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Fentanyl Sublingual Spray Dosage

Fentanyl Sublingual Spray Dosing Titration

If the initial 100-mcg dosage did not adequately relieve your breakthrough pain, your dosage will be slowly increased, until a dose is found that provides adequate pain relief with minimal side effects. This is called dose titration.
 
Normally, fentanyl sublingual spray is increased to 200 mcg, and then 400 mcg if necessary. If a 400-mcg dosage does not adequately relieve your pain, the next dosage increase is usually to 600 mcg. If this amount is ineffective, the dose is then usually increased to 800 mcg.
 
If you are still in pain 30 minutes after using fentanyl sublingual spray, you may take another dose of the same strength. Do not use more than two doses to treat a breakthrough pain episode.
 

Fentanyl Sublingual Spray Maintenance Dosage

Once an effective dosage is found, your healthcare provider will prescribe the appropriate fentanyl sublingual spray strength that will allow you to use only one spray for each breakthrough pain episode. This is your maintenance dosage. If, on occasion, your pain is not relieved 30 minutes after using your maintenance dose, you may use one additional spray. You must then wait at least four hours before taking another fentanyl sublingual spray dose for breakthrough pain.
 
If you find that your maintenance amount does not adequately manage your pain for several breakthrough episodes in a row, contact your healthcare provider. You may need another dose increase.
 
Do not use fentanyl sublingual spray more than four times a day. If you experience more than four episodes of breakthrough pain episodes each day, your healthcare provider may choose to increase your scheduled (around-the-clock) opioid dosage.
 

General Information on Using Fentanyl Sublingual Spray

Some considerations to keep in mind include the following:
 
  • This medication comes in the form of a liquid that is sprayed under the tongue. It is usually taken no more often than every four hours as needed for breakthrough pain.
 
  • Do not use more than two doses of this medication (30 minutes apart) for each breakthrough pain episode. Also, do not use it more than four times in a day (once you have found a successful dosage).
 
  • Continue to take your regularly scheduled, around-the-clock, opioid pain medication. Fentanyl sublingual spray alone will not control your pain.
 
  • Each dose comes in its own spray bottle, in a blister package. Keep the medication in the sealed blister unit until just before use.
 
  • This medication may be very dangerous, and even fatal, if ingested by a child or someone for whom it was not prescribed. Store the unopened blisters in a safe place, out of the reach of children (see Subsys Storage and Disposal for more information).
 
  • Each package of fentanyl sublingual spray contains everything you need to safely dispose of the used medication. Please follow the disposal instructions closely, as used bottles can pose a dangerous risk, especially for children. This is because the used bottles are no longer protected by the blister packaging, and they may still contain enough medication to cause a fatal overdose.
 
  • For the medication to work properly, it must be used as prescribed. Do not stop using this medication suddenly, or increase your dosage without your healthcare provider's approval.
 
  • If you are unsure about anything related to dosing with fentanyl sublingual spray, please talk with your healthcare provider or pharmacist.
What Your Pharmacist Wishes You Knew About Chronic Pain Medications

Fentanyl Sublingual Spray Information

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