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

PubMedBMC pediatrics2026-11-12

Weaning critically ill children undergoing prolonged sedation: challenges in achieving standardized practice.

Colosimo Denise D, Bindi Diletta D, Mannini Diletta D, Piombino Edoardo E et al.

The aim of this study was to observe how drug dose reduction and interruption is conducted in critically ill children receiving sedation for longer than 5 days, analyzed as drug dose percentage modifications relative to the first day of weaning. We also assessed adherence to a predefined tapering target between 10 and 20% of the initial sedative dose. Retrospective cohort study in a tertiary pediatric intensive care unit (PICU). Overall, 41 patients were enrolled. The cohort median (interquartile range) daily percentage reductions during the weaning phase were 10.6% (3.8-20.4) for fentanyl, 3.3% (0-13.7) for midazolam, 0% (0-10.7) for dexmedetomidine, 5.4% (0-15.4) for ketamine, and 10.5% (0-20.0) for propofol. Median reductions were significantly lower from the 20% target for midazolam, dexmedetomidine, ketamine, and propofol, while fentanyl showed a borderline difference. Adherence to the scheduled tapering range (10-20%) was low across all sedatives during weaning phase. Fentanyl had the highest proportion of weaning days within the target range (19.8%). Overall, only 16 (39%) patients had Withdrawal Assessment Tool 1 (WAT-1) data. Of these, 8 (50%) were positive on the first day of evaluation and three (18%) on the last day. In children sedated for more than 5 days the recommended weaning rate was rarely respected. Withdrawal monitoring was suboptimal and did not guide drug weaning.

PMID 43015735
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PubMedJournal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures)2026-11-12

Comparative study between airway pressure release ventilation (APRV) and biphasic positive airway pressure (BIPAP) ventilation for patients with acute respiratory distress syndrome (ARDS).

Abdelraouf Ahmed Fayez AF, Saleh Galal Abouelsoud GA, Kamal Manal Mohamed MM, Mohamed Rana Ayman RA et al.

Severe hypoxemia, decreased respiratory system compliance, and extensive inflammatory infiltrates are the hallmarks of acute respiratory distress syndrome, that commonly requires mechanical ventilation. The best ventilator strategies for ARDS are still being researched, despite advancements in ventilatory control. Pressure-controlled ventilation modes, including airway pressure release ventilation and biphasic positive airway pressure ventilation, are frequently used in clinical practice and can affect oxygenation, respiratory mechanics, and mechanical ventilation duration through a variety of physiological mechanisms. To compare APRV and BiPAP modes regarding oxygenation, respiratory mechanics and clinical outcomes in intubated ventilated ARDS patients. Fifty adult patients with ARDS were recruited in this study after admission to the ICU and initiation of mechanical ventilation. They were randomly assigned to two groups: Group A (APRV) and Group B (BiPAP). The two groups were comparable in terms of age, sex, and hemodynamics throughout study time points. Oxygenation and partial pressure of carbon dioxide, baseline respiratory mechanics (plateau pressure, mean airway pressure and compliance) were comparable between the two groups. Thereafter, mean airway pressure became higher in the APRV group throughout further study time points; however, the differences were statistically significant only on days 1 and 3. Patients in the APRV group required significantly higher doses of fentanyl and midazolam compared with the BiPAP group on day 1 and 3 only. No significant differences were observed between the two groups in ventilation duration, ventilator-free days by day 28, ICU length of stay, clinical complication occurrence or mortality. In ARDS patients, no significant difference observed between APRV mode and BiPAP mode regarding oxygenation, respiratory mechanics, mechanical ventilation duration and occurrence of clinical complications.

PMID 43016790
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PubMedAnesthesiology and pain medicine2026-11-12

Association of Opioid Dependence with the Clinical Performance of Intrathecal Ropivacaine During Spinal Anesthesia: A Prospective Cohort Study.

Razavi Majid M, Ebrahimi Bentolhoda B, Golmakani Ebrahim E, Afzal Aghaee Monavar M et al.

Opioid dependence may be associated with altered pain processing and may influence the efficacy of local anesthetics during spinal anesthesia. This study evaluated the association of opioid dependence with sensory and motor block characteristics and early postoperative analgesic outcomes following intrathecal ropivacaine anesthesia. In this prospective cohort study, 60 patients undergoing surgery under spinal anesthesia were enrolled, including 30 opioid-dependent patients and 30 non-dependent controls. Opioid dependence was characterized by a history of regular use of heroin-containing opioid preparations, with recent exposure confirmed by blood-based screening. All participants received intrathecal 0.5% ropivacaine (8 - 10 mg) with fentanyl 25 μg. Sensory block onset and duration, time to maximum sensory block, motor block characteristics, recovery-room pain scores, rescue analgesia, hemodynamic parameters, adverse events, and patient satisfaction were assessed. Ultimately, 28 patients in each group were analyzed. No statistically significant differences in baseline demographic characteristics were observed between the groups. Opioid-dependent patients had shorter sensory and motor block durations (P = 0.003 and P = 0.001, respectively), longer sensory block onset time (P = 0.001), and longer time to maximum sensory block (P = 0.002). Motor block onset and time to maximum motor block did not differ significantly between the groups. Recovery-room pain scores were higher at several assessment time points in the opioid-dependent group, and 11/28 (39.3%) patients in this group required morphine, compared with 4/28 (14.3%) controls (P = 0.035). No significant differences were observed in overall patient satisfaction or adverse events. Hemodynamic measurements did not differ significantly at most time points; however, systolic blood pressure was higher at 25 minutes and heart rate was lower at 12 minutes after spinal anesthesia in the opioid-dependent group (both P = 0.039). Opioid dependence was associated with shorter sensory and motor block durations, a longer sensory block onset time, and greater analgesic requirements in the early recovery room after spinal anesthesia with intrathecal ropivacaine. These findings suggest that opioid-dependent patients may benefit from individualized perioperative anesthetic and analgesic strategies to optimize pain management and potentially improve clinical outcomes.

PMID 43017444
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PubMedAnalytical chemistry2026-11-11

96-Sample Parallel BioSPME-DART-MS Platform for Rapid Screening of Fentanyl and its Analogues in Biofluids.

Zhou Wei W, Driezen Marc M, Pawliszyn Janusz J

Solid-phase microextraction (SPME) with biocompatible coating material is highly compatible with ambient mass spectrometry (AMS), such as direct analysis in real time (DART), for improving sensitivity and reducing matrix effects. However, the practical throughput of SPME-DART-MS remains limited by the mismatch between parallel sample preparation and device-to-source transfer. Here, we introduce a 96-sample parallel BioSPME-DART-MS platform that integrates automated SPME extraction, 96-channel liquid transfer, and a matched 96-position DART mesh interface. This design enables 96 biological samples to be processed in a plate-based format, greatly improves workflow transferability. Thin HLB/PAN-coated SPME blades were used to provide bio-compatible extraction and cleanup from whole blood, plasma, and urine. After desorption in 200 μL of solvent, only 5 μL of the extract was transferred to the DART mesh for rapid MS/MS screening, while the remaining solution was retained for sequential LC-MS/MS confirmation without additional sample preparation. The system enabling an average analysis time of approximately 40 s per sample. Using six fentanyl and its analogues as model analytes, the BioSPME-DART-MS method achieved good sensitivity across the three biofluids, with limits of detection of 0.10-0.50 ng mL-1 in whole blood, 0.03-0.20 ng mL-1 in plasma, and 0.01-0.20 ng mL-1 in urine. In addition, a comparative study of absolute matrix effects revealed that chromatography-free DART-MS and blade spray-MS remained susceptible to ion suppression, whereas LC-ESI-MS showed negligible matrix effects. This platform establishes a high-throughput, two-tier SPME-MS workflow that combines rapid ambient MS screening with chromatography-based confirmation.

PMID 43010421
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PubMedInternational journal of obstetric anesthesia2026-11-11

Maternal and fetal anesthetic management during in utero embolization for fetal vein of Galen malformation: a case series.

Seifert Sebastian M SM, Roth Joeli J, Guidugli Tyler T, Reale Sharon C SC et al.

In utero embolization for fetal vein of Galen malformation is a novel ultrasound-guided transuterine, transcranial fetal neurointervention. We describe the anesthetic management for this procedure. We conducted a retrospective case series of the anesthetic management of patients undergoing in utero vein of Galen malformation embolization at a fetal surgery program. Maternal and fetal anesthetic techniques and perioperative complications were assessed using descriptive statistics. Nine patients underwent attempted embolization. Combined spinal-epidural anesthesia was employed in all cases, with conversion to general anesthesia in one. Fetal anesthesia consisted of intramuscular fentanyl, rocuronium, and atropine. Complications included fetal bradycardia and emergent delivery. Fetal vein of Galen malformation embolization can be performed under combined spinal-epidural anesthesia with general anesthesia in reserve. Direct fetal anesthesia provides analgesia and immobility. Multidisciplinary maternal-fetal anesthetic coordination and preparedness for emergent delivery are essential. These findings provide guidance for anesthetic management of this novel procedure.

PMID 43013901
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PubMedDrug and alcohol dependence2026-11-10

Fentanyl and xylazine precipitated withdrawal in Swiss Webster mice.

Shepherd Brandon B, Cakir Kerim K, Walker Ellen A EA

In recent years, α2-adrenoreceptor (α2AR) agonists have become common adulterants of illicit fentanyl supplies. One such drug is xylazine, a veterinary anesthetic not approved for human use. There is little known about effects of xylazine upon repeated administration, interactions between fentanyl and xylazine, and how xylazine may alter withdrawal from fentanyl. In this work, we established a precipitated withdrawal procedure with the goal of understanding withdrawal from xylazine and how it may impact withdrawal from fentanyl. Mice received fentanyl, xylazine, or both, followed by antagonists naloxone, idazoxan, or both 2h later. Mice were then placed into a large glass beaker and observed for two 60s intervals at 9- and 17-min post injection, and presence of withdrawal signs was recorded in each interval. Injections of fentanyl or xylazine followed by antagonists naloxone or idazoxan, respectively, each produced a unique set of precipitated withdrawal signs. Both produced significant grimace and wet dog shakes; however, precipitated fentanyl withdrawal also produced paw tremors and jumps whereas xylazine withdrawal produced scratching. Xylazine coadministration with fentanyl increased the frequency of some signs of fentanyl precipitated withdrawal while decreasing others. This work suggests that the addition of xylazine to illicit fentanyl supplies is changing the somatic state of fentanyl withdrawal, which may impact patients in clinical settings.

PMID 43008358
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