What are Actiq Lozenges used for?

• Actiq Lozenge is used to relieve severe pain, for example due to cancer. It comes in several different forms.
• Actiq Lozenges are used to relieve long-term, ongoing (chronic) severe pain. The fentanyl is steadily absorbed from lozenge into the bloodstream, to provide continuous relief from pain.
• Sometimes cancer pain can get worse despite using regular Actiq Lozenges - this is called 'breakthrough' pain. Fast-acting forms of fentanyl, such as tablets that dissolve under the tongue and nasal sprays, can be used to get rapid relief from severe breakthrough pain. The fentanyl is rapidly absorbed into the bloodstream from these dose forms through the rich supply of blood vessels found in the mouth or nose.
• Fentanyl may also be given by injection or drip into a vein to provide pain relief during surgery.

How do Actiq Lozenges work?

• Fentanyl is a type of strong painkiller known as an opioid or opiate. Opioids work by mimicking the action of natural pain-reducing compounds called endorphins, which are produced in the brain and spinal cord.
• Fentanyl acts on the same opioid receptors as our natural endorphins. It stops pain signals being sent by the nerves to the brain. This means that even though the cause of the pain may remain, less pain is actually felt.

Important Point

• Fentanyl has severe, potentially fatal side effects in an overdose. Never exceed the dose prescribed by your doctor. If you become very sleepy or have slow and/or shallow breathing while using fentanyl, you or your carer should contact your doctor immediately and call for emergency help. Make sure your fentanyl is always kept out of the sight and reach of children and pets.

Is fentanyl addictive?

• Yes, opioids are addictive when used recreationally. But in reality, if you're using fentanyl to relieve pain it's highly unlikely that you will get addicted to it in the psychological sense, because you're not taking it to get a 'high'.
• If you need to use fentanyl for long periods of time your body can become tolerant to it, so it may get less effective and you may then need higher doses to control pain. With prolonged use it is possible to become dependent on fentanyl. However, this is not usually a problem when you stop using it, because withdrawal symptoms can be avoided by reducing treatment gradually.
• It's important that you don't take a higher dose of fentanyl than prescribed by your doctor, or take it for longer than they recommend. When stopping treatment always follow your doctor's instructions.

Can I drink alcohol with fentanyl?

• Don't drink alcohol while using fentanyl, as this will make you more likely to get side effects like drowsiness, dizziness, confusion and blurred vision. It may also increase the risk of serious side effects such as shallow breathing with a risk of stopping breathing, and loss of consciousness.

Can I drive while using fentanyl?

• It may be an offence to drive while you are using fentanyl. Do not drive if you think it affects your ability to drive safely, for example if it makes you feel sleepy, dizzy, unable to concentrate or make decisions, or if you have blurred or double vision.
• If you are driving dangerously while using fentanyl you will be breaking the law. If you feel you are safe to drive while using fentanyl, it's sensible to carry your prescription with you in case you are asked to take a saliva test by the police. If you test positive for fentanyl there is a medical defence if you are taking it as prescribed, as long as your driving is not impaired.

Can I travel with fentanyl?

• If you want to travel abroad with fentanyl you should check its legal status in the countries you are travelling both through and to. There are legal limits on how much you can take abroad with you and if you need to take more than this limit you will have to apply to the Home Office for a licence before you travel. Even if you don't need a licence, if you're taking fentanyl abroad it's always a good idea to carry a letter from your doctor confirming your need for the medicine. Always carry it in correctly labelled packaging, as dispensed by the pharmacy.

Side effects

• Feeling drowsy, sleepy or dizzy. Do not drive if affected.
• Constipation.
• Feeling sick and vomiting.
• Abdominal pain, diarrhoea or indigestion.
• Dry mouth.
• Loss of appetite.
• Headache.
• Rash, itching, flushing or sweating.
• Feeling short of breath. If your breathing becomes slow or shallow your should contact your doctor straight away.
• Difficulty sleeping (insomnia).
• Anxiety.
• Feeling weak, tired, cold or generally unwell.
• Tremor or twitching.
• Pins and needles sensations.
• Finding it difficult to pass urine.

Uncommon fentanyl side effects

• Feeling confused or disorientated, or having problems concentrating. Do not drive if affected.
• Problems with your vision, such as blurred or double vision. Don't drive if affected.
• Pinpoint pupils.
• Mood changes, which may include feeling happy, depressed or uneasy.
• Hallucinations (seeing or hearing things that aren't really there) or paranoia.
• Reduced level of consciousness.
• Memory loss.
• Loss of sensation (numbness).
• Reduced sense of smell or taste.
• Convulsions.
• Slow or fast heart rate (bradycardia or tachycardia).
• Low blood pressure (hypotension).
• Difficulty getting an erection (erectile dysfunction).
• Rash, redness or itching of skin where you apply a fentanyl patch. Vary the site where you apply a patch as much as possible.
• Mouth, tongue, gum or lip ulcers with oral forms of fentanyl. Vary the site where you put the tablet, film or lozenge as much as possible.
• Tooth decay with Actiq lozenges. If you're using these on a regular basis make sure you pay attention to your dental hygiene to avoid potential problems.
• Runny nose, nasal discomfort or irritation, nosebleeds or ulcers inside the nose with fentanyl nasal sprays.

If you accidentally use too much fentanyl, or if you become very sleepy or have very slow and/or shallow breathing while or after using it, you or your carer should contact your doctor immediately and call for emergency help.

References:

https://medlineplus.gov/druginfo/meds/a601202.html

https://www.netdoctor.co.uk/medicines/cancer-drugs/a27506/fentanyl-side-effects/

https://olh.ie/wp-content/uploads/2014/09/Can-transdermal-fentanyl-patches-be-changed-every-48-hours-instead-of-every-72-hours.pdf

https://www.healthline.com/health/fentanyl/transdermal-patch