ABSTRACT
Concurrent fentanyl pharmacotherapy with other CNS depressant pharmacotherapy will generally necessitate a reduction in the dosage of fentanyl by 25% to 75%. Adjust the dosage cautiously, according to individual patient response. When moderate or high doses of fentanyl are required, assure that resuscitative equipment and adequately prepared medical personnel are readily available for monitoring the patient’s respiratory and cardiovascular function until the patient’s response to fentanyl pharmacotherapy is known. Although initial dosages have been suggested and used clinically, transdermal fentanyl pharmacotherapy generally is reserved for patients whose chronic, severe pain (e.g., terminal cancer pain), has been adequately managed with other opiate analgesics. If transdermal fentanyl pharmacotherapy requires discontinuation, remove the system and monitor patient response carefully. Fentanyl’s onset of action is almost immediate following intravenous injection. However, its maximal analgesic and respiratory depressant actions may not occur for several minutes.
