Fentanyl Citrate Injection in the UK: A Guide to Brand Names, Uses, and Clinical Overview
Fentanyl citrate is a potent synthetic opioid analgesic, commonly acknowledged in clinical medicine for its quick onset and short duration of action. Within the United Kingdom's health care system, fentanyl plays an important function in perioperative care, intensive care, and the management of intense, extreme pain. Due to the fact that of its potency-- approximated to be 50 to 100 times that of morphine-- its administration via injection is strictly controlled and normally reserved for medical facility settings.
For health care experts, trainees, or patients seeking to comprehend the medicinal landscape in the UK, determining the available brand and producers of fentanyl citrate injection is important. read more supplies a detailed introduction of the brand, medical indicators, and regulatory status of fentanyl citrate injections in the United Kingdom.
What is Fentanyl Citrate?
Fentanyl citrate is a phenylpiperidine derivative that serves as a powerful agonist at the μ-opioid (mu-opioid) receptors in the central nerve system. When administered by means of intravenous (IV) or intramuscular (IM) injection, it provides quick analgesia. In the UK, it is categorized as a Class A controlled drug under the Misuse of Drugs Act 1971 and falls under Schedule 2 of the Misuse of Drugs Regulations 2001.
Its primary appeal in surgical settings is its ability to offer extreme discomfort relief while keeping hemodynamic stability, making it a favored option for cardiac surgeries and for patients with fragile cardiovascular systems.
Fentanyl Citrate Injection Brand Names and Manufacturers in the UK
In the UK market, lots of pharmaceutical items are prescribed by their generic name (Fentanyl) instead of a trademark name. However, a number of producers provide the NHS and private healthcare facilities with particular solutions. Historically, the most well-known trademark name connected with fentanyl citrate was Sublimaze, originally established by Janssen Pharmaceutica. While the name Sublimaze is still used worldwide and informally in some UK theatres, the bulk of the supply in the UK is now supplied by generic manufacturing specialists.
Table 1: Common Manufacturers and Product Details in the UK
| Maker | Product Description | Typical Strengths |
|---|---|---|
| Hameln Pharma | Fentanyl Citrate Injection BP | 50 micrograms/ml (2ml, 10ml ampoules) |
| Wockhardt UK | Fentanyl Citrate Injection | 50 micrograms/ml (2ml, 10ml ampoules) |
| Martindale Pharma | Fentanyl Citrate | 50 micrograms/ml (2ml, 10ml, 20ml ampoules) |
| Janssen-Cilag | Sublimaze (Historical Brand) | 50 micrograms/ml |
| Pirimal Critical Care | Fentanyl Citrate Injection | 50 micrograms/ml |
While the trademark name "Sublimaze" might still appear on some procurement lists, the UK medical landscape is controlled by Hameln and Martindale generic variations, which are bioequivalent to the original branded item.
Scientific Indications for Injection
Fentanyl citrate injection is utilized throughout different departments, from the Emergency Department (ED) to the Operating Theatre. Its usage is usually divided into 3 classifications:
1. Anaesthesia
Fentanyl is a cornerstone of modern anaesthesia. It is utilized as an analgesic supplement during the induction and maintenance of basic anaesthesia. It helps blunt the body's physiological "tension response" to intubation and surgical incision.
2. Post-operative Recovery
In the Recovery Room (PACU), fentanyl may be administered in little, titrated boluses to manage immediate post-surgical pain before transitions are made to longer-acting opioids or oral medications.
3. Intensive Care (ICU)
In the Intensive Care Unit, fentanyl is often used as an infusion to offer constant analgesia for clients who are mechanically aerated. Its brief half-life allows for more foreseeable "wake-up" tests compared to drugs like morphine.
Table 2: Clinical Application Summary
| Application | Role of Fentanyl |
|---|---|
| Pre-medication | To provide sedation and analgesia before moving to theatre. |
| Induction | To work together with induction representatives (like Propofol) for a smooth transition to unconsciousness. |
| Maintenance | To manage the surgical pain stimulus during the procedure. |
| Analgesic Supplement | Utilized in local anaesthesia (like epidurals) to enhance pain relief. |
Mechanism of Action and Pharmacokinetics
Fentanyl works by binding to mu-opioid receptors. This binding inhibits ascending pain paths, altering the perception of and response to pain. It also increases the discomfort limit.
- Start of Action: 1-- 2 minutes (Intravenous).
- Peak Effect: 3-- 5 minutes.
- Duration: 30-- 60 minutes (making it highly titratable).
- Metabolic process: Primarily in the liver by means of the CYP3A4 enzyme.
- Excretion: Mostly by means of the kidneys.
Because fentanyl is extremely lipid-soluble, it crosses the blood-brain barrier practically quickly, which describes why the analgesic impact is felt so much faster than with morphine or oxycodone.
Safety and Side Effects
Just like all powerful opioids, fentanyl citrate carries a risk of considerable negative effects, especially connecting to the respiratory and cardiovascular systems.
Typical Side Effects:
- Respiratory Depression: The most major danger; it minimizes the drive to breathe.
- Bradycardia: A sluggish heart rate.
- Hypotension: Low high blood pressure.
- Muscle Rigidity: Specifically "wooden chest syndrome," where the chest wall ends up being too stiff to aerate quickly (typically takes place with high-dose rapid IV administration).
- Queasiness and Vomiting: Common in the post-operative stage.
- Pruritus: Itching, frequently around the nose or upper body.
Contraindications and Cautions:
- Known hypersensitivity to fentanyl or other opioid agonists.
- Breathing anxiety in the absence of resuscitative devices.
- Concurrent use of Monoamine Oxidase Inhibitors (MAOIs) within the last 14 days (threat of serotonin syndrome).
- Myasthenia gravis (due to muscle-relaxing interactions).
Guideline and Storage in the UK
In the United Kingdom, fentanyl citrate is strictly controlled to avoid diversion and abuse.
- Storage: It needs to be kept in a locked "Controlled Drugs" (CD) cabinet that fulfills the British Standard for security.
- Record Keeping: Every dosage administered need to be recorded in a Controlled Drugs Register, signed by 2 certified health care specialists (typically a medical professional and a nurse, or more nurses).
- Disposal: Any lost or unused part of an ampoule should be seen and damaged according to local trust policy (usually using a denaturing kit).
FREQUENTLY ASKED QUESTION: Fentanyl Citrate Injection in the UK
1. Is Sublimaze still offered in the UK?
While the trademark name Sublimaze is the "innovator" item, most UK healthcare facilities currently use generic versions made by business like Hameln or Martindale. These are pharmacologically similar.
2. What is the basic concentration of Fentanyl injection in the UK?
The basic concentration is 50 micrograms per millilitre (50 mcg/ml). It is usually offered in 2ml (100mcg) and 10ml (500mcg) ampoules.
3. Can Fentanyl injection be offered at home?
No. Fentanyl citrate injection is nearly solely used in hospital settings (theatre, ICU, A&E) since of the danger of quick breathing depression, which needs immediate access to oxygen and resuscitation equipment.
4. How does Fentanyl compare to Morphine in strength?
Fentanyl is roughly 50 to 100 times more powerful than morphine. This means 100 micrograms of fentanyl is approximately comparable to 10 milligrams of morphine.
5. What is the remedy for a Fentanyl overdose?
Naloxone (brand name Prenoxad or generic) is the basic opioid antagonist utilized to reverse the impacts of fentanyl if breathing depression takes place.
Summary
Fentanyl citrate stays one of the most essential medications in the UK's surgical and extensive care environments. While it may be referred to by the historical brand Sublimaze, it is mainly utilized in its generic type provided by manufacturers such as Hameln, Wockhardt, and Martindale Pharma.
Its high potency and fast start make it an unequaled tool for managing severe discomfort and helping with anaesthesia, but these exact same qualities necessitate the greatest level of scientific monitoring and regulatory oversight. Comprehending the brand names and the medicinal profile of this drug is essential for safe practice and patient security within the NHS and the wider UK healthcare sector.
Disclaimer: This article is for informative functions only and does not make up medical recommendations. Healthcare experts should always refer to the British National Formulary (BNF) or their local Trust standards for dosing and administration procedures.
