Fentanyl

General

• Type: Opioids
• Dosage Forms: IV, intranasal, transdermal
• Common Trade Names: Sublimaze

Adult Dosing

• Analgesia: 1-2 mcg/kg IV/IM, q30-60 min PRN
• Sedation: 1-3 mcg/kg/hr continuous infusion
• Dosing based off total body weight

Pediatric Dosing

• 0.5-2 mcg/kg IV/IN q1-2 hr

Special Populations

• Pregnancy Rating: C
• Lactation: Excreted in breast milk, not recommended
• Renal Dosing
  • Adult
    • Not defined
  • Pediatric
    • Not defined but recommendations for IV:
      • GFR > 50 mL/minute/1.73 m²: no adjustment
      • GFR 10 to 50 mL/minute/1.73 m²: 75% of usual dose
      • GFR < 10 mL/minute/1.73 m²: 50% of usual dose
      • Hemodialysis: 50% of usual dose
• Hepatic Dosing
  • Adult
    • Not defined
  • Pediatric
    • Not defined

Contraindications

• Allergy to class/drug

Adverse Reactions

Serious

• Apnea

Common

• Confusion
• Constipation
• Nausea/Vomiting
• Somnolence
• Sweating
• Asthenia

Pharmacology

• Half-life: 2-4 hours
• Metabolism: Hepatic
• Excretion: Renal
• Mechanism of Action: Narcotic opiate receptor agonist

Indications by Condition

The following table is automatically generated from disease/condition pages across WikEM.

Indication	Dose	Context	Route	Population
Acute pain management	1.0 mcg/kg IV; titrate 25-50 mcg IV q2-3min	Step 3 - Severe pain (opioid, short-acting)	IV	Adult
Procedural sedation	0.5-1 mcg/kg	Procedural sedation (with midazolam)	IV	Adult
Procedural sedation	0.5-1 mcg/kg	Procedural sedation (with etomidate)	IV	Adult
Procedural sedation	0.5-1 mcg/kg	Procedural sedation (with brevital)	IV	Adult
Rapid sequence intubation	3 mcg/kg	Premedication	IV	Adult

See Also

• Intranasal sedation