Fentanyl

Fentanyl is a powerful synthetic opioid analgesic. It is used to treat breakthrough pain, sudden episodes of pain that occur despite round the clock treatment with pain medication in cancer patients at least 18 years of age who are taking regularly scheduled doses of another narcotic or opiate pain medication, and who have grown tolerant to narcotic pain medications. Fentanyl belongs to narcotic or opiate analgesics which work by altering the nervous system and the brain’s response to pain. It is like morphine, however, 50 to 100 times stronger. It is a Schedule II prescription drug, and it is mainly prescribed to treat patients with severe pain or to manage pain after surgery.

Fentanyl is known by brand names such as Actiq®, Duragesic®, and Sublimaze® amongst others. Dr Paul Janssen, under a patent held by his company Janssen Pharmaceutica first prepared and developed Fentanyl in 1959. Fentanyl was first developed in the 1950s to fill a need for strong and rapid analgesia.

Dosage and forms:

Fentanyl is available as a lozenge on a handle, a sublingual tablet, a film, and a buccal tablet that dissolves in the mouth. Fentanyl is used as needed but not more than four times a day. Normally the doctors start the patient on a low dose and gradually increase to find the pain relief. There is very serious health warning associated with using this drug. When it comes to administering this drug, The Buccal tablets are to be swallowed whole, while being careful not to split, chew, or crush. The patients are also recommended to not chew or bite the lozenge on a handle.

ISSUE: FDA is requiring drug manufacturers for all opioid pain relievers and medicines to treat opioid use disorder (OUD) to add new recommendations about naloxone to the prescribing information. This will help ensure that health care professionals discuss the availability of naloxone and assess each patient's need for a naloxone prescription when opioid pain relievers or medicines to treat OUD are being prescribed or renewed.

The price of Fentanyl

In the USA, the consumers have to pay an average retail price of $147.61 for a generic carton of 5 patches of 25mcg/hr. in India, the same supply cost less than USD35.

How does Fentanyl work?

Fentanyl actions are similar to other opioids. It targets opioid receptor systems in the body, which are localized in the brain within specialized neuroanatomical structures. These are vital in controlling emotions, pain, and the part of the brain that is associated with addictive behaviour based on reward. Biochemically, Fentanyl is a Mu-selective opioid agonist. However, it can also activate other opioid system receptors like the delta and kappa-receptors. The activation of these Mu-receptors produces analgesia. As the medicine increases neurotransmitter dopamine levels in the reward areas of the brain, it elicits stereotypical exhilaration and relaxation effects. Often this is associated with and is typically associated with the addiction Fentanyl.

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