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Name of the generic: fentanyl (buccal/sublingual) [ FEN-tan-il-BUK-alSub-LIN-gwal [FEN-tan-il BUK-al-/ sub-LIN
The brand names are: Abstral, Fentora, Subsys
Drug class: Opioids (narcotic analgesics)

What is Subsys?

Subsys spray can be described as an opioid painkiller. Opioids are sometimes referred to as a Narcotic.

Subsys spray is utilized for treating "breakthrough" cancer pain that cannot be controlled by other treatments. Subsys can be used along with other non-fentanyl pain medications that are utilized all the time. Subsys is not a treatment for pain that isn't related to cancer.


Don't utilize Subsys to substitute any other type of fentanyl such as Actiq, Fentora, Onsolis, Duragesic, Lazanda, or any generic brand of Fentanyl (injection patches, skin patches dissolving film "lollipop" device). Subsys can only be purchased from a certified pharmacy as part of an exclusive program. You must have a membership with the program and be aware of the potential risks and benefits of using this drug.

Don't use Subsys spray unless already receiving treatment with an opioid pain medication similar to Subsys in your body. Your body may be well-adapted to Subsys spray. Consult your physician in case you aren't sure you're an opioid-tolerant. Subsys is not a treatment for the pain that isn't cancer-related like pain from dental surgery or other procedures migraine headaches, back pain. Fentanyl can cause a slowing or stopping of your breathing, particularly when you begin using this medication or when your dose is modified. Do not take Subsys in greater quantities, or for longer than the prescribed time.

Certain medications can interfere with fentanyl, and can increase the effect on breathing. Before taking this medication consult your physician that you are taking antibiotics or other medications for treating high blood pressure or heart rhythm disorders, depression or viral diseases like hepatitis HIV as well as AIDS. The risk of fatal side effects could occur when you mix the medicine in conjunction with alcohol or other substances which cause drowsiness or a slowing of breathing. Fentanyl can cause dependence even in regular doses. Use this medication as directed by your doctor. Do not share this medicine with a person else. Misuse of NARCOTIC PAIN MEDICATIONS CAN CAUSE an overdose, addiction, or death, particularly in the case of a child or another patient who is taking the medication without prescription.

Before you take this drug

Do not apply Subsys unless you're using an opioid medication that is available 24/7 and are comfortable with Subsys. You should not utilize Subsys in the event that you are allergic to fentanyl or you suffer from:

  • Severe asthma or breathing issues;
  • An obstruction of the bowel or stomach (including an ileus that is paralytic).

To ensure that Subsys is suitable for you, inform your doctor if ever experienced:

  • Breathing issues sleep apnea, breathing problems
  • Any breathing issue or lung disease
  • A head injury, seizures or brain tumors;
  • Lower blood pressure heartbeats that are slow or any other heart rhythm disorder;
  • Addiction to alcohol or drugs and schizophrenia, depression, or hallucinations;
  • Kidney disease or liver failure;
  • Urination issues or
  • Troubles related to your gallbladder, thyroid or the pancreas.

Inform your doctor whether there are children within the house in which you store this medication. The quantity of fentanyl present in this medication could be fatal to children. If you are using Subsys when you're pregnant the baby could develop dependent to the drug. This can cause severe withdrawal symptoms for the newborn after it's born. Baby's who become dependent on the habit-forming medication could require medical treatment for a few weeks. Inform your doctor if are expecting or planning to be pregnant. Do not breastfeed during the time you take this medication.

How to take Subsys?

Follow Subsys exactly as directed by your physician. Follow all instructions on the prescription label. Fentanyl can cause a slowing or stopping of your breathing. Follow the exact dosage advised by your doctor. Talk to your doctor if this medication isn't working or isn't able to ease the discomfort. Fentanyl could be addictive. Do not share this medication with anyone else, especially one with an addiction history or addiction. Misuse of NARCOTIC MEDICINES can lead to addiction or even death particularly for children or any other person who is using the medication without having a medical prescription. Selling or giving Fentanyl for free is against the law. Take note of all patient information including medication guides and instruction sheets you are given. Consult your physician or pharmacist should you have any concerns. Do not utilize Subsys to substitute any other type of fentanyl. Examples include Actiq, Fentora, Onsolis, Duragesic, Lazanda, or any generic brand of Fentanyl (injection or skin patch dissolving film "lollipop" device).

If you choose Subsys from a different form of fentanyl, you'll not receive the same amount. Start at the lowest dosage (100 milligrams). Your doctor can alter your dosage to ensure you are getting the most effective results. Place the Subsys spray nozzle in your mouth and lift your tongue and spray the medicine on your tongue. Place the liquid on your tongue for 30-60 minutes. Don't swallow, spit or wash the mouth at this period of time. It is possible to use the second Subsys dose 30 seconds after you took the initial. Make sure to use that strength dosage you took for the first dose. Contact your physician if you are still experiencing discomfort after taking the second tablet. Don't take more than two doses for each bout of pain from cancer that has exploded. You should wait at least 4 hours following the last dose of Subsys before you are able to treat a pain-related episode that has recurred. more than 4 instances of pain per day using this medication.

Don't stop taking Subsys in a hurry or you may experience painful withdrawal signs. Consult your physician about how you can completely stop taking this medication.

Keep at ambient temperature, away from humidity and heat. Don't freeze. Place your medicine in a safe place so that others are unable to access it. Be aware of the dosage of medication used. Fentanyl is a substance that can cause abuse, and you should be aware of any person who is taking the medication in a way that is not legal and without prescription.

Make sure this medication is away from the reach of pets or children. The quantity of fentanyl contained in every Subsys spray can prove fatal for pets or children if a pet accidentally swallows or suckers up the substance. Seek emergency medical care if this happens. Follow the disposal guidelines carefully when this medication has been used up. Remove the used Subsys spray units into the bags for disposal provided with this medicine. Take out any spray units you don't use into the container for disposal that is provided.

What happens If I miss a dose?

Because Subsys is a medication used to treat discomfort, you're less likely 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. Don't take extra medication to make up for the missed dose.

What happens if I overdose?

Get medical attention immediately or contact emergency medical attention or call the Poison Help line at 1-800-222-1222. Fentanyl overdoses are fatal, especially in children or another patient who is taking the medication without prescription. Overdose symptoms may include a severe drowsiness or weakness as well as a slow pulse, clammy and cold skin, narrow pupils and a slow breathing (breathing could cease).

What should be avoided?

The medication may affect your reactions or thinking. Avoid operating machinery or driving until you are aware of what effects Subsys can have on your thinking and reactions. Drowsiness or extreme dizziness can cause accidents or falls. Avoid drinking alcohol. Dangerous side effects or even death could happen. Grapefruit and grapefruit juice can react with fentanyl, which can result in undesirable negative side effects. Do not use grapefruit juice while taking Subsys.

Side effects of Subsys

Take immediate medical attention If you show symptoms for an allergic reaction Subsys: hives; difficulty breathing and swelling of your lips, face and tongue.

Similar to other narcotic medications that are available, fentanyl may slow the rate of breathing. It is possible to die if your breathing becomes difficult. Anyone who cares 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 up.

See your doctor right away If you suffer from:

  • Slow heart rate, sighing deep breathing breath that stops when you sleeping;
  • Severe drowsiness, feeling like you might pass out;
  • Anxiety, extreme fear extreme fear, strange thoughts or behavior extreme fear, confusion, unusual thoughts or behavior
  • Low levels of cortisol nausea nausea, vomiting, loss of appetite, dizziness and a rise in fatigue or weakness.

You should seek medical attention now if you are experiencing signs of serotonin-related syndrome, like hallucinations, agitation, sweating, fever and shivering. You may also experience a rapid heart rate, muscle stiffness or twitching. Also, you may experience loss of coordination nausea, vomiting or diarrhea.

Side effects that are serious could be more prevalent for older people and those who suffer from malnutrition or are debilitated.

Opioid medication used for long periods can impact the fertility (ability in having kids) in men or women. It is not yet known if the effects of opioids on fertility last for a long time.

The most common side-effects of Subsys be:

  • Headache dizziness, drowsiness thin skin fatigue, feeling tired or weak;
  • Constipation, nausea, vomiting; or
  • Swelling of your feet or hands.

This isn't a complete list of all side effects. Other effects may also be present. Consult your physician for advice regarding medical adverse effects. You can report any symptoms to the FDA at 1-800-FDA-1088.

Interaction with other drugs

Certain medications can increase or decrease your level of blood fentanyl that can trigger side effects or render Subsys less efficient. Talk to your doctor if you are using any antibiotics, antifungal medicines as well as heart or blood pressure medication, or medications for treating HIV as well as AIDS.

Fentanyl is a drug that can interact with other drugs and can cause serious adverse effects or even death. Be sure your doctor is aware of if you take:

  • Medicine for allergies or colds such as bronchodilator asthma/COPD medicine or a diuretic ("water pill");
  • Medicine to treat motion sickness IBS, motion sickness, or bladder overactive;
  • Other narcotic drugs like opioid pain medication as well as prescription-only cough medicines
  • An sedative similar to Valium (also known as diazepam alprazolam lorazepam, Xanax, Klonopin, Versed, and others;
  • Substances that cause you to be tired or cause breathing to slow A sleep pill, muscle relaxer, or medicine for treating mental or mood disorders; or
  • Medications that alter serotonin levels within your body A stimulant or medicine to treat Parkinson's disease, depression, severe infections, migraines such as vomiting and nausea.