Sometimes we get unbearable pain, don't we? This pain is especially painful for someone living with a medical condition like cancer. At times like these, when ordinary painkillers fail to provide relief, doctors may prescribe a special, very strong medication. Today we are going to talk about one such medication, a nasal spray. This is called Fentanyl Nasal Spray.
What is Fentanyl?
Simply put, fentanyl is a very powerful painkiller. It belongs to a class of drugs called opioids. It works by blocking pain signals to the brain, reducing the sensation of pain.
This medicine is not a medicine for a common headache or backache. It is used to control breakthrough pain in people who are already taking other strong painkillers to control severe pain. That is, it is a medicine that is used only in very special cases, under medical supervision.
Things you need to tell your doctor before taking this medicine
Before giving you this medicine, your doctor will need to know your complete health history. This is because using this medicine with certain medical conditions can be risky. Therefore, if you have any of the following conditions, be sure to tell your doctor.
| Disease or condition | Why should we say it without hiding it? |
|---|---|
| Alcohol or drug addiction | This medication also carries a risk of addiction, so it's important for your doctor to be aware of it. |
| A head injury, brain tumor, or seizures | These conditions can be severe because this drug affects brain function. |
| Lung diseases, breathing difficulties such as asthma | Because fentanyl can slow breathing, it can worsen existing respiratory conditions. |
| Liver or kidney disease | Because this organ affects the process of removing drugs from the body, the dosage may need to be changed. |
| Heart disease or low blood pressure | This medicine may further lower blood pressure or affect heart rate. |
| Mental illness, pregnancy, or breastfeeding | In these cases, medical advice is essential as the effects of the medication on the mother and child may be different. |
| Allergies to other drugs, foods, or substances | It is important to know if you are allergic to fentanyl or any of the ingredients in it. |
How should I use this medicine?
This is a nasal spray. The most important thing is to use it exactly as your doctor tells you, and only in the amount he tells you. Do not use it more often or in a larger amount than prescribed. If you are not sure how to use the spray correctly, ask your doctor again.
This is a medicine prescribed for you only. Never, under any circumstances, share this medicine with anyone else or give it to anyone else. It is very dangerous and illegal.
What if I overdose?
If you think you have taken more medicine than you think, immediately call the National Poisons Information Centre at the Colombo National Hospital, or go to the ETU (Emergency Treatment Unit) of the nearest hospital. This is not something to delay.
Other things that may interact with the medication
This is very important. Fentanyl is a powerful drug that can react with many other medications and even some foods and drinks, causing serious side effects.
- It is very dangerous to take this medicine with alcohol .
- Some medicines for colds, coughs, and allergies (Antihistamines)
- Medication for anxiety or sleep
- Some medications used for depression
- Some antiviral medications taken for HIV or AIDS
- Some antifungals and antibiotics
- Grapefruit juice
- Other opioid medications for pain or cough
This list is not complete. Therefore, be sure to tell your doctor about all the medications you take (including vitamins, traditional medicines, and supplements), as well as your habits (drinking alcohol, smoking), without hiding anything.
Things to keep in mind when using the medicine
- The difference between tolerance and addiction: When you take this medication for a long time, you may find that the dose that worked for you before is no longer enough. This is called 'tolerance'. This is normal, not addiction. Addiction is the use of a medication for pleasure without a medical reason. Just because you are taking the medication for pain does not make it addictive. If you need to change the dose, that is up to your doctor.
- Do not stop suddenly: Do not stop taking the medication suddenly without your doctor's advice. Doing so can cause severe side effects (withdrawal symptoms). If you do stop, you should reduce the dosage gradually, as your doctor tells you.
- Be aware of Naloxone: This is an emergency treatment for an opioid overdose. Talk to your doctor about this medication, how to get it, and how to use it. It's important to make your family aware of this as well.
- Drowsiness and dizziness: This medication may make you feel drowsy and dizzy. Therefore, avoid driving or operating machinery until you know how it affects you. If you are an elderly person, get up and sit down frequently to reduce the risk of falling.
- Constipation: Constipation is a very common side effect of this medication. If you have difficulty having a bowel movement for more than 3 days, talk to your doctor.
What are the possible side effects?
| Side effect | Description |
|---|---|
| Serious side effects that should be reported to your doctor or ETU immediately | |
| Allergic reactions | Skin rash, itching, swelling of the face, lips, tongue or throat. |
| Central nervous system depression (CNS depression) | Breathing that is very slow or shallow, difficulty breathing, extreme drowsiness, unconsciousness, inability to wake up. |
| Low blood pressure | Severe dizziness, fainting, blurred vision. |
| Side effects that usually go away, but should be reported to the doctor if they persist | |
| Constipation | Dry, hard stools. |
| Dizziness/Drowsiness | Feeling light. |
| Nausea/Vomiting | Feeling sick to your stomach. |
How to keep medicine safe?
Never leave this in a place where small children or pets can get hold of it. It can be fatal if used by a small child. Therefore, always keep this medicine in a safe place that can be locked and closed.
It is also important to safely dispose of unused and expired medications. Some pharmacies or government agencies have programs to take back these medications. If you can't find a way to do so, it is recommended to flush them down the toilet. This is to prevent someone else from accidentally using them because of the potency of these medications.
Take-Home Message
- Fentanyl nasal spray is a very powerful medication for severe pain. Follow your doctor's instructions carefully.
- Tell your doctor about all other medications, vitamins, and your habits (such as drinking alcohol) without hiding anything.
- Avoid driving and performing tasks that require attention after taking this medication, as drowsiness and dizziness may occur.
- Never share this medicine with others. Store in a safe place out of the reach of children and pets.
- If you experience a severe side effect such as difficulty breathing, excessive drowsiness, or inability to wake up, go to the ETU (Emergency Treatment Unit) immediately.
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