API

Drug classification

Opioid analgesic (phenylpiperidine opioid).

Dosage form

Injection

API strength per dosage

50MCG/ML

Dose

Adults: 50–100 mcg IV slowly over 1–2 minutes; repeat as needed. Pediatrics: 1–2 mcg/kg IV slowly; repeat as needed. Elderly or debilitated: Use lower initial doses and titrate cautiously. Adjust dose in hepatic or renal impairment; monitor closely.

Mechanism of action

Binds selectively to μ-opioid receptors (MOR, OPRM1) in the central nervous system, activating inhibitory G-proteins, reducing adenylate cyclase activity, decreasing cAMP, inhibiting voltage-gated calcium channels, and opening potassium channels, resulting in hyperpolarization and inhibition of nociceptive neurotransmitter release, producing analgesia and sedation.

Indications

Side effects

Respiratory depression, hypotension, bradycardia, chest wall rigidity, nausea, vomiting, constipation, sedation, dizziness, confusion, pruritus, urinary retention, anaphylaxis.

Pregnancy category

Category C

Precautions

Respiratory depression, opioid tolerance, risk of addiction, hypotension, bradycardia, impaired consciousness, hepatic or renal impairment, elderly or debilitated patients, concomitant CNS depressants, head injury, pregnancy and lactation, abrupt discontinuation, myasthenia gravis, increased intracranial pressure, monitoring in postoperative settings.

Contraindications

Hypersensitivity to fentanyl or components, severe respiratory depression, acute or severe bronchial asthma, known or suspected paralytic ileus, patients without resuscitative equipment or monitoring, significant central nervous system depression.