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Subsys Dosage

Generic name: fentanyl (buccal/sublingual)
Brand names: Abstral, Fentora, Subsys
Drug class: Narcotic analgesics

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



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