Despite the fact that fentanyl has been a prescription opioid painkiller available since the early 1960s, there is still a lot of misunderstandings and a lot of questions people have about it. It would seem that even many medical professionals remain unsure of how fentanyl is intended to be used and what the guidelines for prescribing it are.

One of the common questions a lot of people ask is “Why is fentanyl not given orally?” when in fact, it is. There are several different ways prescription fentanyl is given, including orally.

The following explains the answer to the question “Why is fentanyl not given orally?” and shows how in some forms it is, although these aren’t necessarily the most common routes of administration for this opioid.

Fentanyl Sublingual Tablet

The fentanyl tablet is one way this drug can be given orally, although it can be dangerous and it’s not intended for short-term pain, which is why fentanyl is not given orally in tablet form in many cases. The fentanyl tablet can be deadly not only for children but also for adult patients who don’t have a tolerance to opioid pain medicine.

This oral version of fentanyl is meant only for breakthrough cancer pain in patients who are least 18 years old and are already receiving around-the-clock narcotic pain medicine. In some patients who take the fentanyl tablet, it can result in dangerous and even fatal breathing problems, particularly if the patient isn’t already using other narcotic pain medicine or they’re taking other medicines at the same time.

There are intended restrictions on the use of fentanyl given orally as a tablet, including the fact that the patient has to wait at least two hours after their last fentanyl tablet dose to receive treatment for another episode of breakthrough pain. This is not something that can be done when fentanyl is prescribed for patients at home, which is why people believe fentanyl isn’t given orally.

Fentanyl Buccal Tablet

Even though people often ask why is fentanyl not given orally, as mentioned above, it is in certain situations. Another way it’s given orally is in the form of the fentanyl buccal tablet, which is put in the buccal cavity where it disintegrates and is absorbed by the oral mucosa. This oral form of fentanyl is unique because it creates a carbon dioxide-releasing reaction when the tablet meets saliva.

However, this again carries many warnings, which is why people frequently believe fentanyl is not given orally. The brand names of the fentanyl buccal tablet have differences in pharmacology from other fentanyl products. These differences can raise the risk of overdose.


Fentanyl can also be given in lollipop form, which is technically an oral way to give the drug. It’s made of fentanyl citrate that is for oral transmucosal administration. In scientific terms, this version of orally administered fentanyl includes a solid drug matrix on a handle. It dissolves in the mouth slowly. The handle is included so that if there are signs of too much opioid exposure, it can be removed from the mouth quickly.

This form of the medication is usually given to cancer patients with breakthrough pain who are least 16 years old and who are tolerant to around-the-clock cancer pain.

This form of fentanyl cannot be given to patients who aren’t opioid-tolerant because of the high risk of respiratory depression and death when a patient isn’t on a long-term opioid treatment plan.

To answer the question “Why is fentanyl not given orally?”: it is, in different forms that include tablets and lollipops. However, these administrations are particularly dangerous, so they’re less common than options such as the fentanyl transdermal patch. There is a high likelihood of abuse with the oral versions of fentanyl, and also respiratory depression and death if they’re not given in a carefully monitored environment.

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Editor – Megan Hull
Megan Hull is a content specialist who edits, writes and ideates content to help people find recovery. Read more
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The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.