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What Is Fentanyl?

Also sold under the brand names Actiq, Duragesic, and Sublimaze, Fentanyl is the most heavy-duty opioid painkiller on the market. It is used as a last resort, to relieve pain no other drug can touch. Up to 100 times more potent than morphine and up to 50 times stronger than heroin, those with breakthrough cancer pain — pain that literally "breaks through" other, already used, painkillers — will be grateful it exists. When prescribed responsibly, as lozenges, transdermal patches, tablets that dissolve in the mouth or tongue, or films, fentanyl can make life bearable where it otherwise wouldn't be. 

There's good reason fentanyl comes with such a long list of warnings, however. Fentanyl is highly addictive (habit-forming), withdrawing from the drug can be extremely difficult, and when used as a street drug, it's been known to kill people during their first use. 

How To Use Fentanyl As A Prescription Drug

Strictly in accordance with your prescribing physician's instructions and the instructions on the package insert, and in no other way. This refers not only to the dose or the number of times you use fentanyl per day, but also to other limitations. Tell your doctor everything they need to know about your current lifestyle, diet, and health, other medications you use using (including herbal supplements), and any side effects you may experience while taking fentanyl. Do not consume grapefruit, in any form, while using this medication. 

Just because it's important, we'll say this again as well — do not overdose, that is, take more than you were prescribed. 

Let your doctor know if you experience any of the following side effects for a longer period of time, or severely:

  • Gastrointestinal symptoms such as an upset stomach, heartburn, and gas. 
  • Weight loss. 
  • Pain in any part of your body. 
  • Vision changes. 
  • Difficulty urinating. 
  • A dry mouth or sores in the mouth (when taking the medication orally. 
  • Mental health changes like bizarre thoughts, anxiety, strange dreams, and depression. 
  • Redness on your body. 
  • Shaking (which can indicate seizures). 

Withdrawing From Fentanyl

Because withdrawing from fentanyl can be difficult as well as dangerous, it is important to do so under the supervision of your treating doctor. (Where you have been using fentanyl as a street drug, rehab facilities are also available for you.)

Typical fentanyl withdrawal symptoms include cravings, sweating, nausea and vomiting, increased yawning, hot and cold flashes, muscle aches, anxiety, and agitation. Some people withdrawing from fentanyl can lose consciousness and aspirate their vomit, while others become dehydrated. The biggest risk of discontinuing the drug is, however, the possibility that your cravings are so strong that you cannot bear the thought of stopping the drug. If you have previously taken fentanyl as a prescription drug and are then tempted to continue it without prescription, the risk of overdose is great. 

All these difficulties mean that your withdrawal process should closely be supervised by a doctor. On your part, as a proactive patient, the best step you can take when you are having difficulty with withdrawing from fentanyl is to promptly and openly inform your treating physician. Your physician can then offer you additional help during the process. 

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