Subsys Dosage
Medically reviewed by A Ras MD.
Recommended Adult Dosing
Dosage forms: SPRAY: 100 mcg per actuation, 200 mcg per actuation, 400 mcg per actuation, 600 mcg per actuation, 800 mcg per actuation
Restricted Distribution in US
Special Note
- [prescribing info]
- Info: consider prescribing naloxone if risk of opioid overdose or accidental ingestion
- [formulation clarification]
- Info: transmucosal fentanyl products not bioequivalent, caution advised if switching between products; see pkg insert for conversion from other transmucosal forms; not interchangeable w/ other fentanyl products, do not substitute on a mcg to mcg basis
Breakthrough cancer pain, opioid-tolerant pts
- [individualize dose SL x1 prn]
- Start: 100 mcg SL x1, may repeat x1 after 30min; Max: 2 doses/episode; 4 doses/24h once pain control achieved; Info: use lowest effective dose, shortest effective tx duration; must wait at least 4h before treating another episode; may titrate prn w/ each subsequent episode to 200 mcg dose, then 400 mcg dose, then 600 mcg dose, then 800 mcg dose, then 1200 mcg dose, then 1600 mcg dose; taper dose gradually to D/C if no longer require opioid tx
Renal dosing
- renal impairment: not defined, caution advised
- HD/PD: not defined
Hepatic dosing
- [not defined]
- hepatic impairment: caution advised
SRC: NLM .