Fentanilo
Fentanyl
Fentanyl citrate
También conocido como: Sublimaze · Duragesic · Actiq · Fentora · Ionsys · Fentadon · Durogesic · Fentanyl citrate · fentanylum · fentanyli citras · phentanyl citrate · McN-JR-4263-49 · Fentanil
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Perioperative pain | The combination of a 10 micro-grams/kg loading dose IV followed by a CRI of 10 micrograms/kg/hour | IV/CRI | Continuous | Perioperative | 🌎 NA |
| Pain management | 2-5 micrograms/kg IV, followed by a CRI at 2-5 micrograms/kg/hr | IV/CRI | Continuous | — | 🌎 NA |
| Surgical analgesia | CRI at 10-45 micrograms/kg/hr | CRI | Continuous | Intraoperative | 🌎 NA |
| Analgesia | 2-6 micrograms/kg/hour | CRI | Continuous | — | 🌎 NA |
| Induction | 0.001-0.005 mg/kg IV | IV | Single dose | — | 🌎 NA |
| MAC reduction during general anesthesia | 10-45 micrograms/kg/hr CRI | CRI | Continuous | Intraoperative | 🌎 NA |
| Severe to excruciating pain in the emergent patient | Fentanyl at 1050 micrograms/kg, administered IV titrated to effect; use the effective dose as an hourly CRI. | IV/CRI | Titrated to effect | — | 🌎 NA |
| Epidural for pain control | 0.004 mg/kg (4 micrograms/kg), diluted with 0.2 mL with preservative-free saline or local anesthetic. | Epidural | Single dose | 1/2 hour | 🌎 NA |
| Transdermal Analgesia (<5kg) | 25 mcg/hr or 12.5 mcg/hr | Transdermal | q72h | — | 🌎 NA |
| Transdermal Analgesia (5-10 kg) | 25 mcg/hr | Transdermal | q72h | — | 🌎 NA |
| Transdermal Analgesia (10-20 kg) | 50 mcg/hr | Transdermal | q72h | — | 🌎 NA |
| Transdermal Analgesia (20-30 kg) | 75 mcg/hr | Transdermal | q72h | — | 🌎 NA |
| Transdermal Analgesia (>30 kg) | 100 mcg/hr | Transdermal | q72h | — | 🌎 NA |
| Intraoperative analgesia | Intermittent bolus doses or continuous rate infusion (exact dose not specified) | IV | Intermittent or CRI | Intraoperative | 🌍 EU |
| Postoperative analgesia | Low end of the dose range by continuous rate infusion | IV | CRI | Postoperative | 🌍 EU |
| Postoperative or chronic pain | Transdermal patch (size based on patient requirement) | Topical | Apply 24 hours before surgery | Up to 72 hours | 🌍 EU |
- Perioperative pain: Guideline for CRI during general anesthesia
- Pain management: Loading dose followed by CRI
- Severe to excruciating pain in the emergent patient: Note: '1050' appears exactly as written in source text, likely a typo for 10-50. May combine with ketamine and lidocaine.
- Epidural for pain control: Onset in less than 10 minutes
- Transdermal Analgesia (<5kg): Apply 12-24 hours prior to need. Half-patch dosing may be desired for very small dogs.
- Transdermal Analgesia (5-10 kg): Apply 12-24 hours prior to need.
- Transdermal Analgesia (10-20 kg): Apply 12-24 hours prior to need.
- Transdermal Analgesia (20-30 kg): Apply 12-24 hours prior to need.
- Transdermal Analgesia (>30 kg): Apply 12-24 hours prior to need.
- Intraoperative analgesia: Give slowly to avoid severe bradycardia/asystole.
- Postoperative analgesia: Monitor respiratory function closely.
- Postoperative or chronic pain: Takes ~24 hours to attain adequate plasma concentrations. Use as an adjunctive analgesic.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Perioperative pain | 2-3 micrograms/kg IV plus 2-3 micrograms/kg/hour IV infusion | IV/CRI | Continuous | Perioperative | 🌎 NA |
| Pain management | 1-3 micrograms/kg IV, followed by a CRI at 1-4 micrograms/kg/hr | IV/CRI | Continuous | — | 🌎 NA |
| Surgical analgesia | CRI at 10-30 micrograms/kg/hr | CRI | Continuous | Intraoperative | 🌎 NA |
| Analgesia | 2-4 micrograms/kg/hour | CRI | Continuous | — | 🌎 NA |
| Induction | 0.001-0.002 mg/kg IV | IV | Single dose | — | 🌎 NA |
| MAC reduction during general anesthesia | 10-20 micrograms/kg/hr CRI | CRI | Continuous | Intraoperative | 🌎 NA |
| Severe to excruciating pain in the emergent patient | Fentanyl at 1050 micrograms/kg, administered IV titrated to effect; use the effective dose as an hourly CRI. | IV/CRI | Titrated to effect | — | 🌎 NA |
| Epidural for pain control | 0.004 mg/kg (4 micrograms/kg), diluted 0.2 mL with preservative-free saline or local anesthetic. | Epidural | Single dose | 1/2 hour | 🌎 NA |
| Maintenance analgesia/heavy sedation in critically ill hypotensive animals | fentanyl at 0.5-0.8 micrograms/kg/minute (equivalent to 30-50 micrograms/kg/hr). | CRI | Continuous | — | 🌎 NA |
| Transdermal Analgesia | 25 mcg/hr or 12.5 mcg/hr | Transdermal | q120h | Up to 5 days | 🌎 NA |
| Intraoperative analgesia | Intermittent bolus doses or continuous rate infusion (exact dose not specified) | IV | Intermittent or CRI | Intraoperative | 🌍 EU |
| Postoperative analgesia | Low end of the dose range by continuous rate infusion | IV | CRI | Postoperative | 🌍 EU |
| Postoperative or chronic pain | Transdermal patch (size based on patient requirement) | Topical | Apply 7 hours before surgery | Up to 72 hours | 🌍 EU |
- Pain management: Loading dose followed by CRI
- Severe to excruciating pain in the emergent patient: Note: '1050' appears exactly as written in source text, likely a typo for 10-50.
- Epidural for pain control: Onset in less than 10 minutes
- Maintenance analgesia/heavy sedation in critically ill hypotensive animals: Used in addition to a local line block. May combine with midazolam.
- Transdermal Analgesia: Apply 6-24 hours prior to need. 12 mg patches are available for very small cats.
- Intraoperative analgesia: Give slowly to avoid severe bradycardia/asystole.
- Postoperative analgesia: Monitor respiratory function closely.
- Postoperative or chronic pain: Takes ~7 hours to attain adequate plasma concentrations. Use as an adjunctive analgesic.
Pequeños mamíferos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Perioperative pain (Rabbits/Rodents/Small Mammals) | 5-20 micrograms/kg IV bolus | IV | Single dose | 30-60 minute duration | 🌎 NA |
| Postoperative analgesia (Rabbits) | 1/2 small patch (25 micrograms/hr) per medium sized rabbit (3 kg) every 3 days. Do not cut patch | Transdermal | q72h | — | 🌎 NA |
- Perioperative pain (Rabbits/Rodents/Small Mammals): Causes sedation and respiratory depression
Hurones
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Pre-op dose | 5-10 micrograms/kg IV | IV | Single dose | Pre-op | 🌎 NA |
| Intra-operatively | CRI at 10-20 micrograms/kg/hr with a ketamine CRI (0.3-0.4 mg/kg/hr) | CRI | Continuous | Intraoperative | 🌎 NA |
| Postoperatively | 2-5 micrograms/kg/hr with a ketamine CRI. | CRI | Continuous | Postoperative | 🌎 NA |
Caballos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Transdermal Analgesia (350-500 kg) | 100 mcg/hr | Transdermal | q48h | — | 🌎 NA |
- Transdermal Analgesia (350-500 kg): Apply 6+ hours prior to need. ARCI UCGFS Class 1 Drug.
Cerdos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Transdermal Analgesia (17-25 kg) | 50 mcg/hr | Transdermal | — | — | 🌎 NA |
Ovejas
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Transdermal Analgesia | 25 mcg/hr | Transdermal | — | — | 🌎 NA |
Cabras
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Transdermal Analgesia | 25 mcg/hr | Transdermal | — | — | 🌎 NA |
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
El Fentanilo es un analgésico opiáceo sintético derivado de la fenilpiperidina de Clase II, altamente potente y utilizado ampliamente en medicina veterinaria para el manejo del dolor de moderado a severo.
Características farmacológicas clave:
- Potencia: Aproximadamente 75 a 100 veces más potente que la morfina.
- Lipofilia: El fentanilo es altamente lipofílico, lo que le permite cruzar rápidamente la barrera hematoencefálica (resultando en un inicio de acción muy rápido cuando se administra IV) y lo convierte en un candidato excelente para la administración transdérmica.
- Duración: Cuando se administra como un bolo IV único, su duración de efecto es extremadamente corta (15-30 minutos) debido a la rápida redistribución desde el cerebro hacia otros tejidos. Por lo tanto, se administra más comúnmente mediante Infusión a Velocidad Constante (CRI) o parche transdérmico para una analgesia sostenida.
Aplicaciones clínicas:
- Control adyuvante del dolor posoperatorio.
- Manejo de dolor severo, crónico, sordo o dolor generalizado inespecífico (p. ej., cáncer, pancreatitis, tromboembolismo aórtico).
- Uso perioperatorio para reducir significativamente la Concentración Alveolar Mínima (MAC) de los anestésicos inhalados, proporcionando estabilidad cardiovascular en pacientes comprometidos.
Perla clínica: Aunque los parches transdérmicos son muy convenientes, la absorción es notoriamente variable entre animales individuales. Siempre debe haber disponible un analgésico inyectable de "rescate" cuando se dependa del fentanilo transdérmico.
Mecanismo de acción
Fentanyl is a highly selective full agonist at the mu-opioid receptor (MOR).
Mechanism Pathway:
- Receptor Binding: Fentanyl binds to presynaptic and postsynaptic mu-receptors primarily located in the central nervous system (limbic system, spinal cord, thalamus, midbrain) and peripheral tissues.
- G-Protein Activation: Binding activates inhibitory G-proteins (Gi/Go).
- Cellular Effects:
- Inhibits adenylate cyclase, decreasing intracellular cAMP.
- Promotes the opening of inward-rectifying potassium (K+) channels, leading to neuronal hyperpolarization.
- Inhibits the opening of voltage-gated calcium (Ca2+) channels on presynaptic nerve terminals.
- Analgesia: This cascade profoundly inhibits the release of excitatory, nociceptive neurotransmitters (such as Substance P and glutamate) and decreases the excitability of postsynaptic neurons, effectively blocking pain transmission.
Seguridad y advertencias
Contraindicaciones
- Known hypersensitivity to fentanyl or patch adhesive
- Conditions where additional respiratory or CNS depression would be deleterious
- No specific contraindications available in the monograph (use with caution in patients with respiratory compromise)
Efectos adversos
- Dose-related respiratory depression
- CNS depression (sedation)
- Circulatory depression (bradycardia)
- Dysphoria or agitation (especially in cats)
- Urine retention
- Constipation
- Contact dermatitis/rash at patch site
- Altered thermoregulation (hypothermia or hyperthermia)
- Severe bradycardia
- Asystole (with rapid IV injection)
- Reduction in heart rate
Precauciones
Patient Selection: Use with extreme caution in geriatric, severely ill, or debilitated patients, and those with preexisting respiratory compromise.
Transdermal Patch Warnings:
- Heat Exposure: Do NOT allow the applied patch to be exposed to exogenous heat sources (e.g., heating pads, heated cages, direct sunlight). Heat significantly increases drug release and absorption, which has resulted in fatal overdoses.
- Fever: Febrile patients may have increased absorption of fentanyl and require intense monitoring. Consider removing the patch if a fever develops.
- Patch Integrity: Do NOT cut patches unless specifically advised by a pharmacist (cutting alters the drug-releasing membrane of gel-reservoir patches, leading to rapid, uncontrolled drug release).
- Variable Absorption: Absorption is highly variable. Always have injectable rescue analgesia available.
Feline Specifics: Opioids may cause mydriasis (dilated pupils) in cats. Approach slowly to avoid startling them, and keep them out of bright light.
Laboratory Alterations: Opiates can increase biliary tract pressure, potentially elevating plasma amylase and lipase values for up to 24 hours post-administration.
Interacciones farmacológicas
May inhibit fentanyl metabolism, increasing risk of toxicity
Additive CNS and respiratory depressant effects
Opiates may decrease diuretic efficacy in congestive heart failure patients
May inhibit fentanyl metabolism
Severe and unpredictable opiate potentiation; generally not recommended within 14 days of MAOI use
Fentanyl may enhance neuromuscular blockade
High fentanyl doses combined with nitrous oxide may cause cardiovascular depression
May increase the metabolism of fentanyl, reducing its efficacy
May increase the metabolism of fentanyl
Fentanyl may exacerbate the effects of tricyclic antidepressants
Opiates may potentiate anticoagulant activity
Reduces the dose requirement for other anaesthetic agents
Monitorización
- Analgesic efficacy (pain scoring)
- Heart rate (monitor for bradycardia)
- Respiratory rate and depth
- Body temperature (monitor for fever which increases patch absorption)
- Neurologic status (sedation, dysphoria)
- Heart rate and rhythm (monitor for bradycardia)
- Blood pressure
- Adequacy of analgesia
- Body temperature (avoid external heat on patches)
Farmacocinética
Vida media
Absorción
Transdermal absorption is highly variable among patients. Cats tend to achieve therapeutic levels faster than dogs. Dogs require patch application 12-24 hours in advance; cats 6-24 hours; horses ~6 hours. Febrile patients may have significantly increased absorption.
Distribución
Rapidly distributes due to high lipophilicity. Exhibits a large volume of distribution (5 L/kg in dogs).
Metabolismo
Hepatic metabolism (implied by interactions with CYP inhibitors like azole antifungals and macrolides).
Eliminación
Total clearance in dogs is 78 mL/min/kg.
Sobredosis
Clinical Signs of Overdose: Profound respiratory and/or CNS depression, cardiovascular collapse, bradycardia, hypothermia, tremors, neck rigidity, and seizures. Newborns are particularly susceptible.
Treatment:
- Naloxone is the specific reversal agent of choice for treating respiratory depression.
- Because naloxone's duration of action is often shorter than fentanyl's, repeated doses or a CRI of naloxone may be required.
- Patients must be closely monitored for re-narcotization.
- Mechanical respiratory support should be instituted in cases of severe respiratory depression.
Productos disponibles
Formulaciones
- Injectable solution (0.05 mg/mL)
- Transdermal patch (12, 25, 50, 75, 100 mcg/hr)
- Buccal tablets
- Transmucosal lozenges
- Iontophoretic transdermal system
- Oral tablets: 100 μg, 200 μg, 400 μg, 600 μg, 800 μg
- Injectable solution: 50 μg/ml
- Transdermal patches: 12.5 μg/h, 25 μg/h, 50 μg/h, 75 μg/h, 100 μg/h
Veterinario
- None (No veterinary-labeled products available)
- Fentadon 50 μg/ml solution
Etiquetado para humanos
- Fentanyl Buccal Tablets: 100 mcg, 200 mcg, 400 mcg, 600 mcg, & 800 mcg (Fentora)
- Fentanyl Injectable: 0.05 mg/mL (50 mcg/mL) in various ampules and vials (Sublimaze)
- Fentanyl Transdermal System: 12 mcg/hr, 25 mcg/hr, 50 mcg/hr, 75 mcg/hr, 100 mcg/hr (Duragesic)
- Fentanyl Iontophoretic Transdermal System: 40 mcg/dose (Ionsys)
- Fentanyl Transmucosal System (Lozenges): 200 mcg to 1600 mcg (Actiq)
- Durogesic patches
- Fentanyl patches/tablets
- Fentora tablets
- Sublimaze solution
Estado regulador
POM-V CD SCHEDULE 2
POM-V CD SCHEDULE 2, POM CD SCHEDULE 2
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Transdermal patches: Store below 25°C (77°F). Apply immediately after removing from the sealed package. Do not cut patches. Buccal tablets: Store at room temperature; do not refrigerate or freeze. Injectable: Protect from light; it is hydrolyzed in acidic solutions.
Información para el cliente
Información de seguridad importante para los propietarios de mascotas:
- Precaución extrema con niños y mascotas: El fentanilo es un narcótico altamente potente. Si un parche se cae o es retirado por la mascota, puede ser fatal si es masticado o ingerido por un niño u otro animal. Deseche los parches usados de forma segura (p. ej., doblando los lados adhesivos juntos y tirándolos por el inodoro o devolviéndolos a la clínica).
- Contacto humano accidental: Si toca accidentalmente el lado adhesivo del parche o el gel, lávese las manos inmediatamente con agua sola SOLAMENTE. NO use jabón, alcohol o desinfectantes de manos, ya que estos pueden aumentar la absorción del fármaco a través de su piel.
- NO usar fuentes de calor: Nunca permita que su mascota se acueste sobre una almohadilla térmica, manta eléctrica o bajo la luz solar directa intensa mientras usa el parche. El calor hace que el fármaco se libere rápidamente, lo que puede causar una sobredosis fatal.
- Efecto retardado: El parche tarda tiempo en comenzar a funcionar (12-24 horas en perros, 6-12 horas en gatos). Su veterinario puede recetar otros medicamentos para el dolor para cubrir este intervalo.
- Monitoreo: Observe a su mascota de cerca para detectar letargo extremo, cambios severos en la respiración (muy lenta o superficial) o agitación inusual. Contacte a su veterinario inmediatamente si esto ocurre.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.