What is Fentanyl?

Fentanyl is a medication for managing pain. Your child’s care team may choose fentanyl if one of the other pain medications is no longer providing the best symptom relief at increasing doses, or if your child experienced bothersome side effects to morphine or hydromorphone. Fentanyl can also be useful as needed for short acting pain relief just prior to procedures or activities that are expected to cause discomfort.

How is Fentanyl given?

Children can take fentanyl via a patch applied to the skin, or an injection (into the veins or under the skin) for long term pain relief. Fentanyl can also be given sublingually (under the tongue), buccally (inside the cheek pocket), or intranasally (with a special device sprayed into the nostrils) for quick and short acting pain relief. We will discuss which route will work best for your child. Further instructions will be provided on how to administer fentanyl in the way ordered for your child. Only administer via the route that was prescribed.

What is the dose?

Our team will work out a starting dose (usually based on your child’s weight), which may need to be increased or decreased depending on your child’s response. The amount of fentanyl needed varies between children.

If your child is receiving regular doses of the medication, do not stop the medication without consulting your child’s doctor or nurse practitioner. Any dose changes (increases or decreases) need to be monitored carefully with the help of your child’s medical team.

The optimal dose of fentanyl is the amount that eases your child’s pain. To provide your child with optimal pain control and minimal side effects, tell the team if you think your child still has pain.

Your child’s body may get used to a certain dose of fentanyl, and so the dose may need to be increased over time. This is called “tolerance”. A dose increase does not mean your child’s condition is getting worse or your child is becoming addicted.

Do they really need it?

Children can move about, participate in activities, and interact with family if their pain is well controlled. This improves their quality of life.

What are the side effects of fentanyl?

Irritation around the patch site: If skin is angry red or very itchy, contact Canuck Place.

  • Constipation: Children may need to take a laxative.
  • Nausea and vomiting: Nausea (feeling sick) or vomiting happens in some children but usually gets better in a few days. Some children may need to take extra medication to help with nausea.
  • Drowsiness: Many children are drowsy in the first few days after fentanyl is started or after the dose is increased, but this improves with time. Have your child avoid activities that require alertness until you see how the medication affects them.
  • Dizziness: Have your child rise slowly over several minutes from sitting or lying down.
  • Slowed breathing: Sometimes, a child’s breathing might slow down. As a result, the team will monitor changes in dose so that it doesn’t slow down more than is wanted. Contact Canuck Place if they are having difficulty breathing.
  • Dry Mouth: Chewing on ice chips and sugar free candy may help. If your child is unable to take food by mouth, then swab their mouth with a small amount of water.

Sometimes, the side effects may become uncomfortable or intolerable, or not well managed by using other medications. If this happens, your child may need to change to another similar medication instead.

If you have any questions call a Canuck Place Nurse at 604-742-3478 and for immediate assistance call the Kid’s Counter at 604-742-3475

Fentanyl pdf 294.17 kb