres above the ground is a good place to store medicines.

Do not leave it in the car on hot days.

Disposal

Make sure that you return to your doctor or pharmacist any injections that have passed the use by (expiry) date marked on the pack, or if you have any left over when your doctor says you no longer need to be given Fentanyl injections.

Product description

Fentanyl injection is a clear, colourless solution.

Each Fentanyl injection contains fentanyl citrate 50mcg/mL as the active ingredient in Water for Injection BP plus

Citric acid - anhydrous (E330)

Sodium citrate (E331)

Sodium chloride

Sodium hydroxide (for pH adjustment).

Fentanyl is available in

Polyamp® Duo Fit® 10 x 2 mL and 10 x 10mL

Manufacturer

AstraZeneca Pty Ltd
ABN 54 009 682 311
Alma Road
NORTH RYDE NSW 2113
Tel: 1800 805 342

This leaflet was prepared in February 2008.

Australian Registration Numbers:

100mcg/2mL 12100
500mcg/10mL 48369

® Trade Marks herein are the property of the AstraZeneca group

BRAND INFORMATION

Brand name

Fentanyl Solution for injection

Active ingredient

Fentanyl

Schedule

S8

 

1 Name of Medicine

Fentanyl citrate.

6.7 Physicochemical Properties

Fentanyl citrate is chemically identified as N-(1-phenethyl-4-piperidyl) propionanilide citrate, MW 528.61. The chemical formula is C22H28N2O.C6H8O7.

Chemical structure.


CAS number.

990-73-8.

2 Qualitative and Quantitative Composition

2 mL sterile solution of pH 4.0 - 7.5 containing 100 microgram of fentanyl (as citrate).
10 mL sterile solution of pH 4.0 - 7.5 containing 500 microgram of fentanyl (as citrate).
Excipient with known effect: sodium citrate dihydrate, sodium chloride, sodium hydroxide.
For the full list of excipients, see Section 6.1 List of Excipients.

3 Pharmaceutical Form

Injection solution. Clear, colourless solution.

5 Pharmacological Properties

5.1 Pharmacodynamic Properties

Mechanism of action.

Fentanyl is a opioid analgesic. A dose of 100 microgram (0.1 mg or 2.0 mL) is approximately equivalent in analgesic activity to 10 mg of morphine or 75 mg of pethidine. The principal actions of therapeutic value are analgesia and sedation. Alterations in respiratory rate and alveolar ventilation associated with opioid analgesics may last longer than the analgesic effect. As the dose of opioid is increased, the decrease in pulmonary exchange becomes greater. Large doses may produce apnoea. Fentanyl appears to have less emetic activity than either morphine or pethidine. Histamine assays and skin wheal testing in man indicate that clinically significant histamine release rarely occurs with fentanyl. Recent assays in man show no clinically significant histamine release at doses up to 50 microgram/kg (0.05 mg/kg or 1 mL/kg). Fentanyl preserves cardiac stability and blunts stress related hormonal changes at higher doses.
Fentanyl produces minimal cortical depression and may act by filling receptor sites located in the thalamus, midbrain and spinal cord. A specific morphine antagonist (e.g. nalorphine) produces reversal of respiratory, cardiovascular, miotic and motor incoordination effects and also produces reversal of analgesia, euphoria and sedation. Rigidity of the diaphragm and intercostal muscles can be eliminated by suxamethonium. Cholinergic effects such as bradycardia are reversed by atropine.
As with longer acting opioid analgesics, the duration of the respiratory depressant effect of fentanyl may be longer than the analgesic effect. The following observations have been reported concerning altered respiratory response to CO2 stimulation following administration of fentanyl to man.
1. Diminished sensitivity to CO2 stimulation may persist longer than depression of respiratory rate. Fentanyl frequently slows the respiratory rate (see Section 4.4 Special Warnings and Precautions for Use).
2. Altered sensitivity to CO2 stimulation has been demonstrated for up to four hours following a single intravenous dose of 600 microgram (12 mL) fentanyl to healthy volunteers.
3. Duration and degree of respiratory depression is dose related.
4. The peak respiratory depressant effect of a single intravenous dose of fentanyl is noted 5 to 15 minutes following injection. (See Section 4.4 Special Warnings and Precautions for Use concerning respiratory depression).

Clinical trials.

No data available.

5.2 Pharmacokinetic Properties

Absorption and distribution.

The pharmacokinetics of fentanyl can be described by a three compartment model, with a distribution time of 1.7 minutes, redistribution of 13 minutes and a terminal elimination half-life of 219 minutes. The volume of distribution for fentanyl is 4 L/kg.
The onset of action is almost immediate when the drug is given intravenously; however, the maximal analgesic and respiratory depressant effect may not be noted for several minutes. The usual duration of action of the analgesic effect is 30 to 60 minutes after a single IV dose of up to 100 microgram. Following intramuscular administration, the onset of action is from seven to eight minutes and the duration of action is one to two hours.
Fentanyl plasma protein binding capacity increases with increasing ionisation of the drug.
Alterations in pH may affect its distribution between plasma and the central nervous system. It accumulates in skeletal muscle and fat, and is released slowly into the blood.

Metabolism and excretion.

Fentanyl is primarily transformed in the liver and demonstrates a high first pass clearance with approximately 75% of an intravenous dose excreted in urine, primarily as metabolites with less than 10% representing the unchanged drug. Approximately 9% of the dose is recovered in the faeces, primarily as metabolites. Fentanyl has a terminal elimination half-life of 219 minutes.

5.3 Preclinical Safety Data

Genotoxicity.

No data available.

Carcinogenicity.

No data available.

4 Clinical Particulars

4.1 Therapeutic Indications

Short duration analgesia during premedication, induction and maintenance of anaesthesia, and in the immediate postoperative period.
Opioid analgesic supplement to general and regional anaesthesia.
Combination with a neuroleptic as an anaesthetic premedication for the induction of anaesthesia, and as an adjunct in the maintenance of general and regional anaesthesia.

4.3 Contraindications

Known hypersensitivity or intolerance to fentanyl or other opioid analgesics.
Bronchial asthma (See Section 4.4 Special Warnings and Precautions for Use).
Head injuries and increased intracranial pressure. As for any opioid analgesic, fentanyl should not be used in patients susceptible to respiratory depression, such as comatose patients who may have head injuries or brain tumour (see Section 4.4 Special Warnings and Precautions for Use). Fentanyl may obscure the clinical course of patients with head injury.
Concomitant MAO inhibitors. Severe and unpredictable potentiation by MAO inhibitors has been reported with opioid analgesics and the use of fentanyl in patients who have received MAO inhibitors within 14 days is not recommended (see Section 4.5 Interactions with Other Medicines and Other Forms of Interactions, MAO inhibitors).
Myasthenia gravis. Fentanyl may cause muscle rigidity upon IV administration. Therefore, the need for reversal with muscle relaxants contraindicates its use in patients with a history of myasthenia gravis.
Children two years of age or younger. Safe conditions for use have not been established.
Use in patients after operative interventions in the biliary tract.

4.4 Special Warnings and Precautions for Use

Adequate facilities should be available for postoperative monitoring and ventilation.
Resusciative equipment, oxygen and an opioid antagonist should be readily available to manage apnoea.
Fentanyl should only be used by experienced doctors and in patients who are under constant supervision.

Concomitant neuroleptics.

If fentanyl is administered with neuroleptics, the user should be familiar with the special properties of each drug, particularly with regard to durations of action. In addition, when such a combination is used, fluids and other countermeasures to manage hypotension should be available.

Total opioid dose.

As with other potent opioids, the respiratory depressant effect of fentanyl persists longer than the measured analgesic effect. The total dose of all opioid analgesics should be considered before additional opioid analgesics are given during recovery from anaesthesia. It is recommended that postoperative opioids, when required, should be used initially in reduced doses, as low as 1/4 to 1/3 of those usually recommended.

Muscle rigidity.

Fentanyl may cause muscle rigidity, particularly involving the muscles of respiration. This effect is related to the dose and speed of injection and may be reduced by slow intravenous injection. If this effect occurs, it may be managed by the use of assisted or controlled respiration and, if necessary, by administration of a neuromuscular blocking agent compatible with the patient's condition.
Nonepileptic myoclonic movements can occur.

Drug dependence.

Fentanyl can produce drug dependence of the morphine type and therefore has the potential for being abused.
Patients on chronic opioid therapy or with a history of opioid abuse may require higher doses to achieve an adequate therapeutic effect.

Respiratory depression.

Depression of respiration is the most marked and dangerous side effect of fentanyl. In the postoperative period, patients may exhibit delayed depression of respiration. Patients should be monitored for this possibility and appropriate countermeasures taken as necessary (see also 'Impaired respiration').

Impaired respiration.

Fentanyl should be used with caution in patients with severe impairment of pulmonary function because of the possibility of respiratory depression (e.g. chronic obstructive pulmonary disease, patients with decreased respiratory reserve or any patient with potentially compromised respiration).
In such patients, opioids may further decrease respiratory drive and increase airway resistance. During anaesthesia, this can be managed by assisted or controlled respiration.

Use of opioid antagonists for respiratory depression.

Respiratory depression caused by opioid analgesics can be reversed by opioid antagonists.
However, appropriate surveillance should be maintained because the duration of respiratory depression of doses of fentanyl employed during anaesthesia is usually longer than the duration of opioid antagonist action. Consult individual product information (nalorphine or naloxone) before employing opioid antagonists.

Impaired liver and kidney function.

Fentanyl should be administered with caution to patients with liver and kidney dysfunction because of the importance of these organs in the metabolism and excretion of drugs.

Bradycardia.

Fentanyl may produce bradycardia, and possibly asystole. Bradycardia may be treated with atropine; however, fentanyl should be used with caution in patients with cardiac bradyarrhythmias.

Sphincter of Oddi spasm.

As has been observed with all opioid analgesics, episodes suggestive of sphincter of Oddi spasm may occur with fentanyl.

Adjunct to conduction anaesthesia.

Certain forms of conduction anaesthesia, such as spinal anaesthesia and some peridural anaesthetics, can alter respiration by blocking intercostal nerves.
Through other mechanisms fentanyl can also alter respiration. Therefore, when fentanyl is used to supplement these forms of anaesthesia, the anaesthetist should be familiar with the physiological alterations involved and be prepared to manage them in patients selected for these forms of anaesthesia.

Monitoring.

Vital signs should be monitored routinely.

Use in the elderly and debilitated patients.

The initial fentanyl dose should be reduced in elderly and debilitated patients. Elderly patients may be more susceptible to adverse effects, such as respiratory depression and cardiovascular effects. They may also have age related kidney function impairment, resulting in lower clearance rates of fentanyl. Opioids should be titrated with caution in patients with any of the following conditions: uncontrolled hypothyroidism, pulmonary disease, decreased respiratory reserve, alcoholism, impaired hepatic or renal function. Such patients also require prolonged postoperative monitoring.

Hypotension.

Opioids may induce hypotension, particularly in hypovolaemic patients. Appropriate measures should be taken to maintain stable arterial pressure.

Paediatric use.

The safety of fentanyl in children younger than two years of age has not been established.

Effects on laboratory tests.

No data available.

4.5 Interactions with Other Medicines and Other Forms of Interactions

Other CNS depressants.

Other CNS depressant drugs, e.g. barbiturates, tranquilizers, benzodiazepines, alcohol, neuroleptics, opioids and general anaesthetics, will have additive or potentiating effects with fentanyl. When patients have received such drugs, the dose of fentanyl required will be less than usual. Likewise, following the administration of fentanyl, the dose of other CNS depressant drugs should be reduced (see Section 4.4 Special Warnings and Precautions for Use).

Fentanyl/ neuroleptic combination.

(See Section 4.8 Adverse Effects (Undesirable Effects)). When a neuroleptic such as droperidol is used with fentanyl, pulmonary arterial pressure may be decreased. Hypotension can occur and, possibly, hypovolaemia (which should be managed with appropriate parenteral fluids).
Repositioning of the patient to improve venous return to the heart should be considered when operative conditions permit. Care should be exercised in moving and positioning of patients because of the possibility of orthostatic hypotension. If volume expansion with fluids together with other countermeasures do not correct hypotension, the administration of pressor agents other than adrenaline should be considered. Because of the α-adrenergic blocking action of droperidol, adrenaline may paradoxically decrease the blood pressure in patients treated with droperidol.
When droperidol is used with fentanyl and the EEG is used for postoperative monitoring, it may be found that the EEG pattern returns to normal slowly.

MAO inhibitors.

Severe and unpredictable potentiation by MAO inhibitors has been reported with opioid analgesics. Since the safety of fentanyl in this regard has not been established, the use of fentanyl in patients who have received monoamine oxidase inhibitors within 14 days is not recommended (see Section 4.3 Contraindications).

Nitrous oxide.

Nitrous oxide has been reported to produce cardiovascular depression when given with high doses of fentanyl.

Amiodarone.

Profound bradycardia, sinus arrest and hypotension have occurred when patients receiving amiodarone have been given fentanyl for anaesthesia.

Adrenergic blockers and calcium channel blockers.

The combination of calcium channel blockers and beta-adrenergic blockers during fentanyl anaesthesia should be used with caution since severe hypotension has been reported to occur.

Serotonin syndrome.

Opioids can interact with antidepressants and migraine medicines to cause a serious central nervous system reaction called serotonin syndrome, in which high levels of the chemical serotonin build up in the brain and cause toxicity.

Coadministration of the following drugs may enhance or prolong the effects of fentanyl.

Azole antifungals, macrolide antibiotics and protease inhibitors such as Ritonavir.

Coadministration of the following drugs may decrease the plasma concentration of fentanyl.

Phenytoin.
Coadministration of sibutramine hydrochloride with fentanyl may increase the risk of serotonin syndrome (hypertension, hypothermia, myoclonus and mental status changes).
The concurrent administration of fentanyl and naltrexone precipitates opioid withdrawal symptoms.
See Section 6.2 Incompatibilities.

4.6 Fertility, Pregnancy and Lactation

Effects on fertility.

No data available.
(Category C)
Opioid analgesics may cause respiratory depression in the newborn infant. These products should only be used during labour after weighing the needs of the mother against the risk to the foetus. If fentanyl is nevertheless administered, an antidote should always be at hand for the child. The safe use of fentanyl has not been established with respect to possible adverse effects upon foetal development. Therefore it should be used in women of childbearing potential only when in the judgement of the physician the potential benefits outweigh the possible hazards.
Withdrawal symptoms in newborn infants have been reported with prolonged use of opioids.
Fentanyl may enter the maternal milk. Therefore, breastfeeding is not recommended for 24 hours following the administration of this drug.

4.8 Adverse Effects (Undesirable Effects)

More common.

Respiratory depression, apnoea, muscular rigidity, myoclonic movements and bradycardia, tachycardia, vein pain, dermatitis allergic.
If these remain untreated, respiratory arrest, circulatory depression or cardiac arrest could occur.
Respiratory depression is more likely to occur with intravenous administration if a dose is given too rapidly; it rarely occurs with intramuscular administration. If respiratory depression occurs during anaesthesia, assisted or controlled respiration will provide adequate ventilation without reversing analgesia. Respiratory depression can be immediately reversed by opioid antagonists (e.g. nalorphine) which, it should be noted, will also reverse analgesia. Secondary rebound respiratory depression has been observed after the operation in rare instances.
Muscular rigidity may be associated with reduced pulmonary compliance and/or apnoea, laryngospasm or bronchospasm. Prompt reversal of this effect can be achieved with the intravenous administration of an appropriate single dose of a muscle relaxant such as suxamethonium. Assisted or controlled respiration is required to provide ventilation after the use of muscle relaxants.
Bradycardia and other cholinergic effects may occur and can be controlled with the appropriate dose of atropine. The inclusion of atropine or other anticholinergic agents in the preanaesthetic regimen tends to reduce the occurrence of such effects.

Less common.

Hypotension, hypertension, dizziness, blurred vision, miosis, nausea, emesis, laryngospasm, diaphoresis, itching, euphoria, seizures, spasm of the sphincter of Oddi, anaphylaxis, headache, loss of consciousness, myoclonus, phlebitis, hyperventilation, hiccups, hypothermia, airway complications of anaesthesia, agitation postoperative. Motor stimulation and bronchospasm may occur with high doses of fentanyl. Less frequently, cardiac arrhythmias, postoperative mental depression, paradoxical CNS excitation or delirium may occur.

Fentanyl/ neuroleptic combination.

When a neuroleptic such as droperidol is used with fentanyl, the following adverse reactions can occur: chills and/or shivering, restlessness and postoperative hallucinatory episodes sometimes associated with transient periods of mental depression; extrapyramidal symptoms (dystonia, akathisia and oculogyric crisis) have been observed up to 24 hours postoperatively. When they occur, extrapyramidal symptoms can usually be controlled with antiparkinson agents.
Postoperative drowsiness is also frequently reported following the use of droperidol.
Elevated blood pressure with or without pre-existing hypertension, has been reported following administration of fentanyl combined with droperidol. This might be due to unexplained alterations in sympathetic activity following large doses; however, it is also frequently attributed to anaesthetic and surgical stimulation during light anaesthesia.

Reporting of suspected adverse reactions.

Reporting suspected adverse reactions after registration of the medicinal product is important. It allows continued monitoring of the benefit-risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions at http://www.tga.gov.au/reporting-problems.

4.2 Dose and Method of Administration

Dosage should be individualised according to age, bodyweight, physical status, underlying pathological condition, use of other drugs, type of anaesthesia to be used and the surgical procedure involved (see Section 4.4 Special Warnings and Precautions for Use). Fentanyl injection contains no antimicrobial agent. It should be used only once and any residue discarded.

Adults.

Premedication.

(To be appropriately modified in the elderly, debilitated and those who receive other depressant drugs.) 50 to 100 microgram (1 to 2 mL) may be administered intramuscularly 30 to 60 minutes prior to surgery.

Adjunct to general anaesthesia.

Induction.

50 to 100 microgram (1 to 2 mL) IV initially, repeat at two to three minute intervals until desired effect is achieved. A reduced dose of 25 to 50 microgram (0.5 to 1 mL) is recommended in elderly and poor risk patients.

Maintenance.

25 to 50 microgram (0.5 to 1 mL) IV or IM when movement and/or changes in vital signs indicate surgical stress or lightening of analgesia.

Adjunct to regional anaesthesia.

50 to 100 microgram (1 to 2 mL) may be administered IM or slowly IV when additional analgesia is required.

Postoperatively (recovery room).

50 to 100 microgram (1 to 2 mL) may be administered IM for the control of pain, tachypnoea and emergence delirium. The dose may be repeated in one or two hours as needed.

Children.

For induction and maintenance in children 2 to 12 years of age, a reduced dose of 20 to 30 microgram (0.4 to 0.6 mL)/10 kg is recommended.

Renal impairment.

Fentanyl should be used with caution.

Hepatic impairment.

Fentanyl should be used with caution.

4.7 Effects on Ability to Drive and Use Machines

The effects of this medicine on a person's ability to drive and use machines were not assessed as part of its registration.

4.9 Overdose

For information on the management of overdose, contact the Poison Information Centre on 131126 (Australia).

Symptoms.

Narcosis (which may be preceded by marked skeletal muscle rigidity), cardiorespiratory depression accompanied by cyanosis, followed by a fall in body temperature, circulatory collapse, coma and possibly death.

Treatment.

In the presence of hypoventilation or apnoea, oxygen should be administered and respiration assisted or controlled as necessary. A patent airway must be maintained.
If depressed respiration is associated with muscular rigidity, an intravenous neuromuscular blocking agent might be required to facilitate assisted or controlled respiration.
The patient should be carefully observed for 24 hours; body warmth and adequate fluid intake should be maintained.
If severe or persistent hypotension occurs, the possibility of hypovolaemia should be considered and managed with appropriate parenteral fluid therapy.
A specific opioid antagonist, such as nalorphine or naloxone, should be available for use as indicated to manage respiratory depression. This does not preclude the use of more immediate countermeasures. The duration of respiratory depression following overdosage of fentanyl is usually longer than the duration of opioid antagonist action.

7 Medicine Schedule (Poisons Standard)

S8.

6 Pharmaceutical Particulars

6.1 List of Excipients

Citric acid, sodium citrate dihydrate, sodium chloride, water for injection, sodium hydroxide for pH adjustment.

6.2 Incompatibilities

Fentanyl is incompatible with thiopentone sodium and methohexitone sodium.

6.3 Shelf Life

In Australia, information on the shelf life can be found on the public summary of the Australian Register of Therapeutic Goods (ARTG). The expiry date can be found on the packaging.

6.4 Special Precautions for Storage

Store below 25°C (2 mL ampoule).
Store below 30°C (10 mL ampoule).

6.5 Nature and Contents of Container

2 mL or 10 mL polyethylene ampoules (Polyamp DuoFit) in packs of 10.

6.6 Special Precautions for Disposal

In Australia, any unused medicine or waste material should be disposed of by taking to your local pharmacy.

Summary Table of Changes