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Generic name: fentanyl (sublingual) 
Name of the brand: Abstral, Fentora, Subsys
Drug class: Narcotic analgesics

What is Abstral?


Abstral is an opioid painkiller. Sometimes, opioids are referred to as a Narcotic.

Abstral sublingual tablets are utilized in the treatment of “breakthrough” cancer pain that isn’t managed by other drugs.

Sublingual tablets are laid on the surface of your mouth, under the tongue (sublingual) and then allowed to disintegrate.

Abstral is not a treatment for the pain that isn’t related to cancer.


Fentanyl can cause breathing to slow or stop and can cause dependence. Make sure you only take the dose prescribed by your doctor. Do not give away Abstral with a person else.

The misuse of this medication could lead to addiction, overdose or even death, particularly for children or any other user of the medication without prescription.

Side effects that are fatal can be experienced if you take this medication in combination with alcohol or other substances that can cause drowsiness, or slow breathing.

Before taking this medication, following point should be consider in mind.

  • A clinically significant respiratory or CNS depressions can be experienced. Check patients regularly for any signs of CNS depression.
  • Do not change patients on a mg per mcg basis from a different Fentanyl-based product to Abstra.
  • Abstra is a fentanyl-containing dosage that could be fatal for a child. Make sure that the product is properly stored and disposed of.
  • Combining it together with other CNS depressants as well as powerful Cytochrome P450 3A4 inhibitors can cause depressant-related effects such as hypotension, hypoventilation, and deep sleepiness. Make adjustments to dosage if needed.
  • Titrate Abstra carefully in patients suffering from chronic obstructive lung disease or other medical conditions that may predispose them to hypoventilation. Also, in patients who are susceptible to CO2 retention effects that affect the intracranial area.

Before taking this medication, you must consult your physician

Do not take Abstral unless you’re already taking an opioid medication that is available 24/7 and you are tolerant of this. You should not take Abstral when you have an allergy to fentanyl, or you are:

  • severe asthma or breathing problems;
  • A bowel obstruction or stomach (including an ileus that is paralytic).

To be sure Abstral is suitable for you, ask your physician if you’ve previously had:

  • breathing issues sleep apnea
  • any breathing issue or lung disease
  • an injury to the head, a seizures or brain tumors;
  • Low blood pressure heartbeats that are slow or other heart rhythm disorders;
  • Addiction to alcohol or drugs or schizophrenia or hallucinations;
  • kidney disease or liver failure;
  • Problems with urination and
  • troubles that concern your gallbladder, thyroid or the pancreas.

Inform your doctor whether there are children within the home in which you’ll store this medicine. The quantity of fentanyl present in this medication could be fatal to children.

If you are using Abstral during pregnancy the baby may become dependent to the medication. This can cause dangerous withdrawal symptoms for the infant after it is born. Baby’s who become dependent on habit-forming medications could require medical treatment for a period of time. Inform your doctor if are pregnant or are planning to be pregnant.

Do not breastfeed when you take this medication.


How to take  Abstral?

Abstral is dissolved under the tongue and is taken up by your body in order to ease your cancer discomfort.

Follow the directions on the prescription label. Fentanyl can cause a slowing or stopping of your breathing. Do not use this medication in greater quantities or for longer than the time prescribed. Inform your physician in the event that the medicine appears to be unable to work in relieving discomfort.

Fentanyl can be a habit-forming drug even when taken in regular doses. Don’t share this medication with a person you know, particularly one with a history addiction or abuse. Misuse of narcotics can cause addiction or overdose, or even death particularly in those who is taking the medication without prescribed prescription. Selling or giving Abstral to others is prohibited by law.

Take note of all information for patients such as medication guides, instructions sheets that you receive. Consult your physician or pharmacist for any additional concerns.

If you’ve used a different form of Fentanyl (injection or peel patch or “lollipop” gadget) Your sublingual or buccal dose could be different.

Abstral is packaged in a blister card that includes the blister unit of four. Each blister comes with the Abstral tablet. It is essential to keep the tablet inside the unit till you’re ready to take it out for use.

If you experience an episode of intense pain you should take the dosage recommended by your doctor in the following manner:

  • In case your mouth has dryness, drink a glass of water to make it moister. Spit out or take the water. Clean your hands, if they’re damp prior to handling Abstral tablets.
  • When you are ready take your tablet, tear off any of the units of the blister card and tear it across the lines of dotted line (perforations) until it’s completely separated.
  • Once the blister has completely separate then peel off the foil, starting from the unsealed region where it is marked. Remove the tablet gently. Don’t try pushing Abstral tablet through foil. This could damage the tablet.
  • Once you’ve removed your Abstral tablet from its blister Place it in the surface of your mouth underneath your tongue as far as you are able to. Avoid chewing, sucking, or chew on the tablet. Allow the tablet to disintegrate completely. Don’t drink or eat any food until it has dissolves under your tongue, and you are able to not taste it inside your mouth.
  • When more than one tablet are needed then spread them out on the mouth’s floor beneath your tongue.

You should not take at least two doses Abstral in each instance of cancer-related pain that is sudden and intense.

You should take one dose in the event of an incident of cancer that is causing breakthrough pain. If the pain that you experience during your breakthrough isn’t relieved within 30 minutes following the administration of your first dosage of Abstral You can add a dose according to the instructions advised by your physician.

If the pain that you feel during your breakthrough isn’t getting better even after the 2nd dose Abstral contact your physician for directions. Don’t take a second dose right now.

Take at least 2 hours before treating a fresh attack of cancer pain using Abstral.

If you are only required to take a single dose of Abstral to treat an episode of pain that is breakthrough and you are waiting 2 hours after the date of that dose to get the next dose in case of pain breakthrough.

If you are required to have two doses to treat an episode of pain that is breakthrough it is recommended to wait two hours following the second dose to get the next dose in order to prevent a second period of breakthrough pain.

It is crucial to take your 24-hour opioid pain medication when you take Abstral.

Discuss with your doctor If you experience more than four instances of pain from cancer that is a breakthrough each day. The dosage of your roundall-hours opioid pain medication might have to be adjusted.

Consult your physician If your dosage of Abstral isn’t helping to ease the pain of cancer that you have been experiencing. Your healthcare professional will decide the dose that needs to be altered.

Do not stop taking Abstral in a hurry otherwise you might experience uncomfortable withdrawal symptoms. Discuss with your doctor the best way to completely stop taking this medication.

Never break or crush an Abstral tablet in order to inhale it or mix it with liquid and inject this drug directly into your vein.

Keep at room temperature, free of heat and moisture. Avoid freezing. Make a note of the quantity of medicine taken in each bottle. Place your medicine in a safe place so that others aren’t able to access it. Fentanyl is a drug that is subject to misuse and you must be aware of anyone using the medication in a way that is not legal or without the prescription.

Make sure this medicine is out of pet or child’s reach. The quantity of fentanyl present in each tablet could cause death for a pet or child who accidentally swallows or consumes it. Seek emergency medical assistance if this occurs.

Follow the disposal guidelines after this medication is no longer required. Do not keep any leftover opioid medications. One dose could cause death in someone taking the medication in error or incorrectly. Find out from your pharmacist how you can find a drug take-back program for disposal. If there’s no take-back service, you can dispose of any remaining Abstral tablets by taking the blisters from them before flushing them in the toilet.


If I don’t take a dose?

Because Abstral is a painkiller and pain relief, it’s unlikely to be able to miss the dose. Do not miss any doses in the event that it is near the time to take your next dose. Do not take any extra medicine to replace the missed dose.

If I consume too much?

For medical emergencies, seek immediate medical attention or contact for help at the Poison Help line at 1-800-222-1222. An overdose of fentanyl could be fatal, particularly for children or any other user of the drug without having a prescription. Overdose symptoms may include severe weakness or drowsiness. It could also cause a slow pulse as well as clammy and cold eyes, pinpoint pupil and a slow breathing (breathing could be stopped).

What to avoid when using Abstral?

This medication could impair your reactions or thinking. Avoid operating machinery or driving until you are aware of what Abstral can affect your body. Drowsiness or extreme dizziness can result in falls and other accidents.

Avoid drinking the alcohol. Dangerous side effects or even death could happen.

Grapefruit and grapefruit juice can be in contact with fentanyl, which can lead to unwelcome adverse consequences. Avoid using grapefruit juice when you are taking Abstral.

Abstral side effects

Take immediate medical attention Get medical attention immediately if you show symptoms that you are experiencing an allergic reaction due to Abstral. symptoms of hives; breathing difficulties or swelling of your lips, face and tongue.

As with other narcotics that are available, fentanyl may slow the rate of breathing. The risk of death is when the breathing becomes difficult. The person who is caring for you should seek immediate medical treatment if you suffer from breath that is slow, with long pauses and blue lips or if it is difficult to get back up.

Consult your physician immediately If you are suffering from:

  • Slow heart rate, sighing and breathing shallowly breath that stops when you sleeping;
  • severe drowsiness, feeling like you might pass out;
  • anxiety, extreme fear extreme fear, strange thoughts or behavior and
  • low levels of cortisol nausea loss of appetite, vomiting dizziness, a rise in tiredness or weakness.

Get medical attention now if you are experiencing signs of serotonin-related syndrome, for example: hallucinations, agitation sweating chills, shivering, rapid heart rate muscle stiffness and twitching, nausea vomiting or diarrhea.

Side effects that are serious could be more common for people over the age of 65 and those who suffer from malnutrition or are debilitated.

The long-term use of opioids can impact the fertility (ability for having children) in men or women. It is not established whether the effects of opioids on fertility are lasting.

The most common side-effects of Abstral could include:

  • headache dizziness, drowsiness thin skin, feeling weak or fatigued;
  • constipation, nausea, vomiting; or
  • swelling of your feet or hands.

This is not a comprehensive list of possible side effects, and other side effects could occur. Contact your doctor to seek medical advice on the effects. You can report any adverse reactions to the FDA at 1-800-FDA-1088.


What other medications can impact Abstral?

Certain drugs may raise or decrease your Fentanyl levels in your blood that can trigger side effects or render Abstral less efficient. Inform your doctor if are taking antibiotics, antifungal medicines as well as heart or blood pressure medications, or other medications that treat HIV as well as AIDS.

Fentanyl is a drug that can be a drug that interacts with many other medications and trigger dangerous adverse effects or even death. Be sure your doctor is aware if you are taking:

  • medications for allergies or colds such as bronchodilator asthma/COPD medicine or diuretic (“water pill”);
  • medicine to treat motion sickness IBS, motion sickness, or an overactive bladder.
  • other narcotic medicines like opioid pain medication and prescription medicine for cough
  • a sedative that is similar to Valium is diazepam alprazolam lorazepam, Xanax, Klonopin, Versed, and others;
  • substances that cause you to be feel sleepy or cause breathing to slow such as a sleeping pill, a muscle relaxer, medication to treat mental illnesses or mood disorders as well as
  • drugs that alter serotonin levels within your body as a stimulant or medication to treat Parkinson’s disease, depression severe infections, migraines or vomiting and nausea.

This list isn’t comprehensive. Other medications can be incompatible with fentanyl, such as medications that are prescribed and available over the counter as well as vitamins and herbal products. There are not all interactions mentioned in this drug guide.

More details

Keep all medicines away from the reach of children. Do not let your medications be shared with anyone else Use Abstral only as given.

Always seek advice from your doctor to confirm that the information presented on this page is applicable to you.

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