Sublimaze
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PACKAGE LEAFLET: INFORMATION FOR THE USER © J-C 2014 GB - aw_94332
Sublimaze® 50 micrograms/ml solution for injection or infusion
Fentanyl citrate
Sublimaze is a registered trademark
Read all of this leaflet carefully before you start using this medicine because it contains important information for you.
• Keep this leaflet. You may need to read it again
• If you have any further questions, ask your doctor or nurse
• This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours
• If you get any side effects talk to your doctor or nurse. This includes any possible side effects not listed in this leaflet. See section 4.
What is in this leaflet
1 What Sublimaze is and what it is used for
2 What you need to know before you are given Sublimaze
3 How Sublimaze is given
4 Possible side effects
5 How to store Sublimaze
6 Contents of the pack and other information
1 What Sublimaze is and what it is used for
Sublimaze contains a medicine called fentanyl citrate.
It belongs to a group of medicines called ‘opioid analgesics'. Sublimaze is a strong painkiller that works for a short period of time.
Sublimaze is used to prevent or relieve pain during different types of surgery. It can be used for:
• Short operations, where you go home on the same day
• Longer operations where you may stay in hospital for a number of days
High doses of Sublimaze are also used to lower your natural breathing rate when you are on a ventilator. During major operations, it is used together with a sedative known as a neuroleptic to put you to sleep. It can also be used to relieve severe pain such as during a heart attack.
2 What you need to know before you are given Sublimaze
Do not have Sublimaze if:
• You are allergic to anything in Sublimaze (listed in section 6 below)
• You are allergic to other strong medicines for pain called ‘opioid analgesics'
• You suffer from breathing difficulties called ‘obstructive airways disease' or ‘respiratory depression'. You may only be able to have Sublimaze if your breathing
is helped by a machine called a ventilator
• You are in labour or before the cord is clamped during a Caesarean section, Sublimaze may affect the baby's breathing
Do not use this medicine if any of the above applies to you. If you are not sure, talk to your doctor or nurse before having Sublimaze.
Warnings and precautions
Check with your doctor or nurse before using this medicine if you have or have ever had:
• Problems with your lungs, liver or kidneys
• An underactive thyroid gland
• Problems with alcohol (alcoholism)
• A muscle weakness called ‘myasthenia gravis'
• Long-term treatment with strong painkillers
• Low blood volume
• A recent head injury
• If you are elderly or weak due to ill health
Your doctor will carefully monitor the amount of Sublimaze they give you. If you are not sure if any of the above applies to you, talk to your doctor or nurse before having Sublimaze.
Special monitoring
• Sublimaze may make you breathe more slowly.
Your breathing will be carefully monitored until it returns to normal.
• Your blood pressure and heart rate may also be monitored
Other medicines and Sublimaze
Please tell your doctor or nurse if you are taking or have recently taken any other medicines. This includes medicines that you buy without a prescription or herbal medicines.
In particular, do not have this medicine and tell your doctor or nurse if:
• You have taken medicines for depression called ‘monoamine oxidase inhibitors' (MAOIs) in the past two weeks
If this applies to you, do not have Sublimaze
It is especially important to talk to your doctor or nurse if you are taking any of the following:
• Medicines for depression (such as citalopram, duloxetine, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, venlafaxine)
The effects of Sublimaze or any of these medicines may be increased when they are taken together
• Other strong medicines for pain called ‘opioid analgesics' such as morphine or codeine
• Medicines for putting you to sleep called ‘anaesthetic agents'
• Medicines for anxiety or to help you sleep such as tranquillisers or sleeping pills
• Medicines for HIV infection (called antiviral protease inhibitors) such as ritonavir, indinavir or saquinivir
• Medicines for treating a fungal infection such as fluconazole or voriconazole
The dose of etomidate and midazolam may need to be reduced if given together with Sublimaze.
Talk to your doctor before having Sublimaze if you are taking any of these medicines. They may have to change the amount of Sublimaze or the other medicines you are given.
Pregnancy and breast-feeding
You must tell your doctor before having Sublimaze if you are pregnant, think you may be pregnant or might become pregnant.
You may still be able to have Sublimaze if your doctor thinks you need to.
Sublimaze should not be used during childbirth as it can affect the baby's breathing.
Sublimaze may get into breast milk. Do not breast-feed for 24 hours after having Sublimaze.
Ask your doctor or pharmacist for advice before taking any medicine if you are pregnant or breast-feeding.
Driving and using machines
Do not drive or use any tools or machines for 24 hours after having Sublimaze. You may be less alert than usual.
This medicine can affect your ability to drive as it may make you sleepy or dizzy.
• Do not drive while taking this medicine until you know how it affects you.
• It is an offence to drive if this medicine affects your ability to drive.
• However, you would not be committing an offence if:
- The medicine has been prescribed to treat a medical or dental problem and
- You have taken it according to the instructions given by the prescriber or in the information provided with the medicine and
- It was not affecting your ability to drive safely
Talk to your doctor or pharmacist if you are not sure whether it is safe for you to drive while taking this medicine.
Sublimaze contains sodium
If you need to control your salt intake (controlled sodium diet) be aware that:
• Each millilitre of Sublimaze contains 3.5 mg of sodium
• The contents of the ampoule may be diluted in a salt solution before being given to you. This salt solution also contains sodium
3 How Sublimaze is given
Sublimaze is given by a doctor experienced in using this type of medicine. Check with your doctor or nurse if you are not sure about anything.
How Sublimaze is given
• Sublimaze is given as a drip (infusion) or injection into a vein or a muscle
• You may be given an anaesthetic at the same time
• You may be given other medicines to help with some
of the side effects of Sublimaze such as slower heart rate and rigid muscles
How much Sublimaze is given
Your doctor will decide how much Sublimaze you need. This may depend on:
• Your body weight in kilograms
• Your general health
• Your age
• The reason you are being given it
• Other medication
Sublimaze given by injection
If you are to breathe by yourself
• adults and children aged 12 to 17 years old:
- You will usually be given an initial dose of 50 - 200 micrograms
- If necessary, you will be given further injections of 50 micrograms during the operation
• children aged 2 to 11 years old:
- You will usually be given an initial dose of 1-3 micrograms per kilogram
- If necessary, you will be given further injections
of 1-1.25 microgram per kilogram during the operation
When your breathing is helped by a machine (ventilator)
• adults and children aged 12 to 17 years old:
- The initial dose will be 300 - 3500 micrograms
- If necessary, further injections of 100 - 200 micrograms will be given during the operation
• children aged 2 to 11 years old:
- You will usually be given an initial dose of 1-3 micrograms per kilogram
- If necessary, you will be given further injections of 1-1.25 micrograms per kilogram during the operation
Sublimaze given as a drip (infusion)
• The dose of Sublimaze is based on body weight in kilograms
• You may be given an initial dose of 1 microgram per kilogram during each minute for the first 10 minutes
• If necessary, this may be followed by 0.1 micrograms per kilogram during each minute of your operation
• The drip will normally be stopped 40 minutes before the end of your operation
Elderly patients
Less Sublimaze may be used in patients that are elderly or weak due to ill health.
If you have too much Sublimaze
It is unlikely that you will be given too much Sublimaze. This will be monitored during your operation.
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© J-C 2014 GB - AW_94332
4 Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them. Your doctor will monitor these effects during your operation.
Very common (affects more than 1 in 10 people)
• Feeling sick (nausea), being sick (vomiting)
• Muscle stiffness (which may involve your chest muscles) Common (affects fewer than 1 in 10 people)
• Agitation
• Difficulty with body movements
• Drowsiness
• Dizziness
• Problems with vision
• Irregular heartbeat (slow or fast)
• Low or high blood pressure
• Pain in your veins
• Choking caused by cramping (spasm) of the muscles in your throat
• Difficulty in breathing or wheezing
• Stop breathing for a short period of time. If necessary, your breathing will be helped by a machine (ventilator)
• Skin rash
• Confusion after the operation
Uncommon (affects fewer than 1 in 100 people)
• Changes in blood pressure
• Breathing complications
• Breathing faster than normal
• Fall in body temperature below normal or chills
• Headache
• Swelling and clotting in a vein
• Hiccups
• Feeling of extreme happiness
Other side effects (frequency not known):
• Serious allergic reaction which may cause difficulty in breathing or dizziness, and hives or nettle rash (urticaria)
• Convulsions (fits or seizures)
• Loss of consciousness
• Muscle twitching
• Stopping of the heart
• Slow or shallow breathing
• Itching of the skin
Other side effects when Sublimaze is used together with medicines called neuroleptics, which can be given before or during an operation:
• Shivering and restlessness
• Seeing things that aren't there (hallucinations)
• Unusual movements, including trembling and shaking of the hands and fingers, twisting movements of the body, shuffling walk and stiffness of the arms and legs
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard
By reporting side effects you can help provide more information on the safety of this medicine.
5 How to store Sublimaze
Sublimaze is kept out of the sight and reach of children. It is stored in a Controlled Drug Store in the hospital pharmacy. Do not store above 30°C. Keep the ampoules in the outer carton to protect from light.
Sublimaze will not be used after the expiry date stated on the label. The expiry date refers to the last day of that month.
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6 Contents of the pack and other
What Sublimaze contains
• The active substance is fentanyl citrate. Each millilitre (ml) contains 50 micrograms of fentanyl (as the citrate).
• The other ingredients are sodium chloride and water.
What Sublimaze looks like and contents of the pack
Sublimaze is supplied in a clear glass ampoule containing 2 ml (packs of 10) or 10 ml (packs of 5) of liquid.
Marketing Authorisation Holder:
JANSSEN-CILAG LTD, 50-100 Holmers Farm Way,
High Wycombe, Buckinghamshire HP12 4EG, UK
Manufacturer:
GlaxoSmithKline Manufacturing S.p.A., Strada Provinciale Asolana N. 90 (loc San Polo), 43056 Torrile (PR), Italy
OR
McGregor Cory Ltd, Middleton Close, Banbury,
Oxfordshire OX16 4RS, UK
information
For information in large print, tape, CD or Braille, telephone 0800 7318450.
This leaflet was last revised in June 2014
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