Fentanyl: Accidental Ingestion

Fentanyl: Accidental Ingestion 

Fentanyl has a long history of use as a synthetic narcotic analgesic as well as a drug of abuse. “Fentanyl may increase the patient’s tolerance for pain and decrease the perception of suffering, although the presence of the pain itself may still be recognized.”2 It is sold under the brand names such as Sublimaze®, Actiq®, Durogesic®, Duragesic® and more. It is available as intravenous injectable, lozenges, nasal sprays, buccal tablets, inhalers and transdermal patches. Recently, the Food and Drug Administration (FDA) approved changes to the Duragesic® transdermal patch labeling requiring the concentration (strength) and name of the compound be printed in “long-lasting ink in a color clearly visible to patients and caregivers, and has asked manufacturers of the generic versions to make the same changes. The previous ink color varied by strength and was not always easy to see”.1

The Duragesic® and generic versions of the transdermal patch are intended to contain enough slow releasing compound to provide pain relief for 3 days.1  Unfortunately, it is the transdermal patches that have found their way into the hands and mouths of children resulting in accidental exposure as well as overdose. Although, the transdermal patches were specifically named in the required change in labeling, other preparations of fentanyl such as the lozenges, buccal tablets and nasal sprays/inhalers (as well as any medication) could also be accidently ingested by children if not safely stored out of their reach. The change in labeling and increased patient education on the risk to children of improper storage and handling will hopefully save lives and prevent unnecessary exposure.

References:

  1. Food and Drug Administration (2013). Fentanyl Patch Can Be Deadly to Children. http://www.fda.gov/forconsumers/consumerupdates/ucm300803.htm
  2. European Monitoring Centre for Drugs and Drug Addiction (2013). Fentanyl.  http://www.emcdda.europa.eu/publications/drug-profiles/fentanyl

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