DOSAGE RANGE CHART
TOTAL DOSAGE
Low Dose — 2 mcg/kg
(0.002 mg/kg) (0.04 mL/kg)
fentanyl. Fentanyl in small
doses is most useful for
minor, but painful, surgical
procedures. In addition to
the analgesia during
surgery, fentanyl may also
provide some pain relief in
the immediate postoperative
period.
Moderate Dose — 2 to 20
mcg/kg (0.002 to 0.02 mg/kg)
(0.04 to 0.4 mL/kg). Where
surgery becomes more
major, a larger dose is
required. With this dose,
in addition to adequate
analgesia, one would expect
to see some abolition of the
stress response. However,
respiratory depression will
be such that artificial
ventilation during anesthesia
is necessary and careful
observation of ventilation
postoperatively is essential
High Dose — 20 to 50
mcg/kg (0.02 to 0.05 mg/kg)
(0.4 to 1 mL/kg). During open
heart surgery and certain more
complicated neurosurgical and
orthopedic procedures where
surgery is more prolonged, and
in the opinion of the
anesthesiologist, the stress
response to surgery would
be detrimental to the well
being of the patient, dosages
of 20 to 50 mcg/kg (0.02 to
0.05 mg) (0.4 to 1 mL) of
fentanyl with nitrous
oxide/oxygen have been
shown to attenuate the
stress response as defined
by increased levels of
circulating growth
hormone, catecholamine,
ADH and prolactin. When
dosages in this range have
been used during surgery,
postoperative ventilation
and observation are
essential due to extended
postoperative respiratory
depression. The main
objective of this technique
would be to produce
“stress free” anesthesia.
DOSAGE RANGE CHART
MAINTENANCE DOSAGE
Low Dose — 2 mcg/kg (0.002 mg/kg)
(0.04 mL/kg).
Additional dosages of fentanyl are
infrequently needed in these minor
procedures.
Moderate Dose — 2 to 20 mcg/kg
(0.002 to 0.02 mg/kg) (0.04 to 0.4 mL/kg).
25 to 100 mcg (0.025 to 0.1 mg) (0.5 to
2.0 mL) may be administered intravenously
or intramuscularly when movement and/or
changes in vital signs indicate surgical
stress or lightening of analgesia.
High Dose — 20 to 50 mcg/kg
(0.02 to 0.05 mcg/kg) (0.4 to 1.0 mL/kg).
Maintenance dosage (ranging from 25
mcg (0.025 mg) (0.5 mL) to one half the
initial loading dose) will be dictated by
the changes in vital signs which indicate
stress and lightening of analgesia.
However, the additional dosage selected
must be individualized especially if the
anticipated remaining operative time is
short.
As a General Anesthetic
When attenuation of the responses to surgical stress is especially important, doses of 50 to 100 mcg/kg (0.05 to 0.1
mg/kg) (1 to 2 mL/kg) may be administered with oxygen and a muscle relaxant. This technique has been reported to
provide anesthesia without the use of additional anesthetic agents. In certain cases, doses up to 150 mcg/kg (0.15
mg/kg) (3 mL/kg) may be necessary to produce this anesthetic effect. It has been used for open heart surgery and
certain other major surgical procedures in patients for whom protection of the myocardium from excess oxygen
demand is particularly indicated, and for certain complicated neurological and orthopedic procedures.
As noted above, it is essential that qualified personnel and adequate facilities be available for the management of
respiratory depression.
See 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.
HOW SUPPLIED
Fentanyl Citrate Injection, USP 50 mcg/mL (equivalent to 50 mcg/mL Fentanyl base) is available as:
NDC 17478-030-02 2 mL ampules in packages of 10
NDC 17478-030-05 5 mL ampules in packages of 10
NDC 17478-030-10 10 mL ampules in packages of 5
NDC 17478-030-20 20 mL ampules in packages of 5
NDC 17478-030-25 2 mL ampules in packages of 25
NDC 17478-030-55 5 mL ampules in packages of 25
Reference ID: 3336008