Lozenge
CAUTIONARY AND ADVISORY LABELS 2
EXCIPIENTS:May contain Propylene glycol
▶Actiq(Teva UK Ltd)
Fentanyl (as Fentanyl citrate) 200 microgramActiq
200 microgram lozenges with integral oromucosal applicator|
3 lozengeP£ 21. 05 DT = £ 21. 05 b| 30 lozengeP£ 210. 41
DT = £ 210. 41 b
Fentanyl (as Fentanyl citrate) 400 microgramActiq
400 microgram lozenges with integral oromucosal applicator|
3 lozengeP£ 21. 05 DT = £ 21. 05 b| 30 lozengeP£ 210. 41
DT = £ 210. 41 b
Fentanyl (as Fentanyl citrate) 600 microgramActiq
600 microgram lozenges with integral oromucosal applicator|
3 lozengeP£ 21. 05 DT = £ 21. 05 b| 30 lozengeP£ 210. 41
DT = £ 210. 41 b
Fentanyl (as Fentanyl citrate) 800 microgramActiq
800 microgram lozenges with integral oromucosal applicator|
3 lozengeP£ 21. 05 DT = £ 21. 05 b| 30 lozengeP£ 210. 41
DT = £ 210. 41 b
Fentanyl (as Fentanyl citrate) 1.2 mgActiq 1. 2 mg lozenges with
integral oromucosal applicator| 3 lozengeP£ 21. 05 DT =
£ 21. 05 b| 30 lozengeP£ 210. 41 DT = £ 210. 41 b
Fentanyl (as Fentanyl citrate) 1.6 mgActiq 1. 6 mg lozenges with
integral oromucosal applicator| 3 lozengeP£ 21. 05 b|
30 lozengeP£ 210. 41 beiiiiF 273Hydromorphone hydrochloride
lINDICATIONS AND DOSE
Severe pain in cancer
▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES
▶Child 12–17 years: 1. 3 mg every 4 hours, dose to be
increased if necessary according to severity of pain
▶BY MOUTH USING MODIFIED-RELEASE MEDICINES
▶Child 12–17 years: 4 mg every 12 hours, dose to be
increased if necessary according to severity of painlCONTRA-INDICATIONSAcute abdomen
lCAUTIONSPancreatitis.toxic psychosis
lINTERACTIONS→Appendix 1 : opioids
lSIDE-EFFECTS
GENERAL SIDE-EFFECTS
▶Common or very commonAbdominal pain.anxiety.
appetite decreased.asthenia.sleep disorders
▶UncommonDepression.diarrhoea.dyspnoea.erectile
dysfunction.malaise.movement disorders.paraesthesia.
peripheral oedema.taste altered.tremor
▶Rare or very rareLethargy
▶Frequency not knownHyperalgesia.paralytic ileus.seizure
.withdrawal syndrome neonatal
lBREAST FEEDINGAvoid—no information available.
lRENAL IMPAIRMENTAvoid use or reduce dose; opioid
effects increased and prolonged and increased cerebral
sensitivity occurs.
lDIRECTIONS FOR ADMINISTRATIONForimmediate-release
capsules, swallow whole capsule or sprinkle contents on
soft food. Formodified-releasecapsules, swallow whole or
open capsule and sprinkle contents on soft cold food
(swallow the pellets within the capsule whole; do not crush
or chew).
lPATIENT AND CARER ADVICEPatients or carers should be
given advice on how to administer hydromorphone
hydrochloride capsules and modified-release capsules.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: oral solution
Modified-release capsule
CAUTIONARY AND ADVISORY LABELS 2
▶Palladone SR(Napp Pharmaceuticals Ltd)
Hydromorphone hydrochloride 2 mgPalladone SR 2 mg capsules|
56 capsuleP£ 20. 98 bHydromorphone hydrochloride 4 mgPalladone SR 4 mg capsules|
56 capsuleP£ 28. 75 b
Hydromorphone hydrochloride 8 mgPalladone SR 8 mg capsules|
56 capsuleP£ 56. 08 b
Hydromorphone hydrochloride 16 mgPalladone SR 16 mg capsules
| 56 capsuleP£ 106. 53 b
Hydromorphone hydrochloride 24 mgPalladone SR 24 mg capsules
| 56 capsuleP£ 159. 82 b
Capsule
CAUTIONARY AND ADVISORY LABELS 2
▶Palladone(Napp Pharmaceuticals Ltd)
Hydromorphone hydrochloride 1.3 mgPalladone 1. 3 mg capsules
| 56 capsuleP£ 8. 82 b
Hydromorphone hydrochloride 2.6 mgPalladone 2. 6 mg capsules
| 56 capsuleP£ 17. 64 beiiiiF 273Morphine 12-Dec-2016
lINDICATIONS AND DOSE
Pain
▶BY SUBCUTANEOUS INJECTION
▶Neonate:Initially 100 micrograms/kg every 6 hours,
adjusted according to response.▶Child 1–5 months:Initially 100 – 200 micrograms/kg
every 6 hours, adjusted according to response
▶Child 6 months–1 year:Initially 100 – 200 micrograms/kg
every 4 hours, adjusted according to response
▶Child 2–11 years:Initially 200 micrograms/kg every
4 hours, adjusted according to response
▶Child 12–17 years:Initially 2. 5 – 10 mg every 4 hours,
adjusted according to response
▶INITIALLY BY INTRAVENOUS INJECTION
▶Neonate: 50 micrograms/kg every 6 hours, adjusted
according to response, dose to be administered over at
least 5 minutes, alternatively (by intravenous injection)
initially 50 micrograms/kg, dose to be administered over
at least 5 minutes, followed by (by continuous
intravenous infusion) 5 – 20 micrograms/kg/hour,
adjusted according to response.▶Child 1–5 months: 100 micrograms/kg every 6 hours,
adjusted according to response, dose to be
administered over at least 5 minutes, alternatively (by
intravenous injection) initially 100 micrograms/kg,
dose to be administered over at least 5 minutes,
followed by (by continuous intravenous infusion)
10 – 30 micrograms/kg/hour, adjusted according to
response
▶Child 6 months–11 years: 100 micrograms/kg every
4 hours, adjusted according to response, dose to be
administered over at least 5 minutes, alternatively (by
intravenous injection) initially 100 micrograms/kg,
dose to be administered over at least 5 minutes,
followed by (by continuous intravenous infusion)
20 – 30 micrograms/kg/hour, adjusted according to
response
▶Child 12–17 years: 5 mg every 4 hours, adjusted
according to response, dose to be administered over at
least 5 minutes, alternatively (by intravenous
injection) initially 5 mg, dose to be administered over
at least 5 minutes, followed by (by continuous
intravenous infusion) 20 – 30 micrograms/kg/hour,
adjusted according to response
▶BY MOUTH, OR BY RECTUM
▶Child 1–2 months:Initially 50 – 100 micrograms/kg every
4 hours, adjusted according to response
▶Child 3–5 months: 100 – 150 micrograms/kg every
4 hours, adjusted according to response
▶Child 6–11 months: 200 micrograms/kg every 4 hours,
adjusted according to response282 Pain BNFC 2018 – 2019
Nervous system4