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Standard Dilutions [Amount of drug] [Infusion volume] [Infusion rate]
|[0 - 5000 mcg] [50-250ml] [Titrate]
[1250 mcg] [250 ml] [Titrate]
[2500 mcg] [250 ml] [Titrate]
[5000 mcg] [250 ml] [Titrate]
(May concentrate further)
Stability / Miscellaneous
Minimum dilution: 2500 to 5000 mcg/ 50 ml.
Adjunct to regional anesthesia: I.M., slow I.V.: 50-100 mcg/dose; if I.V. used, give over 1-2 minutes
Severe pain: I.M.: 50-100 mcg/dose every 1-2 hours as needed; patients with prior opiate exposure may tolerate higher initial doses
Adjunct to general anesthesia: Slow I.V.:
High dose: Initial: 20-50 mcg/kg/dose; Maintenance: 25 mcg to one-half the initial loading dose may be given as needed
General anesthesia without additional anesthetic agents: Slow I.V.: 50-100 mcg/kg with O2 and skeletal muscle relaxant
Mechanically-ventilated patients (based on 70 kg patient): Slow I.V.: 0.35-1.5 mcg/kg every 30-60 minutes as needed; infusion: 0.7 - 10 mcg/kg/hour
Patient-controlled analgesia (PCA): I.V.: Usual concentration: 50 mcg/mL
DOSAGE AND ADMINISTRATION
Dosage should be individualized. Some of the factors to be considered in determining the dose are age, body weight, physical status, underlying pathological condition, use of other drugs, type of anesthesia to be used and the surgical procedure involved. Dosage should be reduced in elderly or debilitated patients.
Vital signs should be monitored routinely.
I.Premedication— Premedication (to be appropriately modified in the elderly, debilitated, and those who have received other depressant drugs)—50 mcg to 100 mcg (0.05 mg to 0.1 mg) (1 mL to 2 mL) may be administered intramuscularly 30 to 60 minutes prior to surgery.
II.Adjunct to General Anesthesia— See Dosage Range Chart
III.Adjunct to Regional Anesthesia— 50 mcg to 100 mcg (0.05 mg to 0.1 mg) (1 mL to 2 mL) may be administered intramuscularly or slowly intravenously, over one to two minutes, when additional analgesia is required.
IV.Postoperatively (recovery room)— 50 mcg to 100 mcg (0.05 mg to 0.1 mg) (1 mL to 2 mL) may be administered intramuscularly for the control of pain, tachypnea, and emergence delirium. The dose may be repeated in one to two hours as needed.
Usage in Children: For induction and maintenance in children 2 to 12 years of age, a reduced dose as low as 2 mcg/kg to 3 mcg/kg is recommended.
DOSAGE RANGE CHART
As a General Anesthetic:
As noted above, it is essential that qualified personnel and adequate facilities be available for the management of respiratory depression.
See package insert for WARNINGS and PRECAUTIONS for use of fentanyl with other CNS depressants, and in patients with altered response.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.
PROTECT FROM LIGHT. Store at 20 to 25°C (68 to 77°F). [See USP Controlled Room Temperature.]
Revised: April, 2007
Source: [package insert]
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