FENTANYL KALCEKS SOLUTION FOR INJECTION 0.05 MG/ML

GOLDPLUS UNIVERSAL PTE LTD

GOLDPLUS UNIVERSAL PTE LTD

Therapeutic

Prescription Only

INJECTION, SOLUTION

**4.2 Posology and method of administration** The dosage of fentanyl should be individualized according to age, body weight, physical status, underlying pathological condition, use of other drugs, and type of surgery and anaesthesia. To avoid bradycardia, it is recommended to administer a small intravenous dose of an anticholinergic just before anaesthetic induction. A neuroleptic may be given to prevent nausea and vomiting. _Adult_ **Use as an analgesic supplement to general anaesthesia** **_Low dose: 2 mcg/kg_** Fentanyl in small doses is most useful for minor surgery. **_Moderate dose: 2–20 mcg/kg_** Where surgery becomes more complicated, a larger dose will be required. The duration of activity is dependent on dosage. **_High dose: 20–50 mcg/kg_** During major surgical procedures, in which surgery is longer, and during which the stress response would be detrimental to the well-being of the patient, doses of 20–50 mcg/kg of fentanyl with nitrous oxide/oxygen have been shown to have an attenuating effect. When doses in this range have been used during surgery, post-operative ventilation and observation are essential in view of the possibility of extended post-operative respiratory depression. Supplemental doses of 25–250 mcg (0.5–5 ml) should be tailored to the needs of the patient and to the anticipated time until completion of the operation. **Use as an anaesthetic agent** When attenuation of the response to surgical stress is especially important, doses of 50–100 mcg/kg may be administered with oxygen and a muscle relaxant. This technique provides anaesthesia without necessitating the use of additional anaesthetic agents. In certain cases, doses up to 150 mcg/kg may be required to produce this anaesthetic effect. Fentanyl has been used in this fashion 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. _Pediatrics_ For induction and maintenance in children aged 2–12 years, a dose of 2–3 mcg/kg is recommended. _Use in elderly and debilitated patients_ The initial dose should be reduced in elderly and debilitated patients. The effect of the initial dose should be taken into account in determining supplemental doses. _Use in patients with renal and/or hepatic impairment_ The initial dose should be reduced for patients with renal and/or hepatic impairment. _Method of administration_ This medicine should be given only in an environment where the airway can be controlled and by personnel who can control the airway (see section 4.4 – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_). This medicine can be administered intravenously either as a _bolus_ or by infusion, as well as intramuscular injection. Fentanyl Kalceks may be used intravenously in adults and children.