Drug Database
FE

fentanyl (Fentanyl Dura / fentanyl, Lavipharm / fentanyl, Recordati)

✓ Approved

Lavipharm · OPRD1 · Small Molecule

What is fentanyl?

fentanyl is a small molecule developed by Lavipharm. It is approved for therapeutic indications via transdermal.

Drug Profile

Brand NamesFentanyl Dura, fentanyl, Lavipharm, fentanyl, Recordati
CompanyLavipharm
Drug ClassSmall Molecule
Molecular TargetOPRD1, OPRK1, OPRM1
RouteTransdermal
StatusApproved
Sources: ClinicalTrials.gov, Lavipharm

Mechanism of Action

Molecular Targets

fentanyl acts on 3 molecular targets:

OPRD1opioid receptor delta 1 (DOR, OPRD)
OPRK1opioid receptor kappa 1 (KOR1, OPRK)
OPRM1opioid receptor mu 1 (MOR1, LMOR)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

fentanyl is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Gastrointestinal disordersAbdominal pain✓ Approved

Related Research Articles

PubMedIndian journal of anaesthesia2026-07-25

Comparative evaluation of segmental spinal anaesthesia with conventional spinal anaesthesia in endoscopic transurethral surgery.

Kumar Prashant P, Kumari Twinkal T, Vashishth Sumedha S, Kaur Kiranpreet K et al.

Lumbar spinal anaesthesia (LSA) for endoscopic urological procedures often causes extensive sympathetic blockade, leading to hypotension, bradycardia, and delayed ambulation. Thoracic segmental spinal anaesthesia (TSSA) offers targeted sensory blockades with limited motor involvement and improved haemodynamic stability. The primary objective of the study was to compare motor block onset between TSSA and LSA. Secondary objectives included sensory block characteristics, two-segment regression time, haemodynamics, perioperative complications, and patient and surgeon satisfaction. Forty American Society of Anesthesiologists (ASA) class I-II patients were randomised to group T (TSSA, n = 20; 1 mL 0.5% isobaric ropivacaine + 20 µg fentanyl at T11-T12) or group S (LSA, n = 20; 2 mL 0.5% hyperbaric ropivacaine + 20 µg fentanyl at L3-L4). Sensory and motor block, haemodynamic parameters, rescue analgesia, satisfaction scores, and adverse events were recorded. Group T achieved faster sensory block to T10 (1.7 ± 1.08 vs 4.48 ± 1.97 min, P < 0.001), quicker maximum block height (3.42 ± 1.46 vs 8.95 ± 3.3 min, P < 0.001), and shorter two-segment regression (58 ± 6.5 vs 88.77 ± 7.73 min, P < 0.001). Motor block onset was similar (6.6 ± 2.96 vs 5.8 ± 1.67 in groups T and S, respectively), but group S had higher Bromage scores and prolonged blockade (time to Bromage score 0: 61.85 ± 26.37 vs 184.21 ± 30.06 min, P < 0.001). Group S showed greater heart rate and mean arterial pressure reductions (P < 0.05). Patients in Group T ambulated earlier than group S (152.25 ± 29.76 vs 284 ± 26.04 min; P < 0.001). TSSA provides less motor blockade, targeted sensory block, maintains haemodynamic stability, and enables earlier ambulation, making it a safe and effective alternative in endoscopic urological surgery.

PMID 42500634
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PubMedCureus2026-07-25

Progression of Atrioventricular Conduction Disorder Induced by Radiofrequency Ablation for Hepatocellular Carcinoma.

Nakama Rakuhei R, Sone Miyuki M, Shoji Masaaki M, Ogura Nozomu N et al.

Radiofrequency ablation (RFA) is generally considered a safe treatment for hepatocellular carcinoma. Although cardiovascular complications have been occasionally reported, they are primarily attributed to sedatives and analgesics or the vasovagal reflex. However, a unique case is presented where RFA itself was suspected of inducing a progressive atrioventricular disorder. An 80-year-old male underwent RFA for hepatocellular carcinoma. His electrocardiogram showed a first-degree atrioventricular block on admission. Prior to ablation, fentanyl and propofol were administered. Severe bradycardia developed immediately after initiation of ablation. RFA and propofol infusion were terminated, leading to prompt heart rate recovery. After approximately five minutes, ablation was resumed without propofol, but severe bradycardia recurred. The electrocardiogram during RFA revealed a complete atrioventricular block. Therefore, the procedure was terminated. A 12-lead electrocardiogram performed after the aborted procedure revealed progression to a second-degree AV block (Mobitz type II) requiring pacemaker implantation. The exact mechanism of this effect remains unclear, though progression of the atrioventricular conduction disorder was considered to be induced by RFA. Careful intraoperative patient management is crucial during RFA.

PMID 42500801
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PubMedSurgical endoscopy2026-07-25

Transversus abdominis plane block improved surgical conditions in neuromuscular blocker-free pediatric laparoscopic hernia repair: a randomized trial.

Tian Jia-He JH, Zhang Ning N, Wang Chen-Chen CC, Zhu Xiao-Rong XR et al.

Pediatric laparoscopic hernia repair (LHR) is a short, commonly performed ambulatory procedure that can be conducted under general anesthesia without neuromuscular blocker (NMB). This prospective randomized controlled trial evaluated whether a transversus abdominis plane (TAP) block facilitates the implementation of NMB-free anesthesia in this surgical setting. Eighty pediatric patients scheduled for LHR without NMB were stratified by age (≤ 3 or > 3 years) and randomized to receive either a bilateral TAP block after induction (TAPB group) or surgical-site local infiltration at closure (Control group). The primary outcome was the mean intraoperative Leiden Surgical Rating Scale (L-SRS) score. The TAPB group demonstrated significantly higher mean L-SRS scores compared with controls (mean difference, 0.9; 95% CI, 0.69-1.11; p < 0.001), consistent across age subgroups. Age-stratified analysis revealed a markedly increased risk of intraoperative hemodynamic stress responses in the Control group, with adjusted odds ratios of 10.09 (95% CI, 3.46-29.42; Cochran's p < 0.001) for mean arterial pressure elevation ≥ 15% and 4.78 for heart rate elevation ≥ 15%, as well as a higher need for remifentanil rescue (adjusted odds ratio, 10.09; 95% CI, 3.44-29.60; Cochran's p < 0.001). The TAPB group also exhibited improved postoperative recovery, with significantly lower rates of emergence delirium (10 vs. 37.5%), moderate-to-severe pain (37.5 vs. 80%), and postoperative fentanyl rescue (2.5 vs. 20%; all p < 0.05). The addition of a TAP block significantly improved surgical conditions during pediatric LHR under an NMB-free general anesthesia strategy, while attenuating stress responses and enhancing postoperative recovery quality.

PMID 42498867
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PubMedReports (MDPI)2026-07-24

Refractory Uterine Atony After Sequential Neuraxial Opioid Administration-A Case Report.

Moisa Ramona Celia RC, Negrut Nicoleta N, Moisa Cezar Cristian Mihai CCM, But Denisa Florina DF et al.

Background and Clinical Significance: Uterine atony is the most frequent cause of postpartum hemorrhage and remains a major contributor to maternal morbidity worldwide. Neuraxial opioids are routinely used as adjuvants for labor analgesia and cesarean delivery anesthesia; however, their possible influence on myometrial contractility remains incompletely clarified. We describe a severe case of refractory uterine atony after emergency cesarean delivery in a patient exposed sequentially to epidural fentanyl during labor and intrathecal morphine for cesarean anesthesia; Case Presentation: A 34-year-old primigravida at 39 weeks and 4 days of gestation presented with early labor that had begun less than one hour earlier. Epidural labor analgesia was provided with ropivacaine, and the total epidural fentanyl exposure was 100 mcg over an approximately 7 h catheter period. Labor was complicated by dysfunctional uterine activity and cervical dystocia despite 3 h and 30 min of oxytocin augmentation. Emergency cesarean delivery was performed under spinal anesthesia with hyperbaric bupivacaine and intrathecal morphine. After delivery of a healthy neonate and uncomplicated placental separation, the patient developed severe uterine atony with postpartum hemorrhage. Hemorrhage persisted despite uterotonic therapy, continuous uterine massage, hemostatic suturing, and B-Lynch compression suture. Blood loss, measured using the suction canister and estimated from surgical swabs, was approximately 3800 mL. Progressive hemodynamic instability required transfusion therapy, conversion to general anesthesia, norepinephrine support, and emergency total abdominal hysterectomy. The postoperative course was favorable, and the patient was discharged on the eighth postoperative day; Conclusions: This case illustrates the rapid progression and therapeutic complexity of refractory uterine atony after emergency cesarean delivery in the setting of dysfunctional labor, oxytocin augmentation, cesarean delivery, sequential neuraxial opioid exposure, and subsequent hemorrhagic instability. A possible contribution of sequential neuraxial opioid administration to impaired myometrial contractility cannot be excluded; however, causality cannot be established from a single case. Early recognition, structured escalation, transfusion support, and timely multidisciplinary surgical management remain essential in severe postpartum hemorrhage.

PMID 42496524
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PubMedAustralian critical care : official journal of the Confederation of Australian Critical Care Nurses2026-07-24

"A little bit of propofol, a little bit of fentanyl does wonders for everyone": Understanding the sedation practices of healthcare professionals when caring for mechanically ventilated intensive care unit (ICU) patients-A qualitative study.

Varga Sarah S, Moore Tracey T, Seymour Jane J, Mills Gary G et al.

Sedation is commonly used in intensive care units (ICUs), but there is limited evidence about how staff members make sense of their sedation practice or what influences their use of sedation. The aim of this study was to report qualitative case study findings that compare ICU sedation practice and staff perspectives in Australia and the UK, with the aim of informing international practice and policy. A qualitative case study approach was applied in one general ICU in Australia and one in the UK. Between November 2021 and February 2023, nurses, doctors, and allied health professionals were recruited. Data were collected through focus groups, participant observation, clinical notes review, and semistructured interviews. A cross-case analysis was completed using reflexive thematic analysis. In Australia, 43 ICU staff members participated; in the UK, 91 ICU staff members participated. Twenty-four patients were observed, and their notes were reviewed. Two focus groups, 18 interviews, and over 300 observation hours were completed. The cross-case analysis identified similarities and differences in sedation practice between the ICUs. Each unit had differences in sedation reduction and contrasting daily routines influencing sedation use. In both units, key drivers of decision-making were similar, namely the physical layout, perceptions of moral distress, and safety concerns. This paper presents an in-depth exploration of the sedation practices and perspectives of healthcare professionals working in an ICU in Australia and a similar ICU in the UK. Through the cross-case analysis, we have shown the importance of attending to the physical layout of ICUs and understanding the concerns of staff about safety and the moral dimensions of their practice when aspiring to implement best sedation practice. Furthermore, we have revealed that similar ICUs in different countries take different approaches to sedation reduction, highlighting the need for greater international exchange on this crucial area of ICU practice.

PMID 42492346
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PubMedFrontiers in neuroscience2026-07-23

Changes in perineuronal net and parvalbumin expression in the orbitofrontal cortex of male Wistar rats following repeated fentanyl administration.

Dejeux Mariana I H MIH, Jewanee Sarah S SS, Moutos Samuel S, Trehan Arjun A et al.

The misuse of opioid medications is a significant health issue in the United States. Very few studies have investigated the effect of opioids on perineuronal nets (PNNs), scaffold-like structures that surround neurons and are involved in the regulation of plasticity-dependent mechanisms such as development, learning and memory, and acquisition of addiction-like phenotypes. Regulation of PNNs in the orbitofrontal cortex (OFC) during periods of drug intoxication or withdrawal is widely unknown. In this study, male Wistar rats were injected with fentanyl (0.125 mg/kg, s.c.) or 0.9% saline twice daily for 7 days and once on day 8 (7 continuous days following by 3 days of abstinence) or twice daily for 15 days (5 continuous days followed by 2 days of abstinence for more than 3 weeks) and twice on day 16. Antinociception was evaluated using the tail immersion test immediately before and 30 min after injections. Whole-brain coronal slices were collected, and histochemistry was used to identify Wisteria Floribunda Agglutinin (WFA)-positive PNNs and parvalbumin (PV)-expressing cells. Results confirmed that repeated fentanyl injections induced tolerance to the antinociceptive effects, which normalized following acute abstinence periods. WFA intensity decreased following 8 days of injections. Analyses confirmed significant correlations between PV+ density and tail withdrawal latency following 8 days of fentanyl injections. These data confirm that repeated fentanyl injections modulate both WFA+ and PV+ expression in the rodent brain and antinociceptive tolerance in a duration-dependent manner. Overall, these data suggest that perineuronal nets may mediate opioid-induced behavioral effects, such as antinociceptive tolerance, following repeated administration and abstinence in rats.

PMID 42487688
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