Fentanyl, also spelled fentanil, is a highly potent synthetic piperidine opioid drug primarily used as an analgesic. Because fentanyl is 50 to 100 times more potent than morphine, its primary clinical utility is in pain management for cancer patients and those recovering from painful surgical operations. Fentanyl is also used as a sedative. Depending on the method of delivery, fentanyl can be very fast acting and ingesting a relatively small quantity can cause overdose.
Fentanyl works by activating mu-opioid receptors.
Fentanyl is also commonly known as fentanyl citrate, and is sold under the brand name Sublimaze among others.
Pharmaceutical fentanyl's adverse effects resemble those of other narcotic opioids, including addiction, confusion, respiratory depression (which, if extensive and untreated, may lead to arrest), drowsiness, nausea, visual disturbances, dyskinesia, hallucinations, delirium, a subset of the latter known as "narcotic delirium", analgesia, narcotic ileus, muscle rigidity, constipation, loss of consciousness, hypotension, coma, and death. Alcohol and other drugs (i.e., cocaine, heroin) can synergistically exacerbate fentanyl's side effects. Naloxone (also known as Narcan) can reverse the effects of an opioid overdose; however, because fentanyl is so potent, multiple doses might be necessary.
Fentanyl was first synthesized by Paul Janssen in 1959 and was approved for medical use in the United States in 1968. In 2015, were used in healthcare globally. , fentanyl was the most widely used synthetic opioid in medicine; in 2019, it was the 278th most commonly prescribed medication in the United States, with more than a million prescriptions. It is on the World Health Organization's List of Essential Medicines.
Fentanyl continues to fuel an epidemic of synthetic opioid drug overdose deaths in the United States. While prescription opioid deaths remained stable from 2011 to 2021, synthetic opioid deaths increased from 2,600 overdose deaths per year to 70,601 per year across the same period.