• Required field
  • Generic Name: (fentanyl citrate)
    Other Brands: Actiq
  • Last Revised: 09/2013
    • What is this medication and its most common uses?

      Actiq is a medicine used to manage breakthrough cancer pain in people who are already taking other narcotic painkillers around-the-clock for their cancer pain. Actiq is started only after you have been taking other narcotic painkillers and your body has become used to them (you are "opioid-tolerant"). Actiq is available as a lozenge (solid medicine that dissolves slowly in the mouth) that is attached to handle. You place the lozenge in your mouth between your cheeks and gums.

      Actiq is a federally controlled substance because it has abuse potential.

    • What should I know when beginning and continuing on this medication?

      How does this medication work?

      Actiq works in your central nervous system (the brain and spinal cord) and affects the way your body responds to pain.

      What are the beneficial effects of this medication and when should I begin to have results?

      What: Actiq has been shown to help relieve pain.

      When: Everyone responds differently to treatment, so try to be patient and follow your healthcare provider's directions. It is important that you use Actiq exactly as your healthcare provider has prescribed.

      How do I know it is working?

      You may feel an improvement in your pain. This is a good indicator that the medicine is working. Your healthcare provider may also ask you questions from time to time to assess how well your symptoms are controlled with treatment.

    • What are the possible side effects of this medication?

      The following is not a full list of side effects. Side effects cannot be anticipated. If any develop or change in intensity, tell your healthcare provider as soon as possible. Only your healthcare provider can determine if it is safe for you to continue taking this medication.

      Due to the risk of serious, life-threatening breathing problems, do not use Actiq unless you are regularly using another narcotic painkiller around-the-clock for at least one week or longer for your cancer pain and your body is used to these medicines. Also, do not use Actiq to treat pain that you only have now and then ("as needed"), or after surgery if the pain is mild or not expected to last for a long period (including headaches/migraines). Tell your healthcare provider right away if you are breathing more slowly than usual; are experiencing shallow breathing (little chest movement while breathing); or if you feel faint, dizzy, confused, or have any other unusual symptoms.

      Keep Actiq in a safe place away from children. Accidental use may result in serious harm and may be life-threatening.

      Actiq has abuse potential. If you have concerns, talk to your healthcare provider for more information about abuse and addiction. Do not share Actiq with others and take steps to protect Actiq from theft or misuse.

      Actiq is available only through a program called the Transmucosal Immediate Release Fentanyl (TIRF) Risk Evaluation and Mitigation Strategy (REMS) Access Program. Under this program, you must talk to your healthcare provider, understand the benefits and risks of Actiq, agree to all the instructions, and sign the Patient-Prescriber Agreement form in order to receive Actiq.

      More common side effects may include: nausea, dizziness, drowsiness, vomiting, weakness, headache, shortness of breath, constipation, anxiety, confusion, depression, rash, trouble sleeping.

      Less common side effects may include:

      Actiq may lower your heart rate.

    • Who should not take this medication?

      Do not use Actiq if you are allergic to it or any of its ingredients.

      Do not use Actiq if you are not opioid-tolerant.

      Do not use Actiq to treat pain that you only have now and then ("as needed"), or after surgery if the pain is mild or not expected to last for a long period (such as headaches, migraines, or dental pain).

    • What should I tell my healthcare provider before I take the first dose of this medication?

      Tell your healthcare provider about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Actiq. Also, talk to your healthcare provider about your complete medical history, especially if you have trouble breathing or lung problems (such as asthma, wheezing, or shortness of breath); a head injury or brain problems; liver or kidney problems; seizures; diabetes; slow heart rate or other heart problems; low blood pressure; mental health problems (including depression, schizophrenia, or hallucinations); a history of drug or alcohol addiction or a family history of these problems; or if you are pregnant, plan to become pregnant, or are breastfeeding.

    • What is the usual dosage?

      The information below is based on the dosage guidelines your healthcare provider uses. Depending on your condition and medical history, your healthcare provider may prescribe a different regimen. Do not change the dosage or stop taking your medication without your healthcare provider's approval.

      Adults ≥16 years: The starting dose is 200 micrograms. Your healthcare provider may increase your dose as needed, until the desired effect is achieved.

    • How should I take this medication?

      Use Actiq exactly as prescribed by your healthcare provider. Do not change your dose without first talking to your healthcare provider.

      Finish the lozenge completely over 15 minutes to get the most relief. If you bite or chew Actiq or finish it too quickly, you will swallow more of the medicine and get less relief.

      You may drink some water before using Actiq, but do not drink or eat anything while using Actiq.

      Use 1 lozenge of Actiq for an episode of breakthrough cancer pain. If your pain is not relieved 15 minutes after you finished the lozenge, use only 1 more at this time. If your pain does not get better after the second lozenge, call your healthcare provider for instructions. Do not use another lozenge at this time.

      Wait at least 4 hours before treating a new episode of breakthrough cancer pain with Actiq. Talk to your healthcare provider if you have more than 4 episodes of breakthrough cancer pain per day. The dose of your around-the-clock pain medicine may need to be adjusted.

      Talk to your healthcare provider or pharmacist about how to dispose of used and unused Actiq lozenges.

      Please review the instructions that came with your prescription on how to use Actiq properly.

    • What should I avoid while taking this medication?

      Do not drive a car, operate machinery, or engage in other dangerous activities until you know how Actiq affects you.

      Do not drink alcohol or take prescription or over-the-counter medicines that contain alcohol while you are using Actiq.

      Do not eat grapefruit or drink grapefruit juice while you are using Actiq.

    • What are the possible food and drug interactions associated with this medication?

      If Actiq is used with certain other drugs, the effects of either could be increased, decreased, or altered. Actiq may interact with numerous medications. Therefore, it is very important that you tell your healthcare provider about any other medications you are taking.

    • May I receive this medication if I am pregnant or breastfeeding?

      The effects of Actiq during pregnancy are unknown. Actiq can be found in your breast milk if you use it while breastfeeding. Do not use Actiq while you are breastfeeding. Tell your healthcare provider immediately if you are pregnant, plan to become pregnant, or are breastfeeding.

    • What should I do if I miss a dose of this medication?

      Actiq should be used under special circumstances determined by your healthcare provider. If you miss your scheduled dose, contact your healthcare provider or pharmacist for advice.

    • How should I store this medication?

      Store at room temperature. Protect from freezing and moisture.

    • Who should I contact in case of emergency or overdose?
      back to top

      In the event of a medical emergency call your doctor or 9-1-1 immediately. In the event of overdose, call your doctor or poison control for further instructions.
      National Poison Control#: Call 1-800-222-1222

      This PDR+ drug information has been developed by the Physicians’ Desk Reference Network (PDRN), a source of medication information trusted by doctors for over 65 years.

      This monograph summarizes the most important information about your medication and does not cover all the information you may need. If you have any questions or concerns or want to learn more about your medication, ask your healthcare provider; he/she will be able to provide answers to your questions. This medication should only be used by the patient for whom it was prescribed and should not be shared with other people.
    • Additional patient resources.
      back to top Use your PDR® Pharmacy Discount Card when you or a family member fills a prescription and ask for your PDR® Discount every
  • Terms of Service

    This discount plan is NOT insurance or a Medicare prescription drug plan. The plan is not intended as a substitute for insurance and does not meet creditable coverage requirements under state or federal law. The plan provides discounts at participating pharmacies on certain pharmaceutical supplies, prescription drugs, or medical equipment and supplies. The range of discounts will vary depending on the products received. Members are obligated to pay the pharmacy the entire amount of the discounted rate for such products at the point of sale. The plan does not pay pharmacies for products provided to members. No enrollment or periodic fees apply. The pharmacy may pay the plan a fee from amounts the pharmacy collects from the member. The discount plan organization is ProCare Pharmacy Benefit Manager, Inc.,1267 Professional Parkway, ProCare Office Park, Gainesville, GA 30507, 1-888-299-5383. Customer service is provided by PDR, LLC., 5 Paragon Drive, Montvale, NJ, 07645, 1-800-232-7379, www.pdr.net/DiscountCard, customerservice@pdr.net.