The Brand Name DUROGESIC Has Generic Salt :: Fentanyl 

DUROGESIC  Is From Company J.&J. Priced :: Rs. N.I.

DUROGESIC have Fentanyl is comes under Sub class Opioid Analgesics of  Main Class Nervous System

Main Medicine Class:: Nervous System  Sub Medicine Class :: Opioid Analgesics 

Indications for Drugs ::

Pain, Cancer pain, Anesthesia, Analgesia, Breakthrough pain

Drug Dose ::

Adult: PO Breakthrough cancer pain As a loz: Initially, 200 mcg over 15 minutes for an episode of breakthrough pain; may repeat once after 15 minutes if needed. Not more than 4 unit doses/day. IV Adjunct to general anesth Patients w/ spontaneous resp: Initial: 50-200 mcg, w/ supplements of 50 mcg. Patients w/ assisted ventilation: Initial: 300-3,500 mcg (up to 50 mcg/kg), w/ supplements of 100-200 mcg depending on response. IM Premed before anesth 50-100 mcg 30-60 mins before induction of anesth. Transdermal Intractable cancer pain Initial: Apply patch that delivers ?25 mcg/hr of fentanyl in opioid-naive patients. Adjust dose according to response. For patients who have been receiving a strong opioid, initial dose should be based on the previous 24-hr opioid requirement. Replace patch 72 hrly and apply new patch to a different site.

Contraindication ::

Hypersensitivity.

Drug Precautions ::

Myasthaenia gravis. Head injury; increased intracranial pressure; intracranial lesions; renal or hepatic impairment; neonates; opioid-nontolerant patients. Increased risk of respiratory depression in elderly, debilitated patients, patient with hypoxia or hypercapnia. Hypothyroidism, prostatic hyperplasia, inflammatory bowel disorders, bradycardia or bradyarrhythmias. Rapid IV infusion may cause skeletal muscle and chest wall rigidity, impaired ventilation or respiratory distress/arrest. Prolonged use may cause tolerance, psychological and physical dependence. Abrupt withdrawal after prolonged admin may lead to withdrawal symptoms. Lactation. Pregnancy (avoid high doses or prolonged usage).

Drug Side Effects ::

Nausea, vomiting; bradycardia, oedema, CNS depression, confusion, dizziness,drowsiness, headache, sedation, transient hypotension, peripheral vasodilation; increased intracranial pressure. High IV dose may cause chest wall rigidity. Transdermal: Rash, erythema and itching. Potentially Fatal: Respiratory depression, trunk rigidity, laryngospasm, bronchoconstriction.

Pregnancy category ::

3

Drug Mode of Action ::  

Fentanyl is a potent opioid analgesic that increases pain threshold, alters pain reception and inhibits ascending pain pathways by binding to stereospecific receptors w/in the CNS.

Drug Interactions ::

Concomitant use w/ CYP3A4 inhibitors (e.g. erythromycin, clarithromycin, troleandomycin, azole antifungals, ritonavir, amiodarone, nefazodone, aprepitant, diltiazem and verapamil) increases serum levels of fentanyl and may potentiate fatal resp depression. Increased risk of life-threatening serotonin syndrome w/ SSRIs, SNRIs and MAOIs. May reduce serum levels w/ rifamycin derivatives. Enhanced depressant effect w/ general anaesth, tranquilisers, barbiturates and narcotics. May increase excretion w/ ammonium Cl. May increase hypotensive effect w/ phenothiazines. May reduce efficacy of pegvisomant.