Approved Hospital Formulary
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Approved Hospital Formulary
Search results for:
fentanyl
fentaNYL
- Formulary Narcotic - Oral Formulary
| Drug Name | Form | Strength | Formulary Unrestricted | Formulary Restricted | Non-Formulary | Interchange |
|---|---|---|---|---|---|---|
| Onsolis | FILM, BUCCAL | 200 mcg, 400 mcg, 600 mcg, 800 mcg, 1200 mcg | ||||
| Duragesic | FILM, EXTENDED RELEASE, TRANSDERMAL | 12 mcg/hr, 25 mcg/hr, 50 mcg/hr, 75 mcg/hr, 100 mcg/hr | ||||
| Actiq | LOZENGE, ORAL TRANSMUCOSAL | 200 mcg, 400 mcg, 600 mcg, 800 mcg, 1200 mcg, 1600 mcg | ||||
| Sublimaze | SOLUTION, INJECTABLE | 50 mcg/mL | ||||
| Lazanda | SPRAY, NASAL | 100 mcg/inh, 400 mcg/inh | ||||
| Subsys | SPRAY, SUBLINGUAL | 1,200 mcg, 1,600 mcg | ||||
| Subsys | SPRAY, SUBLINGUAL | 100 mcg, 200 mcg, 400 mcg, 600 mcg, 800 mcg | ||||
| Fentora | TABLET, BUCCAL | 100 mcg, 200 mcg, 300 mcg, 400 mcg, 600 mcg, 800 mcg | ||||
| Actiq, Abstral | TABLET, SUBLINGUAL | 100 mcg, 200 mcg, 300 mcg, 400 mcg, 600 mcg, 800 mcg |
Last updated: Jan. 23, 2020
- Black Box Warning: Buccal Tablet: Serious adverse events, deaths; abuse potential
- Black Box Warning: Nasal Spray: Schedule II Controlled Substance: Abuse potential
- Black Box Warning: Sublingual Spray: Risk of respiratory depression, medication errors, abuse potential
- Black Box Warning: Transdermal: High concentration of Schedule II opioid agonist
FentaNYL patch orders are restricted to the following FDA approved indications: continuation of a home medication, conversion of chronic opioids according to the package insert, or dose increases of existing patch according to the package insert. Off label use is restricted to patients with an active AND/DNR order receiving comfort care only. See verification guidelines below:
FentaNYL Patch Verification Guidelines
FentaNYL patch restrictions reviewed: August 27, 2019
fentaNYL intranasally - This dosage form is prepared from the injection and used for procedural sedation and analgesia in pediatric patients and in adult ER patients via a mucosal atomization device. Onset of action is 2-5 minutes and duration of effect is 30-60 minutes. It was approved for formulary use for the above listed indications.
Transmucosal immediate release fentaNYL (TIRF) products include ACTIQ, FENTORA, ONSOLIS, ABSTRAL, SUBSYS, and LAZANDA. The formulary agent is generic ACTIQ (buccal lollipop). All other products are non-formulary, not stocked. If a TIRF product other than ACTIQ is ordered, the patient may use his/her own supply. If this is not possible, conversion to generic ACTIQ should be considered; NOTE: THE CONVERSION RATIO BETWEEN DOSAGE FORMS IS NOT 1:1 DUE TO BIOAVAILABILITY DIFFERENCES. Other options for breakthrough pain control could be considered, including parenteral narcotics. In rare situations where one of the non-stocked TIRF products is deemed necessary, it may be ordered as a non-formulary item for that particular patient.
DETERRA INFORMATION:
Deterra drug deactivation system is to be used for the disposal of fentaNYL patches. When a patch is placed inside the pouch and water is added the drug is deactivated. The sealed pouch is then discarded in the regular trash. The Deterra pouch is removed from pyxis by the nurse under the patient's name with a witness.
Deterra Drug Deactivation Pouch Disposal
Deterra Drug Deactivation Pyxis Removal
Reviewed: October 25, 2006 (FENTORA) and November 15, 2011 (intranasal fentaNYL) and April 24, 2012 (TIRF products)
REMS (Duragesic): View FDA REMS Info
REMS (Abstral, Actiq, Fentora, Lazanda, Onsolis, Subsys): View FDA REMS Info